Att minska risken för våld och att främja återhämtning i den rättspsykiatriska vården : Patienters och personalens erfarenheter av vägen mot återhämtning

Detta avhandlingsarbete är utfört inom en rättspsykiatrisk vårdkontext och återspeglar patienters[1] och personals[2] erfarenheter och upplevelser av vändpunkter i samband med minskad risk för våld och återhämtning. Med utgångspunkt från ett holistiskt och salutogent hälsovetenskapligt perspektiv har avhandlingen ett tvärvetenskapligt förhållningssätt.   Teoretiska ämnesdiscipliner såsom psykiatrisk omvårdnad, kriminologi och sociologi har influerat arbetet. Avhandlingens övergripande syfte var att utifrån de salutogena aspekterna i det rättspsykiatriska omvårdnadsarbetet undersöka vad som är relaterat till vändpunkter i samband med minskad risk för våld och vad som bidrar till återhämtning. Avhandlingen baseras på fyra olika studier. Syftet med den inledande kvantitativa delstudien (I) var att identifiera och jämföra rättspsykiatriska patienter som sänkt sin bedömda risk för våld med 30 % eller mer enligt riskbedömningsinstrument HCR-20. Resultatet visade att den bedömda risken för våld minskade över tid. En demografisk analys genomfördes för att studera skillnader mellan de patienter som sänkt sin bedömda risk för våld och de som inte sänkt sin risk. Det framgick att rättspsykiatriska patienter som bedömts med hjälp av riskbedömningsinstrumentet HCR-20, minskade den bedömda risken för våld, både på kort och på lång sikt. Den rättspsykiatriska vården fungerade bäst när det gällde att förbättra de kliniska riskfaktorerna (C-skalan). Riskhanteringen (R-skalan) gällande eventuell utskrivning och framtida friförmåner visade inte samma goda progress. Demografiska karaktäristika såsom ålder, alkohol och drogmissbruk och psykiatriska diagnoser var inte relaterade till minskad risk för våld, dock var kvinnliga patienter och patienter utan psykopatidiagnos mer benägna att sänka sin risk för våld. Ett urval av de patienter som minskade sin risk för våld med 30 % eller mer utgjorde basen för delstudie II och III. I delstudie II intervjuades tretton rättspsykiatriska patienter om upplevelser och erfarenheter kring vad som bidrar till minskad respektive ökad risk för våld inne på en rättspsykiatrisk avdelning. Data analyserades med hjälp av en tolkande beskrivning (Interpretive Description). Studien visade att orsakerna till ökad respektive minskad risk för våld var processrelaterad, där interaktioner mellan personal och patienter bidrog till en utveckling som antingen präglades av välbefinnande eller disharmoni. Delstudie II utgjorde en viktig kunskapskälla som präglade ansatsen i delstudie III och IV. Detta med hänvisning till att flertalet patienter i delstudie II lämnade intressanta beskrivningar av vändpunkter i samband med minskad risk för våld och återhämtning. Sålunda intervjuades i delstudie III, tio rättspsykiatriska patienter om deras upplevelser av förändringsprocesser i samband med vändpunkter och återhämtning. Dataanalysen skedde med hjälp av en kvalitativ innehållsanalys. Processen beskrevs utifrån tre faser där man i högriskfasen upplevde kaotiska och överväldigande känslor. Vändpunkten upplevdes som ett känsligt skede som präglades av att tvingas hitta en ny, konstruktiv väg i livet. Återhämtningsfasen präglades av ett accepterande och en mognad. Stöd och erkännande från omgivningen ansåg främja dessa processer. Delstudie IV bestod av intervjuer med tretton personal. Syftet var att belysa upplevelser och erfarenheter kring rättspsykiatriska patienters vändpunkter och återhämtning. Kvalitativ innehållsanalys användes för att analysera data. Beskrivningar kring hur en vändpunkt kunde bevaras och främjas baserades på vikten av att vara uppmärksam, lyhörd och att inte skynda på processen. En vändpunkt upplevdes genom att patienten uppvisade synbara positiva förändringar. Sammansättningen på personalen och patienterna ansågs påverka atmosfären på avdelningen, och bidrog till huruvida processen mot vändpunkter och återhämtning underlättades eller försvårades. Avhandlingen visar hur ett ständigt växelspel mellan patienter och mellan personal bidrog till huruvida vårdatmosfären upplevdes såsom hälsofrämjande eller ej. Vidare framgår att processer kring vändpunkter i samband med minskad risk för våld och återhämtning präglades av känslor av sårbarhet och utsatthet. Processen beskrevs som ett känsligt förlopp som behövde understödjas av förtroendefulla relationer med andra, samt möjligheter att få vistas i en trygg miljö. [1] Den vetenskapliga litteraturen använder sig av begrepp såsom client, consumer, service user eller forensic patient för att beteckna människor som är inskrivna inom den rättspsykiatriska vården. Inom det psykiatriska svenska fältet kan begreppen brukare, vårdtagare eller patient förekomma. I denna avhandling kommer begreppet patient och vårdtagare omväxlande att användas för att beteckna de människor som är föremål för den rättspsykiatriska vården. De patienter som deltagit i avhandlingens två delstudier kommer omväxlande att benämnas såsom deltagare eller patienter, för att åstadkomma en varierande och läsvänlig text. [2] I denna avhandling anser begreppet personal den personalkategori som arbetar med omvårdnad inom en rättspsykiatrisk kontext. Det är främst sjuksköterskor och skötare som inkluderas i begreppet omvårdnadspersonal inom den vetenskapliga litteraturen. Sjuksköterskor benämns såsom registered mental health nurses eller registered nurses. Övrig omvårdnadspersonal tituleras till exempel som nurse manager eller assistant nurses. När begreppen personal, vårdare eller omvårdnadspersonal används i denna avhandling avses då den personalkategori som arbetar närmast patienten med omvårdnad och ingen åtskillnad kommer att göras mellan de båda yrkesgrupperna. Personalen som deltar i delstudie IV har omväxlande kallats för personal eller vårdare.

