Developing leadership in managers to facilitate the implementation of national guideline recommendations : a process evaluation of feasibility and usefulness

Background: Previous research supports the claim that managers are vital players in the implementation of clinical practice guidelines (CPGs), yet little is known about interventions aiming to develop managers’ leadership in facilitating implementation. In this pilot study, process evaluation was employed to study the feasibility and usefulness of a leadership intervention by exploring the intervention’s potential to support managers in the implementation of national guideline recommendations for stroke care in outpatient rehabilitation. Methods: Eleven senior and frontline managers from five outpatient stroke rehabilitation centers participated in a four-month leadership intervention that included workshops, seminars, and teleconferences. The focus was on developing knowledge and skills to enhance the implementation of CPG recommendations, with a particular focus on leadership behaviors. Each dyad of managers was assigned to develop a leadership plan with specific goals and leadership behaviors for implementing three rehabilitation recommendations. Feasibility and usefulness were explored through observations and interviews with the managers and staff members prior to the intervention, and then one month and one year after the intervention. Results: Managers considered the intervention beneficial, particularly the participation of both senior and frontline managers and the focus on leadership knowledge and skills for implementing CPG recommendations. All the managers developed a leadership plan, but only two units identified goals specific to implementing the three stroke rehabilitation recommendations. Of these, only one identified leadership behaviors that support implementation. Conclusion: Managers found that the intervention was delivered in a feasible way and appreciated the focus on leadership to facilitate implementation. However, the intervention appeared to have limited impact on managers’ behaviors or clinical practice at the units. Future interventions directed towards managers should have a stronger focus on developing leadership skills and behaviors to tailor implementation plans and support implementation of CPG recommendations.

A Comparison of Audio Recordings and Therapist's Process Notes in Child and Adolescent Psychoanalytic Psychotherapy

Therapistsʼ process notes - written descriptions of a session produced shortly afterwards from memory - hold a significant role in child and adolescent psychoanalytic psychotherapy. They are central in training, in supervision, and in developing oneʼs understanding through selfsupervision and forms of psychotherapy research. This thesis examines such process notes through a comparison with audio recordings of the same sessions. In so doing, it aims to generate theory that might illuminate the causes of significantly patterned discrepancies between the notes and recordings, in order to understand more about the processes at work in psychoanalytic psychotherapy and to explore the nature of process notes, their values and limitations. The literature searches conducted revealed limited relevant studies. All identified studies that compare process notes with recordings of sessions seek to quantify the differences between the two forms of recording. Unlike these, this thesis explores the meaning of the differences between process notes and recordings through qualitative data analysis. Using psychoanalytically informed grounded theory, in total nine sets of process notes and recordings from three different psychoanalytic psychotherapists are analysed. The analysis identifies eight core categories of findings. Initial theories are developed from these categories, most significantly concerning the role and influence of a ʻcore transference dynamicʼ between therapist and patient. Further theory is developed on the nature and function of process notes as a means for the therapistʼs conscious and unconscious processing of the session, as well as on the nature of the influence of the relationships – both internal and external – within which they are written. In the light of the findings, a proposal is made for a new approach for learning about the patient and clinical work, ʻthe comparison methodʼ (supervision involving a comparison of process notes and recordings), and, in particular, for its inclusion within the training of psychoanalytic psychotherapists. Further recommendations for research are also made.

Technology strategies in the process of student retention and efficiency of academic management

This article discusses the application of Information and Communication Technologies and strategies for best practices in order to capture and maintain faculty students' attention. It is based on a case study of ten years, using a complete information system. This system, in addition to be considered an ERP, to support the activities of academic management, also has a strong component of SRM that provides support to academic and administrative activities. It describes the extent to which the presented system facilitates the interaction and communication between members of the academic community, using the Internet, with services available on the Web complementing them with email, SMS and CTI. Through a perception, backed by empirical analysis and results of investigations, it demonstrates how this type of practice may raise the level of satisfaction of the community. In particular, it is possible to combat failure at school, avoid that students leave their course before its completion and also that they recommend them to potential students. In addition, such a strategy also allows strong economies in the management of the institution, increasing its value. As future work, we present the new phase of the project towards implementation of Business Intelligence to optimize the management process, making it proactive. The technological vision that guides new developments to a construction based on Web services and procedural languages is also presented.

