Facility closure management:the case of Vauxhall Motors Luton

Purpose – The purpose of the paper is to present the findings of a study of factory closure management. It details the sequence and the results of the key strategic manufacturing management decisions made from the time of the announcement of the plant closure to the cessation of operations. The paper also includes an analysis of the human resource management (HRM) actions taken during this same time period and their consequences upon all those involved in the closure management process. Design/methodology/approach – The case study methodology consisted of two initial site visits to monitor closure management effectiveness (adherence to plan and the types and frequency of closure management communications). During these visits, documentary evidence of the impact of the closure decision upon production performance was also collected (manufacturing output and quality performance data). Following plant closure, interviews were held with senior business, production and HRM managers and production personnel. A total of 12 interviews were carried out. Findings – The case study findings have informed the development of a conceptual model of facility closure management. Information obtained from the interviews suggests that the facility closure management process consists of five key management activities. The unexpected announcement of a factory closure can cause behavioural changes similar to those of bereavement, particularly by those employees who are its survivors. In addition, similar reactions to the closure announcement may be displayed by those who choose to remain employed by the factory owner throughout the phased closure of the plant. Originality/value – Facility closure management is an insufficiently researched strategic operations management activity. This paper details a recommended procedure for its management. A conceptual model has also been developed to illustrate the links between the key facility closure management tasks and the range of employee changes of behaviour that can be induced by their execution.

"I'm a better manager":A biographic narrative study of the impact of personal trauma on the professional lives of managers in the UK

This doctoral study aims to understand how experiences of critical illness or bereavement affect the way managers view and approach their work and their relationships at work. This is an interpretative phenomenological study examining the subjective meanings of personal experience and is underpinned by biographic narratives from four participants and interviews with their nominated workplace witnesses (i.e. colleagues who worked alongside the individual at the time of their trauma). As a consequence of the findings that have emerged across this study, three contributions to theory are presented. All four participants described their traumas as a professional growth experience for themselves as managers, which resulted in self-reported and observed behaviour change at work. Consequently, the first area of theoretical contribution is a suggested extension to the post-traumatic growth (PTG) framework (Calhoun & Tedeschi, 2006) with the addition of a new behavioural dimension called ‘managerial growth’, when applied to the context of ‘ordinary’ organizations. The second area of theoretical contribution arose through the reflexive process that was created during data collection where participants and their witnesses remembered episodes of compassion interaction at work. The second area of contribution thus seeks to extend the existing model of compassion at work (Dutton, Worline, Frost and Lilius, 2006), by conceptualising compassion as a dyadic process between a compassion ‘giver’ and a compassion ‘receiver’ in which the compassion receiver ‘trusts or ‘mistrusts’; ‘discloses’ or ‘withholds’; ‘connects’ or ‘disconnects’ with the compassion giver. The third area of contribution is a new conceptualisation of reflexivity, ‘three-dimensional reflexivity’ (3DR) (Armstrong, Butler and Shaw, 2013). 3DR brings together three of the elements that have been missing from critically reflexive management research; by working with multiple variants of reflexivity in the same study; surfacing different reflexive voices to guard against the researcher’s (potentially) solipsistic own; and remaining sensitive to the concept of reflexive time. In doing so, 3DR not only provides a deeper understanding of individual lived experience; it is also a vehicle in which self-insight is gained. Furthermore, by engaging in its practice, those involved in this study have developed both personally and professionally as a result.

The World in Singing Made: David Markson's "Wittgenstein's Mistress"

In line with Wittgenstein's axiom that "what the solipsist means is quite correct; only it cannot be said, but makes itself manifest," this thesis aims to demonstrate how the gulf between analytic and continental philosophy can best be bridged through the mediation of art. The present thesis brings attention to Markson's work, lauded in the tradition of Faulkner, Joyce, and Lowry, as exemplary of the shift from modernity to postmodernity, wherein the human heart is not only in conflict with itself, but with the language out of which it is necessarily constituted. Markson limns the paradoxical condition of the subject severed from intersubjectivity, and affected not only by the grief of bereavement, which can be defined in Heideggarian terms as anxiety for the ontic negation of a being (i.e., death), but by loss, which I assert is the ontological ground for how Dasein encounters the nothing in anxiety proper.

