Anna Lloyd, Joseph Lloyd Davies, Rebecca Semmens-Wheeler, Ali Isa Alfaraj, Domingo Gonzalez Naranjo and Kieran Breen
This study aims to explore the ethical challenges of managing the weight of psychiatric patients in the least restrictive manner in secure mental health settings and whether these…
Abstract
Purpose
This study aims to explore the ethical challenges of managing the weight of psychiatric patients in the least restrictive manner in secure mental health settings and whether these could be considered as a source of moral distress for health practitioners, which may be linked to staff burnout and ultimately lead to suboptimal patient care.
Design/methodology/approach
A qualitative semi-structured interview study design was used to explore the understanding, views and experiences of six staff members working on two medium-secure wards in a UK mental health hospital using an opportunity sampling technique and Interpretative Phenomenological Analysis.
Findings
Analysis of semi-structured interviews revealed a multitude of moral events that evoked feelings of frustration, powerlessness and anxiety related to the management of obesity in the least restrictive way, which is indicative of moral distress.
Research limitations/implications
Due to the small sample size and the qualitative nature of the research, the findings of this study are of explorative in nature. Further quantitative research would be required to establish a causative link between the ethical challenges associated with obesity management and staff’s moral distress.
Practical implications
Addressing the health-care professionals’ knowledge deficit on how to achieve the right balance in their duty of care through inclusion of bioethics into professional discussions and training could improve staff’s well-being and the organisation’s ethical climate.
Originality/value
To the best of the authors’ knowledge, this is the first qualitative work exploring the role of least restrictive practice in the challenges associated with health promotion within secure psychiatric settings, and the effect these challenges have on mental health staff.
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Carrie Anna Courtad and Jeffrey P. Bakken
In other words, LD can affect the way in which a person takes in, remembers, understands, and expresses information. Typically, a person with LD is of average intelligence, based…
Abstract
In other words, LD can affect the way in which a person takes in, remembers, understands, and expresses information. Typically, a person with LD is of average intelligence, based on his/her intelligence quotient (IQ); however his/her academic performance is different from how they should be able to perform. People with LD are intelligent and have abilities to learn despite difficulties in processing information; however, they require specialized interventions in home, school, community, and workplace settings, appropriate to their individual strengths and needs, including but not limited to (a) specific skill instruction, (b) the development of compensatory strategies, (c) the development of self-advocacy skills, and (d) appropriate accommodation. Typically, a student with mild LD, who is identified and provided learning-disabilities instruction, can enhance his/her academic achievement, however, a student with undetected LD can struggle with low grades, low self-esteem, a loss of interest in higher education, and later reduced employment opportunities as an adult (Burkhardt, Obiakor, & Rotatori, 2004).
Anna-Maija Hietajärvi, Kirsi Aaltonen and Harri Haapasalo
Project alliancing – a project delivery model used in delivering complex projects – demands new organizational capabilities for successful project implementation. The purpose of…
Abstract
Purpose
Project alliancing – a project delivery model used in delivering complex projects – demands new organizational capabilities for successful project implementation. The purpose of this paper is to define the concept of project alliance (PA) capability and to identify the elements that constitute an organization’s PA capability.
Design/methodology/approach
This study provides empirical evidence of PA capability based on an investigation of participants’ experiences of Finnish construction and infrastructure alliance projects. The adopted research approach is qualitative and inductive.
Findings
The paper conceptualizes PA capability and defines the elements that constitute an organization’s PA capability, including important activities in the pre-formation, development and post-formation phases of PAs and the contractual, behavioral, relational, and operational skills that organizations need for successful alliance project initiation and implementation.
Practical implications
The identified alliance project activities are targets for routinization and best practices that organizations can deploy from one project to another. The identified skills indicate areas in which organizations should build and develop expertise.
Originality/value
There is limited empirical research on the elements defining an organization’s capability to bid, manage and operate in alliance projects. This study presents some preliminary thoughts to augment knowledge of the successful initiation and management of alliance projects and to suggest why some organizations may be more successful than others in alliance projects.
