Implementation of PSRO legislation : hearings before the Subcommittee on Health of the Committee on Finance, United States Senate, Ninety-third Congress, second session, May 8 and 9, 1974.

Includes index.

Legislative history of professional standards review organization : provisions of the Social Security Act Amendments : legislature through October 25, 1977.

Cover title.

The Effectiveness of Learning Portfolios: A Study of Quality Assurance Programs of Selected Health Regulatory Colleges in Ontario

Health regulatory colleges promote quality practice and continued competence through Quality Assurance (QA) programs. For many colleges, a QA program includes the use of portfolios that incorporate self-directed learning. The purpose of this study was to determine some of the issues surrounding the effectiveness of QA portfolio programs. The literature review revealed that portfolios are valuable tools, but gaps in knowledge include a comparative analysis of QA programs and the perspective of regulatory college administrators. Data were collected through interviews with 6 administrators and a review of 14 portfolio models described on college websites. The results from the two data sources were applied to Robert Stake's responsive evaluation framework to identify issues related to the portfolio's effectiveness (Stake, 1967). The learning components of portfolios were analyzed through the humanist and constructivist lenses. All 14 portfolio models were found to have 3 main components: self-diagnosis, learning plan and activities, and self-evaluation. However, differences were uncovered in learners' autonomy in selecting learning activities, methods of portfolio evaluation, and the relationship between the portfolio and other QA components. The results revealed a dual philosophy of learning in portfolio models and an apparent contradiction between the needs of the individual learner and the organization. Paths for future research include the tenuous relationship between competence and learning, and the impact of technical approaches on selfdirected learning initiatives. A key recommendation is to acknowledge the unique identity of each profession so that health regulatory colleges can address legislative demands and learner needs.

A intersecção da psicologia com a lei: problematizando a psicologia jurídica na prática profissional dos psicólogos

Pós-graduação em Psicologia - FCLAS

Organizational Frames for Professional Claims: Private Military Corporations and the Rise of the Military Paraprofessional

Corporations, nongovernmental organizations, and other organizational forms are major players in the sodal world. Recently, sociological scholarship on organizations has converged with research on the professions to discuss the ways in which professions are shaped or influenced by different organizational forms. In this article, I borrows from the notion of framing within social movement research to argue that organizational forms frame the bids of aspiring professionals. More specifically, I argue that certain organizational forms-such as that of the modern corporation-can aid would-be professionals in making their claims for professional recognition. Organizations do this, I argue, by providing aspiring professionals with a ready-made setting, rationale, and guarantees that make the newcomers more easily recognizable as professionals to outside audiences. I explore this argument by examining how the corporate form has facilitated private military contractors in their attempts to legitimate and develop this highly controversial new industry. The data are drawn from my interviews with private military contractors, state officials, and other interested parties surrounding private military corporations, as well as from archival data that detail the rise of the private military industry.

PSRO program manual.

Cover title.

The impact of PSROs on health care-costs : update of CBO's 1979 evaluation /

Item 1005-C

Organizations in time:history, theory, methods

Book review: Organizations in Time, edited by R Daniel Wadhwani and Marcelo Bucheli, Oxford University Press, 2014. The title of this edited volume is slightly misleading, as its various contributions explore the potential for more historical analysis in organization studies rather than addressing issues associated with time and organizing. Hopefully this will not distract from the important achievement of this volume—important especially for business historians—in further expanding and integrating business history into management and organization studies. The various contributions, elegantly tied together by R. Daniel Wadhwani and Marcelo Bucheli in their substantial introduction (which, by the way, presents a significant contribution in its own right), opens up new sets of questions, especially in terms of future methodological and theoretical developments in the field. This book also reflects the changing institutional location of business historians, who increasingly make their careers in business schools rather than history departments, especially in Europe, reopening old questions of history as a social science. There have been several calls to teach more history in business education, such as the Carnegie Foundation report (2011) that found undergraduate business education too narrow in focus and highlighted the need to integrate more liberal arts teaching into the curriculum. However, in the contemporary research-driven environment of business and management schools, historical understanding is unlikely to permeate the curriculum if historical analysis cannot first deliver significant theoretical contributions. This is the central theme around which this edited volume revolves, and it marks a milestone in this ongoing debate. (In the spirit of full disclosure, I should add that even though I did not contribute to this volume, I have coauthored with several of its contributors and view this book as central to my current research practice.)