Serviço Social e Política: uma análise da participação dos assistentes sociais no Conselho Regional de Serviço Social 14ª região

This paper analyzes the political participation of Social Workers at the Social Service Regional Council Region 14th. The theoretical and methodological framework of this investigation has as its perspective the totality of social life and its determining relations within the object of study. To the production, analysis and collecting of data it was used a qualitative approach considering a bibliographical and documental research as well as a series of twelve interviews with 2005-2008 and 2008-2011 managing counselors of CRESS/RN. It was also used the data obtained from other special interviews held with the social workers in the period between 2007 and 2008. The results of this study allow and affirm the political dimension of Caseworkers and the CRESS/RN as a space of political activity with opportunities for effective and collective elaboration of strategies in order to reach the fulfillment of the ethical and professional policy of the Social Work. From a historical viewpoint, the beginning of this process is marked by the struggle for democracy, the end of military dictatorship, the establishment of the State of Human Rights. The Democratization of the so called Federal Council of Social Workers and its Regional Councils of Social Workers, CFAS / CRAS, respectively, area a result of the participation of the category in an effort to fight for democratization in Brazil. The objective of this research, so, is to understand which the socio-historical determinants are, that focus objectively and subjectively in the demobilization of social workers in CRESS Region 14th - in the contemporary and historical context. Among the results obtained we identified the ignorance of some professional workers and also of some advisors, regarding the existence and the role of the Council, as well as the commercialization of Education that compromises the quality of the professional training in its theoretical and methodological, ethical and political dimensions. According to our understanding, this shows a the presence of a non-critical professional profile based on a false reality, on the precariousness of employment contracts which undermine the political organization and submit the worker to various social exploring mechanisms such as double shift and ultimately the fragility of the management of the Regional Council -, as a consequence of the offensive capitalist system that ideologically invests to stop the political organization founded in a critical and democratic perspective. The low participation of some advisors and, in general, the category in CRESS / RN, despite its objective conditions, is a reality and it is presented to us as a challenge to future managements and policy consolidation to society. Inasmuch as the category intends to guarantee the high quality of its social workers, the demands of future counselors, their skills and abilities in dealing with regulatory issues, administrative policies that pervade the everyday life of CRESS / RN are necessary