Treatment for Complicated Grief : State of the Science and Ways Forward

Peer reviewed

The spiritual and professional impact of stillbirth

Stillbirth is without question one of the most devastating experiences of grief for parents and families. The death of a baby is also a distressing experience for healthcare professionals who share hopes of a live healthy baby at the end of pregnancy. It is a sad reality however, that in Ireland one in 238 babies will die before birth. The creation and nurture of new life in pregnancy is a spiritual experience as a new baby is at the same time experienced and anticipated. There is little in the published literature concerning the spiritual impact of stillbirth on healthcare chaplains who are the main providers of spiritual care for parents and staff colleagues in Irish maternity units. In addition there are few qualitative studies that explore the impact of stillbirth on consultant obstetricians and no published studies on the spiritual impact of stillbirth on bereaved parents. This study explored the spiritual and professional impact of stillbirth on Irish maternity healthcare chaplains, consultant obstetricians and bereaved parents. Following an overall review of spiritual care provision following stillbirth in the Irish maternity services, thematic analysis was used in the first phase of the study following in-depth interviews with maternity healthcare chaplains. Interpretative Phenomenological Analysis was used in the second and third phases with consultant obstetricians and bereaved parents respectively. The data from both maternity healthcare chaplains and consultant obstetricians revealed that stillbirth posed immense personal, spiritual and professional challenges. Chaplains expressed the spiritual and professional impact of stillbirth in terms of perception of their role, suffering, doubt and presence as they provided care for bereaved parents. A review of spiritual care provision in the Irish maternity services revealed a diversity of practice. The data from consultant obstetricians identified considerable personal, professional and spiritual impact following stillbirth that was identified in superordinate themes of human response to stillbirth, weight of professional responsibility, conflict of personal faith and incongruence between personal faith and professional practice. Data from bereaved parents revealed that stillbirth was spiritually challenging and all parents expressed that stillbirth posed considerable challenge to their faith/ belief structure. The parents of only three babies felt that their spiritual needs were adequately addressed while in hospital. The data had six superordinate themes of searching for meaning, maintaining hope, importance of personhood, protective care, questioning core beliefs and relationships. Other findings from the data from bereaved parents outlined the importance of environment of care and communication. This study has revealed the immense impact of stillbirth on healthcare chaplains, consultant obstetricians and most especially the spiritual impact for bereaved parents. Recommendations are made for improvements in clinical and spiritual care for bereaved parents following stillbirth and for staff wellbeing and support initiatives. Further research areas are recommended in the areas of spiritual care, theological reflection, bereavement care, post-mortem consent procedures and staff wellbeing.

Duelo, ansiedad y depresión en familiares de pacientes en una unidad de cuidados paliativos a los dos meses de la pérdida

Aim: This study is going to assess the prevalance of prolonged grief diagnoses and it will evaluate the severity of the symptoms of depression, anxiety and complicated grief two months after a loved one is lost. We also intend to study which variables associated with the risk of grief could be more decisive when diagnosing it, its symptoms and the consequent emotional distress.Method: A total of 66 families of patients in the Palliative Care Unit (PCU) at Hospital San Cecilio in Granada have been evaluated. Measurements were taken two months after the death. This investigation has explored the existing emotional distress using the following questionnaires: Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), Inventory of Complicated Grief (ICG) and Prolongued Grief Disorder (PG-12).Results: The results show that 33.3% and 21.21% of the sufferers had high levels of depression and clinical anxiety two months after the death. The prevalence of prolongued grief diagnoses, according to the PG-12, is 10.6% and 53.03% of the participants showed symptoms of complicated grief according to the ICG. Additionally, statistically significant differences are found in the sufferers with and without a prolongued grief diagnosis and scores in the ICG and BDI-II. The family’s financial situation is linked to the presence of symptoms of anxiety and depression and complicated grief, with the most determining variable being the risk of grief. Finally, the greater the age of the deceased and the longer the time spent in the PCU is linked to fewer symptoms of grief. However, important links have been found between the sufferers who have experienced stressful critical events prior to losing their loved one, with symptoms of depression, anxiety and complicated grief.Conclusions: The high numbers of cases of symptoms of complicated grief and levels of anxiety and clinical depression two months after a death suggests that early interventions should be carried out in those individuals with greater vulnerability.

Music therapy, in tuning at the end of life

In this article music therapy is presented as a helpful tool to support the persons (and their relatives) living at the end of their life and, also, as a non pharmacological and complementary therapy in an integral and holistic medicine. What we report here comes from the direct experience, nourished after many years of interventions and reflections in oncology and palliative care units. We’re talking about silence, music, therapy, models and techniques. We will read and feel therapeutic sessions… but above all, we’re talking about life, conscience and love.

Arteterapia en el final de la vida

El arteterapia permite una aproximación creativa biográfica particularmente valiosa en la etapa final de la vida. La persona enferma presenta múltiples necesidades – físicas, emocionales, sociales y espirituales – que solo una atención holística puede pretender abarcar, tal como lo contempla la filosofía de los cuidados paliativos. El arteterapeuta integrado en el equipo interdisciplinar contribuye a aliviar y acompañar el sufrimiento del paciente y su familia. Se presentan aquí las bases teóricas y la metodología de la intervención, así como el marco sanitario en el cual se inscribe.

