Facilitating Emergence: Complex, Adaptive Systems Theory and the Shape of Change

This study used Principal Component Analysis to examine factors that facilitate emergent change in an organization. As organizational life becomes more complex, today’s dominant management paradigms no longer suffice. This is particularly true in a health care setting where multiple sources of disease interacting with each other meet with often-competing organizational priorities and accountabilities in a highly complex world. This study identifies new ways of approaching complexity by embracing the capacity of complex systems to find their own form of order and coherence. Based on a review of the literature, interviews with hospital CEOs, and my organization development practice experience in the health care sector, I identified nine constructs of interest: a strategic framework; organizational culture; work structures; CEO and executive team; leadership culture; quality control systems; accountability framework; learning structures; and feedback processes. One hundred and sixty-two senior leaders, managers, and staff at a hospital in Toronto, Canada, who had completed an eight-week leadership program, completed an Emergence Survey© based on the nine constructs of interest. The survey included Likert items representing the nine constructs, as well as opportunities to provide narrative feedback. In the initial analysis of the survey results, the items taken as a whole would not converge on a clear set of components. It was also clear that the mean for most of the items was very high. I theorized that the size of the sample and possibility that they were a favorably biased convenience sample because they had self-selected as leaders may have contributed to the lack of convergence and high mean. I then theorized three clusters of constructs, based on what appeared to be natural affinities. At that point I facilitated two focus groups with people who were among the survey group. Both focus groups affirmed the importance of each of the factors in improving organizational performance indicators such as patient satisfaction, staff engagement, and quality. I then completed a principal component analysis of each of the three clusters of constructs. From this analysis, seven components emerged. Five of these, executive engagement, safe-fail culture, collaborative decision-processes, a collaborative quality, and intentional learning processes had reliability \u3e.70; culture of experimentation and purposeful orientation had reliability \u3c .70. The electronic version of this Dissertation is at OhioLink ETD Center, www.ohiolink.edu/et

Psychological interventions to improve psychological well-being in people with dementia or mild cognitive impairment: systematic review and meta-analysis protocol

Open Access ArticleINTRODUCTION: Dementia and mild cognitive impairment are associated with an increased risk of depression, anxiety, psychological distress and poor mental health-related quality of life. However, there is a lack of research examining the evidence base for psychological interventions targeting general psychological well-being within this population. Furthermore, there is little research relating to the design of randomised controlled trials examining psychological interventions for dementia and mild cognitive impairment, such as effective recruitment techniques, trial eligibility and appropriate comparators. METHODS AND ANALYSIS: Systematic review of electronic databases (CINAHL; EMBASE; PsychInfo; MEDLINE; ASSIA and CENTRAL), supplemented by expert contact, reference and citation checking, and grey literature searches. Published and unpublished studies will be eligible for inclusion with no limitations placed on year of publication. Primary outcomes of interest will be standardised measurements of depression, anxiety, psychological distress or mental health-related quality of life. Eligibility and randomisation proportions will be calculated as secondary outcomes. If data permits, meta-analytical techniques will examine: (1) overall effectiveness of psychological interventions for people with dementia or mild cognitive impairment in relation to outcomes of depression, anxiety, psychological distress or mental health-related quality of life; (2) clinical and methodological moderators associated with effectiveness; (3) proportions eligible, recruited and randomised. ETHICS AND DISSEMINATION: Ethical approval is not required for the present systematic review. Results will inform the design of a feasibility study examining a new psychological intervention for people with dementia and depression, with dissemination through publication in peer-reviewed journals and presentations at relevant conferences. TRIAL REGISTRATION NUMBER: CRD42015025177.National Institute for Health Research (NIHR

Gothic visions of classical architecture in Hablot Knight Browne’s “dark” illustrations for the novels of Charles Dickens

In the early gothic literature of the eighteenth century danger lurked in the darkness beneath the pointed arches of gothic buildings. During the nineteenth century there was a progressive, although never complete, dislocation of gothic literary readings from gothic architecture. This article explores a phase in that development through discussion of a series of ‘dark’ illustrations produced by Hablot Knight Browne to illustrate novels by Charles Dickens. These show the way in which the rounded arches of neo-classical architecture were depicted in the mid-nineteenth century as locales of oppression and obscurity. Such depictions acted, in an age of political and moral reform, to critique the values of the system of power and authority that such architecture represented

Dynamics of capacitively coupled double quantum dots

We consider a double dot system of equivalent, capacitively coupled semiconducting quantum dots, each coupled to its own lead, in a regime where there are two electrons on the double dot. Employing the numerical renormalization group, we focus here on single-particle dynamics and the zero-bias conductance, considering in particular the rich range of behaviour arising as the interdot coupling is progressively increased through the strong coupling (SC) phase, from the spin-Kondo regime, across the SU(4) point to the charge-Kondo regime; and then towards and through the quantum phase transition to a charge-ordered (CO) phase. We first consider the two-self-energy description required to describe the broken symmetry CO phase, and implications thereof for the non-Fermi liquid nature of this phase. Numerical results for single-particle dynamics on all frequency scales are then considered, with particular emphasis on universality and scaling of low-energy dynamics throughout the SC phase. The role of symmetry breaking perturbations is also briefly discussed.Comment: 14 pages, 6 figure

Single-particle dynamics of the Anderson model: a two-self-energy description within the numerical renormalization group approach

Single-particle dynamics of the Anderson impurity model are studied using both the numerical renormalization group (NRG) method and the local moment approach (LMA). It is shown that a 'two-self-energy' description of dynamics inherent to the LMA, as well as a conventional 'single-self-energy' description, arise within NRG; each yielding correctly the same local single-particle spectrum. Explicit NRG results are obtained for the broken symmetry spectral constituents arising in a two-self-energy description, and the total spectrum. These are also compared to analytical results obtained from the LMA as implemented in practice. Very good agreement between the two is found, essentially on all relevant energy scales from the high-energy Hubbard satellites to the low-energy Kondo resonance.Comment: 12 pages, 6 figure

Homelessness and the meaning of home: rooflessness or rootlessness?

