scholarly journals Transformational Change in maternity services in England: a longitudinal qualitative study of a national transformation programme ‘Early Adopter’

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Beck Taylor ◽  
Alistair Hewison ◽  
Fiona Cross-Sudworth ◽  
Kevin Morrell
Keyword(s):  
Participant Observation ◽  
Evidence Synthesis ◽  
National Policy ◽  
Transformational Change ◽  
Large System ◽  
Urban Setting ◽  
System Transformation ◽  
Maternity Services ◽  
What Works ◽  
The Individual

Abstract Background Large system transformation in health systems is designed to improve quality, outcomes and efficiency. Using empirical data from a longitudinal study of national policy-driven transformation of maternity services in England, we explore the utility of theory-based rules regarding ‘what works’ in large system transformation. Methods A longitudinal, qualitative case study was undertaken in a large diverse urban setting involving multiple hospital trusts, local authorities and other key stakeholders. Data was gathered using interviews, focus groups, non-participant observation, and a review of key documents in three phases between 2017 and 2019. The transcripts of the individual and focus group interviews were analysed thematically, using a combined inductive and deductive approach drawing on simple rules for large system transformation derived from evidence synthesis and the findings are reported in this paper. Results Alignment of transformation work with Best et al’s rules for ‘what works’ in large system transformation varied. Interactions between the rules were identified, indicating that the drivers of large system transformation are interdependent. Key challenges included the pace and scale of change that national policy required, complexity of the existing context, a lack of statutory status for the new ‘system’ limiting system leaders’ power and authority, and concurrent implementation of a new overarching system alongside multifaceted service change. Conclusions Objectives and timescales of transformation policy and plans should be realistic, flexible, responsive to feedback, and account for context. Drivers of large system transformation appear to be interdependent and synergistic. Transformation is likely to be more challenging in recently established systems where the basis of authority is not yet clearly established.

Fulfilling the Right to Food for South Africa: Justice, Security, Sovereignty and the Politics of Malnutrition

2020 ◽  
Vol 11 (3) ◽  
pp. 112-152
Author(s):  
Busiso Helard Moyo ◽  
Anne Marie Thompson Thow
Keyword(s):  
South Africa ◽  
Food Systems ◽  
Food System ◽  
Food Sovereignty ◽  
Food Justice ◽  
System Transformation ◽  
Right To Food ◽  
Economic Rights ◽  
The Individual ◽  
The Right

Despite South Africa’s celebrated constitutional commitments that have expanded and deepened South Africa’s commitment to realise socio-economic rights, limited progress in implementing right to food policies stands to compromise the country’s developmental path. If not a deliberate policy choice, the persistence of hunger, food insecurity and malnutrition in all its forms is a deep policy failure.  Food system transformation in South Africa requires addressing wider issues of who controls the food supply, thus influencing the food chain and the food choices of the individual and communities. This paper examines three global rights-based paradigms – ‘food justice’, ‘food security’ and ‘food sovereignty’ – that inform activism on the right to food globally and their relevance to food system change in South Africa; for both fulfilling the right to food and addressing all forms of malnutrition. We conclude that the emerging concept of food sovereignty has important yet largely unexplored possibilities for democratically managing food systems for better health outcomes.

scholarly journals A IMPLANTAÇÃO DE PROGRAMAS E AÇÕES INCLUSIVAS EM UM MUNICÍPIO DO OESTE PAULISTA: PDDE ACESSIBILIDADE

2018 ◽  
Vol 15 (Especial 2) ◽  
pp. 57-69
Author(s):  
Ana Mayra Samuel da Silva ◽  
Elisa Tomoe Moriya Schlünzen ◽  
Danielle Aparecida do Nascimento dos Santos ◽  
Ana Virginia Isiano Lima
Keyword(s):  
Inclusive Education ◽  
Participant Observation ◽  
School Context ◽  
National Policy ◽  
School Management ◽  
Qualitative Approach ◽  
Management Team ◽  
Ministry Of Education ◽  
The West

