Pathologies of Patriarchy: Death, Suffering, Care and Coping in the Gendered Gaps of HIV/AIDS Interventions in Nigeria

Thesis (Ph.D.)--University of Washington, 2016-08

Exploring value propositions and service innovation : a service-dominant logic study

This paper presents an eight-firm study, conducted from the service-dominant logic perspective, which makes a contribution regarding knowledge of the anatomy of value propositions and service innovation. The paper suggests that value propositions are configurations of several different practices and resources. The paper finds that ten common practices, organized in three main aggregates, constitute and fulfill value propositions: i.e. provision practices, representational practices, and management and organizational practices. Moreover, the paper suggests that service innovation can be equated with the creation of new value propositions by means of developing existing or creating new practices and/or resources, or by means of integrating practices and resources in new ways. It identifies four types of service innovation (adaptation, resource-based innovation, practice-based innovation, and combinative innovation) and three types of service innovation processes (practice-based, resource-based, and combinative). The key managerial insight provided by the paper is that service innovation must be conducted and value propositions must be evaluated from the perspective of the customers’ value creation, the service that the customer experiences. Successful service innovation is not only contingent on having the right resources, established methods and practices for integrating these resources into attractive value propositions are also needed.

L'accessibilité aux services de physiothérapie en clinique externe dans les centres hospitaliers du Québec

Des contraintes d’accessibilité aux services de physiothérapie en clinique externe ont été rapportées dans les établissements publics au Canada. Celles-ci se traduisent souvent par un temps d’attente élevé avant d’obtenir des services. Différentes stratégies ont été proposées afin de gérer les listes d’attente, mais leur impact sur le temps d’attente est méconnu, notamment dans le contexte des services de physiothérapie au Québec. Le but de cette étude était de documenter l’accessibilité aux services de physiothérapie en clinique externe dans les centres hospitaliers au Québec. Les objectifs spécifiques étaient de 1) décrire les caractéristiques organisationnelles en lien avec l’accessibilité aux services de physiothérapie, 2) quantifier le temps d’attente pour accéder aux services et 3) explorer l’association entre les caractéristiques organisationnelles et le temps d’attente. Une enquête a été réalisée dans les cliniques externes de physiothérapie des centres hospitaliers publics du Québec offrant des services à des adultes souffrant de troubles musculosquelettiques. Des données ont été obtenues auprès de 97 (99%) centres hospitaliers. Au moment de l’enquête, 18 245 personnes étaient sur les listes d’attente. Le temps d’attente médian était de plus de six mois dans 41% des centres hospitaliers. Parmi les pratiques organisationnelles et les stratégies de gestion de listes d’attente évaluées, les politiques en cas d’annulation ou d’absence (99%) et la priorisation des demandes (96%) étaient les plus utilisées. Selon les résultats d’analyses multivariées, seule l’utilisation d’une méthode de priorisation comprenant une rencontre d’évaluation et une intervention initiale était associée au temps d’attente (p=0,008). Les résultats de cette étude démontrent qu’une grande quantité de personnes sont inscrites sur les listes d’attente des services de physiothérapie et que le temps d’attente peut être très élevé. D’après nos résultats, l’implantation d’une méthode de priorisation comprenant une évaluation et une intervention pourrait permettre d’améliorer l’accès en temps opportun aux services de physiothérapie.

THE INTERPLAY PERFORMANCE PRACTICE: PLAY AND SOCIAL CHANGE IN LATE CAPITALISM

Practitioners of the performance form “InterPlay” utilize dance, storytelling and song to build community and generate social change. I elucidate how this community of practitioners conceptualizes “social change.” I argue that the InterPlay social movement organizes around the application of play to performances of self in everyday life. I explore how the InterPlay non-profit corporation, Body Wisdom Inc., employs this technique to address racial justice in its organizational practices. I also examine how practitioners understand their use of this performance play in places of work, concluding that—even in these endeavors—they see social change as a process immanent to both individual people and the systems they create, not as the intervention of an autonomous external power. Ultimately, I argue that, within late capitalism, play should no longer be conceptualized as an activity separate from everyday sociality but as an immanent process of change constitutive of a socioaesthetic domain.

