Managing wireless networks in the healthcare sector:emerging experiences of cultural impacts

The existing body of knowledge has generally supported that organizational culture plays a significant role in shaping group identity, work pattern, communication schemes, and interpersonal relations; all of these cultural elements are important organizational factors that shape workplaces and operational routines. In the context of emerging information technology, it has also been suggested that organizational culture could affect IT implementation and management. However, little is known about how emerging information technology shapes organizational culture, which in turn helps reshape the organization as a whole. The purpose of this paper is thus to build empirical understanding of how IT in general and emerging wireless networks in particular reshapes organizational culture. Case studies conducted in two hospitals situated in southwest U.S.A. illustrated that the implementation of wireless networks indeed helped shape and/or reshape organizational culture in the healthcare sector and in turn enhance healthcare organizations’ competitiveness in the marketplace. For IT managers and practitioners in healthcare institutions, effective strategy to plan and manage emerging ITs such as wireless networks will thus have long-term implications on cultivating organizational culture that could eventually reshape workplace and competitiveness.

Governance in foreign policy-making in Germany and Poland and Polish-German relations:the role of non-state actors

This thesis examines the influence of non-state actors on Polish-German relations by considering foreign policy-making towards Poland in Germany and vice versa. The approach chosen for this thesis is interdisciplinary and takes into consideration literature from domestic politics (Area Studies), Foreign Policy Analysis and International Relations (IR). The thesis argues that IR, by purely looking into the quality of inter-state relations, too often treats these relations as a result of policies emanating from the relevant governments, without considering the policies’ background. Therefore, the thesis argues that it is necessary to engage with the domestic factors which might explain where foreign policies come from. It points out that non-state actors influence governments’ choices by supplying resources, and by cooperating or competing with the government on an issue at stake. In order to determine the degree of influence that non-state actors can have on foreign policymaking two variables are examined: the institutionalisation of the state relations in question; and the domestic structures of the relevant states. Specifically, the thesis examines the institutionalisation of Polish-German relations, and examines Germany’s and Poland’s domestic structures and their effect on the two states’ foreign policy-making in general. Thereafter, the thesis uses case studies in order to unravel the influence of non-state actors on specific foreign policies. Three case studies are examined in detail: (i) Poland’s EU accession negotiations with regard to the free movement of capital chapter of the acquis communautaire; (ii) Germany’s EU 2004 Eastern Enlargement negotiations with regard to the free movement of workers chapter of the acquis communautaire; and (iii) Germany’s decision to establsh a permanent exhibition in Berlin that will depict the expulsions of millions of Germans from the East following WWII.

Differentiation of self and emerging adulthood

Today's young people are progressing from adolescence into adulthood differently than past generations, including taking a longer time to make this transition. Some believe that the developmental markers and tasks of this transitional period are unique enough to merit the designation of a new life stage--"emerging adulthood." Recently, this new life stage of emerging adulthood has received increasing attention in the developmental literature, including attention to the probable causes for its evolution. However, little is known about specific aspects of intra- and interpersonal development that occur during emerging adulthood. The purpose of this study was to empirically assess hypothesized relations between variables associated with the psychological constructs of attachment, psychosocial maturity, and differentiation of self, in a sample of emerging adults. Structural equation modeling (SEM) analyses indicated an association between the variables measuring these constructs (anxiety, avoidance, I-position, reactivity, cutoff, fusion, identity, and intimacy). The results from structural equation modeling (SEM) analyses helped to confirmed and extended previous research by demonstrating significant associations between attachment, psychosocial maturity, and differentiation of self through the variables operationalizing these constructs. Psychosocial maturity predicted differentiation of self (with intimacy predicting emotional cutoff and identity predicting cutoff and I-position). Attachment also predicted differentiation of self (with anxiety predicting all differentiation variables, and avoidance predicting emotional reactivity and cutoff). However, associations between anxiety and cutoff and between avoidance and cutoff were mediated by psychosocial identity and intimacy, and associations between anxiety and I-position were mediated by identity. Thus, these results corroborate and elaborate previous research conducted on these constructs. Specifically, relational tendencies thought to be influenced by attachment security impact interpersonal functioning in emerging adulthood, but this association is influenced by the degree of resolution of key psychosocial tasks.

