Damage, recovery, and the geographies of military–civil entanglements

This paper explores two forms of entanglements between military and civilian phenomena and activities, in contexts of recovery from damaging events. One concerns global civil–military entanglements in low earth orbital space, where recovery from damage is necessary for sustaining the civilian and military service support systems on which we increasingly depend. The other uses the damage caused by the UK state’s regimes of financial austerity to highlight how gendered, spatialized forms of personal labour through military Reserve forces sustain recovery. Both suggest ways in which military and political geography and geographers can find new ways of thinking through civil–military entanglements

Language and text in adjudication and dispute settlement in administrative tribunals and related settings

This thesis has four main objectives; a) to provide an understanding of Legal Aid Appeals Tribunals, from a description of individual cases and the activities that occur therein, focusing in the main on those at which an appellant and/or their representative is present; b) to explore the use of documentation in the tribunal practices of tribunal panel members, legal aid clerks, appellants and their representatives; c) to explore the possibilities that post-analytic ethnomethodology as the adopted research methodology allows, and to clarify what this radical research 'programme' entails; and d) taking legal positivism as an epistopic to explore its possible ethnomethodological respecification in light of the descriptions of practice in legal aid tribunals. Although this thesis explores the possibility of post-analytic descriptions it is not a theoretical investigation into post-analytic ethnomethodology, but an empirical investigation of phenomena of legal aid tribunals which allows an exploration of the practical application of post-analytic ethnomethodology. Nevertheless, some clarification is attempted of just what a post-analytic ethnomethodology may entail. Used in conjunction with the description of the use of texts in legal tribunals, the investigation of epistopics, though not a common research practice does here help develop our understanding of the situated nature of legal practical, legal decision making, and legal objectivity. In a wider sense this approach highlights an argument made throughout this research, that texts are both significant and researchable as they are utilised in everyday practices, and do not have to be research solely with reference to an isolated reader and an isolated content

Language and text in adjudication and dispute settlement in administrative tribunals and related settings

This thesis has four main objectives; a) to provide an understanding of Legal Aid Appeals Tribunals, from a description of individual cases and the activities that occur therein, focusing in the main on those at which an appellant and/or their representative is present; b) to explore the use of documentation in the tribunal practices of tribunal panel members, legal aid clerks, appellants and their representatives; c) to explore the possibilities that post-analytic ethnomethodology as the adopted research methodology allows, and to clarify what this radical research 'programme' entails; and d) taking legal positivism as an epistopic to explore its possible ethnomethodological respecification in light of the descriptions of practice in legal aid tribunals. Although this thesis explores the possibility of post-analytic descriptions it is not a theoretical investigation into post-analytic ethnomethodology, but an empirical investigation of phenomena of legal aid tribunals which allows an exploration of the practical application of post-analytic ethnomethodology. Nevertheless, some clarification is attempted of just what a post-analytic ethnomethodology may entail. Used in conjunction with the description of the use of texts in legal tribunals, the investigation of epistopics, though not a common research practice does here help develop our understanding of the situated nature of legal practical, legal decision making, and legal objectivity. In a wider sense this approach highlights an argument made throughout this research, that texts are both significant and researchable as they are utilised in everyday practices, and do not have to be research solely with reference to an isolated reader and an isolated content

The challenge of electronic health records (EHRs) design and implementation: responses of health workers to drawing a 'big and rich picture' of a future EHR programme using animated tools

Background and aim To investigate the use of animation tools to aid visualisation of problems for discussion within focus groups, in the context of healthcare workers discussing electronic health records (EHRs). Method Ten healthcare staff focus groups, held in a range of organisational contexts. Each focus group was in four stages: baseline discussion, animator presentation, post-animator discussion and questionnaire. Audio recordings of the focus groups were transcribed and coded and the emergent analytic themes analysed for issues relating to EHR design and implementation. The data allowed a comparison of baseline and post-animator discussion. Results The animator facilitated discussion about EHR issues and these were thematically coded as: Workload; Sharing Information; Access to Information; Record Content; Confidentiality; Patient Consent; and Implementation. Conclusion We illustrate that use of the animator in focus groups is one means to raise understanding about a proposed EHR development. The animator provided a visual 'probe' to support a more proactive and discursive localised approach to end-user concerns, which could be part of an effective stakeholder engagement and communication strategy crucial in any EHR or health informatics implementation programme. The results of the focus groups were to raise salient issues and concerns, many of which anticipated those that have emerged in the current NHS Connecting for Health Care Records programme in England. Potentially, animator- type technologies may facilitate the user ownership which other forms of dissemination appear to be failing to achieve