Gestão Social em Empreendimentos Econômicos Solidários: uma abordagem no Oeste Potiguar

The central research question was to search for data to ratify the theory and discourse of the so-called practitioners of economic solidarity, by defending the substantive rationality should guide the principles of economic solidary, designing the space economy incidental and not the primacy of relations in determining social as well, reflecting the predominance of dimensions of social management in administrative practices of ESS's. For both analyzed the theoretical dimensions of social management - sociopolitical, economic, organizational and environmental - manifested in organizational practices supportive of economic organization Potiguar West. For the success of the research realized the triangulation involving a combination of quantitative and qualitative methodological approaches. At first the research will use a quantitative approach, from the cluster analysis, to verify the behavior of the sample chosen for this study. In the second stage of the qualitative study was carried out focus group technique (FLICK, 2002) for further analysis of the dimensions of social management on organizational practices supportive of economic organization, related to the principles of Solidary Economy, established in a quantitative approach. In quantitative analysis, the socio-political dimension, it was clear that the more equity instruments of internal and external, from the purposeful living in public spaces, the best monetary results. Another point worth stressing concerns the economic dimension, with the practice reciprocity prevailing in market. Thus, the qualitative approach was possible to understand the processes of exchange of product or service. Rural enterprises surveyed in the allocation of the agro-ecological products have the following scale of priority, sequentially: self-consumption (domestic), market and exchange. The research leads to the fact that training and practices that enhance the socio-political dimension (knowledge, empowerment, sense of belonging) become the guiding principle for the strengthening of the social management in the context of other dimensions, leading to gains sociopolitical, economic, organizational and environmental. Despite the weaknesses found in the organizational dimension and environment, both in a quantitative as in qualitative, we determined that the practices of ESS's Potiguar West incorporate predominantly elements of social management and economic solidarity, with a preponderance of substantive rationality in the primacy of the instrumental. Finally, research has brought information that the participants of the ESS's do not give the money economy primacy in determining social relations, which in turn leads to the confirmation that, in practice the solidarity economy, prevailing the dominance of substantive rationality, as a guide for organizational practices

Être médecin diplômé à l’étranger au Québec : des parcours contrastés d’intégration professionnelle