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Anna Gupta and Edward Lloyd‐Jones
The Children Act 1989 revolutionised the way in which care proceedings were conducted. Gone were the rudimentary procedures of the old system, where parents and children had…
Abstract
The Children Act 1989 revolutionised the way in which care proceedings were conducted. Gone were the rudimentary procedures of the old system, where parents and children had limited access to independent representation. Instead, the Act enabled the local authority, parents and children to be equally represented and for evidence to be presented in an open and accessible manner. The changes were widely welcomed and hailed as the most significant reform of children's law for decades. Drawing on academic, legal and policy literature, this article examines the changing nature and context for the representation of children and parents over the past two decades. While there have been developments that have strengthened the representation of children and parents, it is argued that more recent changes, including increased bureaucracy and the introduction of the Public Law Outline, may well have the effect of subverting the system introduced by the Children Act 1989 and of returning matters to the inadequate pre‐existing system.
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Investigates the differences in protocols between arbitral tribunals and courts, with particular emphasis on US, Greek and English law. Gives examples of each country and its way…
Abstract
Investigates the differences in protocols between arbitral tribunals and courts, with particular emphasis on US, Greek and English law. Gives examples of each country and its way of using the law in specific circumstances, and shows the variations therein. Sums up that arbitration is much the better way to gok as it avoids delays and expenses, plus the vexation/frustration of normal litigation. Concludes that the US and Greek constitutions and common law tradition in England appear to allow involved parties to choose their own judge, who can thus be an arbitrator. Discusses e‐commerce and speculates on this for the future.
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Anna-Maija Hietajärvi, Kirsi Aaltonen and Harri Haapasalo
This study aims to explore how to identify and manage opportunities successfully in a large multi-organizational infrastructure project. Large projects struggle with exploiting…
Abstract
Purpose
This study aims to explore how to identify and manage opportunities successfully in a large multi-organizational infrastructure project. Large projects struggle with exploiting and capturing opportunities because of the lack of practices that support active and continuous opportunity management over the project lifecycle in inter-organizational project networks.
Design/methodology/approach
This study provides empirical evidence of a successful opportunity management process based on an investigation of an infrastructure alliance project. The adopted research approach is an inductive case study.
Findings
By analyzing an infrastructure alliance project, this paper identifies key activities of opportunity management and furthermore, discusses the enablers of active and continuous opportunity management.
Practical implications
This study supports practitioners by providing knowledge about the possibilities and activities that could be deployed during the project lifecycle to improve opportunity management process and about the enablers – factors that facilitate alliance partners’ capabilities to manage opportunities.
Originality/value
There is limited empirical research on the practices of opportunity management that support continuous, active opportunity management in inter-organizational project contexts, although multidisciplinary project networks have possibilities for taking advantage of opportunities that emerge over the project lifecycle.
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H. Alistair Bailie, Anna Tickle and Michael Rennoldson
Peer support (PS) workers are being employed despite uncertain evidence for clinical and cost-effectiveness. Psychological theories have been proposed to explain the mechanisms of…
Abstract
Purpose
Peer support (PS) workers are being employed despite uncertain evidence for clinical and cost-effectiveness. Psychological theories have been proposed to explain the mechanisms of PS but these lack empirical validation and specificity to professional PS. The purpose of this paper is to develop a substantive interpretive grounded theory of service-users’ experience of professional PS work.
Design/methodology/approach
Constructivist grounded theory was used throughout. Semi-structured interviews were conducted with ten service-users who had engaged with a professional PS worker.
Findings
Three overarching themes were constructed. “The process of disclosure” describes how disclosure of mental health difficulties, experiences as a service-user and wider disclosure about life experiences, interests and values facilitate the development of a shared identity with the PS worker. “The product of disclosure” highlights the sense of being understood as a result of the disclosure and marks a deepening of the relationship. “Dual roles” describes the tenuous position of holding both a professional relationship and friendship.
Research limitations/implications
Future research should seek to refine the theory developed and compare the effects of therapist self-disclosure with that found within PS. There were limitations within the study, including limited diversity within the sample as well as difficulties with recruitment.