In order for all to be included according to their needs and specificities, the objectives proposed by school education must be directed to the recognition and problematization of differences. The objective of this study was to analyze the implementation of programs and actions proposed in the scope of the National Policy of Special Education from the perspective of Inclusive Education (BRASIL, 2008), in a school located in a small municipality in the west of São Paulo. The methodology consisted of formative intervention on public educational policies, programs and actions in an inclusive perspective, and participant observation to follow the actions developed by the school management team, based on a qualitative approach. The programs and actions of the Ministry of Education are effective, since they aim to contribute and help with the guarantee, not only of access, but also of the permanence with the quality of students in the school context.

scholarly journals Publikowanie w sieci jako reakcja odbiorcy na przekaz masowy w interakcji medialnej

2021 ◽  
Vol 13 ◽  
pp. 51-65
Author(s):  
Anna Granat
Keyword(s):  
Qualitative Research ◽  
Participant Observation ◽  
Indirect Interaction ◽  
Individual Interview ◽  
Online Publishing ◽  
Media Interaction ◽  
Auto Ethnography ◽  
The Media ◽  
The Individual ◽  
Web Publishing

The article demonstrates the mass media receiver, who interacts with media and after reading, listening or watching the content online reacts by web publishing. The article presents examples of such reactions in the form of texts, obtained as a result of expe-rimental research (hidden ethnographic participant observation, survey auto-ethnography, in-depth, standardized/structured individual interview), which subjects them to qualitative research. This rese-arch consists in the analysis of the content and its form by using methods dedicated to examine lingu-istic pragmatics and interactionism.Therefore, it is assumed that the individual receiver participates in the media interaction, which I understand as the mutually indirect interaction of the sender and the receiver in media communica-tion process. The receiver’s reaction in this process may be, among others, online publishing, which is named as “surfer commentary”.

scholarly journals The Disrupted and Realigned Self: Exploring the Narratives of New Zealanders with  Chronic Fatigue Syndrome/Myalgic Encephalomyelitis

2021 ◽  
Author(s):  
◽  
Lara Joyce Milka Bell
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Participant Observation ◽  
Physical Exertion ◽  
Chronic Fatigue ◽  
Myalgic Encephalomyelitis ◽  
Community Interactions ◽  
Self Identity ◽  
Authentic Self ◽  
Fatigue Syndrome ◽  
The Individual

<p>Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) causes pronounced, debilitating fatigue that is not alleviated by rest, along with muscle and joint weakness, pain, cognitive difficulties and can be worsened through mental and physical exertion. However, it is also without an aetiology, and there is little consensus amongst both medical and patient spheres as to what CFS/ME actually is. In this thesis I draw on interviews with people with CFS/ME and participant observation in a patient-led support group in order to explore the way in which CFS/ME shaped participants’ identities and narratives of the self. I argue that participants moved through two stages that I call ‘The Disrupted Self’ and ‘The Realigned Self’. Falling ill with CFS/ME rapidly disrupted participants’ understandings of the bodies, their position within their family and the community, interactions with doctors, and all the usual markers on which they had previously formed their self-identities. In this state, I argue that participants and those with whom they engaged viewed both CFS/ME and my participants as liminal, ‘betwixt and between’ (Turner 1969) social roles and contemporary New Zealand ideals of illness, the individual, and the ‘sick person’. As the initial disruption and confusion of falling ill subsided, however, my participants worked to develop a new secure self-identity, the ‘Realigned Self’. They move into a normalised long-term liminal state by prioritising their health, adjusting their expectations of their body, developing their own conception of the aetiology of CFS/ME and forming a positive narrative of their new lives. This identity work utilised wider cultural ideals about the active, responsibilised and authentic self; common to late modern contemporary life (Beck and Beck-Gernsheim 2001, Desjarlais 1994, Giddens 1991, Rose 1996). Yet this realignment was often not reflected in the views of my participants’ friends, families and doctors. This illustrates the diverse perspectives and different degrees of liminality that exist within experiences and narratives of CFS/ME and contested illnesses.</p>

scholarly journals Implementing large-system, value-based healthcare initiatives: a realist study protocol for seven natural experiments

