Reviewing the Literature on the Breakdown of Foster Care Placements for Young People: Complexity and the Social Work Task

Young people in long-term foster care are at risk of experiencing poor social, emotional, behavioural and educational outcomes. Moreover, these placements have a significantly greater chance of breaking down compared to those involving children. This article critically evaluates the factors associated with this particular outcome. It was carried out through a literature review conducted by a social work practitioner in one Health and Social Care Trust in Northern Ireland. The findings evidenced that, apart from overriding safety concerns, placement breakdown was not a one-off event but rather a complex process involving the interplay between a range of dynamic risk and protective factors over time, operating in the wider context of the young person’s history and life experiences. The significance of these findings for social work practitioners is finally considered by identifying key theories to inform understanding and intervention.

Attending Physician Variability: A Model of Four Supervisory Styles

Purpose: There is wide variability in how attending physician roles on teaching teams, including patient care and trainee learning, are enacted. This study sought to better understand variability by considering how different attendings configured and rationalized direct patient care, trainee oversight, and teaching activities. 

Method: Constructivist grounded theory guided iterative data collection and analyses. Data were interviews with 24 attending physicians from two academic centers in Ontario, Canada, in 2012. During interviews, participants heard a hypothetical presentation and reflected on it as though it were presented to their team during a typical admission case review. 

Results: Four supervisory styles were identified: direct care, empowerment, mixed practice, and minimalist. Driven by concerns for patient safety, direct care involves delegating minimal patient care responsibility to trainees. Focused on supporting trainees’ progressive independence, empowerment uses teaching and oversight strategies to ensure quality of care. In mixed practice, patient care is privileged over teaching and is adjusted on the basis of trainee competence and contextual features such as patient volume. Minimalist style involves a high degree of trust in senior residents, delegating most patient care, and teaching to them. Attendings rarely discussed their styles with the team. 

Conclusions: The model adds to the literature on variability in supervisory practice, showing that the four styles reflect different ways of responding to tensions in the role and context. This model could be refined through observational research exploring the impact of context on style development and enactment. Making supervisory styles explicit could support improvement of team competence.

Determinants of online travel purchase intentions: a holistic approach

Online travel shopping has attracted researchers due to its significant growth and there is a growing body of literature in this field. However, research on what drives consumers to purchase travel online has typically been fragmented. In fact, existing studies have largely concentrated on examining consumers’ online travel purchases either grounded on Davis’s Technology Acceptance Model, on the Theory of Reasoned Action and its extension, the Theory of Planned Behaviour or on Roger’s model of perceived innovation attributes, the Innovation Diffusion Theory. A thorough literature review has revealed that there is a lack of studies that integrate all theories to better understand online travel shopping. Therefore, based on relevant literature in tourism and consumer behaviour, this study proposes and tests an integrated model to explore which factors affect intentions to purchase travel online. Furthermore, it proposes a new construct, termed social media involvement, defined as a person’s level of interest or emotional attachment with social media, and examines its relationship with intentions to purchase travel online. To test the 18 hypotheses, a quantitative approach was followed by first collecting data through an online survey. With a sample of 1,532 Worldwide Internet users, Partial Least Squares analysis was than conducted to assess the validity and reliability of the data and empirically test the hypothesized relationships between the constructs. The results indicate that intentions to purchase travel online is mostly determined by attitude towards online shopping, which is influenced by perceived relative advantages of online travel shopping and trust in online travel shopping. In addition, the findings indicate that the second most important predictor of intentions to purchase travel online is compatibility, an attribute from the Innovation Diffusion Theory. Furthermore, even though online shopping is nowadays a common practice, perceived risk continues to negatively affect intentions to purchase travel online. The most surprising finding of this study was that Internet users more involved with social media for travel purposes did not have higher intentions to purchase travel online. The theoretical contributions of this study and the practical implications are discussed and future research directions are detailed.

