Assessment of early warning signs in hospital projects' front-end phase

PurposeThe front-end phase plays an important role in achieving project success, and establishment of performance measurement systems considering project challenges or pitfalls is a way of keeping track of this phase. Early warning signs, a type of proactive performance indicators, may serve as means for improving decision-making and project processes aiming for short- and long-term project success. In this paper, the authors present findings from a study on early warning signs (EWS) in hospital projects' front-end. A preliminary systematisation of identified signs as a contribution to front-end improvement is provided.Design/methodology/approachThe paper is based on a mixed methods approach, using a sequential, exploratory research design comprising document studies, interviews and a survey.FindingsThe authors identified 62 challenges for hospital projects' front-end performance and further established four categories of EWS as follows: (1) structure and tools, (2) context and frame factors, (3) management and (4) relational factors and properties. This mirrors the presence of hard and soft issues from previous studies. There is need for clarifying terminology and raising consciousness on EWS. Processual approaches to identify EWS are considered more useful than subsequent established indicators.Originality/valueThe findings from this paper provide insight into EWS in hospital projects' front-end phase. This adds to the general understanding of EWS and contributes to more knowledge on the front-end phase in general.

Interorganizational Alliances

Polarizing conversations and “othering” are becoming norms in individual and organizational discourse, while social, political, economic, and cultural issues—and solutions to manage them—are recognized as increasingly interconnected. Interorganizational alliances (IAs) are one means through which social workers can leverage collective resources toward just and common ground. As systems, policies, and contexts continue to drive the coalescing of organizations into IAs, social workers have an important role to play. All IAs fundamentally operate to address emergent issues. Understanding the ways organizations come together, the circumstances that drive them, and factors that contribute to their success is essential for maximizing results. IAs vary along a continuum, ranging from loosely connected to structurally unified, and can be broadly understood by the processes that underlie them. No position on the continuum is better (or worse) than another. Their evolution is dynamic, greatly shaped by relational factors such as leadership styles, organizational cultures, and the goals of those who will be affected. Regardless of whether organizational participants align for internal, operational gain or to better address issues raised within their environment, IAs must clearly identify all who are intended to benefit. In so doing, they must consciously analyze historic interactions, recognizing patterns of discrimination and oppression and establishing systems and narratives that center previously marginalized voices. Only in this way can IAs advance a just and equitable future. Given appropriate preparation through macro education, social workers are well situated for this work.

Faculty Perceptions of Mattering in Teaching and Learning: A Qualitative Examination of the Views, Values, and Teaching Practices of Award-Winning Professors

We summarize qualitative research conducted on the mattering construct and then describe a qualitative investigation focused on mattering as a key aspect of the relational factors which influence the learning and development of students. Semi-structured interviews were conducted with 12 professors recognized for their teaching excellence. Specifically, we assessed professors’ attitudes towards student perceptions of mattering and awareness of mattering in terms of their own self-reported beliefs, attitudes, and teaching practices that convey to students that they matter. Thematic analysis confirmed that almost all the award-winning professors interviewed recognized students’ need to matter and found effective ways to convey to students that they matter. These professors tended to be more similar than different in their approaches and attitudes. Key themes included the need for professors to show students they care about them as students and as people, seeing and treating students as individuals who are collaborators in the learning process, and the need to avoid anti-mattering micro-practices that can result in students becoming disengaged and disillusioned. We discuss these findings in terms of how an explicit focus on mattering promotion is warranted as a central attribute of effective teaching and learning, how the current findings enhance understanding of the mattering construct and how it should be assessed.

Factors that Influence Intraoperative Decision-Making Among Pediatric Neurosurgeons: A Grounded Theory Study

Introduction: Pediatric neurosurgery is a sub-specialty of medicine that is responsible for diagnosing, managing, and treating neurological disease in children with the use of surgery. Good intraoperative decisions making is critical to ensuring patient safety, yet almost nothing is known about what factors play a role in intraoperative decisions. As such, the purpose of this paper was to explore the factors that influence intraoperative decisions when pediatric neurosurgeons encounter something unexpected or uncertain during surgery. Methods: The study utilized the Grounded Theory method of data collection and analysis. Twenty-six pediatric neurosurgeons from 12 countries around the world were interviewed between June-October 2020 about the factors that go into making intraoperative decisions. Data was analyzed line by line and constant comparison was used to examine relationships within, and across codes and categories. Results: Pediatric neurosurgeons reflected on six factors while operating in order to come to a decision about how to proceed when they encountered an uncertainty or complication. The study findings resulted in a conceptual model that describes how concrete data including biological and technological factors and contextual data including emotional/relational factors, surgeon factors, and cultural factors influence risk assessment when making an intraoperative decision during surgery. Conclusions: The findings from this research can be used for training and educating surgeons about intraoperative decision-making processes. Pedagogical modules can be developed that includes training sessions on factors that may implicitly and explicitly influence thinking processes during an operation. Surgeons may also benefit from having open discussions with surgical colleagues about the rich, emotional, intellectual scope of the work that they do with all the challenges that these relationships can bring into decision-making in the operating room.

