Public-private partnerships and efficiency in public procurement of primary healthcare infrastructure: a qualitative research in the NHS UK

Aim There is growing interest in the contribution of public-private partnerships (PPPs) bridging the shortage of financial resources and management expertise in developing public healthcare infrastructure. However, few studies have evidenced PPPs’ ability in increasing efficiency in public procurement of primary healthcare infrastructure. The aim of this study was to assess to what extent PPPs would increase efficiency in public procurement of primary healthcare facilities. Subject and Methods A qualitative analysis, adopting a realistic research evaluation method, used data collected from a purposive sample of public (n=23) and private sector staff (n=2) directly involved in the UK National Health Service Local Improvement Finance Trust (LIFT). Results We find a positive association of LIFT helping to bridge public sector capital shortages for developing primary care surgeries. LIFT is negatively associated with inefficient procurement because it borrows finance from private banks, leaving public agencies paying high interest rates. The study shows that some contextual factors and mechanisms in LIFT play a major part in obstructing public staff from increasing procurement efficiency. Conclusion PPP’s ability to increase efficiency may be determined by contextual factors and mechanisms that restrict discretion over critical decisions by frontline public sector staff. Developing their capacity in monitoring PPP activities may make partnerships more efficient.

Troubles of one neophyte researcher in getting qualitative research on parthneships in a daycare setting with disadvantaged toddlers

This study is about the troubles encountered by one researcher in getting qualitative research on partnerships between families, in disadvantaged situations and educators in toddler day care settings and how they affect the quality of care as perceived by parents and educators. The study focuses on the conflicts and tensions as perceived by families and educators. A secondary goal of the study is to develop a greater understanding of how day care training programs might incorporate the findings to prepare day care educators to work with families in disadvantaged circumstances. The study is done through a qualitative lens using an ecological framework. The study spans a three month period and is set up in a non-profit, parent-controlled day care center. Detailed 'narratives of experience' are constructed from the participants' reflections on the events. Three main barriers or conflicts have emerged from the study. They are time, fear and a difference in perceptions between the families and the educators. The thesis concludes with advice to researchers who may be contemplating setting up a similar study and some suggestions are proposed for day care training programs. These suggestions include reflections of the researcher and how she implemented changes in her own teaching.

Duo, duel et deuil représentations de la dialectique tradition/novation entourant l'intégration des TIC chez des enseignants d'arts plastiques au secondaire : par une approche qualitative réfléchie

Cette thèse traite des représentations construites par des artistes-enseignants du secondaire au sujet de la dialectique tradition/novation inhérente au processus d'intégration des TIC. Elle rend compte d'une recherche visant à mieux comprendre les disparités en matière d'intégration des technologies, dans les pratiques enseignantes en arts plastiques. L'auteure a observé ce problème dans son parcours professionnel, marqué par son passage du rôle de praticienne à celui de formatrice en enseignement des arts. Elle s'est demandée si cela tenait uniquement à la formation ou si des facteurs intrinsèques tels que les représentations pouvaient intervenir. Ce questionnement est à l'origine d'une étude dont les objectifs étaient d'identifier les représentations entourant la dialectique tradition/novation et de voir s'il existe des interrelations entre représentations et pratiques. Pour arriver à ses fins, l'auteure a utilisé les notions de représentation sociale et de poïétique comme leviers théoriques tout en s'inspirant de la démarche artistique, par souci de cohérence avec le domaine des arts. Le recueil de l'information s'est effectué à partir d'entretiens de type compréhensif, donnant lieu à des représentations discursives, métaphoriques et graphiques. L'analyse des représentations révèle que les artistes-enseignants interviewés voient la dialectique tradition/novation tantôt comme un duo, tantôt comme un duel ou même comme un deuil, et que ces représentations interagissent avec les pratiques. Ces conclusions traduisent l'importance de s'intéresser aux facteurs intrinsèques qui peuvent faire obstacle au changement. Si la rencontre art/technologie est assez bien documentée par les esthéticiens, les philosophes et les artistes, plus rares sont les contributions touchant le corollaire éducatif d'une telle alliance. En ce sens, cette recherche est tout à fait pertinente et originale. Elle l'est également au regard de la méthodologie proposée, qui s'ajuste à la démarche artistique. Bref, cette thèse parle d'art, parle par l'art et parle pour l'art.

