Modularity in Health and Social Services: Perspectives on Organization and Management

Organizations that provide health and social services operate in a complex and constantly changing environment. Changes occur, for example, in ageing, technology and biotechnology, and customers’ expectations, as well as the global economic situation. Organizations typically aim to adapt the changes by introducing new organizational structures and managerial practices, such as process and lean management. Only recently has there been an interest in evaluating whether organizations providing health and social services could apply modularity in order to respond to some of the changes. The concept of modularity originates from manufacturing, but is applied in many other disciplines, such as information technology and logistics. However, thus far, the literature concerning modularity in health and social services is scarce. Therefore the purpose of this thesis is to increase understanding concerning modularity and the possibilities to apply modularity in the health and social services context. In addition, the purpose is to shed light on the viewpoints that are worth taking into account when considering the application of modularity in the health and social services context. The aim of the thesis is to analyze the way in which the modular structures are applied in the health and social services context and to analyze what advantages and possible barriers, as well as managerial concerns, might occur if modularity is applied in the health and social services context. The thesis is conducted by using multiple methods in order to provide a broad aspect to the topic. A systematic literature review provided solid ground for pre-understanding the topic and supported the formulation of the research questions. Theoretical reasoning provided a general overview of the special characteristics of the health and social services context and their effect on application of modularity. Empirical studies concentrated on managerial concerns of modularity particularly from the perspective of health and social services for the elderly. Results of the thesis reveal that structures in products, services, processes, and organizations are rather modular in health and social services. They can be decomposed in small independent units, while the challenges seem to occur especially in the compatibility of the services. It seems that health and social services managers have recognized this problem and they are increasingly paying attention to this challenge in order to enhance the flexible compatibility of services. Advantages and possible barriers of modularity are explored in this thesis, and from the theoretical perspective it could be argued that modularity seems to be beneficial in the context of health and social services. In fact, it has the potential to alleviate several of the challenges that the health and social services context is confronting. For example, modular structures could support organizations in their challenging task to respond to customers’ increasing demand for heterogeneous services. However, special characteristics of the health and social services context create barriers and provide significant challenges in application of modularity. For example, asymmetry of information, negative externalities, uncertainty of demand, and rigid regulation prevent managers from extensively drawing benefits from modularity. Results also reveal that modularity has managerial implications in health and social service. Modularity has the potential to promote and support new service development and outsourcing. Results also provide insights into network management and increases managerial understanding of different network management strategies. Standardization in health and social services is extensive due to legislation and recommendations. Modularity provides alternative paths to take an advantage of standardization while still ensuring the quality of the services. Based on this thesis, it can be concluded, both from a theoretical perspective and from empirical results concerning modularity in health and social services, that modularity might fit well and be beneficial. However, the special characteristics of the health and social services context prevent some of the benefits of modularity and complicate its application. This thesis contributes to the academic literature on the organization and management of health and social services by describing modularity as an alternative way for organizing and managing health and social services. In addition, it contributes to the literature of modularity by exploring the applicability of modularity in the context of health and social services. It also provides practical contribution to health and social services managers by evaluating the pros and cons of modularity when applied to health and social services.

Analyzing the learning of the taking personal and social responsibility model within a new physical education undergraduate degree program in El Salvador

EI Salvador presents an unfortunate history that includes a military regime and a civil war that together created a legacy of violence in which the country still struggle nowadays. Salud Escolar Integral (SEI) was created in 2005 as a program to combat youth violence throughout the re-formulation of physical education (PE) classes in public schools, promoting life skills learning that supports the resolution of conflicts with nonviolent ways. In 2007, SEI supported the creation of a physical e~ucation teacher education (PETE) degree at the Universidad Pedag6gica de EI Salvador (UPES), having the goal to assist pre-service teachers with a better understanding of humanistic principles. The present research analyzed if after attending all three years ofUPES PETE program, students presented high self-perception levels of competence and confidence related to attitude, skills and knowledge to teach PE within humanistic principles. Taking Personal and Social Responsibility (TPSR) was the theoretical framework used to analyze the development of humanistic principles. The study had a mixed-method longitudinal design that included questionnaires, reflection templates and interviews. In conclusion, although it is suggested that UPES should provide better support for the development of the teaching principles of empowering students and transfer learning, most of the humanistic principles were highly promoted by the program. At last, it is suggested that future research should track teachers' progress while teaching in schools, in order to analyze if the theory of promoting humanistic principles have also become a daily practice.

