Age and Life Course Location as Interpretive Resources for Decisions Regarding Disclosure of HIV to Parents and Children: Findings from the HIV and Later Life Study

Studies of disclosure among older people living with HIV (PLWH) are uninformed by critical social-gerontological approaches that can help us to appreciate how older PLWH see and treat age as relevant to disclosure of their HIV status. These approaches include an ethnomethodologically-informed social constructionism that explores how ‘the’ life course (a cultural framework depicting individuals’ movement through predictable developmental stages from birth to death) is used as an interpretive resource for determining self and others’ characteristics, capacities, and social circumstances: a process Rosenfeld and Gallagher (2002) termed ‘lifecoursing’. Applying this approach to our analysis of 74 life-history interviews and three focus groups with older (aged 50+) people living with HIV in the United Kingdom, we uncover the central role that lifecoursing plays in participants’ decision-making surrounding disclosure of their HIV to their children and/or older parents. Analysis of participants’ accounts uncovered four criteria for disclosure: the relevance of their HIV to the other, the other’s knowledge about HIV, the likelihood of the disclosure causing the other emotional distress, and the other’s ability to keep the disclosed confidential. To determine if these criteria were met in relation to specific children and/or elders, participants engaged in lifecoursing, evaluating the other’s knowledge of HIV, and capacity to appropriately manage the disclosure, by reference to their age. The use of assumptions about age and life-course location in decision-making regarding disclosure of HIV reflects a more nuanced engagement with age in the disclosure decision-making process than has been captured by previous research into HIV disclosure, including on the part of people aging with HIV.

Simulating Business Processes of Manufacturing SMEs on the Cloud

Simulating the efficiency of business processes could reveal crucial bottlenecks for manufacturing companies and could lead to significant optimizations resulting in decreased time to market, more efficient resource utilization, and larger profit. While such business optimization software is widely utilized by larger companies, SMEs typically do not have the required expertise and resources to efficiently exploit these advantages. The aim of this work is to explore how simulation software vendors and consultancies can extend their portfolio to SMEs by providing business process optimization based on a cloud computing platform. By executing simulation runs on the cloud, software vendors and associated business consultancies can get access to large computing power and data storage capacity on demand, run large simulation scenarios on behalf of their clients, analyze simulation results, and advise their clients regarding process optimization. The solution is mutually beneficial for both vendor/consultant and the end-user SME. End-user companies will only pay for the service without requiring large upfront costs for software licenses and expensive hardware. Software vendors can extend their business towards the SME market with potentially huge benefits.

“Esto es lo que me gusta y lo que voy a estudiar”: Un estudio cualitativo sobre la toma de decisiones académicas en bachillerato

Durante la educación secundaria los estudiantes comienzan a explorar las ocupaciones y expectativas profesionales, forman sus creencias de autoeficacia y consolidan sus intereses académicos. En este contexto, el artículo presenta los resultados de una investigación realizada en el Principado de Asturias para conocer las percepciones y opiniones que tienen los estudiantes de bachillerato y sus progenitores sobre las elecciones académicas realizadas en la educación secundaria, haciendo especial hincapié en los factores contextuales que pueden ayudar u obstaculizar el desarrollo de la carrera. Se ha usado una metodología cualitativa fundamentada en el uso de la técnica del grupo de discusión. Se han organizado cinco grupos de discusión con estudiantes y dos grupos con progenitores. El total de personas que participó en las entrevistas focales fue de 51 estudiantes y de 14 padres/madres. Los resultados obtenidos nos permiten concluir que el bachillerato sigue siendo considerado la puerta de acceso a la universidad y no a la formación profesional de grado superior. También se concluye que los estudiantes fundamentan sus decisiones académicas sobre la base de la preferencia y gusto personal por determinada opciones y esta razón prevalece sobre otras como las salidas profesionales o el rendimiento académico previo. Respecto a la influencia de distintos agentes sociales en el proceso de decisión académica, los resultados son concluyentes al afirmar que el principal apoyo de los estudiantes son sus progenitores, por encima del que perciben encontrar de docentes y grupo de iguales. El artículo finaliza con algunas sugerencias para mejorar la práctica de la orientación educativa en las instituciones de educación secundaria.