Choix scolaires, perception de la valeur des études et relations sociales de jeunes québécois au postsecondaire : une analyse qualitative longitudinale

La recherche s'intéresse à la valeur accordée aux études par les jeunes québécois de niveau postsecondaire en se basant sur le modèle de type attente-valeur d'Eccles (2007). La perception de la valeur correspond à un jugement posé sur les études, le programme ou le cours au regard de quatre composantes : intérêt, utilité, valeur de réalisation et cout. L'objectif général de la thèse est de mieux comprendre la dynamique entourant les choix scolaires des jeunes québécois de niveau postsecondaire à l'aide du concept de perception de la valeur des études et de ses composantes. Deux objectifs spécifiques en découlent: 1. Décrire les composantes de la perception de la valeur et leur dynamique, en distinguant la perception de la valeur des études en général (le fait d'étudier), d'un programme ou d'un cours et en reliant la perception de la valeur aux choix scolaires des jeunes; 2. Identifier et décrire le lien entre les relations sociales et la perception de la valeur des études. Une analyse secondaire a été menée sur 185 entretiens semi-dirigés réalisés auprès de 36 jeunes sur une période d'environ 5 ans (données de la recherche Famille, réseaux et persévérance au collégial, de Bourdon et Charbonneau). Les résultats valident largement le modèle et les définitions d'Eccles (2007), mais remettent en question certains aspects, en particulier autour des composantes utilité, réalisation et cout. Des aspects dynamiques de la perception de la valeur par ailleurs ont été mis en évidence. Les relations sociales - parents et pairs notamment - peuvent agir, selon différentes modalités, sur la perception de la valeur des études. Le personnel enseignant est mentionné en lien avec la valeur accordée aux cours. Une compréhension plus fine de la valeur accordée aux études, aux programmes et aux cours pourra être réinvestie dans l'organisation scolaire au postsecondaire et dans les pratiques pédagogiques.

Digital unterwegs ohne das virtuelle soziale Netzwerk – qualitative Studie über Facebook-Verweigerung und Virtual Identity Suicide

Das virtuelle soziale Netzwerk Facebook feiert seinen zehnten Geburtstag. Mit über einer Milliarde aktiver Nutzer ist es seit seiner Entstehung zur weltweit größten Internetplattform zur Kommunikation avanciert. Dennoch gibt es in Deutschland eine große Anzahl an Menschen, die sich zwar täglich im Internet bewegt, aber auf eine Mitgliedschaft bei Facebook verzichtet. In dieser Arbeit werden die Gründe untersucht, warum manche Personen Facebook nicht nutzen. Die Leitfrage der Arbeit lautet: „Warum nutzen ausgewählte deutsche Internetnutzer Facebook nicht?“. Es wird zwischen zwei unterschiedlichen Personenkreisen, den Nicht- und den Ex-Nutzern, unterschieden. Basierend auf Leitfadeninterviews mit 25 Befragten, die mittels einer qualitativen Inhaltsanalyse ausgewertet werden, werden elf verschiedene Gründe für eine Verweigerung von Facebook identifiziert. Für die Nicht-Nutzer stellt die Art der Kommunikation den zentralen Grund dar, Facebook nicht zu verwenden. Die Ex-Nutzer wiederum sehen den fehlenden Nutzen der Anwendung als wichtigstes Argument gegen Facebook.

Design and Qualitative/Quantitative Analysis of Multi-Agent Spatial Simulation Library

Thesis (Master's)--University of Washington, 2012

Leadership in Improving Schools: A Qualitative Perspective

This article reports early case-study data gathered from 20 schools involved in the ‘Impact of School Leadership on Pupil Outcomes’ project. We present and discuss the perceptions of headteachers and other school leaders regarding leadership factors that directly and indirectly affect pupil outcomes in these improving schools. Included are issues relating to the pivotal role played by the headteacher in setting and communicating a strategic vision for the school; models of distributed leadership; and the building of leadership capacity so as to build a collective responsibility for the improvement of pupil outcomes.

Exercise Prescription for Patients with Non-specific Chronic Low Back Pain: a Qualitative Exploration of Decision Making in Physiotherapy Practice

Background: Providing an effective exercise prescription process for patients with non-specific chronic low back pain (NSCLBP) is a challenging task. Emerging research has indicated that partnership in care and shared decision making are important for people with NSCLBP and calls for further investigation into the approaches used to prescribe exercise. Objective: To explore how shared decision making and patient partnership are addressed by physiotherapists in the process of exercise prescription for patients with NSCLBP. Design: A qualitative study using a philosophical hermeneutic approach. Methods: Eight physiotherapists were each observed on three occasions undertaking their usual clinical activities (total n=24 observations). They conducted brief interviews after each observation and a later in depth semi-structured interview. Iterative hermeneutic strategies were used to interpret the texts and identify the characteristics and processes of exercise prescription for patients with NSCLBP. Findings: The findings revealed how physiotherapy practice often resulted in unequal possibilities for patient participation which were in turn linked to the physiotherapists? assumptions about the patients, clinical orientation, cognitive and decision making processes. Three linked themes emerged: (1) I want them to exercise, (2) Which exercise? - the tension between evidence and everyday practice and (3) Compliance-orientated more than concordance based. Conclusions: This research, by focusing on a patient-centred approach, makes an important contribution to the body of evidence relating to the management of NSCLBP. It challenges physiotherapists to critically appraise their approaches to the prescription of exercise therapy in order to improve outcomes for these patients.

