A comparative analysis of strategies for design in Finland and Brazil

This paper reports on work in progress and initial findings of a research project that is comparing existing strategies for design (in promotion, support and policy fields) in four selected countries: Finland, South Korea, Brazil and India. For this specific paper, Finland and Brazil are the case studies compared. The paper explains the criteria for selection of these subjects, based on their stage of development and position on the Global Competitiveness Index (World Economic Forum). The objective of the research project is to investigate how countries with different national contexts adopt different strategies for design in coherence with their positions, weaknesses and strengths. Keywords: Design Policy, Design Strategy, Case Study/Ies, Brazil, Finland, Economic Development.</p

THE DEVELOPMENT OF A METHODOLOGY FOR THE COST JUSTIFICATION OF NEW MANUFACTURING INVESTMENTS

This work addresses the problems faced by small and medium manufacturing enterprises (SME's) in cost justifying new investments in tools, techniques and technologies, and presents a methodology which significantly improves on current cost justification techniques. The methodology provides a structured approach which leads a company through a series of workshops, which assist a company in establishing the full company wide benefits and costs associated with new manufacturing investment. A model, in the form of a workbook and the specification for a prototype computer based tool, of the tasks necessary in cost justification is presented. The model is used to structure the decisions relating to possible investments. The research work described involved two distinct stages. The first stage included a fifteen month involvement in the Finjust project - a financial justification project sponsored by the DTI, in collaboration with Quintec Applied Systems, Mundy Johnson, Entrepreneurial Technologies and the University of Plymouth, where the author's individual contribution was for the identification of the links between business needs and technologies and specifying the benefits of the investments. The author's involvement in the project allowed the strategy to be tested in the collaborating companies. In the second stage, the major contribution of the research lies in the development of a new methodology, which whilst based on some of the principles of the Finjust project, incorporates many new ideas which significantly improve its value to SME's. Through the use of this work SME's are encouraged to improve ownership and commitment to the manufacturing solutions identified by fully involving relevant company personnel in the identification of business needs, the generation of solutions and the financial justification of proposed investments. This work also provides a mechanism to facilitate management development and training in financial justification by providing rationales for each activity, forms for the collection of data and tool kits to assist in the completion of specific tasks. The results of this work have provided the data necessary for the specification and building of an improved methodology in the form of a workbook

Helping alliance and unmet needs in routine care of people with severe mental illness across Europe: a prospective longitudinal multicenter study

The helping alliance (HA) refers to the collaborative bond between patient and therapist including shared goals and tasks. People with severe mental illness have a complex mixture of clinical and social needs. Using mixed-effects regression, this study examined in 588 people with severe mental illness whether an increase in the HA is associated with fewer unmet needs over time, and whether change in the HA precedes change in unmet needs. It was found that a reduction of unmet needs was slower in patients with higher HA (B=0.04, p<.0001) only for patient-rated measures. Improvement in both patient-rated and staff-rated HA over time was associated with fewer subsequent patient- (B=-0.10, p<0.0001) and staff-rated (B=-0.08, p=0.0175) unmet needs. With positive changes in the HA preceding fewer unmet needs, findings provide further evidence for a causal relationship between alliance and outcome in the treatment of people with severe mental illness

Clinical Decision Making and Outcome in Routine Care for People with Severe Mental Illness (CEDAR): Study protocol

BACKGROUND: A considerable amount of research has been conducted on clinical decision making (CDM) in short-term physical conditions. However, there is a lack of knowledge on CDM and its outcome in long-term illnesses, especially in care for people with severe mental illness. METHODS/DESIGN: The study entitled "Clinical decision making and outcome in routine care for people with severe mental illness" (CEDAR) is carried out in six European countries (Denmark, Germany, Hungary, Italy, Switzerland and UK). First, CEDAR establishes a methodology to assess CDM in people with severe mental illness. Specific instruments are developed (and psychometric properties established) to measure CDM style, key elements of CDM in routine care, as well as CDM involvement and satisfaction from patient and therapist perspectives. Second, these instruments are being put to use in a multi-national prospective observational study (bimonthly assessments during a one-year observation period; N = 560). This study investigates the immediate, short- and long-term effect of CDM on crucial dimensions of clinical outcome (symptom level, quality of life, needs) by taking into account significant variables moderating the relationship between CDM and outcome. DISCUSSION: The results of this study will make possible to delineate quality indicators of CDM, as well as to specify prime areas for further improvement. Ingredients of best practice in CDM in the routine care for people with severe mental illness will be extracted and recommendations formulated. With its explicit focus on the patient role in CDM, CEDAR will also contribute to strengthening the service user perspective. This project will substantially add to improving the practice of CDM in mental health care across Europe. TRIAL REGISTER: ISRCTN75841675