Development and Evaluation of a Computer-Based, Self-Management Tool for People Recently Diagnosed with Type 2 Diabetes

Aim. The purpose of this study was to develop and evaluate a computer-based, dietary, and physical activity self-management program for people recently diagnosed with type 2 diabetes. 
Methods. The computer-based program was developed in conjunction with the target group and evaluated in a 12-week randomised controlled trial (RCT). Participants were randomised to the intervention (computer-program) or control group (usual care). Primary outcomes were diabetes knowledge and goal setting (ADKnowl questionnaire, Diabetes Obstacles Questionnaire (DOQ)) measured at baseline and week 12. User feedback on the program was obtained via a questionnaire and focus groups. Results. Seventy participants completed the 12-week RCT (32 intervention, 38 control, mean age 59 (SD) years). After completion there was a significant between-group difference in the “knowledge and beliefs scale” of the DOQ. Two-thirds of the intervention group rated the program as either good or very good, 92% would recommend the program to others, and 96% agreed that the information within the program was clear and easy to understand. 
Conclusions. The computer-program resulted in a small but statistically significant improvement in diet-related knowledge and user satisfaction was high. With some further development, this computer-based educational tool may be a useful adjunct to diabetes self-management.

Recruiting faith and non-faith based schools, adolescents and parents to a cluster randomised sexual-health trial: experiences, challenges and lessons from the mixed-methods Jack Feasibility Trial

Background: The move toward evidence-based education has led to increasing numbers of randomised trials in schools. However, the literature on recruitment to non-clinical trials is relatively underdeveloped, when compared to that of clinical trials. Recruitment to school-based randomised trials is, however, challenging; even more so when the focus of the study is a sensitive issue such as sexual health. This article reflects on the challenges of recruiting post-primary schools, adolescent pupils and parents to a cluster randomised feasibility trial of a sexual health intervention, and the strategies employed to address them.
Methods: The Jack Trial was funded by the UK National Institute for Health Research (NIHR). It comprised a feasibility study of an interactive film-based sexual health intervention entitled If I Were Jack, recruiting over 800 adolescents from eight socio-demographically diverse post-primary schools in Northern Ireland. It aimed to determine the facilitators and barriers to recruitment and retention to a school-based sexual health trial and identify optimal multi-level strategies for an effectiveness study. As part of an embedded process evaluation, we conducted semi-structured interviews and focus groups with principals, vice-principals, teachers, pupils and parents recruited to the study as well as classroom observations and a parents’ survey.
Results: With reference to Social Learning Theory, we identified a number of individual, behavioural and environmental level factors which influenced recruitment. Commonly identified facilitators included perceptions of the relevance and potential benefit of the intervention to adolescents, the credibility of the organisation and individuals running the study, support offered by trial staff, and financial incentives. Key barriers were prior commitment to other research, lack of time and resources, and perceptions that the intervention was incompatible with pupil or parent needs or the school ethos.
Conclusions: Reflecting on the methodological challenges of recruiting to a school-based sexual health feasibility trial, this study highlights pertinent general and trial-specific facilitators and barriers to recruitment, which will prove useful for future trials with schools, adolescent pupils and parents.

IMPLEMENTING BACK PAIN TREATMENT PATHWAYS IN CLINICAL PRACTICE: QUALITATATIVE ANALYSIS OF STAKEHOLDER PERCEPTIONS

Background
Evidence-based practice advocates utilising best current research evidence, while reflecting patient preference and clinical expertise in decision making. Successfully incorporating this evidence into practice is a complex process. Based on recommendations of existing guidelines and systematic evidence reviews conducted using the GRADE approach, treatment pathways for common spinal pain disorders were developed.

Aims
The aim of this study was to identify important potential facilitators to the integration of these pathways into routine clinical practice.

Methods
A 22 person stakeholder group consisting of patient representatives, clinicians, researchers and members of relevant clinical interest groups took part in a series of moderated focus groups, followed up with individual, semi-structured interviews. Data were analysed using content analysis.

Results
Participants identified a number of issues which were categorized into broad themes. Common facilitators to implementation included continual education and synthesis of research evidence which is reflective of everyday practice; as well as the use of clear, unambiguous messages in recommendations. Meeting additional training needs in new or extended areas of practice was also recognized as an important factor. Different stakeholders identified specific areas which could be associated with successful uptake. Patients frequently defined early involvement in a shared decision making process as important. Clinicians identified case based examples and information on important prognostic indicators as useful tools to aiding decisions.

Conclusion
A number of potential implementation strategies were identified. Further work will examine the impact of these and other important factors on the integration of evidence-based treatment recommendations into clinical practice.