Repertory grid adaptations in detecting connotative trends and social behaviour problems in education

Please consult the paper edition of this thesis to read. It is available on the 5th Floor of the Library at Call Number: Z 9999 E38 K66 1983

Student self-assessment a feedback seeking strategy through competence evaluation

There is a body of literature that suggests that student self-assessment is a main goal in higher education (Boud et al., 1995; Tan, 2008); moreover new forms of work organization require a high level of skills and competences. The efforts to deal with competence gaps could be developed at many levels, such as employers, educational institutions, individuals and public agents. Employers could put into practice competence development programs to moderate these gaps. Educational institutions can restructure the curriculum to support students in attaining the competences that are essential in the labour market. Individuals themselves may deploy their resources (time and money) in general or specific competence training. Further, government agencies could fund competence promotion programs. Such challenges for education drive change in learning curricula and method, to properly include the competences required for developing global workers who can move beyond basic competence, to enhanced flexibility and adaptability. In performance assessment methods, there is a shift from the traditional exam-based assessments to more innovative task assessment, which considers performance in multiple different tasks carry out by students. ICTs make it technologically feasible to carry out a complete and complex selfassessment of competences, which provides immediate results to students or other recipients. In the case of students, the evaluation of competences is relevant as developing competences is part - if not all - of the objectives of education. Therefore, it is an important element of the quality of educational organizations (e.g., universities), and of their organizational success. Further, educational organizations may put special emphasis on some differentiating competences, which can be a means of positioning and differentiation from competitors. Competence assessment is an instrument to make students conscious of their strengths and weaknesses, leading to higher motivation to develop their own learning career

Gestión de la actividad no presencial y autoevaluación de competencias = Management of student learning outside the classroom and the self-evaluation of competences

La asignatura troncal “Evaluación Psicológica” de los estudios de Psicología y del estudio de grado “Desarrollo humano en la sociedad de la información” de la Universidad de Girona consta de 12 créditos según la Ley Orgánica de Universidades. Hasta el año académico 2004-05 el trabajo no presencial del alumno consistía en la realización de una evaluación psicológica que se entregaba por escrito a final de curso y de la cual el estudiante obtenía una calificación y revisión si se solicitaba. En el camino hacia el Espacio Europeo de Educación Superior, esta asignatura consta de 9 créditos que equivalen a un total de 255 horas de trabajo presencial y no presencial del estudiante. En los años académicos 2005-06 y 2006-07 se ha creado una guía de trabajo para la gestión de la actividad no presencial con el objetivo de alcanzar aprendizajes a nivel de aplicación y solución de problemas/pensamiento crítico (Bloom, 1975) siguiendo las recomendaciones de la Agencia para la Calidad del Sistema Universitario de Cataluña (2005). La guía incorpora: los objetivos de aprendizaje, los criterios de evaluación, la descripción de las actividades, el cronograma semanal de trabajos para todo el curso, la especificación de las tutorías programadas para la revisión de los diversos pasos del proceso de evaluación psicológica y el uso del foro para el conocimiento, análisis y crítica constructiva de las evaluaciones realizadas por los compañeros

El plan de lengua y cohesión social en Catañunya: primeros datos de una investigación = Language and Social Cohesion Plan in Catalonia: Initial research data

Los programas de inmersión lingüística han constituido y constituyen dentro del Sistema Educativo catalán la principal forma para que el alumnado de lengua familiar no-catalana aprenda una nueva lengua, el catalán, sin que, en su proceso de aprendizaje, vea mermado ni el desarrollo de su propia lengua ni su rendimiento académico. El éxito de la inmersión lingüística en las décadas anteriores ha sido frecuentemente utilizado como uno de los argumentos orientativos para justificar la política lingüística que se sigue en la escolarización de la infancia extranjera. Sin embargo, los resultados obtenidos por investigaciones recientes parece que no avalan empíricamente dicho argumento. Este artículo analiza dichos resultados y expone, a partir del Plan para la Lengua y Cohesión Social puesto en marcha por el Departamento de Educación de la Generalitat de Cataluña, cuáles son los retos que se presentan a su Sistema Educativo dentro del nuevo marco que supone el aumento de la diversidad cultural y lingüística en la actual sociedad catalana

Value management and post-occupancy evaluation: closing the loop

This paper considers the relationship between value management and facilities management. The findings are particularly relevant to large client organisations which procure new buildings on a regular basis. It is argued that the maximum effectiveness of value management can only be achieved if it is used in conjunction with an ongoing commitment to post-occupancy evaluation. SMART value management is seen to provide the means of ensuring that an individual building design is in alignment with the client’s strategic property needs. However, it is also necessary to recognise that an organisation’s strategic property needs will continually be in a state of change. Consequentially, economic and functional under-performance can only be avoided by a regular performance audit of existing property stock in accordance with changing requirements. Such a policy will ensure ongoing competitiveness through organisational learning. While post-occupancy evaluation represents an obvious additional service to be provided by value management consultants, it is vital that the necessary additional skills are acquired. Process management skills and social science research techniques are clearly important. However, there is also a need to improve mechanisms for data manipulation. Success can only be achieved if equal attention is given to issues of process, structure and content.

