A study protocol for a pilot randomised trial of a structured education programme for the self-management of type 2 diabetes for adults with intellectual disabilities

BACKGROUND: The need for structured education programmes for type 2 diabetes is a high priority for many governments around the world. One such national education programme in the United Kingdom is the DESMOND Programme, which has been shown to be robust and effective for patients in general. However, these programmes are not generally targeted to people with intellectual disabilities (ID), and robust evidence on their effects for this population is lacking. We have adapted the DESMOND Programme for people with ID and type 2 diabetes to produce an amended programme known as DESMOND-ID. This protocol is for a pilot trial to determine whether a large-scale randomised trial is feasible, to test if DESMOND-ID is more effective than usual care in adults with ID for self-management of their type 2 diabetes, in particular as a means to reduce glycated haemoglobin (Hb1Ac), improve psychological wellbeing and quality of life and promote a healthier lifestyle. This protocol describes the rationale, methods, proposed analysis plan and organisational and administrative details.

METHODS/DESIGN: This trial is a two arm, individually randomised, pilot trial for adults with ID and type 2 diabetes, and their family and/or paid carers. It compares the DESMOND-ID programme with usual care. Approximately 36 adults with mild to moderate ID will be recruited from three countries in the United Kingdom. Family and/or paid carers may also participate in the study. Participants will be randomly assigned to one of two conditions using a secure computerised system with robust allocation concealment. A range of data will be collected from the adults with ID (biomedical, psychosocial and self-management strategies) and from their carers. Focus groups with all the participants will assess the acceptability of the intervention and the trial.

DISCUSSION: The lack of appropriate structured education programmes and educational materials for this population leads to secondary health conditions and may lead to premature deaths. There are significant benefits to be gained globally, if structured education programmes are adapted and shown to be successful for people with ID and other cognitive impairments.

TRIAL REGISTRATION: Registered with International Standard Randomised Controlled Trial (identifier: ISRCTN93185560 ) on 10 November 2014.

Studying administrative reforms through textual analysis: the case of Italian central government accounting

This paper contributes to the literature on public-sector reforms by proposing textual analysis as a useful research strategy to explore how reform archetypes and related ideas are deployed in the parliamentary debate and regulations advancing reforms. Public Administration (PA) (Wilson 1887; Weber 1922), New Public Management (NPM) (Hood 1991, 1995; Dunleavy and Hood 1994; Ferlie et al. 1996) and Public Governance (GOV) (Osborne 2010; Rhodes 1997) can be depicted as three different archetypes providing characteristic administrative ideas and concepts (i.e. interpretive schemes) and related tools and practices (i.e. structures and systems) which lead reforms. We use textual analysis to look into more than twenty years of Italian central government accounting reforms and investigate how the three administrative archetypes have evolved, intertwined and replaced each other. Textual analysis proves a useful tool to investigate reform processes and allows highlighting that in neo-Weberian countries, such as Italy, NPM and GOV, far from being revolutionary paradigms, may represent fashionable trends that did not leave significant traces in the practice and rhetoric of reforms. These results also suggest interesting implications for practitioners and policy makers.

Sharing services, saving money? Five risks to cost saving when organizations share administrative services

Shared services are a popular reform for governments under financial pressure. The hope is to reduce overheads and increase efficiency by providing support services like HR, finance and procurement once to multiple agencies. Drawing on insights from organization theory and political science, we identify five risks that shared services won’t live up to current expectations. We illustrate each with empirical evidence from the UK, Ireland and further afield, and conclude with suggestions on how to manage these risks.

Institutional Hybridity in Public Sector Reform: Replacement, Blending, or Layering of Administrative Paradigms