En 2015, il y aurait au Québec plus de 5 000 médecins diplômés à l’étranger, dont près de 2 500 travaillent comme médecins et possiblement autant qui ont emprunté d’autres voies professionnelles, momentanément ou durablement. Les migrants très qualifiés sont réputés faire face à de multiples barrières sur le marché du travail, particulièrement ceux membres de professions réglementées. Le cas des médecins est exemplaire compte tenu de sa complexité et de la multiplicité des acteurs impliqués au cours du processus de reconnaissance professionnelle. Ayant comme principal objectif de documenter les trajectoires d’intégration professionnelle de diplômés internationaux en médecine (DIM) et leurs expériences sur le marché du travail québécois, cette thèse s’attache à comprendre ce qui pourrait distinguer les trajectoires d’intégration en emploi pour un même groupe professionnel. En observant notamment les stratégies d’intégration et les ressources mobilisées, nous cherchons à mieux saisir les parcours des DIM qui se requalifient et qui exercent au Québec et ceux qui se réorientent vers d’autres secteurs d’activités. La démarche méthodologique est qualitative (terrain 2009 à 2012), le cœur des analyses étant basé sur 31 récits de vie professionnelle de DIM ayant migré au Québec principalement dans les années 2000. Les données secondaires incluent 22 entretiens non dirigés auprès d’acteurs clés de milieux institutionnels, communautaires ou associatifs ainsi qu’auprès de DIM très récemment immigrés ou ayant le projet d’immigrer. S’y ajoute l’observation ethnographique ponctuelle, telle que des activités associatives. La forme retenue pour cette thèse en est une par articles. Le fil directeur est l’exploration de l’interface entre les politiques, les pratiques et les individus au cœur des trajectoires d’intégration professionnelle. Les trois articles (chapitres 4 à 6) visent des focales complémentaires avec le même objectif : l’exploration de la complexité des trajectoires d’intégration professionnelle et la dialectique entre les niveaux micro, méso et macrosociaux. Ces derniers renvoient respectivement à la puissance d’agir des individus et leurs contraintes d’action, les relations sociales, les institutions et les pratiques organisationnelles et plus largement les structures sociopolitiques. Les résultats de cette thèse mettent en lumière des aspects complémentaires de l’intégration professionnelle et en interaction dynamique : 1) dimension macrosociale et politique; 2) dimensions institutionnelles et relations sociales; 3) identité professionnelle. Suite à l’introduction, la problématique (chap. 1) et la méthodologie (chap.2), le chapitre 3 expose les types des trajectoires d’intégration des DIM, leur hétérogénéité, et met en relief leurs récits de vie professionnelle. Le chapitre 4 soulève le paradoxe entre les politiques d’attraction de l’immigration déployés par les gouvernements canadien et québécois et les mécanismes de régulation opérant sur le marché du travail. Le chapitre 5 explore les stratégies et ressources mobilisées par les DIM et met en lumière l’effet positif des ressources symboliques. Les ressources institutionnelles de soutien, quoique élémentaires dans le processus de reconnaissance professionnelle, ne sont subjectivement pas considérées comme un élément central. Ce sont plutôt les ressources informelles qui jouent ce rôle d’appui significatif, en particulier les pairs DIM. Le chapitre 6 adopte une perspective microsociale et explore le caractère dynamique et relationnel de l’identité professionnelle, mais surtout, la puissance des conditions d’appartenance qui obligent à une flexibilité professionnelle et parfois au retrait de la profession ou du pays. Le chapitre 7 discute au plan théorique de l’intérêt d’une combinaison d’échelles analytiques et d’une ouverture disciplinaire afin de souligner les tensions et angles morts en ce qui concerne les mobilités de professionnels de la santé et leur intégration professionnelle. Cette thèse explore l’interrelation complexe entre les ressources économiques, sociales et symboliques, dans un contexte de fragmentation des ressources institutionnelles et de corporatisme.

Resposta coletiva compassiva: Impacto de estrutura e missão organizacional

A capacidade coletiva compassiva tem claras implicações no desempenho e no bem-estar dos indivíduos no contexto organizacional (Lilius, Worline, Maitlis, Kanov, Dutton, & Frost, 2008). O presente estudo tem como objetivo descrever a forma como o efeito combinado de práticas e características de flexibilização de estrutura organizacional contribuem para o aumento de respostas coletivas compassivas (RCC) em organizações com missão pró-social, quando comparadas com organizações cuja missão é focada na produtividade. Este objetivo tem como pressuposto que todas as organizações, independentemente da sua missão (pró-social vs. produtiva), podem ter a capacidade de se auto-organizar de forma compassiva para minimizar o sofrimento dos colaboradores, embora o possam fazer através de mecanismos diferentes. Esta resposta poderá, contudo, ser mais facilitada nas organizações com uma estrutura flexível e com valores culturais humanizados.

El Coaching y el Liderazgo en las Organizaciones

Los estudios de liderazgo han abordado la interacción que existe entre el sujeto denominado líder y sus seguidores. Dentro de dicha relación se han estudiado las habilidades del líder y su impacto como coach. Hoy en día se pueden evidenciar un sinnúmero de estudios y aproximaciones en torno al término coaching, concepto, marcos teóricos, modelos, etc… En el presente artículo se hará un proceso investigativo en el que se define coaching desde el punto de vista de varios autores, expertos y managers que se desarrollan en el ámbito empresarial para poder encontrar una definición que comprenda las dimensiones del mundo organizacional, A continuación, se hará una búsqueda sistemática de las definiciones de coaching y a partir de esta búsqueda se propondrá una definición integradora que dé cuenta de los diversos ámbitos del estudio del liderazgo. Al revisar la terminología en cuanto a liderazgo y coaching, junto con su relación directa no hay una definición que realmente abarque todo el tema organizacional que implica estas dos palabras.