From Contractual Flexibility to Contractor’s Cooperative Behavior in Construction Projects: The Multiple Mediation Effects of Ongoing Trust and Justice Perception

The flexible contract is an important mechanism for owners to govern contractors in construction projects. Given the limited explanatory power of the justice mechanism and the important role of relational factors, this study explored the role of ongoing trust and justice perception in the relationship between contractual flexibility and the contractor’s cooperative behavior and aimed to further reveal the potential influence paths through an empirical analysis. We found the following: (1) apart from justice perception, ongoing trust is another crucial mediation factor in the relationship. (2) Together with the former, ongoing trust plays significantly multiple mediation effects and constitutes the main indirect influence paths, among which the parallel one is strongest and the chain one comes third. (3) Moreover, both factors are more likely to be impacted by contract executing flexibility, compared with contract content flexibility. These findings enrich relational mechanism research and provide some guidance for the owner to build contractual flexibility to govern contractors’ behavior.

Siblings of children with chronic disorders: Family and relational factors as predictors of mental health

Siblings of children with chronic disorders are at increased risk of mental health problems. Predictors of siblings’ mental health require further study to identify children in need of interventions and to design effective intervention programs. Siblings of children with chronic disorders ( n = 107; M age = 11.5 years; SD = 2.1, 54.6% girls) and their parents ( n = 199; 50.3% mothers) were included in a survey study. Siblings and parents completed questionnaires on mental health. Siblings completed questionnaires on parent–child communication, relationships with parents, and an adjustment measure on the sibling situation. Multiple linear regression analyses were applied to identify predictors of siblings’ mental health. Sibling-reported relationship with parents was a significant predictor of sibling mental health reported by siblings, fathers, and mothers ( R 2 = 0.26 - R 2 = 0.46). Siblings’ adjustment was significantly associated with fathers’ report of siblings’ mental health ( r = .36), but not mothers’ report ( r = .17). Siblings’ relationships ( d = 0.26) and communication ( d = 0.33) with mothers were significantly better than with fathers. We conclude that the sibling–parent relationship is a significant factor in identifying siblings at risk and that family-based intervention programs should be developed.

Comprehending socio-relational factors of mental wellbeing in the oldest old within Nordic and Mediterranean countries

Socio-relational aspects are essential for mental wellbeing (MWB), especially in the oldest old age. Our study aims to explore the socio-relational aspects related to MWB in accordance with the experiences of the oldest old of four European countries; and to examine how these differ between Mediterranean and Nordic people. A total of 117 participants aged 80+ years old were recruited, and 23 focus groups were performed. Qualitative content analysis identified five main themes. Family seemed to be the most important driver of the MWB of the oldest old, followed by relationships with close friends. Participants felt better when they had a sense of being needed, cared for, and connected. Loneliness and isolation negatively affected MWB, although solitude was appreciated. Differences appeared between Mediterranean and Nordic regions. Initiatives to promote positive interactions with family and friends, as well as social activities within the community, may contribute to strengthening MWB in the oldest old.

Exploring the Similarity of Partners’ Love Styles and Their Relationships With Marital Satisfaction: A Dyadic Approach

In this paper, we report on the findings of our exploratory research investigating how the similarity or difference of the partners’ love styles could be related to dyadic and familial satisfaction. The empirical literature outlines how love styles are differently associated with various couple dimensions. While most studies employ an individual approach, we assessed whether the similarity of the prevalent love style in each couple was associated with greater dyadic satisfaction. In our sample, comprising 146 heterosexual couples (all married or cohabitating), no such association emerged. Storge and Pragma were the most prevalent love styles; moreover, there was a similar prevalence of the similarity in these two love styles between partners. Hence, the love styles similarity does not show a direct association with marital satisfaction. To establish whether there is some relationship between these variables, it would be useful for future research to investigate the impact of further individual and relational factors and of their interaction.