Participação, organização social e desenvolvimento sustentável no contexto da Resex Mãe Grande de Curuçá

A problemática central desta dissertação é a participação dos usuários da RESEX Mãe Grande de Curuçá nos processos de discussão, formulação, implementação e gestão desta unidade de conservação. Objetiva-se, ainda, analisar a organização social desses sujeitos, especialmente no que respeita às suas instituições representativas e associativas bem como as implicações políticas, econômicas e socioambientais da instalação da RESEX. Este estudo baseou-se em levantamento de dados bibliográficos e documentais – incluindo atas, relatórios, fotografias e mapas – e pesquisa de campo para a coleta de dados. As evidências produzidas revelaram que não obstante a criação de instrumentos e espaços institucionais de cunho participativo, o engajamento das populações usuárias nos processos decisórios concernentes à gestão da UC em questão é afetado por condicionantes diversos, os quais obstam uma participação efetiva. A persistência de práticas insustentáveis de manejo dos recursos naturais, motivada por fatores endógenos e exógenos e os percalços da organização social, denotam dificuldades à concretização da sustentabilidade no contexto estudado. Almeja-se, então, que a análise dessa realidade, efetuada neste trabalho, concorra para o equacionamento das problemáticas evidenciadas. Espera-se, ainda, que este estudo contribua com as reflexões acerca da organização social, participação e sustentabilidade em unidades de conservação na Amazônia.

Representação iterativa e folksonomia assistida para repositórios digitais

Information retrieval has been much discussed within Information Science lately. The search for quality information compatible with the users needs became the object of constant research.Using the Internet as a source of dissemination of knowledge has suggested new models of information storage, such as digital repositories, which have been used in academic research as the main form of autoarchiving and disseminating information, but with an information structure that suggests better descriptions of resources and hence better retrieval.Thus the objective is to improve the process of information retrieval, presenting a proposal for a structural model in the context of the semantic web, addressing the use of web 2.0 and web 3.0 in digital repositories, enabling semantic retrieval of information through building a data layer called Iterative Representation.The present study is characterized as descriptive and analytical, based on document analysis, divided into two parts: the first, characterized by direct observation of non-participatory tools that implement digital repositories, as well as digital repositories already instantiated, and the second with scanning feature, which suggests an innovative model for repositories, with the use of structures of knowledge representation and user participation in building a vocabulary domain. The model suggested and proposed ─ Iterative Representation ─ will allow to tailor the digital repositories using Folksonomy and also controlled vocabulary of the field in order to generate a data layer iterative, which allows feedback information, and semantic retrieval of information, through the structural model designed for repositories. The suggested model resulted in the formulation of the thesis that through Iterative Representation it is possible to establish a process of semantic retrieval of information in digital repositories.

Modelagem de processos de negócios: uma proposta no serviço de atendimento ao usuário da biblioteca da Unesp Guaratinguetá

This work is a study on the Technical Service Library and Documentation Prof. Carlos Alberto de Buarque Borges , on the Faculdade de Engenharia de Guaratinguetá , regarding to the service user , aiming to detect and analyze the current problems and suggesting improvements that could result in optimization of care and increased quality of services. For this, was chosen the methodology of Business Processes Modeling, which enabled the detailing of the processes implemented in the library and the identification the critical points , as low investment and short number of employees, which made possible suggest ways to improve the quality of service to users, as awareness campaigns and the implementation of an system to input the literature needed for each course

Benefício de prestação continuada: reflexos da precarização do trabalho e (des)proteção previdenciária

Pós-graduação em Serviço Social - FCHS

O setor de telefonia móvel: aspectos da regulação e da concorrência na tutela e participação do usuário do serviço de telefonia móvel

Pós-graduação em Direito - FCHS

Online disclosure and privacy concerns: a study of Moroccan and American facebook users

In using online social networks to connect and interact with people has become extremely popular all around the world. Thelargest Social Networking Site (SNS), Facebook, offers its services in over 70 languages and increasingly relies oninternational users to grow its membership. Aiming to understand the role of culture in SNS participation, this study adopts a‘privacy calculus’ perspective to examine the differences in participation patterns between American and MoroccanFacebook users. Survey results show that Moroccans users disclose less on Facebook than US users, yet perceive moredamage should their privacy on Facebook be violated. American users, on the other hand, have lower privacy concerns, trustfellow SNS members and legal system more, and disclose more in their profile. From a practical standpoint, the resultsindicate that SNS providers cannot rely on the same methods to encourage user participation and disclosure in differentcountries.

