Handing Down and Adaption: The Construction of the Material World of Health Care Technology in Spain (1855-1955)

This historical study uses qualitative methods to analyze and describe the components of the material world of nursing care in Spain between 1855 and 1955 based on the analysis of eight nurse training manuals. A total of 360 objects and 45 procedures were recorded. Manual analysis was carried out concurrently with data collection based on the Grounded Theory approach. Findings show that the material world of health care was composed of objects that were handed down by the medical profession to health care professionals and adapted objects, improvised mainly out of everyday household items. While the handing down of medical tools and instruments could be said to be a theoretical and technical achievement, it is not clear whether it was also a scientific accomplishment. The improvisation of objects out of everyday household items promoted by the manuals highlights the artisan-like and ingenious nature of nursing practice, which should be explored further in future studies to provide a greater understanding and promote the recognition of these objects as a health care technology.

Enterprise management:A new frontier for organisations

This paper reports on the theoretical foundations and the practical reasons for the increasing popularity of enterprise management. The research has specifically aimed to investigate the dependency between the prevailing type of core competence and the emergent enterprise structure. Empirical inductive research has been conducted in the German automotive industry using the grounded theory approach. This has involved an initial literature review, transcription and codification of interviews to derive tentative propositions, and the validation of the tentative propositions through a questionnaire survey. The research has resulted in the consolidation of the most valid propositions into a conceptual framework. This conceptual framework has been proposed to support enterprise managers who have to make strategic decisions. This study indicates that the prevailing type of core competence is a significant factor that influences the design and management of the enterprise structure. © 2006 Elsevier B.V. All rights reserved.

The role of interoganisational tension and conflict in market creation practice

Markets exist within a world of constant exchanges which form the basis for changes and the creation of new markets. Therefore, it is important to research these exchanges. One of the areas in which market creation can be observed is interorganisational collaborations, as firms increasingly collaborate to create markets. In market creation practice, however, interorganisational tension and conflict can form from divergent approaches and vested interests of the partners. Interorganisational tension represents the opposing intentions of interorganisational forces, and conflict is generated through disagreements. The aim of this research is to investigate interorganisational tension and conflict on market creation practice. Specifically, it attempts to: (i) expand interorganisational tension and conflict and provide insights to these concepts, as well as establishing a two-dimensional interorganisational tension (productive and unproductive) understanding, (ii) explore the interactions between interorganisational tension and conflict, (iii) develop a conceptual framework that explains the level of market creation depending on the effects of interorganisational tension and conflict, (iv) develop a typology of partnering firms based on interorganisational tension and conflict practice. To achieve this aim, and to respond to the research calls, this study follows a grounded theory approach which intends to expand the understanding of interorganisational tension and conflict. According to the findings, a major characteristic of interorganisational tension is its two dimensions: productive and unproductive. However, it is the intertwined nature of tension and conflict that influences market creation. Fundamental to these are the six interorganisational tension and three conflict types revealed by the findings of this study. The core theoretical contributions of the study are a dynamic framework that portrays the dynamic interactions between interorganisational tension and conflict on market creation practice, and a typology of market-creating partnering firms. Collectively, they explicate the development of market creation practice, and firms’ reactions to interorganisational tension and conflict.

Representation and misrepresentation of scientific evidence in contemporary tobacco regulation:a review of tobacco industry submissions to the UK Government consultation on standardised packaging