Obesity and Overweight among Black American Adolescent Females: The Role of Social Influences in Everyday Dietary Practices

Obesity and overweight disproportionately impact Black American adolescent females—placing them at a lifetime of elevated physical health risks. Despite this burden, the literature that explores the contributors to obesity and overweight among Black American adolescent females remains limited and unclear. This dissertation aims to develop knowledge related to obesity and overweight in Black American adolescent females, by appraising the current understanding of factors that contribute to their obesity and overweight, and explicating the everyday social influences on dietary practices. The primary study conducted for this dissertation used a mixed method, multiple case study design to examine the mother, daughter, and other household contributors to Black American adolescent daughters’ everyday practices of food consumption, acquisition, preparation, and planning. Findings reveal the importance of understanding the complex and dynamic ways mothers and other household members contribute to a holistic view of everyday dietary practices among adolescent daughters. By deeply examining the nuanced ways the multiple cases varied, context-dependent knowledge essential to understanding the complicated health challenge of obesity was produced. Subsequently, recommendations are provided for health providers and scholars to more holistically approach and examine obesity—particularly among populations who are disproportionately affected.

Experiencias de danzaterapia de mujeres que han sufrido cáncer de mama. Un estudio fenomenológico

Objective: This essay aims at identifying, describing and analyzing possible changes both in the experience of the body and in interpersonal relations of women with breast cancer, which result from their participation in Dance Therapy group meetings.Method: This is a phenomenologically oriented qualitative research using Maria Fux´s dance therapy method for group experiences. Eight meetings are described here, and an analysis of descriptions based primarily on Merleau-Ponty and María Fux is provided.Results: The participants have been able to express pain and sorrow over the circumstances that breast cancer and its relational environments have brought to their lives. They have been able to go through moments of creation and surrender to the rhythmic body sensations and experiential environment with different emotions lived separately and jointly. They have revived memories and sensations of their childhood and adolescence, and finally, they have rediscovered their sensitive body through body resignifications marked by the absence of the breast, and by means of feelings of greater acceptance and integration of lived experiences in new gestalts.Conclusions: This project is still under way, but it is already possible to conclude that the life experiences provided in dance therapy have allowed these women to improve their integration and welfare. Likewise, they have felt positive changes in the perception of their corporality and in their way of being in the world and with other subjects, thus experiencing the body in a new and different way.

The use of motivational interviews by nurses to promote health behaviors in adolescents: a scoping review protocol