Behind the curtains of privacy calculus on social networking sites: the study of Germany and the USA

As social networking sites (SNSs) become increasingly global, the issues of cultural differences in participation patterns become acute. However, current research offers only limited insights into the role of culture behind SNS usage. Aiming to fill this gap, this study adopts a ‘privacy calculus’ perspective to study the differences between German and American SNS users. Results of structural equation modeling and multi-group analysis reveal distinct variability in the cognitive patterns of American and German subjects. We contribute to the theory by rejecting the universal nature of privacy-calculus processes. From a practical standpoint, our results signal that SNS providers cannot rely on the “proven” means in ensuring user participation when crossing geographic boundaries. When financial means are limited, SNS providers should direct their investments into enhancing platform enjoyment and granting users with more control and, paradoxically, lobbying for more legalistic safeguards of user privacy.

Leveraging Trust and Privacy Concerns in Online Social Networks: an Empirical Study

Unprecedented success of Online Social Networks, such as Facebook, has been recently overshadowed by the privacy risks they imply. Weary of privacy concerns and unable to construct their identity in the desired way, users may restrict or even terminate their platform activities. Even though this means a considerable business risk for these platforms, so far there have been no studies on how to enable social network providers to address these problems. This study fills this gap by adopting a fairness perspective to analyze related measures at the disposal of the provider. In a Structural Equation Model with 237 subjects we find that ensuring interactional and procedural justice are two important strategies to support user participation on the platform.

Why participate in an online social network: an empirical analysis

Despite their enormous success the motivation behind user participation in Online Social Networks is still little understood. This study explores a variety of possible incentives and provides an empirical evaluation of their subjective relevance. The analysis is based on survey data from 129 test subjects. Using Structural Equation Modeling, we identified that the satisfaction of the needs for belongingness and the esteem needs through self-presentation together with peer pressure are the main drivers of participation. The analysis of a sub-sample of active users pointed out the satisfaction of the cognitive needs as an additional participation determinant. Based on these findings, recommendations for online social network providers are made.

Effectiveness of Justice-Based Measures in Managing Trust and Privacy Concerns on Social Networking Sites: Intercultural Perspective

The unprecedented success of social networking sites (SNSs) has been recently overshadowed by concerns about privacy risks. As SNS users grow weary of privacy breaches and thus develop distrust, they may restrict or even terminate their platform activities. In the long run, these developments endanger SNS platforms’ financial viability and undermine their ability to create individual and social value. By applying a justice perspective, this study aims to understand the means at the disposal of SNS providers to leverage the privacy concerns and trusting beliefs of their users—two important determinants of user participation on SNSs. Considering that SNSs have a global appeal, empirical tests assess the effectiveness of justice measures for three culturally distinct countries: Germany, Russia and Morocco. The results indicate that these measures are particularly suited to address trusting beliefs of SNS audience. Specifically, in all examined countries, procedural justice and the awareness dimension of informational justice improve perceptions of trust in the SNS provider. Privacy concerns, however, are not as easy to manage, because the impact of justice-based measures on privacy concerns is not universal. Beyond theoretical value, this research offers valuable practical insights into the use of justice-based measures to promote trust and mitigate privacy concerns in a cross-cultural setting.