BACKGROUND: Standardised packaging (SP) of tobacco products is an innovative tobacco control measure opposed by transnational tobacco companies (TTCs) whose responses to the UK government's public consultation on SP argued that evidence was inadequate to support implementing the measure. The government's initial decision, announced 11 months after the consultation closed, was to wait for 'more evidence', but four months later a second 'independent review' was launched. In view of the centrality of evidence to debates over SP and TTCs' history of denying harms and manufacturing uncertainty about scientific evidence, we analysed their submissions to examine how they used evidence to oppose SP. METHODS AND FINDINGS: We purposively selected and analysed two TTC submissions using a verification-oriented cross-documentary method to ascertain how published studies were used and interpretive analysis with a constructivist grounded theory approach to examine the conceptual significance of TTC critiques. The companies' overall argument was that the SP evidence base was seriously flawed and did not warrant the introduction of SP. However, this argument was underpinned by three complementary techniques that misrepresented the evidence base. First, published studies were repeatedly misquoted, distorting the main messages. Second, 'mimicked scientific critique' was used to undermine evidence; this form of critique insisted on methodological perfection, rejected methodological pluralism, adopted a litigation (not scientific) model, and was not rigorous. Third, TTCs engaged in 'evidential landscaping', promoting a parallel evidence base to deflect attention from SP and excluding company-held evidence relevant to SP. The study's sample was limited to sub-sections of two out of four submissions, but leaked industry documents suggest at least one other company used a similar approach. CONCLUSIONS: The TTCs' claim that SP will not lead to public health benefits is largely without foundation. The tools of Better Regulation, particularly stakeholder consultation, provide an opportunity for highly resourced corporations to slow, weaken, or prevent public health policies.

The influence of culture and market orientation on services brands:insights from Irish banking and retail firms

Purpose: This paper aims to examine the influence of the culture of the service firm on its interpretation of the role of the brand and on the development and implementation of its brand values. Design/methodology/approach: A grounded theory approach was used. Interviews were conducted with 20 managers within two leading banking firms in Ireland and two leading grocery retailers in Ireland. Findings: The development of the brand, and its role within the firm, is closely related to the firm's culture. The research shows obstacles and opportunities created by the cultural context of firms wishing to disseminate and embed a set of brand values. The paper presents an "involvement model" of brand values implementation and outlines changes required to implement brand values. Research limitations/implications: The study was bound by access to firms, and managers' availability. The authors sought an insight into the relationship between each firm's culture and its brands. They advocate quantitative research to further investigate the findings within these service sectors and to test proposed antecedents (transformational leadership, employee involvement) and outcomes (employee-based brand equity and consumer-based brand equity) of values adoption. Practical implications: The paper identifies aspects of retail and banking cultures which support or detract from brand development. In particular, it presents the learnings from successful brand values implementation in a clan culture, aspects of which are applicable across other cultures. Originality/value: The paper provides valuable insights into the role of the brand within the service firm and the positive and negative influence of context on brand values and their development and implementation. © Emerald Group Publishing Limited.

Navigating health sources on the Internet: A mixed-methods examination of online consumer reviews and expert text on psychotropic drugs

Purpose. The Internet has provided an unprecedented opportunity for psychotropic medication consumers, a traditionally silenced group in clinical trial research, to have voice by contributing to the construction of drug knowledge in an immediate, direct manner. Currently, there are no systematic appraisals of the potential of online consumer drug reviews to contribute to drug knowledge. The purpose of this research was to explore the content of drug information on various websites representing themselves as consumer- and expert-constructed, and as a practical consideration, to examine how each source may help and hinder treatment decision-making.^ Methodology. A mixed-methods research strategy utilizing a grounded theory approach was used to analyze drug information on 5 exemplar websites (3 consumer- and 2 expertconstructed) for 2 popularly prescribed psychotropic drugs (escitalopram and quetiapine). A stratified simple random sample was used to select 1,080 consumer reviews from the websites (N=7,114) through February 2009. Text was coded using QDA Miner 3.2 software by Provalis Research. A combination of frequency tables, descriptive excerpts from text, and chi-square tests for association were used throughout analyses.^ Findings. The most frequently mentioned effects by consumers taking either drug were related to psychological/behavioral symptoms and sleep. Consumers reported many of the same effects as found on expert health sites, but provided more descriptive language and situational examples. Expert labels of less serious on certain effects were not congruent with the sometimes tremendous burden described by consumers. Consumers mentioned more than double the themes mentioned in expert text, and demonstrated a diversity and range of discourses around those themes.^ Conclusions. Drug effects from each source were complete relative to the information provided in the other, but each also offered distinct advantages. Expert health sites provided concise summaries of medications’ effects, while consumer reviews had the added advantage of concrete descriptions and greater context. In short, consumer reviews better prepared potential consumers for what it’s like to take psychotropic drugs. Both sources of information benefit clinicians and consumers in making informed treatment-related decisions. Social work practitioners are encouraged to thoughtfully utilize online consumer drug reviews as a legitimate additional source for assisting clients in learning about treatment options.^

