Working memory correlates of three symptom clusters in schizophrenia

Examined whether discrete working memory deficits underlie positive, negative and disorganised symptoms of schizophrenia. 52 outpatients (mean age 37.5 yrs) with schizophrenia were studied using items drawn from the Positive and Negative Syndrome Scale (PANSS). Linear regression and correlational analyses were conducted to examine whether symptom dimension scores were related to performance on several tests of working memory function. Severity of negative symptoms correlated with reduced production of words during a verbal fluency task, impaired ability to hold letter and number sequences on-line and manipulate them simultaneously, reduced performance during a dual task, and compromised visuospatial working memory under distraction-free conditions. Severity of disorganisation symptoms correlated with impaired visuospatial working memory under conditions of distraction, failure of inhibition during a verbal fluency task, perseverative responding on a test of set-shifting ability, and impaired ability to judge the veracity of simple declarative statements. The present study provides evidence that the positive, negative and disorganised symptom dimensions of the PANSS constitute independent clusters, associated with unique patterns of working memory impairment.

Symptom burden in chronic kidney disease : a review of recent literature

Background: People living with chronic kidney disease (CKD) experience multiple symptoms due to both the disease and its treatment, these symptoms are often under recognized. The majority of studies have focused on an individual symptom; however these symptoms rarely occur in isolation and may instead occur in clusters. Aim of review: This review investigated the total symptom burden in advanced CKD (stages 4 and 5) and identified the key instruments that are used to assess multiple symptoms. Methods: A literature search from 2006 to 2012 was undertaken and a total of 19 articles were included. Result: The most common CKD symptoms were fatigue or lack of energy, feeling drowsy, pain and pruritus. However, symptom assessment instruments varied between studies, often with inconsistent or inadequate symptom dimensions. Conclusion: People with CKD experience a high burden of symptom, although little is known about the burden for people with CKD stage 4 and for those with CKD stage 5 receiving PD. This review recommends that a full range of symptoms be assessed for those at different stages of CKD. Improved understanding of the burden of symptoms could be used as the basis for treatment choices and for identifying priorities which are likely to contribute to a better quality of life and improve the quality of care.

Differences in the symptom experience of older versus younger oncology outpatients : a cross-sectional study

Background: Mortality rates for cancer are decreasing in patients under 60 and increasing in those over 60 years of age. The reasons for these differences in mortality rates remain poorly understood. One explanation may be that older patients received substandard treatment because of concerns about adverse effects. Given the paucity of research on the multiple dimensions of the symptom experience in older oncology patients, the purpose of this study was to evaluate for differences in ratings of symptom occurrence, severity, frequency, and distress between younger (< 60 years) and older ( ≥ 60 years) adults undergoing cancer treatment. We hypothesized that older patients would have significantly lower ratings on four symptom dimensions. Methods: Data from two studies in the United States and one study in Australia were combined to conduct this analysis. All three studies used the MSAS to evaluate the occurrence, severity, frequency, and distress of 32 symptoms. Results: Data from 593 oncology outpatients receiving active treatment for their cancer (i.e., 44.4% were < 60 years and 55.6% were ≥ 60 years of age) were evaluated. Of the 32 MSAS symptoms, after controlling for significant covariates, older patients reported significantly lower occurrence rates for 15 (46.9%) symptoms, lower severity ratings for 6 (18.9%) symptoms, lower frequency ratings for 4 (12.5%) symptoms, and lower distress ratings for 14 (43.8%) symptoms. Conclusions: This study is the first to evaluate for differences in multiple dimensions of symptom experience in older oncology patients. For almost 50% of the MSAS symptoms, older patients reported significantly lower occurrence rates. While fewer age-related differences were found in ratings of symptom severity, frequency, and distress, a similar pattern was found across all three dimensions. Future research needs to focus on a detailed evaluation of patient and clinical characteristics (i.e., type and dose of treatment) that explain the differences in symptom experience identified in this study.

Which patients with chronic kidney disease have the greatest symptom burden? A comparative study of advanced CKD stage and dialysis modality

Background Chronic kidney disease (CKD) leads to a range of symptoms, which are often under-recognised and little is known about the multidimensional symptom experience in advanced CKD. Objectives To examine (1) symptom burden at CKD stages 4 and 5, and dialysis modalities, and (2) demographic and renal history correlates of symptom burden. Methods Using a cross-sectional design, a convenience sample of 436 people with CKD was recruited from three hospitals. The CKD Symptom Burden Index (CKD-SBI) was used to measure the prevalence, severity, distress and frequency of 32 symptoms. Demographic and renal history data were also collected. Results Of the sample, 75.5 % were receiving dialysis (haemodialysis, n = 287; peritoneal dialysis, n = 42) and 24.5 % were not undergoing dialysis (stage 4, n = 69; stage 5, n = 38). Participants reported an average of 13.01 ± 7.67 symptoms. Fatigue and pain were common and burdensome across all symptom dimensions. While approximately one-third experienced sexual symptoms, when reported these symptoms were frequent, severe and distressing. Haemodialysis, older age and being female were independently associated with greater symptom burden. Conclusions In CKD, symptom burden is better understood when capturing the multidimensional aspects of a range of physical and psychological symptoms. Fatigue, pain and sexual dysfunction are key contributors to symptom burden, and these symptoms are often under-recognised and warrant routine assessment. The CKD-SBI offers a valuable tool for renal clinicians to assess symptom burden, leading to the commencement of timely and appropriate interventions.