Propuesta de una metodología para provisión de servicios de outsourcing de TI

El mercado de outsourcing ha estado creciendo en los últimos años y se prevé que lo siga haciendo en los próximos, pero este crecimiento ha estado limitado por el fracaso de muchos proyectos que, en algunos casos, han llevado a las organizaciones a asumir de nuevo esos servicios (insourcing). Estos fracasos se han debido en gran parte a los problemas con los proveedores: falta de experiencia, de capacidades para asumir los proyectos, dificultad en la comunicación,… A diferencia de lo que ocurre en otras disciplinas, no existe una metodología que ayude, tanto a los clientes como a los proveedores de servicios de outsourcing de TI, a gobernar y gestionar sus proyectos y conseguir los resultados buscados. En los últimos años han aparecido, al mismo tiempo que la expansión del outsourcing, algunos modelos y marcos de buenas prácticas para la gestión de los proyectos de outsourcing, pero generalmente sólo cubren algunos aspectos de la gestión. No se los puede considerar metodologías, porque no definen roles, responsabilidades ni entregables. Por lo general, son el resultado de la experiencia en la gestión de otros tipos de proyectos. Hay que considerar también que, excepto eSCM-SP, que es un modelo de buenas prácticas para mejorar la capacidad en la provisión de servicios, están todos orientados al cliente. El objetivo de esta tesis es, por un lado, demostrar la necesidad de contar con una metodología que guíe a los proveedores durante todo el ciclo de vida un proyecto de outsourcing y, por otro, proponer una metodología que contemple desde la fase inicial de la búsqueda de oportunidades de negocio, evaluación de las propuestas RFP, la decisión de hacer una oferta o no para la prestación de servicios, la participación en la due diligence, la firma del contrato, la transición y la entrega de servicios, hasta la finalización del contrato. La metodología se ha organizado en base a un ciclo de vida del outsourcing de cinco etapas, definiendo para cada una de ellas los roles que participan y las responsabilidades que deberán asumir, las actividades a realizar y los entregables que se deberán generar, y que servirán de elementos de control tanto para la gestión del proyecto como para la provisión del servicio. La validación de la metodología se ha realizado aplicándola en proyectos de provisión de servicios de TI de una mediana empresa española y comparando los resultados obtenidos con los conseguidos en proyectos anteriores. ABSTRACT The outsourcing market has been growing in recent years and it is expected to keep doing so in the coming years, but this growth has been limited by the failure of many projects that, in some cases, has led organizations to take back those services (insourcing). These failures have been due to a major degree to problems with providers: lack of experience and capacity to take on the projects, and difficulties of communication. Unlike what happens in other disciplines, there is no methodology for helping both customers and providers of outsourcing services. In recent years, some good practice frameworks have also appeared at the same time as the expansion of outsourcing. They are not methodologies because they have not defined any roles, responsibilities and deliverables. These frameworks aim to help organizations to be successful at managing and governing outsourcing projects. They are usually the result of their experience in managing other kinds of projects. In consequence, it is not appropriate to name them "methodologies" for managing outsourcing projects and much less "standards". It is also important to note that all existing good practice frameworks, except eSCM-SP, are client-oriented. The aim of this thesis is to state the need to propose a methodology that guides providers throughout the whole outsourcing life cycle and facilitates the provision of quality services and their management, and the proposal of a methodology in which the stages, activities, deliverables, roles and responsibilities are clearly defined. The proposed methodology cover all the stages of the outsourcing life cycle, from the early stage of searching for business opportunities, evaluation of the RFP proposals, the decision to bid or not to bid for the service provision, participation in the due diligence if necessary, the signing of the contract, the transition and delivery of service to the termination of the contract. For each activity, roles, responsibilities and deliverables have been defined. The validation of the methodology has been done by applying it in the provision of some outsourcing projects carried out by a Spanish IT medium company and comparing the results with those obtained in previous projects.