The river, the railroad tracks, and the towers: How residents' worldview and use value transformed Wilton Manors into a diverse, gay-friendly, urban village

This case study examines the factors that shaped the identity and landscape of a small island-urban-village between the north and south forks of the Middle River and north of an urban area in Broward County, Florida. The purpose of the study is to understand how Wilton Manors was transformed from a “whites only” enclave to the contemporary upscale, diverse, and third gayest city in the U.S. by positing that a dichotomy for urban places exists between their exchange value as seen by Logan and Molotch and the use value produced through everyday activity according to Lefebvre. Qualitative methods were used to gather evidence for reaching conclusions about the relationship among the worldview of residents, the tension between exchange value and use value in the restructuration of the city, and the transformation of Wilton Manors at the end of the 1990s. Semi-structured, in-depth interviews were conducted with 21 contemporary participants. In addition, thirteen taped CDs of selected members of founding families, previously taped in the 1970s, were analyzed using a grounded theory approach. My findings indicate that Wilton Manors’ residents share a common worldview which incorporates social inclusion as a use value, and individual agency in the community. This shared worldview can be traced to selected city pioneers whose civic mindedness helped shape city identity and laid the foundation for future restructuration. Currently, residents’ quality of life reflected in the city’s use value is more significant than exchange value as a primary force in the decisions that are made about the city’s development. With innovative ideas, buildings emulating the new urban mixed-use design, and a reputation as the third gayest city in the United States, Wilton Manors reflects a worldview where residents protect use value as primary over market value in the decisions they make that shape their city but not without contestation.^

The possible selves method in evaluating youth development interventions: The use of Integrated Qualitative /Quantitative Data Analytic Strategies (IQ -DAS)

This study investigated the feasibility of using qualitative methods to provide empirical documentation of the long-term qualitative change in the life course trajectories of “at risk” youth in a school based positive youth development program (the Changing Lives Program—CLP). This work draws from life course theory for a developmental framework and from recent advances in the use of qualitative methods in general and a grounded theory approach in particular. Grounded theory provided a methodological framework for conceptualizing the use of qualitative methods for assessing qualitative life change. The study investigated the feasibility of using the Possible Selves Questionnaire-Qualitative Extension (PSQ-QE) for evaluating the impact of the program on qualitative change in participants' life trajectory relative to a non-intervention control group. Integrated Qualitative/Quantitative Data Analytic Strategies (IQ-DAS) that we have been developing a part of our program of research provided the data analytic framework for the study. ^ Change was evaluated in 85 at risk high school students in CLP high school counseling groups over three assessment periods (pre, post, and follow-up), and a non-intervention control group of 23 students over two assessment periods (pre and post). Intervention gains and maintenance and the extent to which these patterns of change were moderated by gender and ethnicity were evaluated using a mixed design Repeated Measures Multivariate Analysis of Variance (RMANOVA) in which Time (pre, post) was the within (repeated) factor and Condition, Gender, and Ethnicity the between group factors. The trends for the direction of qualitative change were positive from pre to post and maintained at the year-end follow-up. More important, the 3-way interaction for Time x Gender x Ethnicity was significant, Roy's Θ =. 205, F(2, 37) = 3.80, p <.032, indicating that the overall pattern of positive change was significantly moderated by gender and ethnicity. Thus, the findings also provided preliminary evidence for a positive impact of the youth development program on long-term change in life course trajectory, and were suggestive with respect to the issue of amenability to treatment, i.e., the identification of subgroups of individuals in a target population who are likely to be the most amenable or responsive to a treatment. ^

Higher education, equality & ethnicity:the attainment gap – what should we be doing?

This brief paper draws upon part of the findings of a HEA Sponsored evaluation of work conducted in 8 Universities across UK aimed at addressing the attainment gap between BME and White students. Following a grounded theory approach, semi-structured interviews with staff at each of the institutions were analysed and three main themes identified: Organisational Sensitivities: Language: and, Ownership. This paper provides a brief discussion of the issues identifying two areas where positive change is needed in institutional practice. The conclusion highlights the complexities of the underlying issues impacting and shaping the Attainment Gap before reaffirming the need to identify and evaluate which interventions are most likely to be transferable across the Sector so as to address the issues and thus enhance the experiences of all students.