Despite an abundance of studies on hybridization and hybrid forms of organizing, scholarly work has failed to distinguish consistently between specific types of hybridity. As a consequence, the analytical category has become blurred and lacks conceptual clarity. Our paper discusses hybridity as the simultaneous appearance of institutional logics in organizational contexts, and differentiates the parallel co-existence of logics from transitional combinations (eventually leading to the replacement of a logic) and more robust combinations in the form of layering and blending. While blending refers to hybridity as an ‘amalgamate’ with original components that are no longer discernible, the notion of layering conceptualizes hybridity in a way that the various elements, or clusters thereof, are added on top of, or alongside, each other, similar to sediment layers in geology. We illustrate and substantiate such conceptual differentiation with an empirical study of the dynamics of public sector reform. In more detail, we examine the parliamentary discourse around two major reforms of the Austrian Federal Budget Law in 1986 and in 2007/2009 in order to trace administrative (reform) paradigms. Each of the three identified paradigms manifests a specific field-level logic with implications for the state and its administration: bureaucracy in Weberian-style Public Administration, market-capitalism in New Public Management, and democracy in New Public Governance. We find no indication of a parallel co-existence or transitional combination of logics, but hybridity in the form of robust combinations. We explore how new ideas fundamentally build on – and are made resonant with – the central bureaucratic logic in a way that suggests layering rather than blending. The conceptual findings presented in our article have implications for the literature on institutional analysis and institutional hybridity.

Challenges and Opportunities in Healthcare Volunteer Management: Insights from Volunteer Administrators

Volunteer administrators from 105 hospitals in five states in the northeast and southern United States provided open-ended survey responses about what they perceived to be the most pressing challenges and opportunities facing healthcare volunteer management. Taken together, these 105 hospitals used a total of 39,008 volunteers and 5.3 million volunteer hours during a 12-month period between 2010 and 2011. A qualitative content analysis of administrator responses suggests that primary challenges include volunteer recruitment and retention, administrative issues, and operational difficulties brought about by the current economic crisis. Key opportunities include more explicitly linking the volunteer function to hospital outcomes and community impact, expanding volunteer recruitment pools and roles and jobs, and developing organizational support for volunteers and making the volunteer management function more efficient and effective.

Aplicação da filosofia Lean management:caso de estudo, aplicado à manutenção de edifícios

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia da Manutenção

Knowledge management in higher education institutions: a framework to improve collaboration

The purpose of this paper is to present a framework that increases knowledge sharing and collaboration in Higher Education Institutions. The paper discusses the concept of knowledge management in higher education institutions, presenting a systematization of knowledge practices and tools to linking people (students, teachers, researchers, secretariat staff, external entities)and promoting the knowledge sharing across several key processes and services in a higher education institution, such as: the research processes, learning processes, student and alumni services, administrative services and processes, and strategic planning and management. The framework purposed in this paper aims to improve knowledge practices and processes which facilitate an environment and a culture of knowledge collaboration,sharing and discovery that should characterize an institution of higher education.

Regional differences in self-reported screening, prevalence and management of cardiovascular risk factors in Switzerland.

BACKGROUND: In Switzerland, health policies are decided at the local level, but little is known regarding their impact on the screening and management of cardiovascular risk factors (CVRFs). We thus aimed at assessing geographical levels of CVRFs in Switzerland.¦METHODS: Swiss Health Survey for 2007 (N = 17,879). Seven administrative regions were defined: West (Leman), West-Central (Mittelland), Zurich, South (Ticino), North-West, East and Central Switzerland. Obesity, smoking, hypertension, dyslipidemia and diabetes prevalence, treatment and screening within the last 12 months were assessed by interview.¦RESULTS: After multivariate adjustment for age, gender, educational level, marital status and Swiss citizenship, no significant differences were found between regions regarding prevalence of obesity or current smoking. Similarly, no differences were found regarding hypertension screening and prevalence. Two thirds of subjects who had been told they had high blood pressure were treated, the lowest treatment rates being found in East Switzerland: odds-ratio and [95% confidence interval] 0.65 [0.50-0.85]. Screening for hypercholesterolemia was more frequently reported in French (Leman) and Italian (Ticino) speaking regions. Four out of ten participants who had been told they had high cholesterol levels were treated and the lowest treatment rates were found in German-speaking regions. Screening for diabetes was higher in Ticino (1.24 [1.09 - 1.42]). Six out of ten participants who had been told they had diabetes were treated, the lowest treatment rates were found for German-speaking regions.¦CONCLUSIONS: In Switzerland, cardiovascular risk factor screening and management differ between regions and these differences cannot be accounted for by differences in populations' characteristics. Management of most cardiovascular risk factors could be improved.