‘Designer Vaginas': The Representation of Female Genitals on Canadian Cosmetic Surgeons' Websites

This thesis critically examines the online marketing tactics of 10 (English language) Canadian cosmetic surgery clinics’ websites that offer Female Genital Cosmetic Surgery (FGCS), specifically, labiaplasty (labial reduction) and vaginoplasty (vaginal tightening). Drawing on a qualitative Multimodal Critical Discourse Analysis (MCDA) and a feminist-informed social constructionist framework (Lazar, 2007), I examine how FGCS discourses reiterate and reinforce heteronormative sexual scripts for women, and impose restrictive models of femininity through the pathologization of genital diversity and the appropriation of postfeminist and neoliberal discourses of individual choice and empowerment. I explore feminist analyses of the links between FGCS and contemporary Western women’s postfeminist subjectivity, and the reconfiguration of women’s sexual agency, to better understand what these contemporary shifts may mean for women’s sexual anxiety and expression. My analysis highlights several discourses that organize the online marketing material of Canadian FGCS websites, including: the pathologization of genital diversity; restrictive models of femininity; heteronormative sexual scripts; neoliberal and post-feminist rhetorics of individual choice and empowerment; and psychological and sexual transformation. Overall, these discourses undermine acceptance of women’s genital diversity, legitimize the FGCS industry and frame FGCS as the only viable solution to alleviate women’s genital and sexual distress despite the lack of evidence regarding the long-term benefits and risks of these procedures, and the recommendations against FGCS by professional medical organizations.

Psicologia e educação no contexto das secretarias municipais: algumas contribuições para novas práticas

Visando a refletir sobre diferentes formas de pensar e fazer dos psicólogos que atuam na Educação Municipal, participamos da Comissão de E-ducação do CRP-06/subsede de Assis e entrevistamos psicólogas aí envolvidas. Verificamos que suas ações - condicionadas ao modelo político-ideológico ado-tado pela gestão municipal e pela formação acadêmica recebida - caracterizam-se por práticas tradicionais e/ou compartilhadas por outros profissionais, que não vêm contribuindo para a reversão do quadro de produção do fracasso escolar. Assim, consideramos urgente a revisão dos aspectos relativos à formação dos psicólogos, às práticas atualmente implementadas e ao engajamento dos órgãos dessa classe para a consolidação de uma psicologia mais comprometida com a cidadania.

Frances Lander Spain Papers - Accession 4

The Frances Lander Spain Papers consists of correspondence, clippings, photographs, memorabilia, and copies of her publications relating to her involvement with professional library organizations such as the American Library Association; her library work in Thailand as a Fulbright and Rockefeller Foundation grantee (1951-1952 and 1964-1965); and her work as coordinator of children’s services at the N.Y. Public Library (1953-1961). Correspondents include librarian Louis Round Wilson. There is also a family history which includes the family names Chambers, Collier, Cook, Crossland, Dantzler, Gran, Hardeman, Lander, McDaniel, McPherson, Miller, Pearce, Pierce, Schenk, Snead, Spain, Sparks, Warlick and Zimmerman.