Análisis de los factores de influencia en la adopción de herramientas colaborativas basadas en software social. Aplicación a entornos empresariales

En las últimas dos décadas, se ha puesto de relieve la importancia de los procesos de adquisición y difusión del conocimiento dentro de las empresas, y por consiguiente el estudio de estos procesos y la implementación de tecnologías que los faciliten ha sido un tema que ha despertado un creciente interés en la comunidad científica. Con el fin de facilitar y optimizar la adquisición y la difusión del conocimiento, las organizaciones jerárquicas han evolucionado hacia una configuración más plana, con estructuras en red que resulten más ágiles, disminuyendo la dependencia de una autoridad centralizada, y constituyendo organizaciones orientadas a trabajar en equipo. Al mismo tiempo, se ha producido un rápido desarrollo de las herramientas de colaboración Web 2.0, tales como blogs y wikis. Estas herramientas de colaboración se caracterizan por una importante componente social, y pueden alcanzar todo su potencial cuando se despliegan en las estructuras organizacionales planas. La Web 2.0 aparece como un concepto enfrentado al conjunto de tecnologías que existían a finales de los 90s basadas en sitios web, y se basa en la participación de los propios usuarios. Empresas del Fortune 500 –HP, IBM, Xerox, Cisco– las adoptan de inmediato, aunque no hay unanimidad sobre su utilidad real ni sobre cómo medirla. Esto se debe en parte a que no se entienden bien los factores que llevan a los empleados a adoptarlas, lo que ha llevado a fracasos en la implantación debido a la existencia de algunas barreras. Dada esta situación, y ante las ventajas teóricas que tienen estas herramientas de colaboración Web 2.0 para las empresas, los directivos de éstas y la comunidad científica muestran un interés creciente en conocer la respuesta a la pregunta: ¿cuáles son los factores que contribuyen a que los empleados de las empresas adopten estas herramientas Web 2.0 para colaborar? La respuesta a esta pregunta es compleja ya que se trata de herramientas relativamente nuevas en el contexto empresarial mediante las cuales se puede llevar a cabo la gestión del conocimiento en lugar del manejo de la información. El planteamiento que se ha llevado a cabo en este trabajo para dar respuesta a esta pregunta es la aplicación de los modelos de adopción tecnológica, que se basan en las percepciones de los individuos sobre diferentes aspectos relacionados con el uso de la tecnología. Bajo este enfoque, este trabajo tiene como objetivo principal el estudio de los factores que influyen en la adopción de blogs y wikis en empresas, mediante un modelo predictivo, teórico y unificado, de adopción tecnológica, con un planteamiento holístico a partir de la literatura de los modelos de adopción tecnológica y de las particularidades que presentan las herramientas bajo estudio y en el contexto especifico. Este modelo teórico permitirá determinar aquellos factores que predicen la intención de uso de las herramientas y el uso real de las mismas. El trabajo de investigación científica se estructura en cinco partes: introducción al tema de investigación, desarrollo del marco teórico, diseño del trabajo de investigación, análisis empírico, y elaboración de conclusiones. Desde el punto de vista de la estructura de la memoria de la tesis, las cinco partes mencionadas se desarrollan de forma secuencial a lo largo de siete capítulos, correspondiendo la primera parte al capítulo 1, la segunda a los capítulos 2 y 3, la tercera parte a los capítulos 4 y 5, la cuarta parte al capítulo 6, y la quinta y última parte al capítulo 7. El contenido del capítulo 1 se centra en el planteamiento del problema de investigación así como en los objetivos, principal y secundarios, que se pretenden cumplir a lo largo del trabajo. Así mismo, se expondrá el concepto de colaboración y su encaje con las herramientas colaborativas Web 2.0 que se plantean en la investigación y una introducción a los modelos de adopción tecnológica. A continuación se expone la justificación de la investigación, los objetivos de la misma y el plan de trabajo para su elaboración. Una vez introducido el tema de investigación, en el capítulo 2 se lleva a cabo una revisión de la evolución de los principales modelos de adopción tecnológica existentes (IDT, TRA, SCT, TPB, DTPB, C-TAM-TPB, UTAUT, UTAUT2), dando cuenta de sus fundamentos y factores empleados. Sobre la base de los modelos de adopción tecnológica expuestos en el capítulo 2, en el capítulo 3 se estudian los factores que se han expuesto en el capítulo 2 pero adaptados al contexto de las herramientas colaborativas Web 2.0. Con el fin de facilitar la comprensión del modelo final, los factores se agrupan en cuatro tipos: tecnológicos, de control, socio-normativos y otros específicos de las herramientas colaborativas. En el capítulo 4 se lleva a cabo la relación de los factores que son más apropiados para estudiar la adopción de las herramientas colaborativas y se define un modelo que especifica las relaciones entre los diferentes factores. Estas relaciones finalmente se convertirán en hipótesis de trabajo, y que habrá