The Policy Dystopia Model:an interpretive analysis of tobacco industry political activity

BACKGROUND: Tobacco industry interference has been identified as the greatest obstacle to the implementation of evidence-based measures to reduce tobacco use. Understanding and addressing industry interference in public health policy-making is therefore crucial. Existing conceptualisations of corporate political activity (CPA) are embedded in a business perspective and do not attend to CPA's social and public health costs; most have not drawn on the unique resource represented by internal tobacco industry documents. Building on this literature, including systematic reviews, we develop a critically informed conceptual model of tobacco industry political activity. METHODS AND FINDINGS: We thematically analysed published papers included in two systematic reviews examining tobacco industry influence on taxation and marketing of tobacco; we included 45 of 46 papers in the former category and 20 of 48 papers in the latter (n = 65). We used a grounded theory approach to build taxonomies of "discursive" (argument-based) and "instrumental" (action-based) industry strategies and from these devised the Policy Dystopia Model, which shows that the industry, working through different constituencies, constructs a metanarrative to argue that proposed policies will lead to a dysfunctional future of policy failure and widely dispersed adverse social and economic consequences. Simultaneously, it uses diverse, interlocking insider and outsider instrumental strategies to disseminate this narrative and enhance its persuasiveness in order to secure its preferred policy outcomes. Limitations are that many papers were historical (some dating back to the 1970s) and focused on high-income regions. CONCLUSIONS: The model provides an evidence-based, accessible way of understanding diverse corporate political strategies. It should enable public health actors and officials to preempt these strategies and develop realistic assessments of the industry's claims.

Santeria as an Informal Psychosocial Support Among Latinas Living with Cancer

Among Latinos, Santería functions as both a religion and a health care system in occurrences of health versus illness within various Latino sub-groups in the U.S. This exploratory study offers a comprehensive analysis of the function of the folk healing tradition Santería as a culturally congruent informal mental health support that assists with coping with the psychosocial sequelae of living with cancer among Latinas in Miami-Dade County, FL. It (a) determined the attitudes of Latinas living with cancer towards Santería as an informal mental health support and (b) explored how Santería offers Latinas effective mental health support that assists in coping with the psychosocial sequelae of living with cancer. The mechanisms and characteristics underlying the motivations of Latinas living with cancer to seek and integrate this informal modality for their cancer care were identified. A purposive sample of 15 Latinas ages 18 and older in Miami-Dade County who had received a diagnosis of cancer were recruited from sites in Miami-Dade offering formal mental health support services and botánicas. Data collection incorporated in-depth interviews and a validation focus group. In an effort to generate theory through a modified Grounded Theory approach, data analysis was accomplished by means of multiple coding passes and the constant comparison method which resulted in higher levels codes that were grouped into three major themes: 1) Participants’ Experience with Folk Healers, 2) Influence of Santería on the Cancer Experience, and 3) Participants’ Experience with Conventional Healthcare and Mental Healthcare. Results illustrate how, among Latinas, the folk healing tradition of Santería co-occurs with professional medical and mental health treatment in what Arthur Kleinman defines as the popular sector, which identifies and sets the parameters for culturally acceptable forms of healthcare and mental health treatment options.

Étude exploratoire auprès de médecins des effets perçus d’une formation corps / esprit fondée sur les pratiques du Sensible