Pietilä: El proyecto de Dipoli

Dipoli es un edificio plurifuncional localizado en el campus de Otaniemi que acoge los servicios generales del alumnado. Tanto encargo como propiedad pertenecía, hasta 2013, a la Asociación de Estudiantes de Helsinki University of Technology TKK (actualmente conocida como Aalto University), cuando se vendió y traspasó a la propia universidad. La tesis estudia este proyecto (1961-66) como uno de los ejemplos más significativos de la obra de los arquitectos Reima (1923-93)y Raili Pietilä (1926-), quienes se unieron tanto personal como profesionalmente el mismo año de la convocatoria del concurso (1961). Debido a la dificultad del encargo por la dimensión y flexibilidad de los espacios requeridos, el primer premio quedó desierto puesto que ninguna propuesta cumplía con todos los requisitos establecidos. El jurado otorgó el segundo premio a su proyecto junto con Osmo Lappo y solicitó posteriormente a ambos un desarrollo más profundo del mismo. Finalmente optaron por construir el edificio planteado por los Pietilä. En él debía desarrollarse un amplio abanico de actividades sociales como reuniones, entretenimiento nocturno, actuaciones, proyecciones de películas, cenas y bailes, así como servir de comedor durante los meses de invierno y espacio destinado a congresos en la época estival. Además, en dicho edificio se pretendía acoger el Sindicato de Estudiantes de la Universidad Tecnológica de Helsinki y se localizaría en el nuevo campus de Otaniemi a escasos kilómetros de la capital, donde Alvar Aalto ya estaba diseñando varios equipamientos universitarios siguiendo el planeamiento general que proyectó en el concurso de 1949. El elemento más característico de este proyecto es la cubierta, una estructura continua formada a partir de un caparazón hueco de hormigón in situ capaz de absorber dos lenguajes diferentes y generar, bajo ella, un espacio singular con multitud de posibilidades funcionales. Su geometría permite dividir el programa en estancias de menor tamaño sin perder ni la identidad ni unidad formal. La manera en que se iluminan los espacios bajo ella se consigue de formas diferentes: si bien la volumetría de líneas cartesianas presenta un sistema de aperturas longitudinales por donde penetra la luz cenital, en la forma más libre aparecen un conjunto de lucernarios de diferente tamaños y posiciones aparentemente aleatorias que introducen la luz natural por el plano del techo de forma más controlada, apoyada por la disposición de las ventanas perimetrales. El juego de espesores de la cubierta ofrece un conjunto de matices que pretenden resolver los tres condicionantes principales del proyecto, la adecuación de los usos en su interior, la compatibilidad de circulaciones de los usuarios y la inserción en el lugar. La percepción de este plano horizontal atraviesa lecturas múltiples, desde su uso primario de cubrición y cuya distancia con el plano del suelo se comprime para tensionar la grieta de luz al tiempo que ofrece nuevas relaciones con el paisaje hasta convertirse en fachada al apoyarse en el suelo y crear un límite físico entre interior y exterior. El objetivo fundamental de la tesis es entender mejor la traza particular de Dipoli desde una visión rigurosa que amplíe el conocimiento del edificio y al mismo tiempo explique el espacio propuesto a través de las diferentes herramientas de proyecto. Para ello se ha elaborado una documentación de la obra que parte de recopilar, seleccionar y redibujar la información existente desde el estado previo a la construcción del objeto terminado. El sentido de volver al Centro de Estudiantes de Otaniemi, supone, además de ayudar a comprender el trabajo de sus autores, entender el proceso de la historia de la arquitectura finlandesa y detectar relaciones con otras obras más lejanas con las que pudiese compartir ciertos valores, facilitando un entendimiento más global de la historia. Esta investigación se inicia desde la hipótesis que la forma final del edificio y su relación con el lugar, para proponer un tipo de arquitectura que confía en la observación sensible del programa, del uso, de las escalas de los espacios, del movimiento de las personas y su relación y anclaje con el lugar. Y en este sentido, el trabajo se desarrolla guiado por estos aspectos que se manifiestan también desde la influencia y comprensión de otros trabajos propios y ajenos. Para detectar las claves de proyecto que les han permitido la construcción espacial y formal de su arquitectura, entendiendo éstas como el conjunto de herramientas y mecanismos que reflexionan sobre una particular composición volumétrica y espacios dinámicos que ofrecen un aspecto exterior expresivo, la tesis se articula sobre dos capítulos principales “Contextos” y “Proyecto y Construcción” donde se quiere estudiar el proyecto en su forma más completa. Esta pareja de apartados aborda la descripción del marco temporal, físico, cultural, personal y profesional de los arquitectos, el análisis y síntesis de la propuesta y, por último, la repercusión del proyecto. Contextos pretende ubicar la obra además de facilitar la comprensión del conjunto de aspectos y condicionantes que determinaron la materialización de Dipoli. Este capítulo se subdivide a su vez en cinco apartados: Contexto Histórico, Físico y Cultural, Personal, Profesional e Incidencia de Dipoli. El Contexto histórico se centra en la descripción pormenorizada del conjunto de situaciones que influyen en el arquitecto cuando se toman decisiones durante el proceso de proyectar. El objetivo es definir los condicionantes que pueden haber afectado directa o indirectamente la obra. El capítulo comienza subrayando los temas de interés comunes para el resto de sus homólogos finlandeses. Principalmente se centra en la década de 1950 como etapa previa a la gestación de Dipoli. También atiende el proceso de evolución de la arquitectura finlandesa desde finales del S.XIX unido a la crisis de identidad nacional que el maestro Alvar Aalto superará por sus obras pero también por su personalidad y supondrá una gran sombra al resto de sus compañeros en el marco nacional e internacional provocando una reacción contraria a sus proyectos y persona entre el resto de arquitectos. Por este motivo, al tiempo que se gestaba el proyecto de Dipoli emergieron un grupo de profesionales