Various Joyful Encounters with the Dystopias of Affective Capitalism

This article contends that what appear to be the dystopic conditions of affective capitalism are just as likely to be felt in various joyful encounters as they are in atmospheres of fear associated with post 9/11 securitization. Moreover, rather than grasping these joyful encounters with capitalism as an ideological trick working directly on cognitive systems of belief, they are approached here by way of a repressive affective relation a population establishes between politicized sensory environments and what Deleuze and Guattari (1994) call a brain-becoming-subject. This is a radical relationality (Protevi, 2010) understood in this context as a mostly nonconscious brain-somatic process of subjectification occurring in contagious sensory environments populations become politically situated in. The joyful encounter is not therefore merely an ideological manipulation of belief, but following Gabriel Tarde (as developed in Sampson, 2012), belief is always the object of desire. The discussion starts by comparing recent efforts by Facebook to manipulate mass emotional contagion to a Huxleyesque control through appeals to joy. Attention is then turned toward further manifestations of affective capitalism; beginning with the so-called emotional turn in the neurosciences, which has greatly influenced marketing strategies intended to unconsciously influence consumer mood (and choice), and ending with a further comparison between encounters with Nazi joy in the 1930s (Protevi, 2010) and the recent spreading of right wing populism similarly loaded with political affect. Indeed, the dystopian presence of a repressive political affect in all of these examples prompts an initial question concerning what can be done to a brain so that it involuntarily conforms to the joyful encounter. That is to say, what can affect theory say about an apparent brain-somatic vulnerability to affective suggestibility and a tendency toward mass repression? However, the paper goes on to frame a second (and perhaps more significant) question concerning what can a brain do. Through the work of John Protevi (in Hauptmann and Neidich (eds.), 2010: 168-183), Catherine Malabou (2009) and Christian Borch (2005), the article discusses how affect theory can conceive of a brain-somatic relation to sensory environments that might be freed from its coincidence with capitalism. This second question not only leads to a different kind of illusion to that understood as a product of an ideological trick, but also abnegates a model of the brain which limits subjectivity in the making to a phenomenological inner self or Being in the world.

Somatic pedagogies: Critiquing and resisting the affective discourse of the neoliberal state from an embodied anarchist perspective.

This paper takes as its context widespread feelings of anxiety within neoliberal society caused by a combination of material and discursive factors including precarious access to work and resources. It is argued that the state uses ‘discourses of affect’ to produce compliant subjects able to deal with (and unable to desire beyond) neoliberal precarity and anxiety. Critical education theorists have argued that discourses of ‘well-being’, emotional support and self-help have gained increasing purchase in mainstream education and in popular culture. These discourses are dangerous because they are individualized and depoliticized, and undermine collective political struggle. At the same time there has been a ‘turn to affect’ in critical academia, producing critical pedagogies that resist state affective discourse. I argue that these practices are essential for problematizing neoliberal discourse, yet existing literature tends to elide the role of the body in effective resistance, emphasising intellectual aspects of critique. The paper sketches an alternative, drawing on psychoanalytic and practiced pedagogies that aim to transgress the mind-body dualism and hierarchy, in particular Roberto Freire’s work on Somatherapy.

Fighting Talk: The Statements of 'The IRA/New IRA'

With the advent of the new violent dissident merger, ‘The IRA/New IRA’, the group and its affiliates have had to legitimise their new existence. They have utilised the maintenance of paramilitary activity to achieve this. However, they have also produced a number of organisational statements, justifying their position, tactics and strategies. This article analyses the evolution of these statements, both pre and post-merger from 2007 to 2015. 126 individual statements and 4 magazines are analysed using grounded theory. This analysis found that the statements have a dual strategy, aiming to foster trust in the movement and distrust in their perceived enemies. One of the dominant ways in which the group aims to foster trust, is by proposing their possession of an historical mandate from the republican forefathers of 1916, as well as the internally lauded paramilitaries from the Troubles era PIRA. The focus of the distrust narrative has been on the ‘constitutional nationalism’ of Sinn Féin. However, it also pours scorn on the PSNI, and capitalism, across the island of Ireland. The analysis of these statements can provide us with an understanding of the future direction of the group, as well as giving us insight, which can inform the development of any counter-narrative.