This paper has several objectives. These are: (1) to analyse the meaning of homelessness in the light of recent contributions on the meaning of home: (2) to criticize some current perspectives on homelessness as a social problem; (3) to identify and explore a number of different dimensions of the meaning of home and homelessness; (4) to reassess the evidence on the context of home and homelessness, and re-examine the meaning of homelessness in the light of that reassessed evidence; and (5) to explain the political meaning of homelessness as expressed in official definitions, legislation and state provision (or lack of it)

Occupational Exposure to Polycyclic Aromatic Hydrocarbons and Elevated Cancer Incidence in Firefighters

Cancer incidence appears to be higher amongst firefighters compared to the general population. Given that many cancers have an environmental component, their occupational exposure to products of carbon combustion such as polycyclic aromatic hydrocarbons (PAHs) is of concern. This is the first UK study identifying firefighters exposure to PAH carcinogens. Wipe samples were collected from skin (jaw, neck, hands), personal protective equipment of firefighters, and work environment (offices, fire stations and engines) in two UK Fire and Rescue Service Stations. Levels of 16 US Environmental Protection Agency (EPA) PAHs were quantified together with more potent carcinogens: 7,12-dimethylbenzo[a]anthracene, and 3-methylcholanthrene (3-MCA) (12 months post-initial testing). Cancer slope factors, used to estimate cancer risk, indicate a markedly elevated risk. PAH carcinogens including benzo[a]pyrene (B[a]P), 3-MCA, and 7,12-dimethylbenz[a]anthracene PAHs were determined on body surfaces (e.g., hands, throat), on PPE including helmets and clothing, and on work surfaces. The main exposure route would appear to be via skin absorption. These results suggest an urgent need to monitor exposures to firefighters in their occupational setting and conduct long-term follow-up regarding their health status

Pore water geochemistry along continental slopes north of the East Siberian Sea: inference of low methane concentrations

Continental slopes north of the East Siberian Sea potentially hold large amounts of methane (CH4) in sediments as gas hydrate and free gas. Although release of this CH4 to the ocean and atmosphere has become a topic of discussion, the region remains sparingly explored. Here we present pore water chemistry results from 32 sediment cores taken during Leg 2 of the 2014 joint Swedish–Russian–US Arctic Ocean Investigation of Climate–Cryosphere–Carbon Interactions (SWERUS-C3) expedition. The cores come from depth transects across the slope and rise extending between the Mendeleev and the Lomonosov ridges, north of Wrangel Island and the New Siberian Islands, respectively. Upward CH4 flux towards the seafloor, as inferred from profiles of dissolved sulfate (SO42−), alkalinity, and the δ13C of dissolved inorganic carbon (DIC), is negligible at all stations east of 143° E longitude. In the upper 8 m of these cores, downward SO42− flux never exceeds 6.2 mol m−2 kyr−1, the upward alkalinity flux never exceeds 6.8 mol m−2 kyr−1, and δ13C composition of DIC (δ13C-DIC) only moderately decreases with depth (−3.6 ‰ m−1 on average). Moreover, upon addition of Zn acetate to pore water samples, ZnS did not precipitate, indicating a lack of dissolved H2S. Phosphate, ammonium, and metal profiles reveal that metal oxide reduction by organic carbon dominates the geochemical environment and supports very low organic carbon turnover rates. A single core on the Lomonosov Ridge differs, as diffusive fluxes for SO42− and alkalinity were 13.9 and 11.3 mol m−2 kyr−1, respectively, the δ13C-DIC gradient was 5.6 ‰ m−1, and Mn2+ reduction terminated within 1.3 m of the seafloor. These are among the first pore water results generated from this vast climatically sensitive region, and they imply that abundant CH4, including gas hydrates, do not characterize the East Siberian Sea slope or rise along the investigated depth transects. This contradicts previous modeling and discussions, which due to the lack of data are almost entirely based on assumption

Far infrared observations of pre-protostellar sources in Lynds 183

Using ISOPHOT maps at 100 and 200um and raster scans at 100, 120, 150 and 200um we have detected four unresolved far-infrared sources in the high latitude molecular cloud L183. Two of the sources are identified with 1.3mm continuum sources found by Ward-Thompson et al. and are located near the temperature minimum and the coincident column density maximum of dust distribution. For these two sources, the ISO observations have enabled us to derive temperatures (about 8.3 K) and masses (about 1.4 and 2.4 solar masses). They are found to have masses greater than or comparable to their virial masses and are thus expected to undergo gravitational collapse. We classify them as pre-protostellar sources. The two new sources are good candidates for pre-protostellar sources or protostars within L183.Comment: 12 pages, 7 Postscript figures, 1 JPEG figure. Accepted for publication in Astronomy & Astrophysic