que defendían fuertemente las trazas cartesianas del racionalismo como Aulis Blomstedt o Juhani Pallasmaa y que consiguieron abrir una nueva perspectiva intelectual. Por tanto será inevitable que la presencia del maestro nórdico Alvar Aalto aparezca a lo largo de toda la tesis, permitiéndonos un mejor entendimiento de la carga orgánica y humana de sus trabajos desde la perspectiva de los Pietilä. Posteriormente este capítulo desgrana aquellos intereses que dominaban el marco arquitectónico internacional y que pudieron influir en las soluciones planteadas. Dipoli será puesto en relación a diversas arquitecturas contemporáneas que presentan un enfoque diferente al esbozado por el Movimiento Moderno y cuyo marco de referencias guarda algún tipo de relación con los mismos temas de proyecto. Es el caso del grupo Team 10 o determinados ejemplos de arquitectos alemanes como Hugo Häring y Hans Scharoun, incluso puntos en común con el sistema constructivista del vanguardismo soviético. Estas relaciones con otras arquitecturas matizan su carácter singular e incluso se revisa en qué medida esta propuesta amplifica los aspectos que comparten. En cuanto al Contexto físico y cultural, una primera aproximación al ámbito donde el edificio se sitúa nos revela las características generales de un lugar claramente diferente a la ubicación del resto de edificios del campus. A continuación se adentra en el origen del nuevo centro universitario desde el planeamiento urbanístico de Alvar Aalto y revela tanto la forma de disponer las construcciones como las propuestas que el maestro había desarrollado con anterioridad a la convocatoria del concurso. Además aquí se destacan aquellos aspectos que propiciaron la elección del solar. Prosigue adentrándose en el programa propuesto por el jurado –entre cuyos miembros se encontraba el propio Aalto- y el análisis de las propuestas presentadas por cada uno de los arquitectos que obtuvieron una mención. Por último, se estudian y definen las obras más relevantes localizadas en el entorno físico del proyecto y que existían con anterioridad, destacando principalmente el trabajo de los Siren (Heikki y Kaija) y Alvar Aalto por los motivos desarrollados en el punto anterior. Prosigue con el Contexto Personal donde se seleccionan de datos biográficos que expliquen, en parte, las circunstancias personales que perfilaron su manera de entender la arquitectura y que consecuentemente influyeron en su camino intelectual hasta llegar a Dipoli. A continuación se indaga en la relación profesional y personal con Raili Paatelainen para establecer en qué medida participaron ambos en la propuesta. Este apartado concluye con el estudio de la etapa docente que profundiza en los temas de proyecto que Pietilä presentaba a los alumnos en sus clases de proyectos. En el proceso de comprensión de la evolución teórica y proyectual de los arquitectos se considera imprescindible la revisión de otros edificios propios que se enmarcan en el Contexto profesional. Éstos forman parte de la etapa de mayor actividad del estudio como son el Pabellón de Finlandia para la Exposición de Bruselas (1956-58), la Iglesia de Kaleva en Tampere (1959-66) y el Pabellón Nórdico para la Bienal de Venecia de 1960. Se completa la visión de estos tres ejemplos previos a Dipoli desde las investigaciones teóricas que realizó de forma paralela y que se difundieron a través de varias exposiciones. Nos centraremos en aquellas tres que fueron más relevantes en la madurez del arquitecto (Morfología y Urbanismo, La Zona y Estudios Modulares) para establecer relaciones entre unos aspectos y otros. En esta sección no se pretende realizar un análisis en profundidad, ni tampoco recoger la mayor parte de la obra de los Pietilä, sino más bien revelar los rasgos más significativos que faciliten el entendimiento de los valores anteriormente mencionados. Por último, Incidencia de Dipoli se refiere a la repercusión del edificio durante su construcción y finalización. Desde esta premisa, recoge el conjunto de críticas publicadas en las revistas de mayor difusión internacional que decidieron mostrar la propuesta además desde el propio interés del proyecto, por tratarse de un arquitecto reconocido internacionalmente gracias a la repercusión que obtuvieron sus proyectos anteriores. Se analiza el contenido de los artículos para establecer diversos encuentros con el capítulo Contextos y con los propios escritos de Pietilä. También se recogen las opiniones de críticos relevantes como Kenneth Frampton, Bruno Zevi o Christian Norberg-Schulz, destacando aquellos aspectos por los que mostraron un interés mayor. También se recoge y valora la opinión de sus homólogos finlandeses y que contradictoriamente se sitúa en el polo opuesto a la del juicio internacional. Se adentra en las situaciones complejas que propició el rechazo del edificio al desvincularse por completo de la corriente racionalista que dominaba el pensamiento crítico finés unido a la búsqueda de nuevas alternativas proyectuales que les distanciase del éxito del maestro Alvar Aalto. Pretende esclarecer tanto la justificación de dichos comentarios negativos como los motivos por los cuales Reima y Raili no obtuvieron encargos durante casi diez años, tras la finalización de Dipoli. Nos referiremos también a la propia opinión de los arquitectos. Para ello, en el apartado Morfología Literal se recoge el texto que Reima Pietilä publicó en el número 9 de la revista Arkkitehti para contrarrestar las numerosas críticas recibidas. Se subraya aquellos aspectos de proyecto que inciden directamente en la percepción y razón de ser de la propuesta. Por último, se manifiesta la valoración crítica de dos personas muy próximas al entorno personal y profesional de los Pietilä: Roger Connah y Malcolm Quantrill. Ambas figuras son las que han adentrado en el trabajo de los arquitectos con mayor profundidad y aportado una visión más completa del contexto arquitectónico de Finlandia en el s.XX. Se han interesado principalmente por el conocimiento morfológico que les ha llevado a la observación de los fenómenos de la naturaleza. Se apunta también la falta de objetividad de sus opiniones originadas en parte por haber colaborado profesionalmente y ser amigo íntimo de la familia respectivamente. El valor de la documentación aportada por ambos reside