A influência do eWOM gerado pelos grupos de referência no Facebook, em Portugal

Dissertação apresentada ao Instituto Superior de Contabilidade e Administração do Porto para a obtenção do Grau de Mestre em Marketing Digital. Orientado por Mestre Inês Veiga Pereira

Qualidade e satisfação do sistema de seguimento à distância de cardioversores-desfibrilhadores implantáveis

RESUMO - Com o aumento da esperança de vida e das doenças crónicas, cada vez se tem implantado mais cardioversores-desfibrilhadores (CDI) para prevenção de morte súbita. O aumento exponencial no número de implantes aumenta o número de seguimentos dos dispositivos, sobrecarregando os profissionais de saúde e comprometendo a qualidade dos serviços prestados. Segundo as recomendações internacionais, um CDI deverá ser vigiado a cada 3 meses, o que perfaz 4 consultas por ano/doente no mínimo, se não existirem episódios de “choques” ou “descompensações” clínicas, e mensalmente quando é atingido o indicador de substituição electiva do gerador. A evolução da tecnologia, de algoritmos, visualização de episódios e terapias requer recursos técnicos e humanos diferenciados e um gasto de tempo considerável no seguimento. Em países como os Estados Unidos da América, em que os doentes têm de percorrer distâncias muito grandes para aceder aos cuidados de saúde, tornou-se preemente a necessidade de um sistema de vigilância alternativo. Nesse sentido, e usando o conceito da telemedicina, foi criado o seguimento/monitorização à distância de dispositivos cardíacos. Este reduz os custos em consultas, deslocações e recursos humanos, uma vez que contempla apenas uma consulta presencial por ano. Por outro lado, aumenta a segurança do doente com a monitorização periódica e a criação de alarmes, permitindo uma assistência de qualidade e intervenção adequada imediata. Aproveitando as vantagens que este tipo de sistema de transmissão remota oferece, procedeu-se no meu serviço, à distribuição inicial de 62 comunicadores a doentes portadores de CDI´s ou com Ressincronizadores Cardíacos (TRC´s1). Apesar de ser considerada uma melhoria na qualidade dos serviços prestados, é também uma mudança importante na metodologia da consulta feita até aqui. Segundo vários autores, a avaliação da qualidade dos cuidados em saúde está intrinsecamente ligada ao grau de satisfação dos doentes com esses serviços, ou seja, à relação entre as suas expectativas e os resultados percebidos por eles, sendo considerado um importante indicador de qualidade dos serviços. Com este trabalho, pretende-se avaliar a percepção dos doentes face ao novo seguimento em termos de aceitação, satisfação, validade, segurança e confiança no novo sistema. Se este mantém os mesmos padrões de qualidade que o seguimento presencial. Trata-se de um estudo transversal com uma componente retrospectiva de avaliação da nova metodologia de consulta à distância. Para tal, foi elaborado um questionário, que foi aplicado a 40 doentes (17,5% do género feminino e 82,5% do género masculino; média de idades de 65 anos) que constituíram a amostra do estudo. Verificou-se uma média de 5 anos de tempo de implante do CDI. Dos dados obtidos, é de realçar que 70% dos inquiridos estão satisfeitos e 30% estão muito satisfeitos com esta nova metodologia de consulta e cerca 67,4% prefere a consulta à distância. Quando solicitados para comparar a qualidade do serviço prestado entre as duas consultas, 65% respondeu igual e 27,5% melhor. Todos os inquiridos responderam ter confiança e segurança com o sistema de consulta à distância. Cerca de 87,5% dos inquiridos vê-se mesmo a continuar com este tipo de consulta. Os resultados obtidos são bastante satisfatórios no que diz respeito à transição do modo como a consulta de CDI´s é feita. Reflectem também que a tecnologia não é necessariamente uma barreira no acesso aos profissionais de saúde, desde que suportada por algum contacto directo (telefone e através de uma consulta presencial por ano). 1 TRC – Terapia de Ressincronização Cardíaca

O abuso de informação privilegiada (insider trading)

