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Background. Children with complex health care needs are now being cared for at home as a result of medical advances and government policies emphasizing community-based care. The parents of these children are involved in providing care of a highly technical and intensive nature that in the past would have been the domain of professionals (particularly nurses). Aims of the paper. To assess how the transfer of responsibility from professionals to parents was negotiated, the tensions and contradictions that can ensue, and the implications for professional nursing roles and relationships with parents. Design. Using a Grounded Theory methodology, in-depth interviews were conducted with 23 mothers, 10 fathers and 44 professionals to gain insight into the experience of caring for children and supporting families in the community. Findings. From the parents' perspective, their initial assumption of responsibility for the care of their child was not subject to negotiation with professionals. Prior to discharge, parents' feelings of obligations, their strong desire for their child to come home, and the absence of alternatives to parental care in the community, were the key motivating factors in their acceptance of responsibility for care-giving from professionals. The professionals participating in the study had concerns over whether this group of parents was given a choice in accepting responsibility and the degree of choice they could exercise in the face of professional power. However, it was following the initial discharge, as parents gained experience in caring for their child and in interacting with professionals, that role negotiation appeared to occur. Conclusion. This study supports other research that has found that professionals' expectations of parental involvement in the care of sick children role can act as a barrier to negotiation of roles. In this study, parental choice was also constrained initially by parents' feelings of obligation and by the lack of community services. Nurses are ideally placed to play the central role not only in ensuring that role negotiation and discussion actually occurs in practice, but also by asserting the need for appropriate community support services for families. Being on home territory, and in possession of expertise in care-giving and in managing encounters with professionals, provided parents with a sense of control with which to enter negotiations with professionals. It is important that changes in the balance of power does not lead to the development of parent-professional relationships that are characterized by conflict rather than partnership.

AbstractThis article applies a Bourdieusian lens to a critical analysis of global power dynamics to argue that a field framework is useful for studying praxis and (in)action in complex and dynamic global spaces of decision‐making. It is argued that individuals with global power can interact strategically to change their actions for improved social and economic justice, but it requires resisting dominant practices that may maintain existing inequalities. By exploring the interrelations between positions within the global spaces of the World Social Forum and the World Economic Forum, we offer an original contribution to the field of strategic change. We show how the actors in these global spaces have the potential to provoke greater social justice but also risk perpetuating a status quo that continues to favor the few over the many. Participants are world‐makers who wield symbolic power and can create disruption in the "rules of the game," but the strength of those who seek to defend the status quo can perpetuate inertia. The article offers a novel contribution to the research on global spaces and elite actors by critically analyzing accounts of strategic practices therein, thus offering a more nuanced understanding of world‐making in action or inaction.

AbstractGlobalization has transformed spatial relations, increasing the demand for mobility. Literature tends to see the de‐emphasizing of national identity and the foregrounding of a cosmopolitan identity as central to an individual's ability to navigate this global landscape. For individuals who are constantly moving the question is how do globally mobile workers navigate the intersection of identity, meaningfulness and place? This interpretivist study explores this question through an analysis of 68 semi‐structured interviews with individuals engaged in different forms of global mobility, ranging from traditional expatriate assignments through to global commuting and business travel. Our findings highlight how a complex interplay between national and cosmopolitan identities influences the search for meaningfulness in the lives of these workers. Drawing on notions of meaning and place, we argue that employers should provide opportunities to access identity narratives though networking and other international human resource management (IHRM) practices that enable these workers to create a sense of meaningfulness in their lives. Thus, we offer a contribution to identity studies and the field of global mobility.