principalmente en la fiel transmisión de las explicaciones del propio Pietilä. El último capítulo Proyecto y Construcción engloba tanto la descripción exhaustiva del proyecto como el análisis de la obra. Al tiempo que se explica la propuesta, se establecen continuamente relaciones y paralelismos con otras arquitecturas que ayudan a entenderla. Para ello, se establecen tres apartados elementales: “El lugar”, “Programa y geometrías” y “Presencia y materialidad física” y se pretende identificar aquellas herramientas de proyecto en las que confía para la materialización de la obra al tiempo que se profundiza en la evolución de la propuesta. En cuanto a El lugar, se describe de manera pormenorizada el recorrido hasta alcanzar el edificio y cómo la mirada atenta de la naturaleza que lo rodea está continuamente presente en todos los dibujos de la propuesta. Se realiza un estudio tanto de la multiplicidad de accesos como del vacío existente en planta baja que forma parte del espacio público y que atraviesa el edificio diagonalmente. Desde aquí se evaluará los espacios intermedios existentes que matizan los ámbitos donde se desarrolla cada una de las actividades. A continuación se enfoca el estudio de la ventana como elemento relevante en la transición de espacios interiores y exteriores para posteriormente adentrarnos en la importancia de los recorridos en la planta superior y cómo las salas polivalentes se acomodan a estos. Programas y geometrías explica la solución y desarrollo de la propuesta a través de los tanteos de la planta. Detecta simultáneamente aquellos aspectos que aparecen en otros proyectos y que pueden haber influido en el desarrollo de la obra. Una vez que han sido estudiados los dos niveles se introduce la sección para analizar las conexiones entre ambos planos, destacando los tipos de escaleras y accesos que propician la multiplicidad de recorridos y en consecuencia el movimiento de las personas. En el último apartado se identifica la geometría de la estructura a través de la descripción formal de la cubierta y sus apoyos en planta para conocer cómo responde el volumen definitivo a la adecuación de los usos. El carácter del edificio a través del empleo de los materiales y las técnicas de construcción utilizadas se indaga desde la Materialidad física. Este punto de vista esclarece temas de proyecto como la relación multisensorial de Dipoli y el concepto del tiempo relacionado con espacios de carácter dinámico o estático. Una vez se ha realizado un análisis de la obra construida a través de sus recorridos, se plantea un último regreso al exterior para observar la presencia del edificio a través de su tamaño, color y texturas. Este apartado nos mostrará la mirada atenta a la escala del proyecto como vector de dirección que pretende encontrar la inserción adecuada del edificio en el lugar, cerrando el proceso de proyecto. El motivo de desarrollar esta tesis en torno a Dipoli se apoya en su consideración como paradigma de una arquitectura que confía en la observación sensible del programa, uso, las escalas de los espacios, circulaciones y su relación y anclaje con el lugar como argumentos fundamentales de proyecto, cuya realidad concreta consigue situar la propuesta en el marco histórico de la arquitectura nórdica e internacional. Además la distancia histórica desde mundo actual respecto a la década de los años 60 del s.XX nos permite entender el contexto cultural donde se inserta Dipoli que continúa nuestra historia reciente de la arquitectura y concibe la obra construida como una extensión de nuestro mundo contemporáneo. Por ello se valora el proyecto desde la mirada hacia atrás que analiza las diferencias entre la realidad construida y las intenciones de partida. Esta revisión dotada de una distancia crítica nos permite adentrarnos en la investigación de manera objetiva. Igualmente presenta una distancia histórica (referida al tiempo transcurrido desde su construcción) y socio-cultural que favorece la atenuación de prejuicios y aspectos morales que puedan desviar una mirada analítica y se alejen de una valoración imparcial. Dipoli, enmarcada en dicho periodo, mantiene la capacidad crítica para ser analizada. ABSTRACT The dissertation defends Dipoli ( 1961-1966 ) as one of the most significant examples of the Reima ( 1923-1993 ) Raili Pietilä (1926 -), who joined both personally and professionally the same year of the project´s competition (1961). Due to the difficulty of the commission by the size and flexibility of the required areas, there was not first prize awarded because none of the submitted proposals met all the requirements. The jury awarded Dipoli with second prize together with a competing scheme by Osmo Lappo. The board subsequently asked for a further development of both proposals and finally selected the one by Pietilä. The completed project allows a wide range of social activities such as meetings, night entertainment, performances, film screenings, dinners and dance to take place while the facility can also serve as a dining hall during winter months and conference center in the summer when necessary. In addition, the building was intended to house the Helsinki University of Technology (now Aalto University) Student Union. The University, at the time being designed by Alvar Aalto following his successful entry to the master plan competition in 1949, was located a few kilometers from the capital on the new campus in Otaniemi. The most characteristic element of the project is its roof which can be described as a continuous form achieved an in-situ concrete cavity structure that can modulate two different geometric languages and generate a singular space under it. The building is, in general terms, an unique shell space with many functional possibilities. Its geometry allows the program to split its functions into smaller sizes without losing the identity or formal unity of the general object. The way in which the spaces are illuminated is solved in two different ways. First, while the Cartesian-line volume presents a series of longitudinal openings into which natural light penetrates, the free-form volume shows a set of skylights in apparently random positions that vary in size and that introduce natural light through the roof in a more controlled manner. In addition the perimeter openings are