Adolescents - defined as young people between 10 and 19 years of age1 - are, in general, a relatively healthy segment of the population.2 However, the developmental changes that take place during adolescence may affect their subsequent risk for diseases and for a variety of health-related behaviors. In fact, early onset of preventable health problems (e.g. obesity, malnutrition, STDs) and the engagement in health risk behaviors (e.g., sedentary life style, excessive alcohol consumption, unprotected sex) during adolescence, are likely to put them at greater risk for physical and mental health problems at a later stage in life. Moreover, health related problems and health risk behaviors may disrupt adolescents' physical and cognitive development and therefore may affect their ability to think and act in relation to decisions about their health in the future.1 In summary, health-related behaviors in adolescence, apart from their influence on the continuum of "health-disease", they also have the potential to influence future behaviors. In fact, several studies have shown that past behaviors are good predictors of future behaviors .3,4 Thus, promoting healthy practices during adolescence and taking measures to better protect young people from health risks are essential for the prevention of health problems in adulthood.5 According to the World Health Organization, the main problems affecting young people include mental health problems (such as behavioral disorders, eating disorders, suicide, anxiety or depression), the use of substances (illegal substances, alcohol and tobacco), interpersonal violence, nutrition (a proper nutrition consists of healthy eating habits and physical exercise), unintentional injuries (which are a leading cause of death and disability among young people, with road traffic injuries accounting for about 700 deaths per day), sexual and reproductive health (for example, risky sexual behaviors, early pregnancy and childbirth) and HIV (resulting from sexual transmission and drug injection).5,6 On the other hand, the number of children and youth with chronic health conditions has increased dramatically in the past four decades7 as larger numbers of chronically ill children survive beyond the age of 10.8 Despite the lack of data on adolescents' health making it difficult to determine the prevalence of chronic illnesses in this age group9, it is known that one in ten adolescents suffers from a chronic condition worldwide.10 In fact, national population based studies from Western countries show that 20-30% of teenagers have a chronic illness, defined as one that lasts longer than six months.8 The most prevalent chronic illness among adolescents is asthma and the one with the highest incidence is diabetes mellitus, particularly type II.9 Traditionally, healthcare professionals have been mainly investing in health education activities, through the transmission of knowledge with a view to creating habits, customs and behaviors, and promoting healthy lifestyles. However, empowering people does not only consist of giving them the right information11 , i.e. good information is not enough to cause people to make changes.12 The motivation or desire to change unhealthy behaviors and habits depends on many factors, namely intrinsic motivation, control over personal decisions, self-confidence and perception of effectiveness, personal ambivalence, and individualized assistance.12 Many professionals assume that supplying knowledge is sufficient for behavioral changes; however, even very good advice often fails to generate behavioral change. After all, people continue to engage in unhealthy behaviors despite clearly knowing what they should do and how to change. "What is lacking is the motivation to apply that knowledge".13, p.1233 In fact, behavioral change is a complex phenomenon with multiple determinants that also includes motivational variables. It is associated with ambivalent processes expressed in the dilemma between keeping the current status and moving on to new ways of acting. For example, telling adolescents that if they keep on engaging in a certain behavior, they are increasing the risk of developing a long-term condition such as cardiovascular disease, stroke or diabetes is rarely enough to trigger the desired behavioral change; people are more likely to change when they believe that the change is really effective and that they are able to implement it.12 Therefore, it is essential to provide specific training for "healthcare professionals to master motivational techniques, avoid confrontation with the users, and facilitate behavioral changes".14 In this context, motivating patients to make behavioral changes is also an important nursing task where change in lifestyle is a major element of patients' treatment and preventive interventions.15 One of the nurse's goals is to help improve a patient's health or help them to manage existing health conditions. Once nurses are in a position where they have to focus on accomplishing tasks and telling patients what needs to be accomplished16, the role of the nurse is expanding even more into the use of motivational strategies.17 MI is bringing nurses back to therapeutic communication and moving them closer to successful health promotion and disease management, by promoting behavior change and empowering their patients. As the nursing profession evolves, MI is seen as a challenge and the basis of nurse's interactions with individuals, families and communities.16, 17 In the same way, MI may be taken as an essential tool in the provision of nursing care to adolescents, being itself a workspace with possible therapeutic effects regarding problems, clarification of doubts, and development of skills.18 In fact, MI may be particularly applicable in work with adolescents because of their specific developmental stage. Adolescents attempt to establish their own autonomy and identity while struggling with social interactions and moral issues, which leads to ambivalence.19 Consistent with the developmental challenges during adolescence, "MI explicitly honors autonomy, people's right and irrevocable ability to decide about their own behavior"20 while allowing the person to explore possibilities for change of risky or maladaptive behaviours.19 MI can be defined as a directive, client-centred counselling style for eliciting behavior change by helping clients to explore and resolve ambivalence. It is most centrally defined not by technique but by its spirit as a facilitative style of interpersonal relationship.21 It is a set of strategies and techniques widely used in clinical practice based on the transtheoretical model of change. The Stages of Change model describes five stages of readiness—precontemplation, contemplation, preparation, action, and maintenance—and provides a framework for understanding behavior change.22 The MI has been widely tested and applied in different areas, such as modification of addictive behaviors, interventions with offenders in the context of justice, eating disorders, promotion of therapeutic adherence among chronic patients, promotion of learning in school settings or intervention with adolescents at risk.18,23 In general, clinical practice has been adopting the perspective of motivation as something relatively immutable, i.e., the adolescent is either motivated for change/treatment and, in these conditions, the professional's role is to help him/her, or the adolescent is not motivated and then change/treatment is not feasible. Alternatively the theoretical model underlying the MI technique postulates that the individual's adherence to change/treatment depends on his/her motivation, which can change throughout the therapeutic intervention. As several studies found positive results for effects of MI24-26 and its use by health professionals is encouraged23,27 nurses may play an important role in patients' process of change. As nurses have a crucial role in clinical contexts, they can facilitate the process of ending risk behaviors and/or adopting positive health behaviors through some motivational techniques, namely with adolescents. A considerable number of systematic reviews about MI already exist pointing to some benefits of its use in the treatment of a broad range of behavioral problems and diseases.13,28,29 Some of the current reviews focus on examining the effectiveness of MI for adolescents with diverse health risks/problems 30-32. However, to date there are no reviews that present and assess the evidence for the use of nurse-led MI in adolescents. Therefore, we have little knowledge of what works for whom (which adolescent subpopulation) under what circumstances (in which setting, for what problem) in relation to motivational interviewing by nurses. There is a clear need for scoping or mapping the use of MI by nurses with adolescents to identify evidence gaps and to inform opportunities for future development in nursing practice. On the other hand, information regarding nurse-led implemented and evaluated interventions, techniques and/or strategies used, contexts of application and adolescents subpopulation groups is dispersed in the literature33-36 which impedes the formulation of precise questions about the effectiveness of those interventions conducted by nurses and therefore the realization of a systematic review. In other words, it is known that different kind of motivational interventions have been implemented in different contexts by nurses, however does not exist a map about all the motivational techniques and/or strategies used. Furthermore the literature does not clarify which is the role of nurses at cross professional motivational intervention implemented programs and finally the outcomes and evaluation of interventions are unclear. Thus, the practical implication of this mapping will be clarifying all these aspects. Without this clarification is not possible to proceed to the realization of a systematic review about the effectiveness of the use of motivational interviews by nurses to promote health behaviors in adolescents, in a particular context and/or health risk behavior; or regarding the effectiveness of certain technique and/or strategy of MI. Consequently, there are important questions about the nature of the evidence in this area that need to be answered before formulating a precise question of effectiveness. This scoping review aims to respond to these questions. An initial search of the JBI Database of Systematic Reviews & Implementation Reports, Cochrane Database of Systematic Reviews, , Database of promoting health effectiveness reviews (DoPHER), The Campbell Library, Medline and CINAHL, has revealed that currently there is no Scoping Review (published or in progress) on the subject. In this context, this scoping review will examine and map the published and unpublished research around the use of MI by nurses implemented and evaluated to promote health behaviors in adolescents; to establish its current extent, range and nature and identify its feasibility, outcomes and gaps in the evidence defining research priorities in this field. This scoping review will be informed by the JBI methodology37 that suggests a five stage methodological framework for conducting scoping reviews which includes: identifying the research question, searching for relevant studies, selecting studies, charting data, collating, summarizing and reporting the results.