Applying the security-development nexus on the ground: Land restitution in Colombia

The general consensus on the security-development nexus is that both are key to achieving sustainable peace in war-torn societies. However, this debate has largely taken place among international actors, with little empirical evidence about how security and development relate to each other or are even considered by local actors. The current paper applies the security-development nexus to the case of land restitution in Colombia. Following decades of internal armed conflict, in 2012 the national government passed sweeping land restitution legislation amid on-going violence. Through in-depth interviews and focus groups with multiple actors involved in this process, ranging from international organizations to national government units, from regional institutions to local communities, the paper analyses the objectives, impact, challenges and opportunities for land restitution related to security and development. Undermining peacebuilding, a lack of coherence in the integration of security and development priorities limits the extent to which either supports, or is promoted by, land restitution efforts in Colombia. The paper concludes with reflections on how the security-development nexus may promote peacebuilding amid on-going conflict.

The role of Lean at the interface with between operations management and applied services within a large aerospace organisation: a boundary spanning perspective

Increased complexity in large design and manufacturing organisations requires improvements at the operations management (OM)–applied service (AS) interface areas to improve project effectiveness. The aim of this paper is explore the role of Lean in improving the longitudinal efficiency of the OM–AS interface within a large aerospace organisation using Lean principles and boundary spanning theory. The methodology was an exploratory longitudinal case approach including exploratory interviews (n = 21), focus groups (n = 2), facilitated action-research workshops (n = 2) and two trials or experiments using longitudinal data involving both OM and AS personnel working at the interface. The findings draw upon Lean principles and boundary spanning theory to guide and interpret the findings. It was found that misinterpretation, and forced implementation, of OM-based Lean terminology and practice in the OM–AS interface space led to delays and misplaced resources. Rather both OM and AS staff were challenged to develop a cross boundary understanding of Lean-based boundary (knowledge) objects in interpreting OM requests. The longitudinal findings from the experiments showed that the development of Lean Performance measurements and lean Value Stream constructs was more successful when these Lean constructs were treated as boundary (knowledge) objects requiring transformation over time to orchestrate improved effectiveness and in leading to consistent terminology and understanding between the OM–AS boundary spanning team.

En tolk ska översätta, det är inte som att vara en lärare : Hur upplever skolledare, tolkar, lärare och elever tolkningen i specialskolan?

I denna undersökning intervjuades en skolledare, två tolkar, en lärare och två fokusgrupper med elever om sin syn på tolkning inom specialskolan. Data från de semistrukturerade intervjuerna analyserades enligt en kvalitativ innehållsanalys där liknande svar samlas i temagrupper. Tre teman valdes ut till resultat och dessa är: 1. Information om tolkning 2. Tolken som samordnare 3. Tolkens roll. Information om tolkning handlar om vilken information eleverna får och behöver ha för att tolkningen ska fungera. Tolken som samordnare utgår från Wadensjös (1998) syn på samordning som en reglering av det tolkade samtalet som tolken måste sköta. Tolkens roll undersöktes med främst Metzgers (1999) fundering kring huruvida tolken kan vara neutral. Resultatet pekar på att skolledare och lärare anser att eleverna får mycket information om tolkning, men det tycker inte eleverna själva. Tolkarna anser att mer information behövs för en förståelse för tolkprocessen. Tolkens roll, som neutral och samordnande, är tydlig för tolkar och elever, men inte när det är en lärare som tolkar. Tolkning inom specialskolan är något naturligt som sker ofta och som upplevs fungera till största delen väl när det är tolkar som utför uppdragen.

Représentations des pratiques parentales, de la maltraitance et de la protection de la jeunesse : une comparaison entre parents québécois et colombiens