Bayesian parameter estimation for latent Markov random fields and social networks

Undirected graphical models are widely used in statistics, physics and machine vision. However Bayesian parameter estimation for undirected models is extremely challenging, since evaluation of the posterior typically involves the calculation of an intractable normalising constant. This problem has received much attention, but very little of this has focussed on the important practical case where the data consists of noisy or incomplete observations of the underlying hidden structure. This paper specifically addresses this problem, comparing two alternative methodologies. In the first of these approaches particle Markov chain Monte Carlo (Andrieu et al., 2010) is used to efficiently explore the parameter space, combined with the exchange algorithm (Murray et al., 2006) for avoiding the calculation of the intractable normalising constant (a proof showing that this combination targets the correct distribution in found in a supplementary appendix online). This approach is compared with approximate Bayesian computation (Pritchard et al., 1999). Applications to estimating the parameters of Ising models and exponential random graphs from noisy data are presented. Each algorithm used in the paper targets an approximation to the true posterior due to the use of MCMC to simulate from the latent graphical model, in lieu of being able to do this exactly in general. The supplementary appendix also describes the nature of the resulting approximation.

Institutional framing of CSR and social entrepreneurship interactions in South Africa

Objectives. This paper considers the intersection of Corporate Social Responsibility (CSR) and social entrepreneurship in South Africa through the lens of institutional theories and draws upon a number of illustrative case study examples. In particular it: (1) charts the historically evolving relationship between CSR and social entrepreneurship in South Africa, and how this relationship has been informed by institutional changes since the end of apartheid, particularly over the last few years; (2) identifies different interactional relationship forms between social enterprises and corporates engaging in CSR, with an emphasis on new innovative multi-stakeholder partnerships; and (3) considers internal engagements with social responsibility by SME social enterprises in South Africa. Prior Work. Reflecting South Africa’s history of division, the controversial role of business during apartheid, and the ongoing legacies of that period, the South African government has been particularly pro-active in encouraging companies to contribute to development and societal transformation through CSR and Black Economic Empowerment (BEE). Accordingly a substantial body of work now exists examining and critically reflecting upon CSR and BEE across a range of sectors. In response to perceived problems with BEE, efforts have recently been made to foster broader-based economic empowerment. However the implications of these transitions for the relationship between CSR and social entrepreneurship in South Africa have received scant academic attention. Approach. Analysis is undertaken of legislative and policy changes in South Africa with a bearing on CSR and social entrepreneurship. Data collected during fieldwork in South Africa working with 6 social enterprise case studies is utilised including qualitative data from key informant interviews, focus groups with stakeholders and observational research. Results. The paper considers the historically evolving relationship between CSR and social entrepreneurship in South Africa informed by institutional change. Five different relationship forms are identified and illustrated with reference to case examples. Finally internal engagement with social responsibility concerns by small and medium social enterprises are critically discussed. Implications. This paper sheds light on some of the innovative partnerships emerging between corporates and social enterprises in South Africa. It reflects on some of the strengths and weaknesses of South Africa’s policy and legislative approaches. Value. The paper provides insights useful for academic and practitioner audiences. It also has policy relevance, in particularly for other African countries potentially looking to follow South Africa’s example, in the development of legislative and policy frameworks to promote corporate responsibility, empowerment and transformation.