THE HEALTH OF YOUNG ADULTS WITH DISABILITIES IN THE UNITED STATES: THE COLLECTIVE ROLES OF RISK FACTORS IN SOCIAL ECOLOGIC FRAMEWORK

Background: Over the last few decades, the prevalence of young adults with disabilities (YAD) has steadily risen as a result of advances in medicine, clinical treatment, and biomedical technologythat enhanced their survival into adulthood. Despite investments in services, family supports, and insurance, they experience poor health status and barriers to successful transition into adulthood. Objectives: We investigated the collective roles of multi-faceted factors at intrapersonal, interpersonal and community levels within the social ecological framework on health related outcome including self-rated health (SRH) of YAD. The three specific aims are: 1) to examine sociodemographic differences and health insurance coverage in adolescence; 2) to investigate the role of social skills in relationships with family and peers developed in adolescence; and 3) to collectively explore the association of sociodemographic characteristics, social skills, and community participation in adolescence on SRH. Methods: Using longitudinal data (N=5,020) from the National Longitudinal Transition Study (NLTS2), we conducted multivariate logistic regression analyses to understand the association between insurance status as well as social skills in adolescence and YAD’s health related outcomes. Structural equation modeling (SEM) assessed the confluence of multi-faceted factors from the social ecological model that link to health in early adulthood. Results: Compared with YAD who had private insurance, YAD who had public health insurance in adolescence are at higher odds of experiencing poorer health related outcomes in self-rated health [adjusted odds ratio (aOR=2.89, 95% confidence interval (CI): 1.16, 7.23), problems with health (aOR=2.60, 95%CI: 1.26, 5.35), and missing social activities due to health problems (aOR=2.86, 95%CI: 1.39, 5.85). At the interpersonal level, overall social skills developed through relationship with family and peers in adolescence do not appear to have association with health related outcomes in early adulthood. Finally, at the community level, community participation in adolescence does not have an association with SRH in early adulthood. Conclusions: Having public health insurance coverage does not equate to good health. YAD need additional supports to achieve positive health outcomes. The findings in social skills and community participation suggest other potential factors may be at play for health related outcomes for YAD and the need for further investigation.

What next for unions in Central and Eastern Europe? Invisibility, departure and the transformation of industrial relations

This article examines union revitalization in Central and Eastern Europe, focusing on two countries: Hungary and Latvia. Trade unions have not only had to cope with a declining membership base, but have also had to respond to austerity programmes and government cuts in public sector employment. We argue that the inability of unions to provide a strong voice for alternative policies to the current neoliberal orthodoxy has been driven by a declining membership base, but also by weakened social dialogue mechanisms, limited industrial representation and an ageing membership profile, exacerbated by net outward migration in recent years. However, we find that unions in Latvia and Hungary have responded differently to these issues.

Conquerors, Brides and Concubines. Interfaith Relations and Social Power in Medieval Iberia.