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e044049
Author(s):  
Mitchell N Sarkies ◽  
Emilie Francis-Auton ◽  
Janet C Long ◽  
Andrew Partington ◽  
Chiara Pomare ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Quantitative Data ◽  
Care Delivery ◽  
Qualitative Interviews ◽  
Healthcare Delivery ◽  
Implementation Strategies ◽  
Large System ◽  
Natural Experiments ◽  
System Transformation ◽  
Delivery Models

IntroductionValue-based healthcare delivery models have emerged to address the unprecedented pressure on long-term health system performance and sustainability and to respond to the changing needs and expectations of patients. Implementing and scaling the benefits from these care delivery models to achieve large-system transformation are challenging and require consideration of complexity and context. Realist studies enable researchers to explore factors beyond ‘what works’ towards more nuanced understanding of ‘what tends to work for whom under which circumstances’. This research proposes a realist study of the implementation approach for seven large-system, value-based healthcare initiatives in New South Wales, Australia, to elucidate how different implementation strategies and processes stimulate the uptake, adoption, fidelity and adherence of initiatives to achieve sustainable impacts across a variety of contexts.Methods and analysisThis exploratory, sequential, mixed methods realist study followed RAMESES II (Realist And Meta-narrative Evidence Syntheses: Evolving Standards) reporting standards for realist studies. Stage 1 will formulate initial programme theories from review of existing literature, analysis of programme documents and qualitative interviews with programme designers, implementation support staff and evaluators. Stage 2 envisages testing and refining these hypothesised programme theories through qualitative interviews with local hospital network staff running initiatives, and analyses of quantitative data from the programme evaluation, hospital administrative systems and an implementation outcome survey. Stage 3 proposes to produce generalisable middle-range theories by synthesising data from context–mechanism–outcome configurations across initiatives. Qualitative data will be analysed retroductively and quantitative data will be analysed to identify relationships between the implementation strategies and processes, and implementation and programme outcomes. Mixed methods triangulation will be performed.Ethics and disseminationEthical approval has been granted by Macquarie University (Project ID 23816) and Hunter New England (Project ID 2020/ETH02186) Human Research Ethics Committees. The findings will be published in peer-reviewed journals. Results will be fed back to partner organisations and roundtable discussions with other health jurisdictions will be held, to share learnings.

Who Do You Think You Are?

2020 ◽  
pp. 51-57
Author(s):  
Nicolas Bommarito
Keyword(s):  
The Self ◽  
What Works ◽  
Special Challenge ◽  
Self Knowledge ◽  
The Individual ◽  
The Mind ◽  
Tools And Methods

This chapter explores self-knowledge, which is critical for solving the practical problems involved in getting through life. An awareness of your own quirks, character, and preferences is important for figuring out what works for you. However, self-knowledge is also tricky because it is especially elusive. People commonly learn about themselves only indirectly; often it is only by reading the reactions of others that people can see how harsh, kind, or annoying they are. It is also because when trying to know the self, the thing the individual is trying to see is the very thing that does the looking. Buddhism offers many evocative images to illustrate this special challenge: Just as a knife cannot cut itself, the mind cannot be directed toward itself. This makes knowing the self, especially in a deep way, an especially difficult task. Knowing the self thus requires special kinds of tools and methods. The chapter then considers the concept of Buddha Nature.

Agility in Software Development and Project Value

2022 ◽  
pp. 356-376
Author(s):  
VenuGopal Balijepally ◽  
Gerald DeHondt ◽  
Vijayan Sugumaran ◽  
Sridhar Nerur
Keyword(s):  
Best Practices ◽  
Software Development ◽  
Survey Data ◽  
Theoretical Perspective ◽  
Agile Development ◽  
Software Teams ◽  
What Works ◽  
The Individual ◽  
Development Methods ◽  
Over Time