State capitalism and social responsibility in China's banking industry

China’s financial system has experienced a series of major reforms in recent years. Efforts have been made towards introducing the shareholding system in state-owned commercial banks, restructuring of securities firms, re-organising equity of joint venture insurance companies, further improving the corporate governance structure, managing financial risks and ultimately establishing a system to protect investors (Xinhua, 2010). Financial product innovation, with the further opening up of financial markets and the development of the insurance and bond market, has increased liquidity as well as reduced financial risks. The U.S. subprime crisis indicated the benefit of financial innovations for the economy, but without proper control, they may lead to unexpected consequences. Kirkpatrick (2009) argues that failures and weaknesses in corporate governance arrangements and insufficient accounting standards and regulatory requirements attributed to the financial crisis. Similar to the financial crises of the last decade, the global financial crisis which sparked in 2008, surfaced a variety of significant corporate governance failures: the dysfunction of market mechanisms, the lack of transparency and accountability, misaligned compensation arrangements and the late response of government, all which encouraged management short-termism, poor risk management, as well as some fraudulent schemes. The unique characteristics of the Chinese banking system are an interesting point for studying post-crisis corporate governance reform. Considering that China modelled its governance system on the Anglo-American system, this paper examines the impact of the financial crisis on corporate governance reform in developed economies, and particularly, China’s reform of its financial sector. The paper further analyses the Chinese government’s role in bank supervision and risk management. In this regard, the paper contributes to the corporate governance literature within the Chinese context by providing insights into the contributing factors to the corporate governance failure that led to the global financial crisis. It also provides policy recommendations for China’s policy makers to seriously consider. The results suggest a need for the re-examination of corporate governance adequacy and the institutionalisation of business ethics. The paper’s next section provides a review of China’s financial system with reference to the financial crisis, followed by a critical evaluation of a capitalistic system and a review of Anglo-American and Continental European models. It then analyses the need for a new corporate governance model in China by considering the bank failures in developed economies and the potential risks and inefficiencies in a current State controlled system. The paper closes by reflecting the need for Chinese policy makers to continually develop, adapt and rewrite corporate governance practices capable of meeting the new challenge, and to pay attention to business ethics, an issue which goes beyond regulation.

Temporal lobe epilepsy and social behavior: An animal model

Social behavior depends on the integrity of social brain circuitry. The temporal lobe is an important part of the social brain, and manifests morphological and functional alterations in autism spectrum disorders (ASD). Rats with temporal lobe epilepsy (TLE), induced with pilocarpine, were subjected to a social discrimination test that has been used to investigate potential animal models of ASD, and the results were compared with those for the control group. Rats with TLE exhibited fewer social behaviors than controls. No differences were observed in nonsocial behavior between groups. The results suggest an important role for the temporal lobe in regulating social behaviors. This animal model might be used to explore some questions about ASD pathophysiology. (c) 2008 Elsevier Inc. All rights reserved.

Travel Report from the first field trip within the SIDA supported project "Mini-grids supplied by renewable energy - improving technical and social feasibility : Including visits to Ihushi Development Center, Tweyambe Secondary School and Mavuno Project in Tanzania. Conducted in April 2011

This report describes the outcome of the first visit to Tanzania, within the project "Mini-grids supplied by renewable energy - improving technical and social feasibility". The trip included visits to three different organizations; Ihushi Development Center (IDC) near Mwanza, TIDESO near Bukoba, and Mavuno Project in Karagwe. At IDC, a brief evaluation of the current power system was done and measuring equipment for long term measurements were installed. At all three locations investigations regarding the current and future electricity demand were conducted and connections to people relevant to the study were established. The report is including as well some technical specifications as some observations regarding organization and management of the technical systems. The trip was including only short visits and therefore only brief introductions to the different organizations, based on observations done by the author. The report is hence describing the author’s understanding of the technical system and social structures after only short visits to each of the organizations, and may differ from observations done at another point in time, over a different time period, or by some other person.This report describes the outcome of the first visit to Tanzania, within the project "Mini-grids supplied by renewable energy - improving technical and social feasibility". The trip included visits to three different organizations; Ihushi Development Center (IDC) near Mwanza, TIDESO near Bukoba, and Mavuno Project in Karagwe. At IDC, a brief evaluation of the current power system was done and measuring equipment for long term measurements were installed. At all three locations investigations regarding the current and future electricity demand were conducted and connections to people relevant to the study were established. The report is including as well some technical specifications as some observations regarding organization and management of the technical systems. The trip was including only short visits and therefore only brief introductions to the different organizations, based on observations done by the author. The report is hence describing the author’s understanding of the technical system and social structures after only short visits to each of the organizations, and may differ from observations done at another point in time, over a different time period, or by some other person.