In the stock market, information takes on special relevance, due to the market’s permanent updating and the great fluidity of information existent therein. Just as in any other negotiations, the party with the better information has a bargaining advantage, as it is able to make more advantageous business decisions. However, unlike most other markets, the proper functioning of the stock market is greatly dependent on investors’ trust in the market itself. As such, if there are investors who, due to any condition they possess or office they hold, have access to relevant information which is not accessible to the general public, distrust is bred within the market and, consequently, investment is lessened. Thus, there is a need to prevent those who hold privileged information from using it in abusive ways. In Portugal, abuse of privileged information is set out and punished criminally in Article 378. of the Portuguese Securities Code (‘Código dos Valores Mobiliários’). In this dissertation, I have set out, firstly, to analyze the inherent conditions for there to be a crime of abuse of privileged information; secondly, to analyze two well-known cases, which took place and were decided in other jurisdictions, and attempt to understand how these cases would fall under Article 378. of the Portuguese Securities Code. Whereas the first case, Chiarella v. United States, was scrutinize under Article 378 of the Portuguese Securities Code, in the second, Lafonta v. AMF, the conclusion arrived at was that the crime taken place was different. This analysis allowed, on one hand, the application to a particular case of prerequisites and concepts which were explained, at a first approach, from a more theoretical perspective; on the other hand, it also allowed the further development of specific aspects of the regime, namely the difference between an insider and a tipee, as well as to more clearly set out the limits to the precise character of the information at hand.

Participation rates for organized colorectal cancer screening programmes: an international comparison.

OBJECTIVE: Participation, an indicator of screening programme acceptance and effectiveness, varies widely in clinical trials and population-based colorectal cancer (CRC) screening programmes. We aimed to assess whether CRC screening participation rates can be compared across organized guaiac fecal occult blood test (G-FOBT)/fecal immunochemical test (FIT)-based programmes, and what factors influence these rates. METHODS: Programme representatives from countries participating in the International Cancer Screening Network were surveyed to describe their G-FOBT/FIT-based CRC screening programmes, how screening participation is defined and measured, and to provide participation data for their most recent completed screening round. RESULTS: Information was obtained from 15 programmes in 12 countries. Programmes varied in size, reach, maturity, target age groups, exclusions, type of test kit, method of providing test kits and use, and frequency of reminders. Coverage by invitation ranged from 30-100%, coverage by the screening programme from 7-67.7%, overall uptake/participation rate from 7-67.7%, and first invitation participation from 7-64.3%. Participation rates generally increased with age and were higher among women than men and for subsequent compared with first invitation participation. CONCLUSION: Comparisons among CRC screening programmes should be made cautiously, given differences in organization, target populations, and interpretation of indicators. More meaningful comparisons are possible if rates are calculated across a uniform age range, by gender, and separately for people invited for the first time vs. previously.

Hallintoelinten oikeudenmukainen palkitseminen - toimialavertailu osuustoiminnallisissa organisaatioissa

Työn tarkoituksena oli lähteä tutkimaan palkitsemisen, vaativuuden ja tehtävien eroavaisuuksia kolmen osuustoiminnallisen organisaation hallintoelinten välillä. Tavoitteena oli selvittää, miten palkitsemisen horisontaalista oikeudenmukaisuutta voitaisiin kehittää osuustoiminnallisten organisaatioiden hallintoelimissä. Tutkimus toteutettiin kvantitatiivisena kyselylomaketutkimuksena, ja analysointimenetelmänä käytettiin regressioanalyysiä. Tutkimuksen teoreettinen viitekehys koostui palkitsemisesta ja sen oikeudenmukaisuudesta keskittyen horisontaaliseen ulottuvuuteen, työn vaativuudesta sekä aiempien tutkimusten perusteella palkitsemiseen vaikuttavista tekijöistä muun muassa rakenteen, toimialan ja strategian näkökulmista. Tutkimuksessa havaittiin, että tilaajaorganisaatiossa X palkkiot olivat vertailuorganisaatiota Y ja Z korkeammat. Erot vaativuuden ja tehtävien osalta eivät olleet yhtä suuria kuin palkkioissa, mutta organisaatiossa X nämäkin olivat pääasiassa korkeammalla tasolla. Regressioanalyysissä kävi ilmi, että työn vaativuus selittää suurimman osan palkitsemisen kertymästä ja muut tilastollisesti merkittävät selittävät muuttujat olivat huomattavasti vähäisempiä. Organisaation X korkeamman palkkiotason voitiin nähdä johtuvan erilaisesta palkkiorakenteesta sekä siitä, että se otti palkitsemisessa organisaation koon huomioon; palkkiot vaihtelivat huomattavasti enemmän alueorganisaatioiden kesken kuin organisaatiossa Y ja Z. Johtopäätöksenä voidaan sanoa, että työn vaativuusarviointi palkkioiden horisontaalista oikeudenmukaisuutta arvioitaessa on merkittävimmässä asemassa. Muiden tarkasteltujen muuttujien osalta tulokset eivät olleet aivan odotetun kaltaisia tai täysin yhdenmukaisia aiempien tutkimusten kanssa, vaikka samansuuntaisiakin havaintoja saatiin. Työn tärkein anti oli kuitenkin työn vaativuusarvioinnin tärkeyden havaitseminen hallintoelintyön palkitsemisen yhteydessä horisontaalisella tasolla.