Background. A group of children with complex health care needs have emerged as a result of medical advances and government policies emphasizing the community as the arena for care. Some of these children remain dependent on the medical technology that enabled them to survive and require care of a complex and intensive nature to be carried out by their parents at home. Aims. To explore the experiences of families caring at home for a technology-dependent child; to examine their needs for practical and other support; and to examine how far services are currently meeting these needs. Methods. In-depth interviews were conducted with the parents of 24 technology-dependent children and with 44 health, social care and other professionals. Results. Services in the community were not sufficiently developed to support this group of families. Major problems were identified in the purchasing and provision of both short-term care/ home support services and specialist equipment/therapies in the community. Service provision could be poorly planned and co-ordinated at an operational level and few families had a designated key worker. Parents felt that professionals did not always recognize either the emotional costs entailed in providing care of this nature or their expertise in caregiving. Information-giving to parents was often described as poor and participants reported that hospital professionals failed to negotiate the transfer of caregiving responsibility to parents. Conclusions. Services need to work in partnership with families and with each other at both strategic and operational levels, to develop integrated and co-ordinated services that can meet the needs of this group of families. © 2004 Blackwell Publishing Ltd.

In the United Kingdom a new group of children with intensive and complex health care needs are now being cared for at home as a result of medical advances and government policies emphasising the community as the arena for care. This has led their parents to become involved in providing care of a highly technical and intensive nature that would previously have been considered to be the domain of professionals. In-depth qualitative interviews were conducted with parents and professionals to discover parents' and professionals' experiences of receiving and providing support in a context where parents rather than professionals are the expert caregivers. This paper describes the elements of professional 'support' that were particularly valued by parents and concludes with a discussion of the implications for professional education and roles. © 2002 Elsevier Science Ltd. All rights reserved.

Social networks and social capital have emerged as concepts of great interest and potential to help understand and explain how social structures impact political, social and business practices at the collective and individual levels. The basic premise is: investment in social relations will yield expected returns. Existing research has largely focused on the West; our knowledge of how social capital plays out in the Middle East is limited. This paper explores the prevalent practice of 'wasta' through the social capital lens, namely bonding and bridging social capital, and investigate HR managers' perceptions of wasta in employment selection in Jordan. Often use of wasta in employment selection is related to favouritism and nepotism and the many negative outcomes of not adhering to merit-based selection. However, through in-depth interview data a more nuanced and multifaceted view of wasta in employment selection is revealed and how these impact HR practice in the organisation. ; N/A

Aims. This paper reports a study exploring parents' experiences of caring for a child who is dependent on medical technology, and in particular of performing clinical procedures on their own children. Background. A group of children with a continuing need for the support of medical technology have emerged in community settings as a result of medical advances and government policies. Caring for these children has a significant social and emotional impact on parents, because of their specialized and intensive care needs. Obtaining appropriate and coordinated home support services is problematic. Methods. Grounded theory techniques were used, and in-depth interviews were conducted with the parents of 24 children. Findings. Parents' accounts revealed that their constructions of parenting were shaped by the nature of their role in caring for their child and by the transformation of their homes by medical equipment and personnel. They described themselves as having a role that had both parenting and nursing dimensions. Parents managed this tension and defined their role and relationship to their child to be primarily one of parenting by differentiating parental care-giving and its underpinning knowledge from that of professionals, particularly nurses. Conclusions. Parenting a technology-dependent child alters the meaning of parenting. Professionals need to recognize that providing care has a substantial emotional dimension for parents, and that they need opportunities to discuss their feelings about caregiving and what it means for their parenting identity and their relationship with their child. A key professional nursing role will be giving emotional support and supporting parents' coping strategies. Parents' perceptions of nurses raise questions about whether nurses' caregiving is individualized to the needs of the child and family, and whether parental expertise is recognized. © 2005 Blackwell Publishing Ltd.

AbstractThe bulk of care in the community is carried out by lay carers. Recent policy initiatives to support them in the United Kingdom are outlined. There remains evidence of significant gaps in support from professional health and social‐care workers including community nurses. This paper reports three studies of lay carers: those caring for older people, carers of technology‐dependent children, and home‐care workers involved in the "direct payments" scheme. Findings are reported in the areas of decisions about appropriate caring roles, the lay–professional boundary, training and respite opportunities and the expertise of lay carers. Recommendations for policy and practices are made.