Social entrepreneurship practices and social change In Brazil: a qualitative study in three non-governmental organizations

Social Entrepreneurship (SE) has attracted growing interest from a wide variety of actors over the last 30 years, especially due to a general agreement that it could be an important tool for tackling many of the world’s social ills. In the academic sphere, this growing interest did not translate into a matured field of study. Quite the opposite, a quick look at this literature makes it evident that: SE has been consistently subjected to numerous theoretical discussions and disagreements, especially over the definition of the concept of SE which is often based on a taken-for-granted notion of social change; it has been more systematically investigated in restricted contexts, often leaving aside so called developing/emerging countries like Brazil and especially lacking in-depth qualitative studies; SE literature lags behind SE practices and few studies focus on how SE actually occurs in a daily and bottom-up manner. In order to address such gaps, this thesis examines how social entrepreneurship practices accomplish social change in the context of Brazil. In this investigation I conducted an inductive practice-based, qualitative/ethnographic study in three Non-Governmental Organizations (NGOs) located in different cities in the Brazilian state of São Paulo. Data collection lasted from February 2014 until March 2015 and was mainly done through participant observations and through in-depth unstructured conversations with research participants. Secondary data and documents were also collected whenever available. The participants of this study included a variety of the studied organizations’ stakeholders: two founders, volunteers, employees, donors and beneficiaries. Observation data was kept in fieldnotes, conversations were recorded whenever possible and were later transcribed. Data was analyzed through an iterative thematic analysis. Through this I identified eight recurrent themes in the data: (1) structure; (2) relationship with other organizational actors (sub-themes: relationship with state, relationship with businesses and relationship with other NGOs); (3) beliefs, spirituality and moral authority; (4) social position of participants, (5) stakeholders’ mobilization and participation; (6) feelings; (7) social purpose; and (8) social change. These findings were later discussed under the lens of practice theory, and in this discussion I argue and show that, in the context studied: (a) even though SE embraces a wide variety of different social purposes, they are intertwined with a common notion of social change based on a general understanding and aspiration for social equality; (b) this social change is accomplished in a processual and ongoing manner as stakeholders from antagonistic social groups felt compelled to and participated in SE practices. In answering the proposed research question the contributions of this thesis are: (i) the elaboration a working definition for SE based on its relationship with social change; (ii) providing in-depth empirical evidence which accounts for and explains this relationship; (iii) characterizing SE in the Brazilian context and reflecting upon its transferability to other contexts. This thesis also makes a methodological contribution, for it demonstrates how thematic analysis can be used in practice-based studies.

Habitat use, reproductive traits and social interactions in a stream-dweller treefrog endemic to the Brazilian Cerrado

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Social dimensions of macroeconomic policy: report of the Executive Committee on Economic and Social Affairs of the United Nations

Introduction The social agenda is long-term in nature, in the sense that poverty alleviation along with a better distribution of income, wealth and opportunities are long-term goals. A sound macroeconomic policy, on the other hand, has to do largely with the consistent management of short-term policy instruments pursuing a sustainable and predictable pace for aggregate economic variables and major prices (wages, inflation, interest rates and exchange rates). In spite of the different arena and rationale in which they play, there are strong links between the two. First and most obvious, macroeconomic adjustment and structural reform are more likely to be sustainable when they are equitable. Second, social intervention —i.e., policies, programmes and reforms aimed at improving social performance in the long run—, needs stable funding which is not always available in view of macroeconomic constraints. Third, macroeconomic instability —especially episodes of recession or hyperinflation— increases poverty and inequality, while restoring macroeconomic equilibrium does not restore previous social balances. Finally, there is no unique macroeconomic policy mix to tackle a given situation, and the policy options may not be neutral from a social standpoint. Monetary, fiscal and exchange rate policies, together with structural reform, have major consequences for the social wellbeing of societies, not only in terms of protection against shocks and crises but also in terms of equity. Many, if not all, of the necessary social policies are of a domestic nature. This report thus concentrates on domestic strategies aimed at maximizing the linkages between consistent macroeconomic policies and social progress. Pursuing them, however, depends to a considerable extent on the international enabling environment in which the global financial system, the unsettled debt crisis and increasing ODA flows play a significant role. Countries operate in a world economy where market players everywhere immediately scrutinize domestic monetary, financial or fiscal policy decisions and the performance of exchange rate regimes of individual countries. Under these conditions, the room for manoeuvre of policymakers has become considerably constrained. Consequently, it is becoming increasingly complex to incorporate the social dimensions into such policy decisions, to the extent that external analysts consider that authorities are sacrificing sound macroeconomic policies. The main message of the report is that the expediency of short-term economic efficiency as embedded in much of the advice on macroeconomic stability needs to be tempered by long-term development objectives. The report starts with a short historical background which describes the ascendancy of macroeconomic policies over social development policies (chapter I). It continues with an evaluation of the relation between macroeconomic consistency and social effort (chapter II), and the importance of sustainable and stable growth for social progress (chapter III). The report then turns to the need for an equity-enhancing growth strategy (chapter IV) and an analysis of the priorities of social policies in an integrated approach to growth (chapter V). The final chapter adds some final institutional remarks.