Enablers and barriers to the organizational adoption of sustainable business practices

Individuals, organizations, and governments are increasingly becoming aware of the necessity of sustainability in living, organizing, performing, and managing work. In this context, “green IS” has become an established colloquial term, acknowledging that information technology, corporate information systems, and the surrounding practices are both a contributor to the sustainability challenge and a potential enabler for green and sustainable practices. To date, however, there are few reported studies on the role of information systems for the challenge, and solution, of sustainability. This paper presents results from a case study of a world-wide operating IT software solution provider that is engaged in the development and adoption of sustainable practices. Our study suggests that the adoption of sustainable practices comes along with a number of particularities. We found information technology to be a key enabler of transparency about the progress of sustainability operations. We further found personal, motivator factors as well as organizational factors such as business inclusion, strategy definition, and a dialectic top-management and bottom-up support, to play a role in enabling a company to manage their sustainability. We describe a set of conjectures forthcoming from our case analysis, and detail some implications for further research in this area.

Navigating a complex organizational landscape : leadership challenges and practices

This paper discusses exploratory research to identify the reported leadership challenges faced by leaders in the public sector in Australia and what specific leadership practices they engage in to deal with these challenges. Emerging is a sense that leadership in these complex work environments is not about controlling or mandating action but about engaging in conversation, building relationships and empowering staff to engage in innovative ways to solve complex problems. In addition leaders provide a strong sense of purpose and identity to guide behaviour and decisions to overcome being overwhelmed by the sheer volume of demands in a unpredictable and often unsupportive environment. Questions are raised as to the core competencies leaders need to develop to drive and underpin these leadership practices and the implications this has for the focus on future leadership development programmes. The possible direction of a future research programme will be put forward for further discussion.

Balancing organizational and professional commitments in professional service firms : the HR practices that matter

Due to their potential to positively influence sales quality and performance and reduce employee turnover in service organizations, HR practices targeting employee commitment have received considerable attention in the HRM literature in recent years. Parallel to this, there has been increasing focus on the nature of commitment, and in particular the existence of multiple commitment foci. In this paper, we examine how HR practices influence professionals' commitment to their organization, to their profession or to both organization and profession, in a qualitative study of three Danish financial investment firms. Our findings suggest that in professional service firms, HR practices encourage high levels of organizational commitment primarily and most often through their influence on professional commitment and that HR practices related to flexible work design are essential in creating balance between an employee's commitment to organization and commitment to their profession. Further, the findings suggest that these same HR practices may foster such high levels of professional commitment that labor turnover will increase when opportunities for pursuing professional goals afforded by work design are restricted.

Designing with people with disabilities : adapting best practices of DIY and organizational approaches

Individualization of design is often necessary particularly when designing with people with disabilities. Maker communities, with their flexible Do-It-Yourself (DIY) practices, offer potential to support individualized and cost-effective product design. However, efforts to adapt DIY practices in designing with people with disabilities tend to face difficulties with regard to continuous commitment, infrastructure provision and proper guidance. We carried out interviews with diverse stakeholders in the disability services sector and carried out observations of local makerspaces to understand their current practices and potential for future collaborations. We found that makerspace participants face difficulties in terms of infrastructure provision and proper guidance whereas Disability Service Organizations face difficulties in continuous expertise. We suggest that artful infrastructuring to blend the best of both approaches offers potential to create a sustainable community that can design individualized technologies to support people with disabilities.