que contrastar mediante el estudio empírico. A lo largo del capítulo 5 se especifican las características del trabajo empírico que se lleva a cabo para contrastar las hipótesis que se habían enunciado en el capítulo 4. La naturaleza de la investigación es de carácter social, de tipo exploratorio, y se basa en un estudio empírico cuantitativo cuyo análisis se llevará a cabo mediante técnicas de análisis multivariante. En este capítulo se describe la construcción de las escalas del instrumento de medida, la metodología de recogida de datos, y posteriormente se presenta un análisis detallado de la población muestral, así como la comprobación de la existencia o no del sesgo atribuible al método de medida, lo que se denomina sesgo de método común (en inglés, Common Method Bias). El contenido del capítulo 6 corresponde al análisis de resultados, aunque previamente se expone la técnica estadística empleada, PLS-SEM, como herramienta de análisis multivariante con capacidad de análisis predictivo, así como la metodología empleada para validar el modelo de medida y el modelo estructural, los requisitos que debe cumplir la muestra, y los umbrales de los parámetros considerados. En la segunda parte del capítulo 6 se lleva a cabo el análisis empírico de los datos correspondientes a las dos muestras, una para blogs y otra para wikis, con el fin de validar las hipótesis de investigación planteadas en el capítulo 4. Finalmente, en el capítulo 7 se revisa el grado de cumplimiento de los objetivos planteados en el capítulo 1 y se presentan las contribuciones teóricas, metodológicas y prácticas derivadas del trabajo realizado. A continuación se exponen las conclusiones generales y detalladas por cada grupo de factores, así como las recomendaciones prácticas que se pueden extraer para orientar la implantación de estas herramientas en situaciones reales. Como parte final del capítulo se incluyen las limitaciones del estudio y se sugiere una serie de posibles líneas de trabajo futuras de interés, junto con los resultados de investigación parciales que se han obtenido durante el tiempo que ha durado la investigación. ABSTRACT In the last two decades, the relevance of knowledge acquisition and dissemination processes has been highlighted and consequently, the study of these processes and the implementation of the technologies that make them possible has generated growing interest in the scientific community. In order to ease and optimize knowledge acquisition and dissemination, hierarchical organizations have evolved to a more horizontal configuration with more agile net structures, decreasing the dependence of a centralized authority, and building team-working oriented organizations. At the same time, Web 2.0 collaboration tools such as blogs and wikis have quickly developed. These collaboration tools are characterized by a strong social component and can reach their full potential when they are deployed in horizontal organization structures. Web 2.0, based on user participation, arises as a concept to challenge the existing technologies of the 90’s which were based on websites. Fortune 500 companies – HP, IBM, Xerox, Cisco- adopted the concept immediately even though there was no unanimity about its real usefulness or how it could be measured. This is partly due to the fact that the factors that make the drivers for employees to adopt these tools are not properly understood, consequently leading to implementation failure due to the existence of certain barriers. Given this situation, and faced with theoretical advantages that these Web 2.0 collaboration tools seem to have for companies, managers and the scientific community are showing an increasing interest in answering the following question: Which factors contribute to the decision of the employees of a company to adopt the Web 2.0 tools for collaborative purposes? The answer is complex since these tools are relatively new in business environments. These tools allow us to move from an information Management approach to Knowledge Management. In order to answer this question, the chosen approach involves the application of technology adoption models, all of them based on the individual’s perception of the different aspects related to technology usage. From this perspective, this thesis’ main objective is to study the factors influencing the adoption of blogs and wikis in a company. This is done by using a unified and theoretical predictive model of technological adoption with a holistic approach that is based on literature of technological adoption models and the particularities that these tools presented under study and in a specific context. This theoretical model will allow us to determine the factors that predict the intended use of these tools and their real usage. The scientific research is structured in five parts: Introduction to the research subject, development of the theoretical framework, research work design, empirical analysis and drawing the final conclusions. This thesis develops the five aforementioned parts sequentially thorough seven chapters; part one (chapter one), part two (chapters two and three), part three (chapters four and five), parte four (chapters