26,073 research outputs found

    Self-help/mutual aid groups in mental health : ideology, helping mechanisms and empowerment

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    In the last quarter of the twentieth century, self-help/mutual aid groups for mental health issues started to emerge in growing numbers, mainly in Western societies, offering and/or advocating for alternative non-traditional forms of support, and attracted the attention of many researchers and clinicians for their unique characteristics. Among the subjects of interest are typologies of groups, helping mechanisms and benefits from participation. However, there is lack of systematic research in the area and existing studies have been largely confined to the therapeutic value of these groups instead of acknowledging their socio-political meaning and subsequent psychosocial benefits for their members like personal empowerment. The present study was conducted during the transitional years from a Conservative to a newly elected Labour Government (1996 -1998), with subsequent policy shifts taking place in the welfare sector. The purpose of the study was to explore the potential of self-help groups as part of a broader new social movement, the service user movement, focussing on the English scene. It addressed this issue examining the relevance of a group typology based on political ideology and focus of change. To test the validity of this classification for members, a set of individual characteristics and group mechanisms as well as their change through time were examined. The sample consisted of fourteen mental health selfhelp/mutual aid groups from London and South East England, with a variety of structural and organisational features. The methodology used was a combination of both quantitative (self-completion questionnaires) and qualitative techniques (analysis of written material, participant observation and interviews). Measurements were repeated after a one-year interval (Time 1N=67, Time 2 N=56). Findings showed that, indeed, political ideology of self-help/mutual aid groups provided the basis of a meaningful typology and constitutes a comprehensive way of categorising them. Group ideology was related to specific helping mechanisms and aspects of personal empowerment. Specifically, conservative and combined group members reported more expressive group processes like sharing of feelings and self-disclosure, while radical group members were more empowered and optimistic. Group identification was also associated with specific helping activities and aspects of empowerment in the three group categories. The psychosocial character of group types and the beneficial outcomes for members remained stable through time. In general, prolonged participation was reflected in greater member identification with the group and resulted in improved mental wellbeing, increased social support, companionship and optimism for the future

    Studies of strategic performance management for classical organizations theory & practice

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    Nowadays, the activities of "Performance Management" have spread very broadly in actually every part of business and management. There are numerous practitioners and researchers from very different disciplines, who are involved in exploring the different contents of performance management. In this thesis, some relevant historic developments in performance management are first reviewed. This includes various theories and frameworks of performance management. Then several management science techniques are developed for assessing performance management, including new methods in Data Envelopment Analysis (DEA) and Soft System Methodology (SSM). A theoretical framework for performance management and its practical procedures (five phases) are developed for "classic" organizations using soft system thinking, and the relationship with the existing theories are explored. Eventually these results are applied in three case studies to verify our theoretical development. One of the main contributions of this work is to point out, and to systematically explore the basic idea that the effective forms and structures of performance management for an organization are likely to depend greatly on the organizational configuration, in order to coordinate well with other management activities in the organization, which has seemingly been neglected in the existing literature of performance management research in the sense that there exists little known research that associated particular forms of performance management with the explicit assumptions of organizational configuration. By applying SSM, this thesis logically derives some main functional blocks of performance management in 'classic' organizations and clarifies the relationships between performance management and other management activities. Furthermore, it develops some new tools and procedures, which can hierarchically decompose organizational strategies and produce a practical model of specific implementation steps for "classic" organizations. Our approach integrates popular types of performance management models. Last but not least, this thesis presents findings from three major cases, which are quite different organizations in terms of management styles, ownership, and operating environment, to illustrate the fliexbility of the developed theoretical framework

