Disruption, control and coping: responses of and to the person with dementia in hospital

This qualitative study aimed to gain insight into the experience of hospitalisation from the perspectives of the older person with dementia, their family care-giver and other patients sharing the ward (co-patients). Non-participant observation of care on 11 acute hospital wards was supplemented by 39 semi-structured interviews with 35 family care-givers and four co-patients following discharge. Constant comparative analysis produced the core problem facing all those involved: disruption from normal routine meaning that the experience of hospitalisation was disrupted by the presence and behaviour of the person with dementia. Disruption adversely affected the person with dementia, triggering constructive, disengaged, distressed and neutral behaviours. Using Kitwood's model of person-centred care, these behaviours were interpreted as attempts by the person with dementia at gaining a sense of control over the unfamiliar environment and experience. Family care-givers' lives and experiences both inside and outside the hospital were disrupted by the hospitalisation. They too attempted to gain a sense of control over the experience and to give a sense of control to the patient, co-patients and staff. Co-patients experienced disruption from sharing space with the person with dementia and were left feeling vulnerable and sometimes afraid. They too attempted to gain a sense of control over their situation and give some control by helping the person with dementia, the family care-giver and the staff

Beyond words: Aesthetic knowledge and knowing in design

Aesthetic knowledge comes from practitioners understanding the look, feel, smell, taste and sound of things. It is vital to work in many organizational contexts. In this paper, we explore aesthetic knowledge and knowing in organizations through detailed observation of design work in the architectural practice Edward Cullinan Architects. Through our research, we explore aesthetic knowledge in the context of architectural work, we unpack what it is, how it is generated, and how it is applied in design projects, shared between practitioners and developed at the level of the organization. Our analysis suggests that aesthetic knowledge plays an important part in organizational practice, not only as the symbolic context for work, but as an integral part of the work that people do. It suggests that aesthetic reflexivity, which involves an opening up and questioning of what is known, is experienced as part of practice as well as a `time out' from practice

Toward a client-centered benchmark for self-sufficiency: Evaluating the ‘process’ of becoming job ready.

The purpose of this study is to evaluate how service providers, clients, and graduates of a job training program define the term self-sufficiency (SS). This community-engaged, mixed method study qualitatively analyzes focus group data from each group and quantitatively examines survey data obtained from participants of the program. Findings reveal that psychological transformation as a ‘process’ represents the emic definition of SS—psychological SS—but each dimension of the concept is reflected in varying degrees by group. Provider and participant views are vastly different from the outcome-driven policy and funder definitions. Implications for benchmarking psychological SS as an empowerment-based ‘process’ measure of job readiness in workforce development evaluation are discussed

Investigating the Information Systems Heterarchy

This article assesses how one IS organization is changing in response to the increased globalization of software development and posits the emergence of a new form of multi-national enterprise (MNE)—the heterarchy. Data from two projects create new insights into the structures and behaviors of ISMNEs as they adapt to global systems development. The article identifies four primary dimensions of impact—cultural, economic, operational, and organizational—and suggests how such organizations are evolvin

The Eco-Epidemiology of Pacific Coast Tick Fever in California

Rickettsia philipii (type strain “Rickettsia 364D”), the etiologic agent of Pacific Coast tick fever (PCTF), is transmitted to people by the Pacific Coast tick, Dermacentor occidentalis. Following the first confirmed human case of PCTF in 2008, 13 additional human cases have been reported in California, more than half of which were pediatric cases. The most common features of PCTF are the presence of at least one necrotic lesion known as an eschar (100%), fever (85%), and headache (79%); four case-patients required hospitalization and four had multiple eschars. Findings presented here implicate the nymphal or larval stages of D. occidentalis as the primary vectors of R. philipii to people. Peak transmission risk from ticks to people occurs in late summer. Rickettsia philipii DNA was detected in D. occidentalis ticks from 15 of 37 California counties. Similarly, non-pathogenic Rickettsia rhipicephali DNA was detected in D. occidentalis in 29 of 38 counties with an average prevalence of 12.0% in adult ticks. In total, 5,601 ticks tested from 2009 through 2015 yielded an overall R. philipii infection prevalence of 2.1% in adults, 0.9% in nymphs and a minimum infection prevalence of 0.4% in larval pools. Although most human cases of PCTF have been reported from northern California, acarological surveillance suggests that R. philipii may occur throughout the distribution range of D. occidentalis