Originality/value
This study connects service-users’ accounts of receiving PS with existing psychological theory to move towards an understanding of the relationship between receivers and providers of professional PS.
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Managing megaprojects is challenging due to their inherent complexity and uncertainty. Collaborative project delivery models have been introduced as an alternative to traditional…
Abstract
Purpose
Managing megaprojects is challenging due to their inherent complexity and uncertainty. Collaborative project delivery models have been introduced as an alternative to traditional project management in public infrastructure megaprojects and are often realized through collaborative contracts. These project organizations act as institutional arenas for logic interaction as actors with differing institutional backgrounds interact within the project. This paper aims to study the delivery phase of three megaprojects through an institutional lens, investigating the institutional interaction and alignment of logics therein.
Design/methodology/approach
A multiple case study was employed to reach deep insight into the phenomenon. Sixty-one interviews were conducted over 3 cases with representatives from all levels of the project hierarchy. Respondents were selected through snowball sampling. In two cases, observations of the shared project office were conducted. Data analysis built on first-order codes and second-order themes, collected into a theoretical framework.
Findings
The empirical evidence demonstrates the dynamics shaping institutional logics and gives evidence for changing logics in projects with a well-applied collaborative contract. However, there is a risk of resistance and a return to traditional logics since institutional change is slow and an unsuitably applied collaborative contract can lead to adherence to the conventional way of work.
Originality/value
Current research has focused on the regulatory framework and procurement phase of such models, but little attention has been given to the delivery phase and the interaction of conflicting logics. This paper can serve as an exemplar of the different logics found within public infrastructure projects and their interaction and alignment. Contributions include a heightened emphasis on the start of the project as a meeting point for differing institutional logics and the role change necessary when using a collaborative contract.
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Ingrid Müller, Margret Buchholz and Ulrika Ferm
Current technology offers many possibilities for remote communication. Nevertheless, people with cognitive and communicative disabilities have limited access to common…
Abstract
Current technology offers many possibilities for remote communication. Nevertheless, people with cognitive and communicative disabilities have limited access to common communication technology like text messaging via a mobile phone. This study is part of the project Text messaging with picture symbols ‐ possibilities for persons with cognitive and communicative disabilities. Semi‐structured interviews were used to investigate the experience of using Windows mobiles with adapted functions for text messaging by three men and four women. The participants' opinions about the content and organisation of the project were also evaluated. All participants except one experienced increased possibilities for remote communication via text messaging. Increased participation was another relevant finding. Technical aids and interventions were individually tailored and the majority of the participants thought that Talking Mats for goal setting and repeated interviews during the project had been successful methods.
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Anna-Maija Hietajärvi, Kirsi Aaltonen and Harri Haapasalo
The effective management of inter-organizational integration is central to complex projects. Such projects pose significant challenges for integration, as organizations struggle…
Abstract
Purpose
The effective management of inter-organizational integration is central to complex projects. Such projects pose significant challenges for integration, as organizations struggle with constantly changing inter-organizational interdependencies and must develop and adapt integration mechanisms to meet new demands. The purpose of this paper is to understand what kinds of integration mechanisms are used and how they are developed and adjusted during the infrastructure alliance projects.
Design/methodology/approach
This study provides empirical evidence of integration dynamics in project alliancing by analyzing two infrastructure alliance projects – a complex tunnel construction project and a railway renovation project. The research approach is an inductive case study.
Findings
This paper identifies integration mechanisms adopted in two case projects and three central triggers that led to changes in the integration mechanisms: project lifecycle phase, unexpected events and project team’s learning during the project.
Practical implications
Integration capability should be a precondition for alliance project organizations and requires the adoption of a wide range of integration mechanisms, as well as an ability to adjust those mechanisms in response to everyday dynamics and emergent situations.
Originality/value
Although unplanned contingencies and the responses to them represent important influences in organizations, there is limited amount of research on the dynamics of integration. The findings will be of value in supporting the management of inter-organizational integration in complex, uncertain and time-critical construction projects.