Au Canada, l’immigration est en augmentation depuis les 25 dernières années. À Québec, entre 1999 et 2008, les Colombiens ont été les plus nombreux à s’établir en tant que réfugiés. Cette augmentation de la diversité de la population n’est pas sans conséquences pour les institutions de santé publique. C’est vrai en particulier pour la protection de la jeunesse dans laquelle les familles migrantes et réfugiées sont surreprésentées. Il est par ailleurs reconnu que le processus d’acculturation entraine une transformation des rôles parentaux. De plus, des recherches ont établi un lien entre l’endossement de certaines valeurs, notamment celles axées sur la famille (familismo) et les rôles sexuels (machismo) pour expliquer les pratiques de parents migrants « latinos » et le rapport qu’elles entretiennent avec les institutions. Cette étude comparative a pour objectif d’explorer, à partir de la parole des premiers concernés, c’est-à-dire les parents, les représentations de leurs pratiques parentales, de la maltraitance et de la protection de la jeunesse. Cette exploration a été réalisée auprès de deux populations de parents : des parents québécois et colombiens ayant migrés à Québec. Un devis mixte impliquant des focus groups a été mis en place. Au total, 49 participants (Québécois : 30, 5 focus groups et Colombiens : 19, 4 focus groups) ont été rencontrés et ont rempli trois questionnaires. Ceux-ci mesurent le familismo, le machismo et l’acculturation. Les scores moyens de familismo, de machismo et d’acculturation ont été intégrés à l’analyse thématique. Il apparait que Québécois et Colombiens se différencient peu quant aux pratiques parentales et aux représentations de la maltraitance et de la protection de la jeunesse. Cependant, la question du développement de l’autonomie et de la réussite des enfants sont deux thèmes majeurs pour lesquels il y a des différences. La place qu’occupe l’État québécois, par l’intermédiaire du système de protection de la jeunesse dans la résolution des conflits, suscite également des discours contrastés. La place que ces personnes prennent dans la société devrait avoir un impact sur le fonctionnement des institutions quant à l’intervention et à la diffusion de l’information par rapport au système de la protection de la jeunesse.

Analisi e ottimizzazione del flusso di approvvigionamento in una produzione su commessa: il caso CT Pack S.r.l.

La tesi ha l'obiettivo di analizzare e ottimizzare i flussi di approvvigionamento in un'azienda che produce su commessa: CT Pack S.r.L, specializzata nella realizzazione di macchine automatiche per il packaging di biscotti, gelato e cioccolato. Per raggiungere l'obiettivo si è preso come riferimento il modello proposto dal BPR (Business Process Reengineering): sono stati analizzati i principali attori coinvolti, in particolare fornitori e magazzino, mediante l'uso di KPI definiti ad hoc. Sulla base di questi sono stati individuati due processi critici: il primo riguarda la gestione del magazzino, che presenta un'elevata quantità di codici non movimentati anche a causa del processo di gestione del materiale avanzato al termine di ciascuna commessa; il secondo riguarda il materiale a consumo, che impiega i magazzinieri per un tempo eccessivo, è caratterizzato da giacenze per il 30% non movimentate e da supermarket collocati in officina ridondanti e caratterizzati da bassi tassi di utilizzo (anche sotto il 50%). Per risolvere questi problemi ed effettuare una riprogettazione si fa affidamento agli strumenti proposti dal project management: si imposta quindi un progetto che ha l'obiettivo di ridurre nel breve periodo il valore di magazzino mediante lo smaltimento attraverso diverse vie di codici non utilizzati e agisce nel lungo periodo per evitare che le criticità si ripropongano. Mediante la riprogettazione della gestione dei resi di produzione si prevede un maggior controllo, grazie al lavoro congiunto di ufficio tecnico e ufficio acquisti. La nuova gestione del materiale a consumo ha in se alcune delle tecniche proposte dalla lean production (il kanban, per esempio) e integra il fornitore nella catena di approvvigionamento, garantendo un maggior controllo sulle quantità, un risparmio di circa 7 h/mese di lavoro per i magazzinieri e una riduzione delle giacenze del 46%.

Towards a Better Modelling and Assessment of Construction Risk: Insights from a Literature Review

This paper reviews the literature of construction risk modelling and assessment. It also reviews the real practice of risk assessment. The review resulted in significant results, summarised as follows. There has been a major shift in risk perception from an estimation variance into a project attribute. Although the Probability–Impact risk model is prevailing, substantial efforts are being put to improving it reflecting the increasing complexity of construction projects. The literature lacks a comprehensive assessment approach capable of capturing risk impact on different project objectives. Obtaining a realistic project risk level demands an effective mechanism for aggregating individual risk assessments. The various assessment tools suffer from low take-up; professionals typically rely on their experience. It is concluded that a simple analytical tool that uses risk cost as a common scale and utilises professional experience could be a viable option to facilitate closing the gap between theory and practice of risk assessment.