As its title indicates, this book, which is divided into four chapters, seeks to provide an overview of “the diverse political, social and cultural functions that interfaith marriage alliances and other sexual encounters fulfilled within the overall dynamic of Christian- Muslim relations in the Iberian Peninsula during the medieval period, both within al- Andalus (…) and the expansionist Christian-dominated polities of the North” (4). In this sense, its chronological span reaches from the early eighth century (the conquest of the Iberian Peninsula by the Muslims) to 1492 (the Christian conquest of the Nasrid Kingdom of Granada)

Networks in the shadow of markets and hierarchies : calling the shots in the visual effects industry

The nature and organisation of creative industries and the creative economy has received increased attention in recent academic and policy literatures (Florida 2002; Grabher 2002; Scott 2006a). Constituted as one variant on new economy narratives, creativity, alongside knowledge, has been presented as a key competitive asset, Such industries – ranging from advertising, to film and new media – are seen as not merely expanding their scale and scope, but as leading edge proponents of a more general trend towards new forms of organization and economic coordination (Davis and Scase 2000). The idea of network forms (and the consequent displacement of markets and hierarchies) has been at the heart of attempts to differentiate the field economically and spatially. Across both the discussion of production models and work/employment relations is the assertion of the enhanced importance of trust and non-market relations in coordinating structures and practices. This reflects an influential view in sociological, management, geography and other literatures that social life is ‘intrinsically networked’ (Sunley 2008: 12) and that we can confidently use the term ‘network society’ to describe contemporary structures and practices (Castells 1996). Our paper is sceptical of the conceptual and empirical foundations of such arguments. We draw on a number of theoretical resources, including institutional theory, global value chain analysis and labour process theory (see Smith and McKinlay 2009) to explore how a more realistic and grounded analysis of the nature of and limits to networks can be articulated. Given space constraints, we cannot address all the dimensions of network arguments or evidence. Our focus is on inter and intra-firm relations and draws on research into a particular creative industry – visual effects – that is a relatively new though increasingly important global production network. Through this examination a different model of the creative industries and creative work emerges – one in which market rules and patterns of hierarchical interaction structure the behaviour of economic actors and remain a central focus of analysis. The next section outlines and unpacks in more detail arguments concerning the role and significance of networks, markets and hierarchies in production models and work organisation in creative industries and the ‘creative economy’.

Girl in the Shadows and resilience and coping strategies in contemporary young adult fiction

The novel manuscript Girl in the Shadows tells the story of two teenage girls whose friendship, safety and sanity are pushed to the limits when an unexplained phenomenon invades their lives. Sixteen-year-old Tash has everything a teenage girl could want: good looks, brains and freedom from her busy parents. But when she looks into her mirror, a stranger’s face stares back at her. Her best friend Mal believes it’s an evil spirit and enters the world of the supernatural to find answers. But spell books and ouija boards cannot fix a problem that comes from deep within the soul. It will take a journey to the edge of madness for Tash to face the truth inside her heart and see the evil that lurks in her home. And Mal’s love and courage to pull her back into life. The exegesis examines resilience and coping strategies in adolescence, in particular, the relationship of trauma to brain development in children and teenagers. It draws on recent discoveries in neuroscience and psychology to provide a framework to examine the role of coping strategies in building resilience. Within this broader context, it analyses two works of contemporary young adult fiction, Freaky Green Eyes by Joyce Carol Oates and Sonya Hartnett’s Surrender, their use of the split persona as a coping mechanism within young adult fiction and the potential of young adult literature as a tool to help build resilience in teen readers.

Revisiting Industrial Relations

In 1999 I convened Industrial Relations, the annual ADSA Conference hosted by QUT in Brisbane. This event was promoted as ‘a conference exploring the links between theatre scholarship and professional theatre practice’. As well as academics, there was to be substantial representation by ‘industry professionals’, although interest from the latter category turned out to be modest. One day of the conference was designated a special ‘Links with Industry’ day, during which the Association launched its now defunct ADSAIL (ADSA Industry Links) initiative. Keynote speaker Wesley Enoch commented on ‘the very strong resistance in “the industry” to acknowledging any role of academics’. ‘What is the practical role of having them?’ he asked the ‘them’ gathered before him. In a letter declining our invitation to speak (he later changed his mind), David Williamson remarked that he always felt ‘uneasy at such conferences’: My view of my work is that I’ve successfully filled theatres for 30 years now, something dramatists are supposed to do. I suppose there’s part of me that hopes this will be celebrated. It often is, but rarely in academic drama departments …. Perhaps in fifty years time someone in academe will realise that I wasn’t just reinforcing the attitudes of the Anglo Celtic ruling class. Several years on it seems timely to revisit Industrial Relations; to look again at the extent to which problems of intercultural communication between industry and academy are being addressed. And what are the implications of this for the ADSA History project, which seeks to investigate ADSA’s contribution to the development of theatre / performance studies in Australasia? What are the ‘external’ impacts of ADSA’s ongoing conference enterprise, and how might these be measured? Reflections from delegates on these and other questions will be warmly encouraged.