Résumé: Les pratiques du Sensible sont des pratiques d’accompagnement formatives et soignantes. Elles permettent d’apprendre comment l’expérience du corps et de son mouvement interne conduit au développement de la conscience et de la présence à soi ainsi qu’à l’autre, des qualités enviables pour des professionnelles et professionnels de la relation d’aide du secteur de la santé. Dans ces pratiques, le corps joue un rôle central à travers quatre types d’intervention : la thérapie manuelle, la gymnastique sensorielle, l’introspection sensorielle et l’entretien verbal à propos de l’expérience corporelle. Selon Large (2009), une qualité de présence particulière se construit chez les participantes et le participant aux pratiques du Sensible. Selon lui, ceux-ci se rapprochent de leur intériorité, parviennent à verbaliser à autrui ce qu’ils ressentent et en arrivent à poser des actions qui expriment ce qu’ils deviennent. Large (2009) constate qu’ils acquièrent de la stabilité, de l’adaptabilité et de l’autonomie. À la fois plus affirmatifs, ils gagnent aussi en proximité à l’autre. Bois (2007) note un changement de représentation lié aux idées, aux valeurs, à l’image de soi et au rapport perceptif à soi. Une chercheure et des chercheurs constatent un changement de conception de la santé (Duval, 2010; Laemmlin-Cencig et Humpich, 2009). À notre connaissance, il n’y a pas eu d’étude antérieure concernant l’influence des pratiques du Sensible auprès de médecins. Nous avons exploré, le cas échéant, comment une formation aux pratiques du Sensible, suivie par des médecins, a modifié leur rapport à leur corps, à leur propre santé, à leur conception de la santé, à la qualité de leur présence à eux-mêmes, aux autres professionnelles et professionnels et aux patientes et patients. Des entretiens semi-structurés d’une durée de 90 à 105 minutes ont été effectués auprès de six médecins français (cinq femmes et un homme) ayant été formés aux pratiques du Sensible entre 2005 et 2012. Deux types d’entretiens à visée compréhensive (Kaufmann, 2011) et d’explicitation (Vermersch, 2010; 2012) ont été réalisés. Des informations ont aussi été recueillies sur la formation et les activités professionnelles des participantes et du participant. Deux démarches d’analyse ont été utilisées, entre autres pour vérifier la cohérence des résultats et augmenter la rigueur de notre projet. Notre première démarche d’analyse a été conçue à partir de deux méthodes : au départ avec l’analyse thématique et par la suite une analyse avec les catégories conceptualisantes afin de déboucher sur une théorisation ancrée. La deuxième démarche d’analyse a consisté à créer une liste de vingt-six phénomènes présents pour la majorité des entretiens suite à des discussions tenues avec notre équipe de direction. Selon nos résultats, suite à la formation aux pratiques du Sensible, les cinq participantes témoignent d’une plus grande proximité et attention à leur corps et d’une meilleure écoute de celui-ci. Cet ancrage corporel de leur présence les informe davantage sur leur mode de vie et d’existence. Il en ressort ainsi des prises de conscience importantes grâce auxquelles les participantes font des choix nouveaux pour une vie plus cohérente et recentrée sur leur intériorité. Par le fait même, elles récupèrent leur pouvoir sur leur vie comme sur leur santé. En outre, parmi les six médecins, quatre ont modifié leur conception de la santé. Celle-ci s’est en effet élargie pour inclure de nouveaux éléments, dont la qualité du rapport à soi et l’accordage entre le corps et la pensée. Le corps semble être une voie souterraine à partir de laquelle se sont réalisées des transformations dans la personne, comme si le corps devenait une interface ayant des effets sur plusieurs facettes de la personne. Ces transformations semblent avoir une influence sur la manière dont celle-ci exerce sa profession, comme si un savoir-être renouvelé de la personne transformait son savoir-faire au sein de sa pratique. Au plan de la qualité de la présence aux autres, il est rapporté que les relations professionnelles se sont améliorées pour la majorité des participantes. Des transformations personnelles semblent avoir eu des effets sur leurs relations professionnelles. Par exemple, tous témoignent d’une meilleure qualité de présence et de disponibilité aux patientes et patients. La plupart signalent l’apprentissage d’une juste distance thérapeutique et, en même temps, d’une relation plus singulière avec chaque patiente et patient. Nous constatons par notre analyse que la relation aux patientes et patients est modifiée aux plans de la communication, du toucher et de l’écoute. Le parcours de formation des étudiantes et étudiants en médecine semble créer des conditions favorisant l’épuisement (Brazeau, Schroeder, Rovi et Boyd, 2010; Colombat, Altmeyer, Barruel, Bauchetet, Blanchard, Colombat et al., 2011; Ishak, Nikravesh, Lederer, Perry, Ogunyemi et Bernstein, 2013; Llera et Durante, 2014; Rodrigues, Albiges et Blanchard, 2012). Certaines interventions de type corps / esprit semblent pouvoir minimiser cet impact (Elder, Rakel, Heitkemper, Hustedde, Harazduk, Gerik et al., 2007; Hewson, Copeland, Mascha, Arrigain, Topol et Fox, 2006; Irving, Park-Saltzman, Fitzpatrick, Dobkin, Chen et Hutchinson, 2014; Maclaughlin, Wang, Noone, Liu, Harazduk, Lumpkin et al., 2011; Motz, Graves, Gross, Saunders, Amri, Harazduk et al., 2012; Rosenzweig, Reibel, Greeson, Brainard et Hojat, 2003; Saunders, Tractenberg, Chaterji, Amri, Harazduk, Gordon et al., 2007). Notre recherche démontre chez nos participantes et notre participant que la formation aux pratiques du Sensible leur a permis de faire plusieurs gains pour leur propre santé. Il semble qu’en amont des apprentissages liés à la profession médicale, une qualité de savoir-être puisse solidifier la personne, ses apprentissages et sa future pratique médicale. Les étudiantes et étudiants en médecine seraient ainsi mieux outillés pour traverser ce cursus de formation exigent et épuisant. Il serait intéressant de reprendre la recherche auprès d’un plus grand nombre de médecins ou d’étudiantes et étudiants en médecine afin d’y observer les éléments de théorisation répétitifs inclus dans la théorisation ancrée de notre étude exploratoire. Ainsi, selon les résultats, il serait alors plus aisé de promouvoir l’apprentissage expérientiel d’approches de type corps / esprit (dont les PS) dans les cursus universitaires en médecine.