present that relate directly to the nature that surrounds the building. The adaptable thickness of the roof provides a set of solutions that resolve the three main issues of the project: the adequacy of the functions in the interior areas, the complex capability for user flows and circulation and the manner in which the building is inserted in its context. The perception of the roof´ horizontal plane offers multiple interpretations, from its primary use as a primitive cover whose distance from the ground compresses the void and creates a light tension, to the new relationships with the landscape where by the roof becomes a façade cladding and rests directly on the ground to create a physical boundary between interior and exterior. The main scope of this research is to better understand the particular trace of Dipoli from a rigorous architectural view to deep into the knowledge of the building and, at the same time, to explain the space through a series of project design tools that have been used. For this reason, an accurate documentation has arisen from collecting, selecting and redrawing the existing information from the sketching stage to the built object. A through reanalysis of the Otaniemi Student Center therefore provides not only a more complete understanding of the work of the architects, but also leads to a better comprehension of the history of Finnish architecture, which is related to other cultural relationships and which shares certain architectural values which a more comprehensive understanding of general architectural history. This research starts from the working hypothesis that the final shape of the building and its relationship to its place created a type of architecture that relies on a sensitive observation of the program, the use of varying scales of space, the movement and flow of people and finally the coexistence with the natural context. In this sense, the work is developed based on those aspects that are also reflected in the influence of others architects by understanding both their own and other architects´ work. In order to obtain a personal reading of the project facts that allowed the architects construct Dipoli (understanding the facts as a set of tools and project mechanisms that are able to generate a particular volumetric composition and dynamic spaces that at the same time provide an expressive exterior), the research hinges on two main sections, "Contexts" and "Design and Construction", that study the project from all perspectives. This two parts address the description of temporal , physical , cultural , personal and professional framework, analysis and synthesis of the proposal and finally, the national and international influences on the project. Contexts seek to place the work and to facilitate the understanding of all aspects and conditions that led to the creation of Dipoli. This chapter is subdivided into five sections: Historical Context, Cultural and Physical, Personal, Professional and Dipoli Influences. Historical Context focuses on a detailed description of a set of precedents that influenced the architect when making decisions during design process. The objective is to define the conditions that could directly or indirectly shape the work. This chapter begins by highlighting issues of common interest to the rest its Finnish counterparts. The text is mainly focused on the 1950s as a prelude to Dipoli´s conception. It will also address the process of Finnish architecture from the late nineteenth century as linked to the national identity crisis that the great master Alvar Aalto overcame with both his works and personality, being a great drain on the rest of his colleagues. This aspect caused a reaction against Aalto and his projects. For this reason, at the time that Dipoli came into being a number of professionals who strongly defended the traces of Cartesian Rationalism, including Juhani Pallasmaa and Aulis Blomstedt emerged and brought a new intellectual perspective to the Finnish architecture scene. It is thus inevitable that the presence of Alvar Aalto will be apparent throughout the dissertation to allow a better understanding of the organizational and human character of their work from the Pietiläs´ perspective. Later, this chapter identifies those interests that dominated the international architectural framework that could have influenced Dipoli. The project will be placed in relation to various contemporary architectural works that were created using a different approach to that outlined by the Modern Movement. This is present in the case of Team 10 group and with specific examples of German architects including Hans Scharoun and Hugo Häring, as well as some commonalities with Soviet Constructivism. These relationships with other architecture qualify its singular character and even extend how this proposal amplifies those shared aspects. Physical and Cultural Context involves the unique site where the building is located which includes different features from the location of other buildings on the campus. IT then progresses into the origin of the new campus from the urban planning of Alvar Aalto and reveals both the setting and proposed constructions that Aalto had developed. This section also highlights the aspects that led to the choice of the site. I go deep into the program proposed by the jury (of whom Aalto was a member) and the analysis of the alternative proposals that received a special commendation. Finally, I study and define the most relevant works located near Dipoli, emphasizing primarily the work of the Sirens (Heikki and Kaija) and Alvar Aalto for the reasons developed in the previous section. I then proceed with the Personal Context, where a series of biographical data are selected to begin to explain the personal circumstances that outlined the Pietilas´ architectural understanding and consequently could have influenced their intellectual approach to design Dipoli. Then the text explores their professional and personal relationship to establish what extent they participated in the proposal. This section concludes with the study of the Reima Pietilä´s teaching period at Oulu that explores the issues he presented to his students there. In the process of understanding the Pietiläs´ theoretical and design evolution, it must be considered essential to