Programa integral de atención a las personas mayores en una zona rural

We describe a community intervention program performed in three rural villages in the Alt Empordà region (Girona province). The study provides data on the services available to the elderly in a specific context, based on an initiative proposed by the villages, the local councils, and the elderly themselves. The program is a research-action plan which applies the participative and qualitative methodology characteristic of strategic planning. The study analyses how the initiative arose, the description of the process, and the different parts of the intervention program

Strategian implementoinnin kriittiset tekijät

Tutkielman tavoitteena on ollut analysoida strategian implementoinnin kriittisiä tekijöitä sekä esittää keinoja näiden hallintaan. Tämä on vaatinut myös implementointiprosessin ja siihen olennaisesti liittyvien tekijöiden, kuten johtamisen, kommunikoinnin sekä tavoiteasetannan ja palkitsemisen Läpikäyntiä. Tutkimus on deskriptiivinen ja analyysitapa kvalitatiivinen, kriittisiä tekijöitä on tarkasteltu aikaisempien aihetta käsittelevien tutkimusten pohjalta. Kriittisten tekijöiden tarkastelua lähestytään strategian ymmärryksen ja tavoiteasetannan, organisatoristen tekijöiden, kommunikoinnin sekä johtamisen näkökulmasta. Tutkielmasta käy ilmi, että useat ongelmat ovat yhteydessä toisiinsa ja näin ongelma yhdessä implementointiprosessin tekijässä johtaa helposti uuteen. Tämä asettaa yritykselle haasteen tunnistaa ongelmien lähteet ja etsiä niihin ratkaisut. Tutkielma tarjoaa lähtökohdan strategian implementoinnin kriittisten tekijöiden havaitsemiselle ja niiden hallinnalle.

From Educational Segregation to Transformative Inclusion

Recent studies conducted in Europe using communicative methodology highlight that different ways of grouping students has a direct effect on their academic output. This article analyzes how said research methodology identifies and analyzes those student groupings that provide greater academic success and improve classroom coexistence at Spanish educational centers. Said methodology entails all of the research participants researchers, teachers, families, and students reflecting on the consequences of streaming, mixture, and inclusion for student academic achievement. Following this, our conclusions are compared with the policies and educational practices implemented in Spanish schools, which are not based on scientific knowledge and do not usually lead to academic success. Finally, recommendations are presented for future educational policies with the aim of providing an alternative for teachers and educational managers that would substantially improve student academic success.

Opérationnaliser la théorie de la justice sociale d'Amartya Sen au champ de l'orientation scolaire : les apports d'une étude multicas qualitative et comparative

Nos travaux traitent des dispositifs d'orientation scolaire et professionnelle (DOSP) voués au soutien et à l'accompagnement de jeunes inégalement dotés dans leur parcours d'orientation au moment de la transition aux études supérieures. Des innovations méthodologiques étaient requises afin d'étudier cette question dans la perspective théorique de justice sociale d'Amartya Sen. Nous avons procédé à l'élaboration et à la vérification des qualités scientifiques d'outils de récolte de données dans une étude comparative internationale. Notre étude multicas se fonde sur cinq pays (Burkina Faso, Canada, France, Turquie, Suisse). Dans chacun des cas, des données qualitatives ont été récoltées sur le système éducatif, l'organisation des services et les prestations de service d'orientation. Vingt-six entretiens semi-structurés ont été menés auprès de responsables de service, de conseillères et conseillers d'orientation psychologues ainsi que de jeunes en transition vers le supérieur. La validité interne ou crédibilité des outils a été assurée tout au long de l'élaboration et des révisions du protocole de recherche, empruntant les procédés propres à l'étude de cas. La vérification de la validité de construit et de la validité externe ou transférabilité, effectuée à partir des données de la préenquête, a mis en lumière la valeur heuristique de nos outils. Au final, le cadre comparatif des DOSP, présenté en annexe, compte parmi les toutes premières formes d'opérationnalisation du cadre théorique de Sen au champ de l'orientation.