    Reforming the United Nations

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    The thesis deals with the financial crisis that the United Nations faced starting in 1985 when the US Congress decided to withhold a significant part of the US contribution to the UN regular budget in order to force a greater say for the major contributors on budgetary issues, budgetary restraint and greater efficiency. The UN responded by the adoption of resolution 41/213 of 19 December 1986 that was based on the recommendations of a Group of High-level Intergovernmental Experts ("G-18") set up a year earlier. A new system was introduced regarding the formulation of the regular budget of the United Nations Organisation and a broader process of reform was initiated including a restructuring of the Secretariat and of the intergovernmental machinery in the economic and social fields. After an introductory chapter (Chapter I), the thesis examines the UN problems at the budgetary/financial and administrative/structural levels, the solutions proposed from within and without the United Nations established framework and the actual attempts at reform (Chapters II and ifi). The realisation that the implementation of reforms is rather disjointed and often unsuccessful (e.g. the failure to restructure the intergovernmental machi.neiy) prompts a search for the deeper causes of the UN problems at the political level and the attitudes of the main actors, namely the USA, the USSR, some up-and-coming states, notably Japan, the Third World states and, finally, of the UN Secretary-General and the Secretariat (Chapter 1V). Although the financial crisis may have subsided since 1988 and the USA seem committed to paying up their dues, the deeper UN crisis of identity has not been resolved and is expected to resurface if no bold steps are taken. In that direction, some possible alternative courses for the UN in the future are discussed drawing upon theory and practice (Chapte

    Power in the health service : The effects of reorganisation on professions and bureaucracies

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    The National Health Service (NHS) has been analysed predominantly in terms dictated by a systems/functional model of organisational behaviour. Decision-making processes which did not comply with this model were regarded as pathological or dysfunctional. This study takes a different stance and looks at District Health Authorities (DHAs) to see if the NHS can be better understood by accepting Lukes' conception of a "third dimension of power". The study is not focussed around conflicts of interest because the third dimension of power involves situations in which "real" interests may remain unknown. Power may prevent conflicts becoming apparent and interests becoming realised. Because, however, Lukes had suggested that interests may become realised during periods of change, the study focusses on the restructuring which began with reorganisation of the NHS in 1982. The parts played by medical professionals, administrative staff, nursing staff, and lay-members on DHAs are examined and demonstrate the extent to which their activities were influenced by one another and by their external political environment, notably the Conservative government. The mechanisms of power used during the period 1982-1985 when new management structures were established and then replaced by a further reorganisation of management are examined. This shows the extent to which these new management changes became accepted as legitimate and how the legitimation process began with the 1982 reorganisation. Lukes' third dimension of power is confirmed as too restrictive a conception and that power is more subtle than even he had proposed. Nor is it always repressive or manipulative

    3D printed Microneedles for Transdermal Drug Delivery

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    3D printing is a revolutionary manufacturing and prototyping technology that has altered the outlooks of numerous industrial and scientific fields since its introduction. Recently, it has attracted attention for its potential as a manufacturing tool for transdermal microneedles for drug delivery. In the present thesis, the 3D printability of solid and hollow microneedles via photopolymerisation-based 3D printing was investigated, aiming at establishing robust manufacturing strategies for reproducible, mechanically strong and versatile microneedles. The developed microneedles were employed as drug delivery systems for the treatment of diabetes via insulin administration. Solid microneedles featuring different geometries were designed and 3D printed. It was demonstrated that the printing and post-printing parameters affected the printed quality, a finding that was employed to optimise the manufacturing strategy. Microneedle geometry was also found to have an impact on the piercing and fracture behaviour; however all microneedle designs were found to be mechanically safe upon application. The solid microneedles were subsequently coated with insulin-polymer films, using a 2D inkjet printing technology. The coating process achieved spatial control of the drug deposition, with quantitative accuracy. The microneedle geometry was shown to influence the morphology of the coating film, an effect that was pronounced during in the in vitro delivery studies of insulin to porcine skin. Furthermore, hollow microneedles were designed and 3D printed, featuring different heights. Two photopolymerisation-based technologies were studied, and their performance was compared. The key influential parameters of the printing outcome and microneedle quality were identified to be the printing angle and the size of the microneedle opening. The hollow microneedles were found to be effective in piercing porcine skin without structural damaging. The hollow microneedles were incorporated into complex patches with internal microfluidic structures for the provision and distribution of drug-containing solutions. The developed complex hollow microneedle patches were coupled with a microelectromechanical system to create a novel platform device for controlled, personalised transdermal drug delivery. Advanced imaging techniques revealed that the device achieved distribution of the liquid within porcine skin tissue without the creation of depots that would delay absorption. The device was evaluated for its efficacy to transdermally deliver a model dye and insulin in vitro. In vivo trials were also conducted using diabetic rodents, with the device achieving faster onset of insulin action and sustained glycemic control, in comparison to subcutaneous injections. Overall, the findings of the present research are anticipated to elucidate key problematic areas associated with the application of 3D printing for microneedle manufacturing and propose feasible solutions. The outermost goal of this work is to contribute to the advancement of knowledge in the field of 3D printed transdermal drug delivery systems, in order to bring them one step closer to their adoption in the clinical setting