Expert Insight into the Assessment of Competence in Cognitive–behavioural Therapy: a Qualitative Exploration of Experts' Experiences, Opinions and Recommendations

To offer insight into how cognitive–behavioural therapy (CBT) competence is defined, measured and evaluated and to highlight ways in which the assessment of CBT competence could be further improved, the current study utilizes a qualitative methodology to examine CBT experts’ (N = 19) experiences of conceptualizing and assessing the competence of CBT therapists. Semi-structured interviews were used to explore participants’ experiences of assessing the competence of CBT therapists. Interview transcripts were then analysed using interpretative phenomenological analysis in order to identify commonalities and differences in the way CBT competence is evaluated. Four superordinate themes were identified: (i) what to assess, the complex and fuzzy concept of CBT competence; (ii) how to assess CBT competence, selecting from the toolbox of assessment methods; (iii) who is best placed to assess CBT competence, expertise and independence; and (iv) pitfalls, identifying and overcoming assessment biases. Priorities for future research and ways in which the assessment of CBT competence could be further improved are discussed in light of these findings.

Understanding the Patient Experience Through the Power of Film: a Mixed Method Qualitative Research Project

Film is a highly attractive teaching instrument for the study of different terminal diseases, exploring bioethics (Beauchamp and Childress, 2009) and is a preferred medium over traditional lectures (Edmunds, 2013) to provide realistic examples for adult learners. It can tap into ethical issues; facilitate decision-making; and examine underlying issues such as euthanasia; assisted suicide; and professional responsibility. Contrast this with standard means of teaching, such as scenarios- although a useful pedagogic tool, these are limited because students must imagine the clinical scenario. Film can fill that imaginative gap (Volandes, 2007). It can be utilised as an active teaching strategy for a variety of topics in nursing (Edmunds, 2013) providing a unique way to promote active learning in nursing education (Herrman, 2006). The objectives of the study, aim to help pre registration student nurses from each year of study to engage with their role as health care professionals; provide open discussion and debate on how they view the personal experience of illness/disease/disability/death and to reflect on their role and provision of patient care. It is delivered in 3 tiers to provide a range of data for thematic analysis; 1) Film screening followed by a ‘5 minute reaction’ discussion and post screening questionnaire; 2) Pre screening guided activities for reflection and discussion; 3) Focus groups. This project meets identified aims from the UK Professional Standards Framework (UKPSF) by fostering creative and innovative approaches to teaching and learning; facilitating and supporting the design and delivery of continuing education development programmes and activities; and demonstrates professionalism that staff and institutions bring to teaching. Preliminary feedback and themes will be presented.

Supporting Completion of an Online Continuing Professional Development Programme For Newly Qualified Practitioners: a Qualitative Evaluation

Background: Development programmes to support newly qualified practitioners gain confidence in their first professional role often show varied levels of engagement, due to competing priorities and demands. In Scotland, the Flying Start NHS® programme uses a structured programme of online and work-based learning with associated mentoring, to support individuals through an often difficult transition to become capable, confident practitioners. . Whilst the programme was generally well received, the factors leading to widely varying completion rates between professions and organisations were not well understood. Aim: to identify the factors leading to successful completion of Flying Start, a transition programme for newly qualified practitioners. Method: A qualitative approach was adopted to gather data from two groups of participants. Semi-structured telephone interviews were conducted with strategic and management level participants (n=23), from five health boards in Scotland. Semi-structured interviews (n=22) and focus groups (n=11) were conducted with practitioners within 6 months either side of completing the programme. The interviews were transcribed and analysed using framework analysis. Results: Four key themes related to successful completion emerged from the analysis: organisational support; the format of the programme; understanding completion; motivation and incentives to complete. Factors leading to successful completion were identified at programme, organisational and individual level. These included clear communication and signposting, up-to-date and relevant content, links with continuing professional development frameworks, effective leadership, mentor and peer support, setting clear standards for assessment, and facilitating appropriate IT access. Conclusions: A strong strategic commitment to embedding a development programme for newly qualified practitioners can ensure the necessary support is available to encourage timely completion. The mentor’s role - to provide face-to-face support - is identified as a key factor in completion and is achieved through setting attainable targets, monitoring progress, and providing motivation. However organisational structures that facilitate the mentoring relationship are also necessary.

Analyzing drifter designs and data gathering methods in complex estuarine environments

Senior thesis written for Oceanography 445