Organizational culture predicts job satisfaction and perceived clinical effectiveness in pediatric primary care practices

Background: In recent years, there has been a growing understanding that organizational culture is related to an organization's performance. However, fewstudies have examined organizational culture in medical group practices. Objectives: The purpose of this study was to examine the relationship of organizational culture on provider job satisfaction and perceived clinical effectiveness in primary care pediatric practices. Research Design: This cross-sectional study included 36 primary care pediatric practices located in Connecticut. Participants: There were 374 participants in this study, which included 127 clinicians and 247 nonclinicians. Measures: Office managers completed a questionnaire that recorded staff and practice characteristics; all participants completed the Organizational Culture Scale, a questionnaire that assessed the practice on four cultural domains (i.e., group, developmental, rational, and hierarchical), and the Primary Care Organizational Questionnaire that evaluated perceived effectiveness and job satisfaction. Results: Hierarchical linear models using a restricted maximum likelihood estimation method were used to evaluate whether the practice culture types predicted job satisfaction and perceived effectiveness. Group culture was positively associated with both satisfaction and perceived effectiveness. In contrast, hierarchical and rational culture were negatively associated with both job satisfaction and perceived effectiveness. These relationships were true for clinicians, nonclinicians, and the practice as a whole. Conclusions: Our study demonstrates that practice culture is associated with job satisfaction and perceived clinical effectiveness and that a group culture was associated with high job satisfaction and perceived effectiveness. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Self-reported teamwork in family health team practices in Ontario:Organizational and cultural predictors of team climate

Objective: To determine the organizational predictors of higher scores on team climate measures as an indicator of the functioning of a family health team (FHT). Design: Cross-sectional study using a mailed survey. Setting: Family health teams in Ontario. Participants: Twenty-one of 144 consecutively approached FHTs; 628 team members were surveyed. Main outcome measures: Scores on the team climate inventory, which assessed organizational culture type (group, developmental, rational, or hierarchical); leadership perceptions; and organizational factors, such as use of electronic medical records (EMRs), team composition, governance of the FHT, location, meetings, and time since FHT initiation. All analyses were adjusted for clustering of respondents within the FHT using a mixed random-intercepts model. Results: The response rate was 65.8% (413 of 628); 2 were excluded from analysis, for a total of 411 participants. At the time of survey completion, there was a median of 4 physicians, 11 other health professionals, and 4 management and clerical staff per FHT. The average team climate score was 3.8 out of a possible 5. In multivariable regression analysis, leadership score, group and developmental culture types, and use of more EMR capabilities were associated with higher team climate scores. Other organizational factors, such as number of sites and size of group, were not associated with the team climate score. Conclusion: Culture, leadership, and EMR functionality, rather than organizational composition of the teams (eg, number of professionals on staff, practice size), were the most important factors in predicting climate in primary care teams.

Organizational Attributes of Practices Successful at a Disease Management Program

Objective: To assess the contribution of organizational factors to implementation of 3 asthma quality measures: enrollment in a disease management program, development of a written treatment plan, and prescription of severity-appropriate anti-inflammatory therapy. Study design: A total of 138 pediatric clinicians and 247 office staff in 13 urban clinics and 23 nonurban private practices completed questionnaires about their practice's organizational characteristics (eg, leadership, communication, perceived effectiveness, job satisfaction). Results: 94% of the clinicians and 92% of the office staff completed questionnaires. When adjusted for confounders, greater practice activity and perceived effectiveness in meeting family needs were associated with higher rates of enrollment in the Easy Breathing program, whereas higher scores for 3 organizational characteristics-communication timeliness, decision authority, and job satisfaction-were associated with both higher enrollment and a greater number of written treatment plans. None of the organizational characteristics was associated with greater use of anti-inflammatory therapy. Conclusions: Three organizational characteristics predicted 2 quality asthma measures: use of a disease management program and creation of a written asthma treatment plan. If these organizational characteristics were amenable to change, then our findings could help focus interventions in areas of effective and acceptable organizational change. © 2009 Mosby, Inc. All rights reserved.