Moral Emotions in Palliative Care: Empirical Insights from Austria and Canada

Research aims: Moral emotions as one specific group of emotions play a vital role in delivering palliative care as e.g. ethical issues and moral distress belong to daily routine.
Moral emotions are oriented to the welfare of other persons or the society as a whole. To better understand moral emotions in Palliative Care the aims of the presented study are to ana- lyze care situations from Austria and Canada in different care settings and identify families of moral emotions on one hand and describe influencing contextual factors on the other hand. Methods: Within a qualitative study design a reanalysis of Austrian narratives on ethical issues and Canadian narra- tives on moral distress were conducted. Data in Austria encompass 36 narratives that were generated through qual- itative questionnaires in nursing homes. Canadian data are based on qualitative interviews with home care palliative specialists and encompass 47 critical incidents. The reanal- ysis of data was conducted with narrative analysis. Results: Preliminary results show that moral emotions in palliative care can be found in families around “empathy and relatedness”, “sadness, isolation and bereavement”, “anger, frustration and powerlessness”, “guilt and shame” and “being touched and feel close”. Contextual factors influencing moral emotions can be summarized as “suffer- ing and decline of client”, “expectations and dynamics of family”, “structural conflicts and power issues” and “lack of resources and information”.
Conclusion: The diversity of moral emotions reflects the everyday experiences in palliative care. It became obvious that most of the moral emotions that have been expressed appear to be interconnected within a bundle of other emo- tions. Contextual factors influencing moral emotions in pal- liative care are relatively independent of care settings. In Palliative Care moral emotions and their contextual factors constitute an important source of insight for reflection in organizational ethics.

Predictors of caregiver burden across the home-based palliative care trajectory in Ontario, Canada

Family caregivers of patients enrolled in home-based palliative care programmes provide unpaid care and assistance with daily activities to terminally ill family members. Caregivers often experience caregiver burden, which is an important predictor of anxiety and depression that can extend into bereavement. We conducted a longitudinal, prospective cohort study to comprehensively assess modifiable and non-modifiable patient and caregiver factors that account for caregiver burden over the palliative care trajectory. Caregivers (n = 327) of patients with malignant neoplasm were recruited from two dedicated home-based palliative care programmes in Southern Ontario, Canada from 1 July 2010 to 31 August 2012. Data were obtained from bi-weekly telephone interviews with caregivers from study admission until death, and from palliative care programme and home-care agency databases. Information collected comprised patient and caregiver demographics, utilisation of privately and publicly financed resources, patient clinical status and caregiver burden. The average age of the caregivers was 59.0 years (SD: 13.2), and almost 70% were female. Caregiver burden increased over time in a non-linear fashion from study admission to patient death. Increased monthly unpaid care-giving time costs, monthly public personal support worker costs, emergency department visits and low patient functional status were associated with higher caregiver burden. Greater use of hospice care was associated with lower burden. Female caregivers tended to report more burden compared to men as death approached, and burden was higher when patients were male. Low patient functional status was the strongest predictor of burden. Understanding the influence of modifiable and non-modifiable factors on the experience of burden over the palliative trajectory is essential for the development and targeting of programmes and policies to support family caregivers and reduce burden. Supporting caregivers can have benefits such as improved caregiver health outcomes, and enhancing their ability to meet care-giving demands, thereby potentially allowing for longer patient care in the home setting.

National Office for Suicide Prevention annual report 2010

International research informs us that any economic downturn leads to an increase in suicides. In one recent article in the Lancet it was stated that a 1.0% increase in unemployment led to 0.7% increase in suicides. Such analysis is startling and in Ireland more than relevant as our suicide numbers rose dramatically in 2009 and 2010. Provisional figures for 2009 indicated a record number of 527 recorded suicides and even though there was a slight fall in 2010 the figure remains unacceptably high. It is likely that when the year of occurrence figures for these years are published the numbers will be even higher This year we have included a section in Chapter 5 on the year on year difference between ‘provisional’ (year of registration) data and ‘official’ (year of occurrence) data which highlights the reason why these two data sets cannot be directly compared. We also acknowledge that some undetermined deaths can also be classified as suicides. Ongoing analysis of this data is therefore important. What is particularly worrying and perhaps not unexpected is the rise in suicides in the middle age groups, both men and women. Such a dramatic increase can largely be attributed to the fracturing and resulting stress and pressure on individuals which has occurred in our society due to the economic downturn.   .