study other buildings that are part of their professional context. These projects belong to the most active stage of their office and include the Finnish Pavilion for the World´s Fair in Brussels (1956-1958), Kaleva Church in Tampere (1959-1966) and the Nordic Pavilion at the 1960 Venice Biennale. We will complete the view of Dipoli from previous theoretical investigations performed in parallel that were spread through several exhibitions. We will focus on the three that were most relevant to the evolution of the architect (Morphology and Urbanism, the Zone, and Stick Studies) to establish a series of useful relationships. This section is not intended to be an in-depth analysis nor to collect most of the work of the Pietiläs´; but rather to reveal the most significant features that facilitate an understanding of the above values. Finally, Dipoli´s Impact refers to the influence of the building from many points of view during its construction and after its completion. It collects the reviews published in the world's most relevant magazines which had decided to show the alternate proposals, generally conceived of by internationally-renowned architects. I analyze the content of the articles in order to establish a series of parallels with the chapter Contexts and own writings Pietilä to clarify if main design directions were clear at that time. The views of relevant critics, including Kenneth Frampton, Bruno Zevi and Christian Norberg -Schulz, are also collected here. This episode also collects and assesses the views of these critics´ Finnish counterparts that generally stood at the opposite side of the international debate. It delves into the complex situation that led to the rejection of the building by the rationalists that dominated the Finnish critical thinking while searching for new alternatives to distance themselves from the Alvar Aalto´s success. It aims to clarify both the justification for these negative comments and the reasons why Reima and Raili not obtain a single commission for nearly ten years after the completion of Dipoli. From the critics we will approach the opinion of Reima Pietilä himself. To do this, in the Literal Morphology section we will see how the architect tried to defend his position. Those design tool that directly affected the perception of the proposal are provided through the figures of Roger Connah and Malcolm Quantrill. Finally, a critical –personal and professional- review of these two very close figures will take place. Despite knowing that both delved into the work of architects with greater depth and provided a complete view of the Finnish architectural context in 20th century, they have focused mainly morphological knowledge which has led to the observation of natural phenomena. It also notes the lack of objectivity in their views caused in part by, in the case of Connah, collaborating professionally and in that of Quantrill being a close friend of the Pietilä family. The value of the documentation provided by both resides mainly in the faithful transmission of the Pietiläs´ own explanations. The final chapter covers both Design and Construction and provides a comprehensive project description in order tofaithfully analyse the work. As the proposal is being explained, relationships of its built form are continuously linked to other architectural projects to gain a better understanding of Dipoli itself. To do this we have set three basic sections: "The Place", "Geometries & Function" and "Presence and Materiality. Construction process" that intended to identify those project tools for the realization of the work while deepens the proposal´s evolution. The Place describes how to approach and reach the building in detail and how the view out towards the surrounding natural setting is continuously shown in the proposal´s drawings. We will study both the multiplicity of entrances as well as the corridor downstairs as part of the public space that diagonally goes through the building. Then, the existing voids in the concrete cave for public activities will be evaluated. Lastly, the study will focus on the openings as a significant element in the transition from interior and exterior areas to describe the importance of the circulation on the second floor and how function is able to accommodate through the areas of void. Geometries & Function explains the final solution and the development of the proposal through the floor plan. Simultaneously it detects those aspects that appear in other projects and that may have influenced the development of the work. Once we have analyzed both levels –ground and second floor- section drawings come into the topic to study the connections between the two levels and highlighting the types of hierarchy for the multiple paths to organize the flows of people inside the building. In the last section the structural geometry is identified through the description of the form and how it responds to the final volumetrical settings. The character of the building through the use of materials and construction techniques inquires from Presence and Materiality. This point of view clarifies multisensory project issues as Dipoli relationship to the dynamic or static character or different spaces inside the building. Once the analysis has been made we will step back to a final return to the building´s exterior to analyze the presence of the building through its scale, colour and textures. This section emphasizes the project´s scale and orientation to find the proper insertion of the building in place. In short, this dissertation has been done by the idea that Pietiläs´special abilities were allowed from a sensitive observation of the program, the creation of a variety of special scales, dynamic circulation and the relating relationship with the project´s location as fundamental design tools. From this aspect, Dipoli could be more usefully framed in the historical context of Nordic and international architecture. The dissertation allows us to better understand the cultural context of the 1960s, in which Dipoli was established since it continues our recent architectural history. The final built form is conceived as an extension of our contemporary world. Therefore the project is assessed through the comparison of the architects´ intentions and the final completed project.