The Big idea: Creating Shared Value

Competitividad y valor compartido

Le transfert informel des connaissances tacites chez les gestionnaires municipaux en situation de coordination

Ce rapport de recherche porte sur une étude s’intéressant au transfert des connaissances tacites chez les gestionnaires, c’est-à-dire le partage de ces connaissances et leur utilisation informelle, durant une situation de coordination dans un service municipal. La thèse est articulée autour des questions suivantes : Quelles sont les situations de coordination vécues par les gestionnaires municipaux? Quelles sont les sources de connaissances tacites partagées et utilisées? Quelles sont les relations de connaissances mobilisées de façon informelle lors du transfert des connaissances tacites? Quels sont les facteurs encourageant ou inhibant le transfert informel des connaissances tacites? À partir d’un modèle basé sur une approche situationnelle (Taylor, 1989 et 1991), nous avons revu la documentation touchant nos questions de recherche. Nous avons défini notamment la récursivité des connaissances et le réseau de connaissances, de même que présenté le modèle de la conversion des connaissances (Nonaka, 1994) et celui de l’actualisation de soi (St-Arnaud, 1996). Nous avons questionné 22 répondants à l’aide d’instruments de mesure qui combinent les techniques de l’incident critique, de l’entrevue cognitive et réflexive, le questionnement sur les réseaux organisationnels et l’observation participante. Tels des filets, ces instruments ont permis de traquer et d’obtenir des données d’une grande richesse sur les connaissances tacites et les comportements informels durant le transfert de connaissances en situation de coordination. Ces données ont été analysées selon une approche méthodologique essentiellement qualitative combinant l’analyse de contenu, la schématisation heuristique et l’analyse des réseaux sociaux. Nos résultats montrent que la complexité d’une situation de coordination conditionne le choix des mécanismes de coordination. De plus, les sources de connaissances sont, du point de vue individuel, le gestionnaire et ses artefacts, de même que son réseau personnel avec ses propres artefacts. Du point de vue collectif, ces sources sont réifiées dans le réseau de connaissances. Les connaissances clés d’une situation de coordination sont celles sur le réseau organisationnel, le contexte, les expériences en gestion et en situation complexe de coordination, la capacité de communiquer, de négocier, d’innover et celle d’attirer l’attention. Individuellement, les gestionnaires privilégient l’actualisation de soi, l’autoformation et la formation contextualisée et, collectivement, la coprésence dans l’action, le réseautage et l’accompagnement. Cette étude fournit un modèle valide du transfert contextualisé des connaissances qui est un cas de coordination complexe d’activités en gestion des connaissances. Ce transfert est concomitant à d’autres situations de coordination. La nature tacite des connaissances prévaut, de même que le mode informel, les médias personnels et les mécanismes d’ajustement mutuel. Les connaissances tacites sont principalement transférées au début des processus de gestion de projet et continuellement durant la rétroaction et le suivi des résultats. Quant aux connaissances explicites, les gestionnaires les utilisent principalement comme un symbole à la fin des processus de gestion de projet. Parmi les personnes et les groupes de personnes d’une situation de transfert contextualisé des connaissances, 10 % jouent des rôles clés, soit ceux d’experts et d’intermédiaires de personnes et d’artefacts. Les personnes en périphérie possèdent un potentiel de structuration, c’est-à-dire de connexité, pour assurer la continuité du réseau de connaissances organisationnel. Notre étude a élargi le modèle général de la complexité d’une situation (Bystrom, 1999; Choo, 2006; Taylor, 1986 et 1991), la théorie de la coordination (Malone et Crowston, 1994), le modèle de la conversion des connaissances (Nonaka, 1994), celui de l’actualisation de soi (St-Arnaud, 1996) et la théorie des réseaux de connaissances (Monge et Contractor, 2003). Notre modèle réaffirme la concomitance de ces modèles généraux selon une approche constructiviste (Giddens, 1987) où la dualité du structurel et la compétence des acteurs sont confirmées et enrichies.