Myths and Realities of Inter-professional Working

Introduction: Childhood cancers are rare and community based health care professionals have limited experience in caring for these children and often even less experience in providing their palliative care. It is well recognised that the provision of palliative care falls beyond the remit of any one profession, thus inter professional working is the standard model. This qualitative study aims to examine the experiences of the range of health care professionals involved in providing palliative care at home for children with cancer, focusing on how knowledge is exchanged; the level of communication and support both interprofessionally and at the community/specialist interface. It also aims to examine interprofessional collaboration in palliative care; identifying healthcare professional's perceptions of problems involved, interprofessional boundaries, specific areas of the organisation or provision of care that could be enhanced through changes in practice, support issues and the educational needs of health professionals. Methods The study involves three types of data collection; in-depth interviews, facilitated case discussion (FCD) and field notes from up to 20 cases (a "case" refers to the provision of palliative care to one child). Cases are selected from children who were treated at one regional childhood caner centre. For each case the community based health care professionals (for example the GP, community nurse or health visitor) involved in the care of the child at home are invited to participate in a one-to-one tape recorded in-depth interview followed by a group discussion in the form of a FCD. Field notes are completed following each interview. Data analysis follows a grounded theory approach. The term "social worlds theory" (SWT) his used to define a type of social organisation with no fixed or formal boundaries (such as membership boundaries), for example the range of health professionals that work together to provide palliative care. The boundaries of SW's are determined by the interaction and communication between recognised organisations, such as community nursing teams and general practitioners. SWT examines encounters between different professional groups and can be used to extend knowledge in both the organisation (for example general practice) and the content of what is being provisioned (for example, palliative care). The use of SWT in the analysis of the data is through examining the ethos of the different professions and the associated individual approaches to palliative care, exploring how this determines their roles in the provision of palliative care. Results 10 cases have so far been completed: 47 1:1 interviews (with a range of between 2-7 health care professionals being involved in each case): ( 9 x GP, 19 x CCN, 4 x DN, 3 x HV, 1 x HV assistant 7 x paediatric palliative care nurses, 1 x home support worker, 1 x OT, 1 x physiotherapist, 1 x community paediatrician) and 5 x FCD. The range of participants in the FCDs reflected that of the individual interview sampler. Data obtained to date gives clear insight into the personal experience of the individual health care professional in providing palliative care. Two themes emerging from the data will be focused upon: the continuity of care provision throughout treatment and palliation and the emotional burden experiences by the health care professional. Conclusions SWT can provide a useful framework in examining the social worlds of a disparate group of health care professionals working together for the first and maybe, the only time. A wide variation in the continuity of care provision has been found not only between professions, but also within professions. The emotional burden is evident across the professions.