Information Technology Trends: Impact on Hotel Corporations

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Supporting self-management: development and evaluation of a digital resource for adults with asthma

The problem: Around 300 million people worldwide have asthma and prevalence is increasing. Support for optimal self-management can be effective in improving a range of outcomes and is cost effective, but is underutilised as a treatment strategy. Supporting optimum self-management using digital technology shows promise, but how best to do this is not clear. Aim: The purpose of this project was to explore the potential role of a digital intervention in promoting optimum self-management in adults with asthma. Methods: Following the MRC Guidance on the Development and Evaluation of Complex Interventions which advocates using theory, evidence, user testing and appropriate modelling and piloting, this project had 3 phases. Phase 1: Examination of the literature to inform phases 2 and 3, using systematic review methods and focussed literature searching. Phase 2: Developing the Living Well with Asthma website. A prototype (paper-based) version of the website was developed iteratively with input from a multidisciplinary expert panel, empirical evidence from the literature (from phase 1), and potential end users via focus groups (adults with asthma and practice nurses). Implementation and behaviour change theories informed this process. The paper-based designs were converted to the website through an iterative user centred process (think aloud studies with adults with asthma). Participants considered contents, layout, and navigation. Development was agile using feedback from the think aloud sessions immediately to inform design and subsequent think aloud sessions. Phase 3: A pilot randomised controlled trial over 12 weeks to evaluate the feasibility of a Phase 3 trial of Living Well with Asthma to support self-management. Primary outcomes were 1) recruitment & retention; 2) website use; 3) Asthma Control Questionnaire (ACQ) score change from baseline; 4) Mini Asthma Quality of Life (AQLQ) score change from baseline. Secondary outcomes were patient activation, adherence, lung function, fractional exhaled nitric oxide (FeNO), generic quality of life measure (EQ-5D), medication use, prescribing and health services contacts. Results: Phase1: Demonstrated that while digital interventions show promise, with some evidence of effectiveness in certain outcomes, participants were poorly characterised, telling us little about the reach of these interventions. The interventions themselves were poorly described making drawing definitive conclusions about what worked and what did not impossible. Phase 2: The literature indicated that important aspects to cover in any self-management intervention (digital or not) included: asthma action plans, regular health professional review, trigger avoidance, psychological functioning, self-monitoring, inhaler technique, and goal setting. The website asked users to aim to be symptom free. Key behaviours targeted to achieve this include: optimising medication use (including inhaler technique); attending primary care asthma reviews; using asthma action plans; increasing physical activity levels; and stopping smoking. The website had 11 sections, plus email reminders, which promoted these behaviours. Feedback during think aloud studies was mainly positive with most changes focussing on clarification of language, order of pages and usability issues mainly relating to navigation difficulties. Phase 3: To achieve our recruitment target 5383 potential participants were invited, leading to 51 participants randomised (25 to intervention group). Age range 16-78 years; 75% female; 28% from most deprived quintile. Nineteen (76%) of the intervention group used the website for an average of 23 minutes. Non-significant improvements in favour of the intervention group observed in the ACQ score (-0.36; 95% confidence interval: -0.96, 0.23; p=0.225), and mini-AQLQ scores (0.38; -0.13, 0.89; p=0.136). A significant improvement was observed in the activity limitation domain of the mini-AQLQ (0.60; 0.05 to 1.15; p = 0.034). Secondary outcomes showed increased patient activation and reduced reliance on reliever medication. There was no significant difference in the remaining secondary outcomes. There were no adverse events. Conclusion: Living Well with Asthma has been shown to be acceptable to potential end users, and has potential for effectiveness. This intervention merits further development, and subsequent evaluation in a Phase III full scale RCT.