Self-harm, suicide and risk: helping people who self-harm. Final report of a working group.

The focus of this report is to enquire into and report on why people harm and kill themselves and to consider the role (including the limits of the role) that psychiatrists and other mental healthcare professionals play in their care and treatment. The experiences and views of people who harm themselves as well as those of their carers, health professionals and third-sector workers are central to this enquiry. As there is much policy and guidance on self-harm and suicide prevention, the report does not attempt to retrace this same ground but rather examines the evidence of practice on the ground, including the implementation of the National Institute for Health and Clinical Excellence (NICE) guidelines on self-harm (National Collaborating Centre for Mental Health, 2004). This report is the second in the Royal College of Psychiatristsââ,¬â"¢ programme of work on the broad issue of risk. The College report Rethinking Risk to Others was published in July 2008 (Royal College of Psychiatrists, 2008a) and a new Working Group was set up under the chairmanship of John, Lord Alderdice, to examine risk, self-harm and suicide. This clinical issue is an integral part of the role of the psychiatrist in ensuring the good care and treatment of patients. Our central theme is that the needs, care, well-being and individual human dilemma of the person who harms themselves should be at the heart of what we as clinicians do. Public health policy has a vital role to play and psychiatrists must be involved and not leave these crucial political and managerial decisions to those who are not professionally equipped to appreciate the complexities of self-harm and suicide. But we must never forget that we are not just dealing with social phenomena but with people who are often at, and beyond the limit of what they can emotionally endure. Their aggressive acts towards themselves can be difficult to understand and frustrating to address, but this is precisely why psychiatrists need to be involved to bring clarity to the differing causes for the self-destructive ways in which people act and to assist in managing the problems for the people concerned, including family, friends and professional carers, who sometimes find themselves at the end of their tether in the face of such puzzling and destructive behaviour.

Demographic trends in suicide in the UK and Ireland 1980 - 2010.

Background Ireland has the 17th highest suicide rate in the EU and the 4th highest among 15 to 24-year-old males (WHO 2012). Suicide is the leading cause of death in this age group; death by hanging accounted for 69 % of suicides in 2010. Methods This study examines youth suicide rates from 1980 to 2010 in Ireland and compares them to the rates in Northern Ireland, Scotland, England and Wales. Irish data were obtained from the Central Statistics Office and their annual reports on Vital Statistics. Northern Irish data were obtained from the Northern Ireland Statistics and Research Agency website; Scottish data were from the General Register Office for Scotland and English/Welsh data from the Office for National Statistics website. Results There has been a threefold increase in young male suicide in Ireland over the past three decades (8.9 - 29.7 per 100,000). In contrast, there has been approximately a threefold reduction in deaths by road traffic accidents in young men in the same period (42.7 - 16.2 per 100,000). Suicide rates in young men are similar in Scotland and Northern Ireland for the same period but are 50 % lower in England and Wales. Despite the rates of hanging as a method of suicide increasing in all jurisdictions, the overall rate in England and Wales has continued to decline. Conclusion The suicide rate in Ireland remains very high and strategies to address this are urgently required. Our study indicates that national suicide prevention strategies can be effective.

The iceberg of suicide and self-harm in Irish adolescents: a population-based study

PURPOSE Suicide is a leading cause of death among adolescents. Self-harm is the most important risk factor for suicide, yet the majority of self-harm does not come to the attention of health services. The purpose of this study was to establish the relative incidence of adolescent suicide, hospital-treated self-harm and self-harm in the community. METHODS Annual suicide rates were calculated for 15-17 year-old in the Cork and Kerry region in Ireland based on data from the Central Statistics Office. Rates of hospital-treated self-harm were collected by the Irish National Registry of Deliberate Self-Harm. Rates of self-harm in the community were assessed using a survey of 3,881 adolescents, the Child and Adolescent Self-harm in Europe study. RESULTS The annual suicide rate was 10/100,000. Suicide was six times more common among boys than girls. The annual incidence rate of hospital-treated self-harm was approximately 344/100,000, with the female rate almost twice the male rate. The rate of self-harm in the community was 5,551/100,000, and girls were almost four times more likely to report self-harm. For every boy who died by suicide, 16 presented to hospital with self-harm and 146 reported self-harm in the community. For every female suicide, 162 girls presented to hospital with self-harm and 3,296 reported self-harm. CONCLUSIONS Gender differences in relative rates of self-harm and suicide are very large, with boys who have harmed themselves at particularly high risk of suicide. Knowledge of the relative incidence of self-harm and suicide in adolescents can inform prevention programmes and services.