Investigating Links Between Intimacy and Violence in Intensive Psychotherapy

This research examines links between intimacy and violence within the transference relationship of a three year old boy during intensive psychotherapy. Psychoanalytic clinical findings are used to examine triggers to violence that initially appeared to link with moments of emotional warmth. The research uses a retrospective single case study design. The clinical data cover a period of transition in the child's life from being a 'looked after child' in foster care to being adopted. There was a history of early trauma from neglect and domestic abuse. Clinical process notes from supervised sessions were coded using an adapted grounded theory approach to reveal complex interlinking themes of intimacy, violence, Oedipal issues, control and difficulties regulating affect. Data in this study show how intimacy and violence are linked when there is evidence of a separation between the self and the object of intimacy. Explosive violence is triggered by the threat of loss of the object and the rage is, at times directed towards the object of intimacy. The findings of this study support concepts identified by earlier research in the field about the impact of a lack of maternal containment on innate violence, associated struggles with the Oedipal complex and the impact upon the capacity for symbol formation and thinking. However, the research findings challenge Glasser's (1979) theory of the 'core complex' that suggests that intimacy triggers violence. The results of this research indicate that it is the threat to the loss of intimacy as a result of separation from the object that is the trigger to violence. I believe this study may, in a modest way, further understanding about links between violence and intimacy in human relationships. This may help other child psychotherapists be alert to certain dangers when dealing with violence in the therapy room.

Antecedentes de empresas portuguesas para uma internacionalização gradual de sucesso

O presente trabalho relata e analisa o processo de internacionalização tendo em atenção os antecedentes que conduziram ao sucesso das empresas analisadas. O método utilizado foi a pesquisa qualitativa, e envolveu sete entrevistas individuais realizadas numa pequena e média empresa (PME), a Valart (cinco entrevistas), e duas multinacionais, a Bosch e a Quimialmel (um quadro superior entrevistado em cada uma). Os resultados obtidos foram discutidos à luz da literatura, após a transcrição das entrevistas e codificação dos dados primários recolhidos. Pretendeu-se entender como é que as grandes multinacionais Bosch e Quimialmel alcançaram o seu sucesso a nível internacional, assim como analisar, também, como a Valart cresceu e expandiu-se ao longo do tempo. Foi então realizada uma revisão da literatura em que foram abordados temas como a internacionalização, a globalização, o marketing e a inovação, conceitos relevantes ao desenvolvimento deste estudo, revisão essa completada após o trabalho de campo, seguindo-se o grounded theory. No conteúdo do trabalho também são relatadas as atividades desenvolvidas durante o estágio na Valart, e é feita uma análise da empresa e do produto principal em questão (porta-contentores marítimos ou sideloaders). Assim, com a revisão da literatura e análise dos resultados obtidos foi possível retirar conclusões e tecer recomendações de ação / gestão na Valart, tais como investir em colaboradores especializados, abrir um departamento de marketing interligado com o comercial, e sempre apoiado em ferramentas informáticas que poderão fomentar a inovação. Os antecedentes que guiam as empresas analisadas a uma internacionalização de sucesso, internacionalização essa que tem sido gradual e por fases, nas empresas abordadas, incluem: rede de contactos internacional, competência da força de vendas, investigação e desenvolvimento (I&D) que leva a produtos diferenciados, parcerias com universidades, orientação para o cliente, existência de uma marca forte, estrutura de custos eficiente, e aproveitamento do capital humano interno. Por fim, é relevante referir que a crise interna em Portugal tem sido um fator incentivador da procura de diversificação de mercados a nível internacional. Como resultado deste estudo foi apresentado um artigo na conferência internacional ICERI 2014 (Au-Yong-Oliveira e Coelho, 2014).