Agile Development Methods, considered as an alternative to the traditional plan-based methods, have received much attention since their inception. These practices have evolved and developed over time, culminating in 2001 with the Agile Manifesto. Since that time, preferred methodologies, implementations, and best practices have continued to evolve with a focus on doing what works best for the individual company or project. However, the concept of agility in software development has remained quite nebulous, lacking in clarity particularly about its underlying dimensions. In this research the authors conceive agility in terms of four distinct dimensions. Drawing from the theoretical perspective of holographic organization, they develop a model explaining how each of these underlying dimensions of agility contributes to project value in software teams. The authors test the model using survey data collected from industry practitioners and discuss findings.

scholarly journals Relation between Psychological Restorativeness and Lifestyle, Quality of Life, Resilience, and Stress-Coping in Forest Settings

2019 ◽  
Vol 16 (8) ◽  
pp. 1456 ◽  
Author(s):  
Norimasa Takayama ◽  
Takeshi Morikawa ◽  
Ernest Bielinis
Keyword(s):  
Quality Of Life ◽  
Life Assessment ◽  
Urban Setting ◽  
Stress Coping ◽  
Forest Environment ◽  
Individual Traits ◽  
Individual Trait ◽  
The Individual ◽  
The Relationship

Previous research has mainly dealt with the physiological and psychological restorative effects of the forest environment. However, comparatively few studies have focused on how the traits and attributes of individuals (individual traits) affect the restorative effects of the forest environment. In this study, we examined the relationships between the psychological restorative effects offered by perceived restorativeness of outdoor settings and the individual traits. Then, we investigated the relationships between the restorative indicators that are useful in examining the restorative properties (i.e., the Perceived Restorativeness Scale (PRS); seven indicators in total), the psychological restorative effect (Profile of Mood States (POMS), Restorative Outcome Scale (ROS), positive and negative affect schedule (PANAS), and Subjective Vitality Scale (SVS); 10 indicators in total), and the individual trait indicators that could be used to investigate individual traits (Development of Health and Life Habit Inventory for lifestyle, Lazarus-type Stress Coping Inventory for stress coping, World Health Organization Quality of Life Assessment 26 for quality of life (QOL), and Sukemune-Hiew Resilience test for resilience; 28 indicators in total) in forest and urban settings. Respondents consisted of 46 male students in their twenties. A short-term experiment was conducted using the same method in both environmental settings. We then analyzed the intrinsic restorative properties and the restorative effects of the settings and referred to prior research to determine the restorative effects. Furthermore, we analyzed the relationship between the restorative indicators and the individual trait indicators by correlation analysis and multiple regression (step-wise) analysis. These new findings were obtained: (1) the forest setting was a restorative environment with a higher restorative effect than the urban setting; (2) although the forest setting had a higher restorative effect than the urban setting, and the influence of individual traits was small; (3) in the forest setting, the relationship between the restorative indicators and individual traits indicators were arranged; (4) distancing (Stress coping), psychological health (QOL), and satisfaction with living environment (QOL) were likely important indicators that are related to the restorative effects in the forest setting.

Social Network: A New Perspective on Independence and Illiterate Adults

1983 ◽  
Vol 33 (3) ◽  
pp. 133-146 ◽  
Author(s):  
Arlene Fingeret
Keyword(s):  
Social Networks ◽  
Social Network ◽  
Participant Observation ◽  
Urban Setting ◽  
Social Structures ◽  
Literacy Programs ◽  
Interdependent Networks ◽  
The Social ◽  
New Perspective ◽  
Illiterate Adults

This study explores the social structures illiterate adults create, and their relationship to notions of dependence and independence. In-depth unstructured interviews and participant-observation were used with 43 adults in a medium-sized northeastern urban setting. Analysis shows that illiterate adults create social networks that include readers and are characterized by mutuality. Illiterate adults contribute a range of skills to their networks and see themselves as interdependent. Networks are related to the extent to which illiterate adults are involved in the larger society; this ranges from extensive, for cosmopolitans, to minimal for local adults. Dependent adults have networks that are characterized by asymmetrical relationships. Literacy programs must learn to respond to adults-in-networks.

Sign in / Sign up

Export Citation Format

Share Document