La Commission administrative et la modernisation des structures politiques et administratives de Montréal, 1918-1921

Ce mémoire revient sur la première tutelle de la Ville de Montréal, imposée par le gouvernement provincial de 1918 à 1921. Pour l’occasion, le Lieutenant-gouverneur du Québec nomme cinq administrateurs afin de gérer les affaires courantes de la municipalité. Peu connu des historiens et du public, cet événement suscite des changements profonds dans les structures politiques et administratives de la Ville qui laissent des empreintes dans la vie quotidienne actuelle des Montréalais. Puisqu’ils ne sont pas redevables devant la population, les commissaires mettent en œuvre plusieurs réformes souvent impopulaires qui permettent de rétablir l’équilibre budgétaire de la Ville. Au passage, ils tentent de moderniser l’administration municipale dont le fonctionnement est jusque-là incompatible avec les réalités d’une population grandissante et d’un espace urbain accru par les nombreuses annexions. Notre étude souligne les réformes implantées par la Commission administrative au niveau de la fiscalité, de l’organisation des services municipaux et des politiques d'urbanisme. Elles s’inspirent de réformes mises en œuvre dans plusieurs villes nord-américaines de grande taille. Durant leur mandat, les nouveaux administrateurs cherchent à imposer un modèle d’administration s’inspirant de grandes entreprises privées et réussissent à réduire de manière substantielle le déficit de la Ville. Enfin, une attention particulière est accordée à la fin du mandat de la Commission administrative et au régime administratif qui lui fait suite.

Autonomes Performance-Management in dienstorientierten Architekturen

Die Bedeutung des Dienstgüte-Managements (SLM) im Bereich von Unternehmensanwendungen steigt mit der zunehmenden Kritikalität von IT-gestützten Prozessen für den Erfolg einzelner Unternehmen. Traditionell werden zur Implementierung eines wirksamen SLMs Monitoringprozesse in hierarchischen Managementumgebungen etabliert, die einen Administrator bei der notwendigen Rekonfiguration von Systemen unterstützen. Auf aktuelle, hochdynamische Softwarearchitekturen sind diese hierarchischen Ansätze jedoch nur sehr eingeschränkt anwendbar. Ein Beispiel dafür sind dienstorientierte Architekturen (SOA), bei denen die Geschäftsfunktionalität durch das Zusammenspiel einzelner, voneinander unabhängiger Dienste auf Basis deskriptiver Workflow-Beschreibungen modelliert wird. Dadurch ergibt sich eine hohe Laufzeitdynamik der gesamten Architektur. Für das SLM ist insbesondere die dezentrale Struktur einer SOA mit unterschiedlichen administrativen Zuständigkeiten für einzelne Teilsysteme problematisch, da regelnde Eingriffe zum einen durch die Kapselung der Implementierung einzelner Dienste und zum anderen durch das Fehlen einer zentralen Kontrollinstanz nur sehr eingeschränkt möglich sind. Die vorliegende Arbeit definiert die Architektur eines SLM-Systems für SOA-Umgebungen, in dem autonome Management-Komponenten kooperieren, um übergeordnete Dienstgüteziele zu erfüllen: Mithilfe von Selbst-Management-Technologien wird zunächst eine Automatisierung des Dienstgüte-Managements auf Ebene einzelner Dienste erreicht. Die autonomen Management-Komponenten dieser Dienste können dann mithilfe von Selbstorganisationsmechanismen übergreifende Ziele zur Optimierung von Dienstgüteverhalten und Ressourcennutzung verfolgen. Für das SLM auf Ebene von SOA Workflows müssen temporär dienstübergreifende Kooperationen zur Erfüllung von Dienstgüteanforderungen etabliert werden, die sich damit auch über mehrere administrative Domänen erstrecken können. Eine solche zeitlich begrenzte Kooperation autonomer Teilsysteme kann sinnvoll nur dezentral erfolgen, da die jeweiligen Kooperationspartner im Vorfeld nicht bekannt sind und – je nach Lebensdauer einzelner Workflows – zur Laufzeit beteiligte Komponenten ausgetauscht werden können. In der Arbeit wird ein Verfahren zur Koordination autonomer Management-Komponenten mit dem Ziel der Optimierung von Antwortzeiten auf Workflow-Ebene entwickelt: Management-Komponenten können durch Übertragung von Antwortzeitanteilen untereinander ihre individuellen Ziele straffen oder lockern, ohne dass das Gesamtantwortzeitziel dadurch verändert wird. Die Übertragung von Antwortzeitanteilen wird mithilfe eines Auktionsverfahrens realisiert. Technische Grundlage der Kooperation bildet ein Gruppenkommunikationsmechanismus. Weiterhin werden in Bezug auf die Nutzung geteilter, virtualisierter Ressourcen konkurrierende Dienste entsprechend geschäftlicher Ziele priorisiert. Im Rahmen der praktischen Umsetzung wird die Realisierung zentraler Architekturelemente und der entwickelten Verfahren zur Selbstorganisation beispielhaft für das SLM konkreter Komponenten vorgestellt. Zur Untersuchung der Management-Kooperation in größeren Szenarien wird ein hybrider Simulationsansatz verwendet. Im Rahmen der Evaluation werden Untersuchungen zur Skalierbarkeit des Ansatzes durchgeführt. Schwerpunkt ist hierbei die Betrachtung eines Systems aus kooperierenden Management-Komponenten, insbesondere im Hinblick auf den Kommunikationsaufwand. Die Evaluation zeigt, dass ein dienstübergreifendes, autonomes Performance-Management in SOA-Umgebungen möglich ist. Die Ergebnisse legen nahe, dass der entwickelte Ansatz auch in großen Umgebungen erfolgreich angewendet werden kann.