Rakennusliikkeen arvonlisäverotus

Tutkielman tavoitteena on selvittää rakentamisen arvonlisäverotusta. Tutkimuksen päätavoite on selventää rakentamispalvelun myynnin, rakentamispalvelun omaan käyttöön ottamisen ja perustajaurakoinnin arvonlisäverotukseen liittyviä eroavaisuuksia ja ongelmia. Erityistä huomiota on kiinnitetty rakentamispalvelun oman käytön verotukseen. Tutkielman tutkimusmenetelmänä on ymmärtämiseen ja selittämään pyrkivä kvalitatiivinen tutkimusmenetelmä. Rakentamisen ja kiinteistöjen arvonlisäverotus on käytännössä osoittautunut haastavaksi ja ongelmalliseksi. Siihen liittyy lukuisia poikkeuksia ja erityissäännöksiä. Laki on joissain kohdin ristiriidassa arvonlisäverodirektiivien kanssa. Laki on paikoin vaikeasti ymmärrettävää. Tämän vuoksi lain tulkinnasta onkin olemassa lukuisia oikeuden päätöksiä. Rakennusliikkeet kohtaavat myös käytännön ongelmia laskentatavoissa, eritoten rakentamispalvelun omaan käyttöön ottamisessa. Huolimatta lukuisista oikeuspäätöksistä, moni lain kohta on edelleen vaikeasti tulkittavissa. Moneen käytännön ongelmaan tarvittaisiin selkeitä ohjeita esim. veroviranomaisilta.

Knowledge creation and transfer in an iterative project environment

This Master’s Thesis examines knowledge creation and transfer processes in an iterative project environment. The aim is to understand how knowledge is created and transferred during an actual iterative implementation project which takes place in International Business Machines (IBM). The second aim is to create and develop new working methods that support more effective knowledge creation and transfer for future iterative implementation projects. The research methodology in this thesis is qualitative. Using focus group interviews as a research method provides qualitative information and introduces the experiences of the individuals participating in the project. This study found that the following factors affect knowledge creation and transfer in an iterative, multinational, and multi-organizational implementation project: shared vision and common goal, trust, open communication, social capital, and network density. All of these received both theoretical and empirical support. As for future projects, strengthening these factors was found to be the key for more effective knowledge creation and transfer.

A qualitative study of adolescents with medically unexplained symptoms and their parents. Part 2: How is healthcare perceived?

Medically unexplained symptoms (MUS) are common among adolescents and an important cause of clinical visits. This study sought to understand the experiences with, and perceptions of, the healthcare of adolescents who have MUS and their parents. Using a qualitative approach, six focus groups and two individual interviews were conducted with a total of ten adolescents and sixteen parents. The participants were recruited in a university hospital in Switzerland. A thematic analysis was conducted in accordance with the Grounded Theory. Six main themes emerged: needing a label for the symptoms, seeking an etiology to explain the symptoms, negotiating the medical system, medication and treatments, interactions with doctors, and the inclusion of parents during consultations. Transcending these themes, however, was the need for good communication between the adolescents, their parents and the clinicians. When explaining the symptoms, clinicians should make sure to discuss the results, investigations and lack of organic origin.

A qualitative study of adolescents with medically unexplained symptoms and their parents. Part 1: Experiences and impact on daily life.

Medically unexplained symptoms (MUS) are common among adolescents and are frequently encountered in primary care. Our aim was to explore how these adolescents and their parents experience the condition and its impact on their daily lives and to provide recommendations for health professionals. Using a qualitative approach, six focus groups and two individual interviews were conducted. These involved a total of ten adolescents with different types of MUS and sixteen parents. The respondents were recruited in a university hospital in Switzerland. A thematic analysis was conducted according to the Grounded Theory. The analysis of the data highlighted four core themes: disbelief, being different, concealing symptoms, and priority to adolescent's health. Transcending these themes was a core issue regarding the discrepancy between the strategies that adolescents and their parents use to cope with the symptoms. Health professionals should be made aware of the emotional needs of these patients and their families.