Aims and objectives. To: (1) Examine children's/young people's, parents' and professionals'/workers' perceptions of the effectiveness of different models of self-care support, (2) identify factors that support and inhibit self-care and (3) explore how different models integrate with self-care support provided by other organisations. Background. Childhood long-term illness has been largely overlooked in government policy and self-care support under-researched when compared with adults. There is a lack of evidence on which are the most appropriate models and methods to engage young people and their parents in self-care. Design. Case study. Methods. Case studies of six different models of self-care support were conducted using multiple methods of data collection in 2009. Semi-structured interviews were conducted with 26 young people, 31 parents and 36 self-care support providers. A sample of self-care support activities was observed and relevant documents reviewed. Data were analysed using the Framework approach. Results. The effectiveness of self-care support projects was defined in relation to four dimensions - providing a sense of community, promoting independence and confidence, developing knowledge and skills and engaging children/young people. Self-care support provided by schools appeared to be variable with some participants experiencing barriers to self-management and inclusion. Participants self-referred themselves to self-care support projects, and there was a lack of integration between some projects and other forms self-care support. Conclusion. This study adds to knowledge by identifying four dimensions that are perceived to be central to effective self-care support and the contextual factors that appear to influence access and experiences of self-care support. Relevance to clinical practice. Study findings can inform the development of self-care support programmes to meet the needs of individuals, families and communities. In addition, the findings suggest that healthcare professionals need to support schools if young people with long-term conditions are to have the same educational and social opportunities as their peers. © 2012 Blackwell Publishing Ltd.

The U.K. government is seeking to transform the quality of the National Health Service (NHS) through a process ofmodernization. It is generally thought by government and managers within the service that improving the job satisfaction of employees is an important mechanism for delivering modernization. On the basis of job satisfaction surveys carried out within 2 NHS hospitals, this article suggests that instead of being a driver for improvement, employee perception of job satisfactionmay be acting as a barrier tomodernization. The article then discusses the possibility that there may be structural tensions between the imperatives of modernization and the wish to improve job satisfaction.

Purpose– The purpose of this paper is to examine and conceptualise the ways in which a balance can be achieved between optimising the efficiency and effectiveness of electronic human resource management (e-HRM) systems for human resource management (HRM) and enabling innovation to occur during the system implementation.Design/methodology/approach– An interpretive case study of a UK local authority e-HRM system implementation is examined using the notion of ambidexterity as an analytical device. Ambidexterity relates to how an organisation develops the ability to operate efficiently in the now, while at the same time being able to adapt to environmental changes around and ahead of them in order to grow into the future.Findings– As an intra-organisational capability, ambidexterity is found to derive from the simultaneous interplay and balancing of dual capabilities: exploitation and exploration. e-HRM exploitation concerned the capability to generate new knowledge with innovatory effects, created through the everyday practices performed by practitioners at all levels in the organisation. e-HRM exploration, rather than being a purposeful act, was found to be an accidental consequence of engaging in exploitation to maintain the status quo.Research limitations/implications– The notion of ambidexterity was originally constructed within strategic management and studies in the field have previously been confined to this area. This makes this study theoretically and empirically experimental, making it a challenging research endeavour. Another limitation is that the authors only sought views from the interviewees on how external forces might limit or facilitate their ambidexterity, as opposed to actually studying those forces themselves.Practical implications– The authors suggest that those in organisations who are responsible for strategic HRM need to consider ways in which "intentional" opportunities for ambidexterity in e-HRM systems implementation can be identified and harnessed to ensure better balances between exploitation and exploration in such endeavours and to guard against innovation only occurring through chance.Originality/value– There is a lack of detailed investigation of how organisations actually achieve ambidexterity, particularly in three under-researched areas: ambidexterity in the public sector, at human resourcing functional level and e-HRM systems implementation. Bundling these three areas into an integrated examination allows us to both identify how exploitation and exploration play out in the ambidextrous practices of an e-HRM project and also to identify the dimensions of ambidexterity in balancing e-HRM work.