Suchergebnisse

The research on emergent organizations indicates that they arise during periods of collective stress, serve as transitory social systems providing neglected community inputs and, then, dissolve after the troublesome period has passed (Haas and Drabek, 1973:6; Taylor et. al., 1970:79-108). Quarantelli (1970:4), however, has pointed out that only '... some emergent groups cease to exist when the immediate crisis is over, whereas others become part of a new social order.' The conditions which correspond to such a group becoming an established organization, Quarantelli (1970:11) suggests, '... rest on the new group being defined as one that carries out necessary tasks or activities not the traditional responsibility of already established groups or organizations.' This account may be adequate for depicting community transformation which results from sudden impact disaster agents such as earthquakes, tornadoes, bombings, etc., but it fails to do more than illustrate the 'climate' in which an emergent organization arises. Illustration is important, but it remains insufficient in that it does not facilitate prediction, particularly with respect to the development of a new order or a return to the old. Surprisingly, the mechanism of group emergence and the means whereby such groups dissipate or become formalized and permanent have not yet appeared in the organizational literature. We believe that this missing link may be due to the fact that research on emergent organizations has focused primarily upon the sudden onset, short-duration impact disasters, excluding for the most part the gradual onset, long-duration impact disasters (cf. Barton, 1969:42-46).2 The present note, therefore, reports upon a research project which is currently investigating a gradual onset, long-term disaster. The data are being produced through a longitudinal study of Neighbors in Need (NIN), a welfare organization based in Seattle, Washington. The information for this report is based on interviews with members of NIN's staff as well as data collected and made available by their own research team. Thus far, the research has developed a series of propositions facilitating (I) an understanding of the procedures and processes whereby new organizations emerge, as well as (2) prediction of their future development or demise. Recent theoretical attempts to conceptualize organizational environments has been helpful in interpreting the findings.

A model facilitating the prediction of organizational persistence or dissolution is presented through a series of propositions. Environmental change, community demands for service, organizational capacity, formalization, and task orientations are identified as important dimensions in determining the probability of organizational emergence, maintenance, or demise. The emergence and development of Neighbors in Need (NIN); a Seattle, Washington based welfare organization, is described to illustrate the viability of the model. NIN's career pattern shows a persistence beyond the period of environmental disruption because of the long‐term progressive nature of the system's stress, NIN's formalization, and its task specificity. But a reduction in system stress, the adoption of a more diffuse goal, and the organization's failure to promote interorganizational relations with the local agencies indicates the probable demise of the NIN.

Supportive interventions are needed for the family and carers of people with multiple sclerosis. A rapid realist review and realist evaluation explored what helps, who it helps, when and how. Literature analysis was synthesised with a thematic analysis of qualitative interviews and focus groups with 49 family and carers of people with multiple sclerosis. The resulting model summarised a family of interventions that could help people develop their capabilities and expand their resources, resulting in more positive outcomes. This may prevent or delay a 'tipping point' where capacity to care is overwhelmed by caring roles.

INTRODUCTION: As of 2015, as part of the implementation of the Welsh Government primary care plan and primary care clusters, the Welsh Government has encouraged non-medical healthcare professionals working in primary care to train as independent prescribers (IPs). OBJECTIVES: This research aimed to identify the number of NMIPs in primary care in Wales and describe their prescribing trend of items between 2011 and 2018, in order to compare their prescribing pattern before and after the implementation of primary care clusters for Wales. DESIGN: Retrospective secondary data analysis and interrupted time series analysis in order to compare prescribing by non-medical independent prescribers (NMIPs) preimplementation and postimplementation of primary care clusters across Wales. RESULTS: Over the study period, 600 NMIPs (nurses n=474 and pharmacists n=104) had prescribed at least one item. The number of nurse IPs increased by 108% and pharmacists by 325% (pharmacists had the largest increase between July 2015 and March 2018). The number of items prescribed by NMIPs increased over time by an average of 1380 per month (95% CI 904 to 1855, p<0.001) after the implementation of primary care clusters compared with 496 (95% CI 445 to 548, p<0.001) prior its implementation. Approximately one-third of the items prescribed by NMIPs was within Betsi Cadwaladr University Health Board (HB) with only 4% in Powys Teaching HB. CONCLUSION: The number of NMIPs and their volume of prescribing in primary care in Wales has increased following the implementation of primary care clusters in 2015. This suggests that the Government's recommendations of using NMIPs in primary care have been implemented. Future studies should focus on efficiency and quality of prescribing by NMIPs in primary care.

AbstractBackgroundAlmost no research has been published reporting on evaluations of the effectiveness of psychological interventions for people with severe to profound intellectual disabilities and depression. This paper describes the development and initial feasibility testing of an adapted Behavioural Activation therapy (BeatIt2) for this population.MethodPhase 1 of the study examined participant recruitment and willingness to be randomised in the context of a planned Randomised Controlled Trial (RCT). Phase 2 examined the feasibility of delivering the intervention.ResultsTwenty adults with a severe or profound intellectual disability and clinically significant depression were recruited to Phase 1 of the study. In Phase 2, there was 100% participant retention for those recruited to the study at 6‐month follow‐up. The BeatIt2 therapy was reported to be acceptable for participants.ConclusionCOVID disruption meant that it was not possible to complete the planned feasibility RCT. The positive findings suggest that additional evaluation of BeatIt2 is warranted.

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