Qualitative, quantitative and temporal study of cutting agents for cocaine and heroin over 9 years

Forensic laboratories mainly focus on the qualification and the quantitation of the illicit drug under analysis as both aspects are used for judiciary purposes. Therefore, information related to cutting agents (adulterants and diluents) detected in illicit drugs is limited in the forensic literature. This article discusses the type and frequency of adulterants and diluents detected in more than 6000 cocaine specimens and 3000 heroin specimens, confiscated in western Switzerland from 2006 to 2014. The results show a homogeneous and quite unchanging adulteration for heroin, while for cocaine it could be characterised as heterogeneous and relatively dynamic. Furthermore, the results indicate that dilution affects more cocaine than heroin. Therefore, the results provided by this study tend to reveal differences between the respective structures of production or distribution of cocaine and heroin. This research seeks to promote the systematic analysis of cutting agents by forensic laboratories. Collecting and processing data related to the presence of cutting agents in illicit drug specimens produces relevant information to understand and to compare the structure of illicit drug markets.

Building legitimacy by criticising the pharmaceutical industry: a qualitative study among prescribers and local opinion leaders.

PRINCIPLES: The literature has described opinion leaders not only as marketing tools of the pharmaceutical industry, but also as educators promoting good clinical practice. This qualitative study addresses the distinction between the opinion-leader-as-marketing-tool and the opinion-leader-as-educator, as it is revealed in the discourses of physicians and experts, focusing on the prescription of antidepressants. We explore the relational dynamic between physicians, opinion leaders and the pharmaceutical industry in an area of French-speaking Switzerland. METHODS: Qualitative content analysis of 24 semistructured interviews with physicians and local experts in psychopharmacology, complemented by direct observation of educational events led by the experts, which were all sponsored by various pharmaceutical companies. RESULTS: Both physicians and experts were critical of the pharmaceutical industry and its use of opinion leaders. Local experts, in contrast, were perceived by the physicians as critical of the industry and, therefore, as a legitimate source of information. Local experts did not consider themselves opinion leaders and argued that they remained intellectually independent from the industry. Field observations confirmed that local experts criticised the industry at continuing medical education events. CONCLUSIONS: Local experts were vocal critics of the industry, which nevertheless sponsor their continuing education. This critical attitude enhanced their credibility in the eyes of the prescribing physicians. We discuss how the experts, despite their critical attitude, might still be beneficial to the industry's interests.

Yhteiskuntavastuuraporttien ulkoinen varmentaminen

Tutkimuksen päätavoitteena oli tutkia miten suomalaiset suuret pörssiyritykset ulkoisesti varmentavat yhteiskuntavastuuraporttinsa. Lisäksi tavoitteena oli tutkia miten yritykset arvioivat varmentamisen vaikuttavan raporttien luotettavuuteen. Työn teorian muodosti kansainväliset ja kotimaiset kirjat ja artikkelit. Empiirinen aineisto kerättiin yritysten yhteiskuntavastuuraporteista, yritysten internetsivuilta ja haastatteluilla. Teemahaastatteluja tehtiin neljälle yrityksen edustajalle ja kahdelle tilintarkastusyhteisön ulkoi-selle varmentajalle. Tutkimusmenetelmä oli kvalitatiivinen ja kuvaileva. Yhteiskuntavastuun huomioiminen ja siitä raportoiminen on yleistynyt Suomessa ja maailmalla 2000-luvulla. Yritykset koetaan tänä päivänä merkittäviksi tekijöiksi yhteiskunnassa ja näin ollen yrityksiltä vaaditaan vastuullista ja ehdottoman luotettavaa toimintaa. Vastuun kantamista vaa-ditaan erityisesti kansainvälisiltä yrityksiltä. Sidosryhmät odottavat yritysten yhteiskuntavastuuraporttien tarjoavan luotettavaa tietoa päätöksenteon tueksi. Luotettavuuden ja uskottavuuden lisäämiseksi, jotkut yritykset ovat alkaneet käyttää yhteiskuntavastuuraporttien ulkoista varmennusta. Ulkoisella varmentamisella tarkoitetaan sellaista toimintaa, jossa kolmas riip-pumaton taho varmentaa yrityksen ei-taloudellisen raportin.