Perspectives of Urban Growth Management and Sustainable Development In West Bank, Hebron District as a case Study

The main objective of this PhD research study is to provide a perspective on the urban growth management and sustainable development in Palestine, and more specifically in Hebron district as a case study. Hebron is located 36 km south of Jerusalem, with an overall population size of around 600,000 people living in a total area around1246km2. Hebron is the biggest Palestinian district that has 16 municipalities and 154 localities. The research discusses and analyzes the urban planning system, economical and environmental policies and the solution required to manage and integrate the development elements to develop a sustainable development plan for Hebron. The research provides answers for fundamental questions such as what kind and definition of sustainable development are applicable to the Palestinian case?. What are the sustainability problems there and how the Israeli occupation and unstable political condition affect the sustainable development in Palestine? What are the urban growth management and sustainability policies and actions required from government, public and privets sector in Palestine? The fast urban growth in Palestine is facing many problems and challenges due to the increase in the population size and the resulting impact of this increase including, but not limited to, the demand of new houses, need for more infrastructure services, demands on new industrial, commercial, educational and health projects, which in turn reduces the area of agricultural lands and threatens the natural resources and environment. There are also other associated sustainability problems like the absence of effective plans or regulations that control urban expansion, the absence of sufficient sustainable development plans at the national levels for the district, new job requirements, Israeli restrictions and occupation for more than 60 years, existence of construction factories near residential areas, poor public awareness and poor governmental funds for service projects and development plans. The study consists of nine chapters. Chapter One includes an introduction, study objectives, problems and justifications, while Chapter Two has a theoretical background on sustainability topic and definitions of sustainability. The Palestinian urban planning laws and local government systems are discussed in Chapter Three and the methodology of research is detailed in Chapter Four. As for Chapter Five, it provides a general background on Hebron District including demographical and economical profiles, along with recommendations related to sustainable development for each profile Chapter Six addresses the urban environment, sustainability priorities and policies required. Chapter Seven discusses and analyzes infrastructure services including transportation, water and wastewater. As for Chapter Eight, it addresses the land use, housing and urban expansion beside the cultural heritage, natural heritage with relevant sustainable development polices and recommendations. Finally, Chapter Nine includes a conclusion and comprehensive recommendations integrating all of urban and sustainability event in one map. Hebron has a deep history including a rich cultural heritage aged by thousands of years, with 47% of Hebron district population under 14 years old. Being the biggest Palestinian district, Hebron has thousands of industrial and economical organizations beside a large agricultural sector at Palestine level. This gives Hebron a potential to play major roles in developing a national sustainability plan, as the current urban planning system in Palestine needs urgent reform and development to fulfill the sustainability requirement. The municipalities and ministers should find permanent financial aid for urban planning and development studies so as to face future challenges. The Palestinian government can benefit from available local human resources in development projects; hence Palestinian people have sufficient qualifications in most sectors. The Palestinian people also can invest in the privet sector in Palestine in case businessmen have been encouraged and clear investment laws and plans have been developed. The study provides recommendations associated to the sustainable development in Palestine in general and Hebron, as a case study, in specific. Recommendations include increasing the privet sector as well as the public involvement in urban growth management, and stopping unplanned urban expansion, subjecting granting building permits of new projects to the no-harm environmental impact assessment, increasing the coordination and cooperation between localities and central bodies, protection and renovation of old cites and green areas, increasing the quality and quantity of infrastructure services, establishing district urban planning department to coordinate and organize urban planning and sustainable development activities. Also, among recommendations come dividing Hebron into three planning and administrative areas (north, central and south), and dividing the sustainable development and implementation period (2010 to 2025) into three main phases. Finally, the study strongly recommends benefiting from the same urban development plans in similar districts at national and international levels, also to use new technologies and information systems in urban planning process.