    The application of Evidence-Based Medicine methodologies in sports science: problems and solutions

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    This thesis analyses the use of 'Evidence-Based' methodologies of evidence assessment and intervention and policy design from medicine, and their use in sport and exercise science. It argues that problems exist with the application of Evidence-Based methodologies in sports science, meaning that the quality of evidence used to inform decision-making is lower than is often assumed. This thesis also offers realistic solutions to these problems, broadly arguing for the importance of taking evidence from mechanistic studies seriously, in addition to evidence from RCTs

    Constructing Cassandra: The social construction of strategic surprise at the Central Intelligence Agency 1947-2001

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    This dissertation takes a post-positivist approach to strategic surprise, and examines the identity and internal culture of the US Central Intelligence Agency (CIA) through the lens of social constructivism. It identifies numerous social mechanisms that created and maintained four key, persistent attributes of the CIA’s identity and culture between 1947 and 2001. These features are: 1) homogeneity of personnel; 2) scientism and the reification of a narrow form of ‘reason’; 3) an overwhelming preference for ‘secrets’ over openly-available information; and, 4) a relentless drive for consensus. It then documents the influence of these elements of the CIA’s identity and culture in each phase of the intelligence cycle (Tasking, Collection, Analysis, Production and Dissemination), prior to four strategic surprises: the Cuban Missile Crisis, the Iranian Islamic Revolution of 1979, the collapse of the USSR, and al-Qa’ida’s terrorist attacks on September 11th, 2001. It concludes that these key aspects of the CIA’s identity and culture created the antecedent conditions that allowed these four strategic surprises to occur, and thus prevented the CIA from fulfilling its mandate to ‘prevent another Pearl Harbor’. This conclusion is supported by contrasting the majority views at the CIA prior to these events with the views of ‘Cassandras’ (i.e. individuals inside or outside the Agency who anticipated the approximate course of events based on reasoned threat assessments that differed sharply from the Agency’s, but who were ignored or sidelined). In so doing, this work shifts the burden of proof for explaining strategic surprises back to the characteristics and actions of intelligence producers like the CIA, and away from errors by intelligence consumers like politicians and policymakers. This conclusion also allows this work to posit that understanding strategic surprise as a social construction is logically prior to previously proposed, entirely positivist, attempts to explain or to prevent it

    The future of residue-based bioenergy for industrial use in Sub-Saharan Africa

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    Energy outlooks for Africa feature increased use of fossil fuels. However, they widely ignore that a transition from traditional to modern bioenergy can support the increasing commercial energy demand and offer a high level of flexibility and dispatchability. We use energy statistics, resource assessments and demand analysis to show how switching traditional biomass use to more sustainable technologies could practically eliminate unsustainable fuelwood use. Furthermore, mobilising agricultural and forestry residue for commercial use could grow a sustainable biomass industry and offset Africa's projected expansion of fossil fuels. The assessment focuses on feedstocks and potential energy conversion options for selected and most promising bioenergy pathways in Sub-Saharan Africa's growing and economically relevant industries: cement, agricultural processing, livestock, and horticulture. Examples of specific applications are given to support the high-level resource assessment and demand balances in these sectors. Our results indicate that 3317 PJ bioenergy could be utilised in Sub-Saharan Africa. Even with the calculated gap between biomass availability and biomass demand of 5559 PJ in future energy scenarios, bioenergy can contribute to sustainable energy supply and access in SSA. The sustainability mapping highlighted that bioenergy could deliver integral social and economic impacts because of the close integration with agriculture as the main livelihood supporting sector in SSA. Sustainability frameworks and governance structures must consider bioenergy beyond its cost and clean energy potential to maximise positive trade-offs
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