Corporate image: a service recovery perspective

This article explores direct and indirect antecedents that contribute to corporate image formation in a service recovery context. Two studies were carried out in Egypt. Study 1 comprises 29 semistructured interviews with complainants of mobile phone network service providers in Egypt. Study 2 encompasses a mail survey of another 437 complainants. Findings reveal the importance of perceived justice, namely, interactional justice, in corporate image formation, as well as the mediating role of satisfaction with service recovery in the perceived justice-corporate image relationship. Results also reveal two empirical relationships: problem solving as a determinant of distributive justice and follow-up as a driver of procedural justice. Accordingly, this study contributes to the service field by providing the first empirical evaluation of new direct and indirect antecedents of corporate image formation in a service recovery context. Managerial recommendations are provided that encourage service practitioners to emphasize perceived justice and satisfaction with a service recovery process to enhance the company’s image. Additionally, companies should invest in implementing problem solving and follow-up as service recovery strategies since both significantly enhance perceived justice

Improving medical students' attitudes towards the chronic sick: a role for social science research

<b>Background</b> Many medical students are negatively disposed toward the elderly and chronic sick. The present study assessed the impact of a community-based teaching initiative, the Life History Project, on students' attitudes to these groups. <p></p> <b>Methods</b> A questionnaire including Likert based responses and free text comments was distributed to all first-year MBChB students after completion of their Life History coursework. Data was analysed using SPSS and content analysis. <p></p> <b>Results</b> A high proportion of students believed the Life History Project had increased their understanding of both psychological and social aspects of health and illness and the role of the humanistic social sciences within this. We discovered that the Life History Project not only gave students first-hand experience of the elderly and chronic sick but also had a positive effect on their attitudes towards these groups. The qualitative free text comments corroborated these views. <p></p> <b>Conclusions</b> It is possible to positively influence medical students' attitudes towards these stigmatised groups; it is therefore important that we continue to enhance opportunities for learning about the impact of chronic illness on individuals and society throughout the curriculum

“Hello Central, Give Me Doctor Jazz”: Auto/Ethnographic Improvisation as Educational Event in Doctoral Supervision

Through exchanges within a doctoral supervision, the authors explore a range of dilemmas and challenges for reflexive inquiry. These include the problematic business of naming, the impossibility of objective separation of self from research, the merging of researcher subjectivities, and differences between performance and performativity. We note the educational potential in what can conventionally be considered “unprofessional” approaches to qualitative inquiry: neologisms, personal experience, stories, conversations, music, poetry, paintings, and film. We engage in reflexive interactions with each other and with such “data.” This was undertaken in the spirit of jazz improvisation—an unrehearsed performance—something that “happened,” an unplanned educational event but also an agency enabled by structure

Comparing nuclear power trajectories in Germany and the UK: from ‘regimes' to ‘democracies’ in sociotechnical transitions and Discontinuities

This paper focuses on arguably the single most striking contrast in contemporary major energy politics in Europe (and even the developed world as a whole): the starkly differing civil nuclear policies of Germany and the UK. Germany is seeking entirely to phase out nuclear power by 2022. Yet the UK advocates a ‘nuclear renaissance’, promoting the most ambitious new nuclear construction programme in Western Europe.Here,this paper poses a simple yet quite fundamental question: what are the particular divergent conditions most strongly implicated in the contrasting developments in these two countries. With nuclear playing such an iconic role in historical discussions over technological continuity and transformation, answering this may assist in wider understandings of sociotechnical incumbency and discontinuity in the burgeoning field of‘sustainability transitions’. To this end, an ‘abductive’ approach is taken: deploying nine potentially relevant criteria for understanding the different directions pursued in Germany and the UK. Together constituted by 30 parameters spanning literatures related to socio-technical regimes in general as well as nuclear technology in particular, the criteria are divided into those that are ‘internal’ and ‘external’ to the ‘focal regime configuration’ of nuclear power and associated ‘challenger technologies’ like renewables. It is ‘internal’ criteria that are emphasised in conventional sociotechnical regime theory, with ‘external’ criteria relatively less well explored. Asking under each criterion whether attempted discontinuation of nuclear power would be more likely in Germany or the UK, a clear picture emerges. ‘Internal’ criteria suggest attempted nuclear discontinuation should be more likely in the UK than in Germany– the reverse of what is occurring. ‘External’ criteria are more aligned with observed dynamics –especially those relating to military nuclear commitments and broader ‘qualities of democracy’. Despite many differences of framing concerning exactly what constitutes ‘democracy’, a rich political science literature on this point is unanimous in characterising Germany more positively than the UK. Although based only on a single case,a potentially important question is nonetheless raised as to whether sociotechnical regime theory might usefully give greater attention to the general importance of various aspects of democracy in constituting conditions for significant technological discontinuities and transformations. If so, the policy implications are significant. A number of important areas are identified for future research, including the roles of diverse understandings and specific aspects of democracy and the particular relevance of military nuclear commitments– whose under-discussion in civil nuclear policy literatures raises its own questions of democratic accountability