La convergence de la sécurité informatique et de la protection des renseignements personnels : vers une nouvelle approche juridique

"Mémoire présenté à la Faculté des études supérieures en vue de l'obtention du grade de maîtrise en droit (LL.M.) option Nouvelles technologies de l'information"

L'intégration organisationnelle de la participation : des enjeux locaux pour une santé publique globale

À l’ère de la mondialisation institutionnelle des sociétés modernes, alors que la confluence d’une myriade d’influences à la fois micro et macro-contextuelles complexifient le panorama sociopolitique international, l’intégration de l’idéal participatif par les processus de démocratisation de la santé publique acquiert l’apparence d’une stratégie organisationnelle promouvant la cohésion des multiples initiatives qui se tissent simultanément aux échelles locale et globale. L’actualisation constante des savoirs contemporains par les divers secteurs sociétaux ainsi que la perception sociale de différents risques conduisent à la prise de conscience des limites de la compétence technique des systèmes experts associés au domaine de la santé et des services sociaux. La santé publique, une des responsables légitimes de la gestion des risques modernes à l’échelle internationale, fait la promotion de la création d’espaces participatifs permettant l’interaction mutuelle d’acteurs intersectoriels et de savoirs multiples constamment modifiables. Il s’agit là d’une stratégie de relocalisation institutionnelle de l’action collective afin de rétablir la confiance envers la fiabilité des représentants de la santé publique internationale, qui ne répondent que partiellement aux besoins actuels de la sécurité populationnelle. Dans ce contexte, les conseils locaux de santé (CLS), mis en place à l’échelle internationale dans le cadre des politiques régionales de décentralisation des soins de santé primaires (SSP), représentent ainsi des espaces participatifs intéressants qui renferment dans leur fonctionnement tout un univers de forces de tension paradoxales. Ils nous permettent d’examiner la relation de caractère réciproque existant entre, d’une part, une approche plus empirique par l’analyse en profondeur des pratiques participatives (PP) plus spécifiques et, d’autre part, une compréhension conceptuelle de la mondialisation institutionnelle qui définit les tendances expansionnistes très générales des sociétés contemporaines. À l’aide du modèle de la transition organisationnelle (MTO), nous considérons que les PP intégrées à la gouverne des CLS sont potentiellement porteuses de changement organisationnel, dans le sens où elles sont la condition et la conséquence de nombreuses traductions stratégiques et systémiques essentiellement transformatrices. Or, pour qu’une telle transformation puisse s’accomplir, il est nécessaire de développer les compétences participatives pertinentes, ce qui confère au phénomène participatif la connotation d’apprentissage organisationnel de nouvelles formes d’action et d’intervention collectives. Notre modèle conceptuel semble fournir un ensemble de considérations épistémosociales fort intéressantes et très prometteuses permettant d’examiner en profondeur les dimensions nécessaires d’un renouvellement organisationnel de la participation dans le champ complexe de la santé publique internationale. Il permet de concevoir les interventions complexes comme des réseaux épistémiques de pratiques participatives (RÉPP) rassemblant des acteurs très diversifiés qui s’organisent autour d’un processus de conceptualisation transculturelle de connaissances ainsi que d’opérationnalisation intersectorielle des actions, et ce, par un ensemble de mécanismes d’instrumentalisation organisationnelle de l’apprentissage. De cette façon, le MTO ainsi que la notion de RÉPP permettent de mieux comprendre la création de passages incessants entre l’intégration locale des PP dans la gouverne des interventions complexes de la santé et des services sociaux – tels que les CLS –, et les processus plus larges de réorganisation démocratique de la santé publique dans le contexte global de la mondialisation institutionnelle. Cela pourrait certainement nous aider à construire collectivement l’expression réflexive et manifeste des valeurs démocratiques proposées dans la Déclaration d’Alma-Ata, publiée en 1978, lors de la première Conférence internationale sur les SSP.