Fisheries co-management : ecological and social impacts. A case study of Northern Mozambique

Co-management, or participative management of fisheries, consists of returning or opening to the community the management of fisheries. This work, carried out in northern Mozambique, analyzed the ecological and social impacts of the implementation of co-management of fisheries. Firstly 198 species of fish were found and photographed and a guide to identification of species - essential to who works in the marine environment – was produced. Following, the spill-over effect was identified in a marine sanctuary. It occurred after 6 years and only for herbivore fishes and not to the carnivores. In order to evaluate co–management of fisheries effects, the captures of the entire province were analyzed. No differences were found in the diversity of the species caught, but an increase of the fish size was detected: this size was smaller in the fishing centers with no CCP (Community Fishing Councils), slightly bigger in the fishing centers with CCP and even bigger in the fishing centers with a more efficient management. At the same time it was observed that the size of the fish caught is bigger in the fishing centers further away from the markets. In addition to the ecological effects and the effects on fisheries, it was also analyzed the point of view of those who live the co-management. The socioeconomic factors that have a stronger influence in their perceptions are the age and the wealth. Finally and according to the CCP members, their main achievements are in the fisheries inspection and in the creation of conservation areas. Their main difficulties are the lack of means of transportation and the lack of recognition of the CCP's authority; both among the population and in the coordination with local authorities. This thesis pioneered in Mozambique in assessing the effects of Community sanctuaries and the effects of CCP on fisheries as well as by revealing the profile of the supporters of co-management and marine sanctuaries. Finally, an assessment of the matter of fact problems that the communities have to face when implementing co-management was also made.

EVALUATING THE OIL SANDS RECLAMATION PROCESS: ASSESSING POLICY CAPACITY AND STAKEHOLDER ACCESS FOR GOVERNMENT AND NON-GOVERNMENTAL ORGANIZATIONS OPERATING IN ALBERTA’S OIL SANDS

By employing interpretive policy analysis this thesis aims to assess, measure, and explain policy capacity for government and non-government organizations involved in reclaiming Alberta's oil sands. Using this type of analysis to assess policy capacity is a novel approach for understanding reclamation policy; and therefore, this research will provide a unique contribution to the literature surrounding reclamation policy. The oil sands region in northeast Alberta, Canada is an area of interest for a few reasons; primarily because of the vast reserves of bitumen and the environmental cost associated with developing this resource. An increase in global oil demand has established incentive for industry to seek out and develop new reserves. Alberta's oil sands are one of the largest remaining reserves in the world, and there is significant interest in increasing production in this region. Furthermore, tensions in several oil exporting nations in the Middle East remain unresolved, and this has garnered additional support for a supply side solution to North American oil demands. This solution relies upon the development of reserves in both the United States and Canada. These compounding factors have contributed to the increased development in the oil sands of northeastern Alberta. Essentially, a rapid expansion of oil sands operations is ongoing, and is the source of significant disturbance across the region. This disturbance, and the promises of reclamation, is a source of contentious debates amongst stakeholders and continues to be highly visible in the media. If oil sands operations are to retain their social license to operate, it is critical that reclamation efforts be effective. One concern non-governmental organizations (NGOs) expressed criticizes the current monitoring and enforcement of regulatory programs in the oil sands. Alberta's NGOs have suggested the data made available to them originates from industrial sources, and is generally unchecked by government. In an effort to discern the overall status of reclamation in the oil sands this study explores several factors essential to policy capacity: work environment, training, employee attitudes, perceived capacity, policy tools, evidence based work, and networking. Data was collected through key informant interviews with senior policy professionals in government and non-government agencies in Alberta. The following are agencies of interest in this research: Canadian Association of Petroleum Producers (CAPP); Alberta Environment and Sustainable Resource Development (AESRD); Alberta Energy Regulator (AER); Cumulative Environmental Management Association (CEMA); Alberta Environment Monitoring, Evaluation, and Reporting Agency (AEMERA); Wood Buffalo Environmental Association (WBEA). The aim of this research is to explain how and why reclamation policy is conducted in Alberta's oil sands. This will illuminate government capacity, NGO capacity, and the interaction of these two agency typologies. In addition to answering research questions, another goal of this project is to show interpretive analysis of policy capacity can be used to measure and predict policy effectiveness. The oil sands of Alberta will be the focus of this project, however, future projects could focus on any government policy scenario utilizing evidence-based approaches.