six) and finally part five (chapter seven). The first chapter is focused on the research problem statement and the objectives of the thesis, intended to be reached during the project. Likewise, the concept of collaboration and its link with the Web 2.0 collaborative tools is discussed as well as an introduction to the technology adoption models. Finally we explain the planning to carry out the research and get the proposed results. After introducing the research topic, the second chapter carries out a review of the evolution of the main existing technology adoption models (IDT, TRA, SCT, TPB, DTPB, C-TAM-TPB, UTAUT, UTAUT2), highlighting its foundations and factors used. Based on technology adoption models set out in chapter 2, the third chapter deals with the factors which have been discussed previously in chapter 2, but adapted to the context of Web 2.0 collaborative tools under study, blogs and wikis. In order to better understand the final model, the factors are grouped into four types: technological factors, control factors, social-normative factors and other specific factors related to the collaborative tools. The first part of chapter 4 covers the analysis of the factors which are more relevant to study the adoption of collaborative tools, and the second part proceeds with the theoretical model which specifies the relationship between the different factors taken into consideration. These relationships will become specific hypotheses that will be tested by the empirical study. Throughout chapter 5 we cover the characteristics of the empirical study used to test the research hypotheses which were set out in chapter 4. The nature of research is social, exploratory, and it is based on a quantitative empirical study whose analysis is carried out using multivariate analysis techniques. The second part of this chapter includes the description of the scales of the measuring instrument; the methodology for data gathering, the detailed analysis of the sample, and finally the existence of bias attributable to the measurement method, the "Bias Common Method" is checked. The first part of chapter 6 corresponds to the analysis of results. The statistical technique employed (PLS-SEM) is previously explained as a tool of multivariate analysis, capable of carrying out predictive analysis, and as the appropriate methodology used to validate the model in a two-stages analysis, the measurement model and the structural model. Futhermore, it is necessary to check the requirements to be met by the sample and the thresholds of the parameters taken into account. In the second part of chapter 6 an empirical analysis of the data is performed for the two samples, one for blogs and the other for wikis, in order to validate the research hypothesis proposed in chapter 4. Finally, in chapter 7 the fulfillment level of the objectives raised in chapter 1 is reviewed and the theoretical, methodological and practical conclusions derived from the results of the study are presented. Next, we cover the general conclusions, detailing for each group of factors including practical recommendations that can be drawn to guide implementation of these tools in real situations in companies. As a final part of the chapter the limitations of the study are included and a number of potential future researches suggested, along with research partial results which have been obtained thorough the research.

Revolution or evolution:the challenges of conceptualizing patient and public involvement in a consumerist world

Background Changing the relationship between citizens and the state is at the heart of current policy reforms. Across England and the developed world, from Oslo to Ontario, Newcastle to Newquay, giving the public a more direct say in shaping the organization and delivery of healthcare services is central to the current health reform agenda. Realigning public services around those they serve, based on evidence from service user's experiences, and designed with and by the people rather than simply on their behalf, is challenging the dominance of managerialism, marketization and bureaucratic expertise. Despite this attention there is limited conceptual and theoretical work to underpin policy and practice. Objective This article proposes a conceptual framework for patient and public involvement (PPI) and goes on to explore the different justifications for involvement and the implications of a rights-based rather than a regulatory approach. These issues are highlighted through exploring the particular evolution of English health policy in relation to PPI on the one hand and patient choice on the other before turning to similar patterns apparent in the United States and more broadly. Conclusions A framework for conceptualizing PPI is presented that differentiates between the different types and aims of involvement and their potential impact. Approaches to involvement are different in those countries that adopt a rights-based rather than a regulatory approach. I conclude with a discussion of the tension and interaction apparent in the globalization of both involvement and patient choice in both policy and practice. © 2009 Blackwell Publishing Ltd.