A quantitative analysis of the impact of a computerised information system on nurses' clinical practice using a realistic evaluation framework

Objective: To explore nurses' perceptions of the impact on clinical practice of the use of a computerised hospital information system. Design: A realistic evaluation design based on Pawson and Tilley's work has been used across all the phases of the study. This is a theory-driven approach and focuses evaluation on the study of what works, for whom and in what circumstances. These relationships are constructed as context-mechanisms-outcomes (CMO) configurations. Measurements: A questionnaire was distributed to all nurses working in in-patient units of a university hospital in Spain (n = 227). Quantitative data were analysed using SPSS 13.0. Descriptive statistics were used for an overall overview of nurses' perception. Inferential analysis, including both bivariate and multivariate methods (path analysis), was used for cross-tabulation of variables searching for CMO relationships. Results: Nurses (n = 179) participated in the study (78.8% response rate). Overall satisfaction with the IT system was positive. Comparisons with context variables show how nursing units' context had greater influence on perceptions than users' characteristics. Path analysis illustrated that the influence of unit context variables are on outcomes and not on mechanisms. Conclusion: Results from the study looking at subtle variations in users and units provide insight into how important professional culture and working practices could be in IT (information technology) implementation. The socio-technical approach on IT systems evaluation suggested in the recent literature appears to be an adequate theoretical underpinning for IT evaluation research. Realistic evaluation has proven to be an adequate method for IT evaluation. (C) 2009 Elsevier Ireland Ltd. All rights reserved

Situationally-sensitive knowledge translation and relational decision making in hyperacute stroke: a qualitive study

Stroke is a leading cause of disability. Early treatment of acute ischaemic stroke with rtPA reduces the risk of longer term dependency but carries an increased risk of causing immediate bleeding complications. To understand the challenges of knowledge translation and decision making about treatment with rtPA in hyperacute stroke and hence to inform development of appropriate decision support we interviewed patients, their family and health professionals. The emergency setting and the symptomatic effects of hyper-acute stroke shaped the form, content and manner of knowledge translation to support decision making. Decision making about rtPA in hyperacute stroke presented three conundrums for patients, family and clinicians. 1) How to allow time for reflection in a severely time-limited setting. 2) How to facilitate knowledge translation regarding important treatment risks and benefits when patient and family capacity is blunted by the effects and shock of stroke. 3) How to ensure patient and family views are taken into account when the situation produces reliance on the expertise of clinicians. Strategies adopted to meet these conundrums were fourfold: face to face communication; shaping decisions; incremental provision of information; and communication tailored to the individual patient. Relational forms of interaction were understood to engender trust and allay anxiety. Shaping decisions with patients was understood as an expression of confidence by clinicians that helped alleviate anxiety and offered hope and reassurance to patients and their family experiencing the shock of the stroke event. Neutral presentations of information and treatment options promoted uncertainty and contributed to anxiety. ‘Drip feeding’ information created moments for reflection: clinicians literally made time. Tailoring information to the particular patient and family situation allowed clinicians to account for social and emotional contexts. The principal responses to the challenges of decision making about rtPA in hyperacute stroke were relational decision support and situationally-sensitive knowledge translation

Capability in the digital: institutional media management and its dis/contents

This paper explores how social media spaces are occupied, utilized and negotiated by the British Military in relation to the Ministry of Defence’s concerns and conceptualizations of risk. It draws on data from the DUN Project to investigate the content and form of social media about defence through the lens of ‘capability’, a term that captures and describes the meaning behind multiple representations of the military institution. But ‘capability’ is also a term that we hijack and extend here, not only in relation to the dominant presence of ‘capability’ as a representational trope and the extent to which it is revealing of a particular management of social media spaces, but also in relation to what our research reveals for the wider digital media landscape and ‘capable’ digital methods. What emerges from our analysis is the existence of powerful, successful and critically long-standing media and reputation management strategies occurring within the techno-economic online structures where the exercising of ‘control’ over the individual – as opposed to the technology – is highly effective. These findings raise critical questions regarding the extent to which ‘control’ and management of social media – both within and beyond the defence sector – may be determined as much by cultural, social, institutional and political influence and infrastructure as the technological economies. At a key moment in social media analysis, then, when attention is turning to the affordances, criticisms and possibilities of data, our research is a pertinent reminder that we should not forget the active management of content that is being similarly, if not equally, effective