Management social del no equilibrio. Complejidad y ciencias del comportamiento: aportes teóricos y metodológicos a las ciencias de la dirección

El presente texto busca exponer algunos de los aportes que la disciplina del Management puede tomar para su desarrollo en cuanto a teoría, metodología, concepto y práctica administrativa a partir del estudio de las Ciencias de la Complejidad. Para esto se centrará en las Ciencias del Comportamiento, principalmente en las Ciencias Sociales del No Equilibrio. Ellas establecerán el puente entre el Management y las Ciencias de la Complejidad. El resultado de esta unión será la aparición de una nueva disciplina de estudio y un nuevo campo de acción para el management, a saber: El Management Social del No Equilibrio. El texto es, en sí mismo, solo una introducción al tema y se plantea como objeto de estudio para una nueva disciplina de investigación. Para comenzar se hará una introducción al problema de las Ciencias de la Complejidad. Seguidamente, se definirán las Ciencias de la Dirección y los aprovechamientos que han tenido con respecto a las Ciencias de la Complejidad y las Ciencias Sociales Aplicadas. A continuación, se hará una aproximación a lo que este texto entiende por Ciencias del Comportamiento y su relación con las Ciencias de la Complejidad, dando a luz a las Ciencias Sociales del No-Equilibrio. Para concluir se hará una intersección entre las tres (3) disciplinas usando las Ciencias del Comportamiento como puente para la aparición del Management Social del No Equilibrio. Finalmente, se termina con una conclusión con la invitación de generar nuevas discusiones e investigaciones con respecto al tema.

General induction at companies - between an administrative process and a sociological phenomenon

From the example of the process of general induction into the organization and using certain sociological resources, shows paradox are specialists in human management: is to carefor the motivation and the welfare of workers to achieve its high performance, their fidelity and his tenure at the company; However, current mutations of the social architecture in general and of work in particular –as structure of organized action– force thinking that organizational loyalty tends to be increasingly unlikely and that, conversely, the current personnel administration processes appear made inappropriate notions and appear to contribute directly to the adversities of human beings in organizational settings.

Prospects and challenges for sustainable management of the mango stone weevil, Sternochetus mangiferae (F.) (Coleoptera: Curculionidae) in West Africa: a review

Commercial mango production in Ghana is a relatively young industry faced with several pest problems including the mango stone weevil, Sternochetus mangiferae (F.). There is an urgent need to control this and other pests to facilitate access to the international export market for fresh mango fruits. A literature survey identifies stone weevil control tactics in the areas of host plant resistance, administrative and legislative controls, use of pesticides, biological control, cultural control and quarantine and phytosanitary measures that have been developed in other mango-producing areas. We assess these pest management approaches for their relevance to Ghana and West Africa, with emphasis on the research required for their appropriate, effective and sustainable use in the systems of mango production of the West African sub-region. The importance of processing and value addition technologies, as a means of circumventing the quarantine hurdles of S. mangiferae, is highlighted.