Guideline adaptation: a methodology to enhance efficiency in guideline development and improve utilization.

BACKGROUND: Developing and updating high-quality guidelines requires substantial time and resources. To reduce duplication of effort and enhance efficiency, we developed a process for guideline adaptation and assessed initial perceptions of its feasibility and usefulness. METHODS: Based on preliminary developments and empirical studies, a series of meetings with guideline experts were organised to define a process for guideline adaptation (ADAPTE) and to develop a manual and a toolkit made available on a website (http://www.adapte.org). Potential users, guideline developers and implementers, were invited to register and to complete a questionnaire evaluating their perception about the proposed process.

Quality of Qualitative Research in the Health Sciences : Analysis of the Common Criteria Present in 58 Assessment Guidelines by Expert Users

The number of qualitative research methods has grown substantially over the last twenty years, both in social sciences and, more recently, in the health sciences. This growth came with questions on the quality criteria needed to evaluate this work, and numerous guidelines were published. The latters include many discrepancies though, both in their vocabulary and construction. Many expert evaluators decry the absence of consensual and reliable evaluation tools. The authors present the results of an evaluation of 58 existing guidelines in 4 major health science fields (medicine and epidemiology; nursing and health education; social sciences and public health; psychology / psychiatry, research methods and organization) by expert users (article reviewers, experts allocating funds, editors, etc.). The results propose a toolbox containing 12 consensual criteria with the definitions given by expert users. They also indicate in which disciplinary field each type of criteria is known to be more or less essential. Nevertheless, the authors highlight the limitations of the criteria comparability, as soon as one focuses on their specific definitions. They conclude that each criterion in the toolbox must be explained to come to broader consensus and identify definitions that are consensual to all the fields examined and easily operational.

Complexity of the Paradigms Present in Quality Criteria of Qualitative Research Grids

With qualitative methods being increasingly used in health science fields, numerous grids proposing criteria to evaluate the quality of this type of research have been produced. Expert evaluators deem that there is a lack of consensual tools to evaluate qualitative research. Based on the review of 133 quality criteria grids for qualitative research in health sciences, the authors present the results of a computerized lexicometric analysis, which confirms the variety of intra- and inter-grid constructions, including within the same field. This variety is linked to the authors' paradigmatic references underlying the criteria proposed. These references seem to be built intuitively, reflecting internal representations of qualitative research, thus making the grids and their criteria hard to compare. Consequently, the consensus on the definitions and the number of criteria becomes problematic. The paradigmatic and theoretical references of the grids should be specified so that users could better assess their contributions and limitations.

Hallituksen ja toimitusjohtajan välisen suhteen kehittäminen listaamattomissa suomalaisissa osakeyhtiöissä

Työn tavoitteen oli selvittää mitä erityspiirteitä suomalaisissa listaamattomissa osakeyhtiöissä on ja niiden pohjalta ymmärtää minkälainen hallituksen ja toimitusjohtajan välinen suhde on. Tutkimusmetodologia oli empiirinen eksploratiivinen tutkimus ja tutkimusmenetelmä oli kvalitatiivinen perustuen seitsemään teemahaastatteluun. Tutkimuksen tuloksena oli, että osakeyhtiöt ovat erilaisia perustuen yhtiön omistajamäärään, omistuksen hajaantumiseen ja omistajien aktiivisuuteen. Pääsääntöisesti omistajat ovat lähellä yhtiön toimin- taa. Omistajat rakentavat yrityskulttuuria palkkaamalla hallituksen jäseniksi kulloiseenkin tilanteeseen sopivimmat henkilöt. Suomalaisia toimitusjohtajia pidetään ihmiskäsitykseltään pääsääntöisesti stewardeina ja ihmiskäsitykseen vaikuttaa olennaisesti kulttuurimme. Luottamus on hallituksen ja toimitusjohtajan välisen suh- teen kulmakiviä.