Anticipating future risk in social-ecological systems using fuzzy cognitive mapping: the case of wildfire in the Chiquitania, Bolivia

Understanding complex social-ecological systems, and anticipating how they may respond to rapid change, requires an approach that incorporates environmental, social, economic, and policy factors, usually in a context of fragmented data availability. We employed fuzzy cognitive mapping (FCM) to integrate these factors in the assessment of future wildfire risk in the Chiquitania region, Bolivia. In this region, dealing with wildfires is becoming increasingly challenging because of reinforcing feedbacks between multiple drivers. We conducted semistructured interviews and constructed different FCMs in focus groups to understand the regional dynamics of wildfire from diverse perspectives. We used FCM modelling to evaluate possible adaptation scenarios in the context of future drier climatic conditions. Scenarios also considered possible failure to respond in time to the emergent risk. This approach proved of great potential to support decision making for risk management. It helped identify key forcing variables and generate insights into potential risks and trade-offs of different strategies. The “Hands-off” scenario resulted in amplified impacts driven by intensifying trends, affecting particularly the agricultural production under drought conditions. The “Fire management” scenario, which adopted a bottom-up approach to improve controlled burning, showed less trade-offs between wildfire risk reduction and production compared with the “Fire suppression” scenario. Findings highlighted the importance of considering strategies that involve all actors who use fire, and the need to nest these strategies for a more systemic approach to manage wildfire risk. The FCM model could be used as a decision-support tool and serve as a “boundary object” to facilitate collaboration and integration of different perceptions of fire in the region. This approach also has the potential to inform decisions in other dynamic frontier landscapes around the world that are facing increased risk of large wildfires.

Values and Beliefs Held About Parenting and Education by School Staff and Parents of Pupils with Special Educational Needs in the Context of Home- School Collaboration

Effective collaboration between school staff and parents of children identified as having special educational needs is considered to be an essential component of the child’s successful education. Differences in beliefs and perspectives adopted by the school staff and parents play an important role in the process of collaboration. However, little is known about the precise relationship between the beliefs and the process of collaboration. The purpose of this study was to explore the values and beliefs held by the school staff and parents in the areas of parenting and education. The study also explored the link between these beliefs and the process of collaboration within four parent-teacher dyads from mainstream primary schools. Focus groups and semi-structured interviews based on repertory grid technique were used. The findings highlighted an overall similarity in the participants’ views on collaboration and in their important beliefs about parenting and education. At the same time, differences in perspectives adopted by parents and teachers were also identified. The author discusses how these differences in perspectives are manifested in the process of collaboration from the point of Cultural Capital Theory. The factors such as power differentials, trust between parents and teachers, and limited resources and constraints of educational system are highlighted. Implication for practice for teachers and educational psychologists are discussed.

Os programas de incentivo à cultura e o processo de fomento às organizações culturais no Rio Grande do Norte: o caso da Casa da Ribeira em Natal

Since the emergence of the first demands for actions that were intended to give greater attention to culture in Brazil, came the first discussions which concerned the way the Brazilian government could have a positive influence in encouraging the culture, as is its interaction with the actors interested and involved with the cause. During the military dictatorship, there were programs which relied on the direct participation of the State to ensure that right, from the viewpoint of its support and implementation of public resources in developing the "cultural product" to be brought to society in its various forms of expression - all this, funded by the government. It is an example of "EMBRAFILMES" and "Projeto Seis e Meia", continued until the present day in some regions of the country, though maintained by entities not directly connected with the administration or the government. However, it was from the period of democratization and the end of the dictatorship that the Brazilian government began to look at the different culture, under its guarantee to the society. Came the first incentive laws, led by "Lei Sarney" Nº 7.505/86, which was culture as a segment which could receive foreign assistance in order to assist the government in fulfilling its public duty. After Collor era and the end of the embargo through the encouragement of culture incentive laws, consolidated the incentive model proposed in advance of Culture "Lei Sarney" and the federal laws, state and local regimentares as close to this action. This applies to the Rouanet Law (Lei Rouanet), Câmara Cascudo Law (Lei Câmara Cascudo) and Djalma Maranhão Cultural Incentive Law (Lei de Incentivo à Cultura Djalma Maranhão), existing in Natal and Rio Grande do Norte. Since then, business entities could help groups and cultural organizations to keep their work from the political sponsorship under control and regiment through the Brazilian state in the form of their Cultural Incentive Law. This framework has contributed to the strengthening of NGOs and with the consolidation of these institutions as the linchpin of Republican guaranteeing the right to access to culture, but corporate social responsibility was the one who took off in the segment treated here, through the actions of Responsibility Cultural enterprises arising from the Cultural Organizations. Therefore, in the face of this discourse, this study ascertains the process of encouraging the Culture in Rio Grande do Norte from the Deviant Case Analysis at the Casa da Ribeira, the main Cultural Organization that operates, focused action in Natal in order to assess the relationships established between the same entity and the institutions which are entitled to maintain the process of encouraging treated in this study - Enterprise, from the viewpoint of corporate sponsorship and Cultural Responsibility and State in the form of the Laws Incentive Funds and Public Culture Incentive