Predição da criatividade e saúde mental

A criatividade tem sido mencionada desde há muito tempo pela literatura. A forma de a conceptualizar tem dependido em muito dos investigadores e da sua visão sobre o que é criatividade, porém as suas potencialidades têm tomado cada vez mais interesse pela comunidade científica. Os seus benefícios estendem-se a diversas áreas da vida humana, como sentimentos de satisfação, bem-estar e saúde mental. A investigação aqui apresentada procura encontrar modelos preditivos de comportamentos criativos, pressupondo que estes poderão ser de grande auxílio para o desenvolvimento de um melhor bem-estar psicológico. Assim a investigação comportou o uso de quatro variáveis: a pessoa, o processo, o produto e o ambiente criativo. A amostra contou com 215 estudantes universitários e os resultados revelaram o encontro de quatro modelos preditivos de comportamentos criativos, com uma maior ênfase nas artes visuais e manuais. Conclui-se com a ideia de que a predição de produtos criativos é possível e que tal poderá ser preponderante para um bom desenvolvimento da saúde mental.

Predição da criatividade e saúde mental

A criatividade tem sido mencionada desde há muito tempo pela literatura. A forma de a conceptualizar tem dependido em muito dos investigadores e da sua visão sobre o que é criatividade, porém as suas potencialidades têm tomado cada vez mais interesse pela comunidade científica. Os seus benefícios estendem-se a diversas áreas da vida humana, como sentimentos de satisfação, bem-estar e saúde mental. A investigação aqui apresentada procura encontrar modelos preditivos de comportamentos criativos, pressupondo que estes poderão ser de grande auxílio para o desenvolvimento de um melhor bem-estar psicológico. Assim a investigação comportou o uso de quatro variáveis: a pessoa, o processo, o produto e o ambiente criativo. A amostra contou com 215 estudantes universitários e os resultados revelaram o encontro de quatro modelos preditivos de comportamentos criativos, com uma maior ênfase nas artes visuais e manuais. Conclui-se com a ideia de que a predição de produtos criativos é possível e que tal poderá ser preponderante para um bom desenvolvimento da saúde mental.

On the Wick product and Wong-Zakai approximations.

This thesis is a compilation of 6 papers that the author has written together with Alberto Lanconelli (chapters 3, 5 and 8) and Hyun-Jung Kim (ch 7). The logic thread that link all these chapters together is the interest to analyze and approximate the solutions of certain stochastic differential equations using the so called Wick product as the basic tool. In the first chapter we present arguably the most important achievement of this thesis; namely the generalization to multiple dimensions of a Wick-Wong-Zakai approximation theorem proposed by Hu and Oksendal. By exploiting the relationship between the Wick product and the Malliavin derivative we propose an original reduction method which allows us to approximate semi-linear systems of stochastic differential equations of the Itô type. Furthermore in chapter 4 we present a non-trivial extension of the aforementioned results to the case in which the system of stochastic differential equations are driven by a multi-dimensional fraction Brownian motion with Hurst parameter bigger than 1/2. In chapter 5 we employ our approach and present a “short time” approximation for the solution of the Zakai equation from non-linear filtering theory and provide an estimation of the speed of convergence. In chapters 6 and 7 we study some properties of the unique mild solution for the Stochastic Heat Equation driven by spatial white noise of the Wick-Skorohod type. In particular by means of our reduction method we obtain an alternative derivation of the Feynman-Kac representation for the solution, we find its optimal Hölder regularity in time and space and present a Feynman-Kac-type closed form for its spatial derivative. Chapter 8 treats a somewhat different topic; in particular we investigate some probabilistic aspects of the unique global strong solution of a two dimensional system of semi-linear stochastic differential equations describing a predator-prey model perturbed by Gaussian noise.

Rethinking the Portuguese banking sector in a post-crisis context

As the financial crisis hit the Portuguese banks, the profitability of the whole sector squeezed to historical minimums. Reinventing the banking business model in the post-crisis context is an overriding issue to achieve sustainable profits and a low cost-to-income ratio. We propose banks to adopt a true multichannel approach, proceeding to a branch network reformatting and a relocation of services to online channels; adopt a true customer-centric approach and reduce the product and services portfolio complexity; finally, industrialize operations and rationalize the structure. With these measures in place, Portuguese banks will become leaner and more efficient, aspiring to a cost-to-income ratio below 45%.