Measuring the multidimensions of symptoms in people with advanced stages of chronic kidney disease

Chronic kidney disease (CKD) is increasing globally and in Saudi Arabia it affects approximately 8% annual increment of dialysis population. It is associated with a high symptom burden. Previous studies have largely reported on the prevalence of symptoms only in the haemodialysis population. This study examined symptom burden across disease stages and treatment groups in advanced CKD, and their correlation with demographic and clinical factors. Using a cross-sectional design, a convenience sample of 436 patients with CKD was recruited from three hospitals in Saudi Arabia. The CKD Symptom Burden Index (CKD-SBI) was used to measure 32 CKD symptoms. Demographic and clinical data were also collected. Of the sample 75.5% were receiving dialysis (haemodialysis, n = 287; peritoneal dialysis, n = 42) and 24.5% were non-dialysis (CKD stage 4, n = 69; CKD stage 5, n = 38). Average symptom reported was 13.01 ± 7.67. Fatigue and pain were common and burdensome across all symptom dimensions.Approximately one-third of participants experienced sexual symptoms. Dialysis patients reported greater symptom burden, especially patients on haemodialysis. Haemodialysis treatment, older age and being female were independently associated with greater total symptom burden. In conclusion, symptom burden is high among advanced stages of CKD, particularly among those receiving dialysis. Although fatigue, pain and sexual dysfunction are key contributors to symptom burden in CKD, these symptoms are often under-recognised and warrant routine assessment. The CKD-SBI offers a valuable tool to assess symptom burden, leading to the commencement of timely and appropriate interventions.

The differential effects of organizational antecedents on dimensions of corporate entrepreneurship

This study seeks to further delineate how organizational antecedents differentially influence the three components of corporate entrepreneurship: innovation, venturing or strategic renewal. We argue that structural differentiation may help organizations to maintain multiple and often conflicting demands of entrepreneurial and mainstream activities. Taking a social capital perspective, our study further examines two contingencies in the form of informal integration mechanisms (i.e. connectedness and TMT social integration). Our findings show structural differentiation has a positive effect on all three components of corporate entrepreneurship, yet the effect is moderated by integration mechanisms. Interunit connectedness has a positive moderation effect regarding innovation and venturing, and TMT social integration has a negative moderation effect regarding strategic renewal. This reveals that innovation is influenced by informal integration mechanisms on the organizational level, strategic renewal on top management team level, while venturing is influenced by integration mechanisms on both levels.

One size doesn't fit all. Exploring marketing strategies for influencing three dimensions of brand loyalty

Brand loyalty is a concept that has garnered considerable interest over recent years from both marketing practitioners and academics alike. While marketers are primarily interested in ways they can generate and increase brand loyalty from their customers, academics strive to conducts research which investigates the antecedents and consequences of customer loyalty (See DeWitt, Nguyen and Marshall 2008; Russell-Bennett, McColl-Kennedy and Coote 2007).

The strategic and operational dimensions of staff training and professional development for information professionals : what neXus2 has revealed

The paper seeks to continue the debate about the need for professionals in the library and information services (LIS) sector to continually engage in career-long learning to sustain and develop their knowledge and skills in a dynamic industry. Aims: The neXus2 workforce study has been funded by the ALIA and the consortium of National and State Libraries Australasia (NSLA). It builds on earlier research work (the neXus census) that looked at the demographic, educational and career perspectives of individual library and information professions, to critically examine institutional policies and practices associated with the LIS workforce. The research aims to develop a clearer understanding of the issues impacting on workforce sustainability, workforce capability and workforce optimisation. Methods: The research methodology involved an extensive online survey conducted in March 2008 which collected data on organisational and general staffing; recruitment and retention; staff development and continuing professional education; and succession planning. Encouragement to participate was provided by key industry groups, including academic, public, health, law and government library and information agencies, with the result that around 150 institutions completed the questionnaire. Results: The paper will specifically discuss the research findings relating to training and professional development, to measure the scope and distribution of training activities across the workforce, to consider the interrelationship between the strategic and operational dimensions of staff development in individual institutions and to analyse the common and distinctive factors evident in the different sectors of the profession. Conclusion: The neXus2 project has successfully engaged LIS institutions in the collection of complex industry data that is relevant to the future education and workforce strategies for all areas of the profession. Cross-sector forums such as Information Online 2009 offer the opportunity for stimulating professional dialogue on the key issues.

A model of project complexity : distinguishing dimensions of complexity from severity

There is increasing agreement that understanding complexity is important for project management because of difficulties associated with decision-making and goal attainment which appear to stem from complexity. However the current operational definitions of complex projects, based upon size and budget, have been challenged and questions have been raised about how complexity can be measured in a robust manner that takes account of structural, dynamic and interaction elements. Thematic analysis of data from 25 in-depth interviews of project managers involved with complex projects, together with an exploration of the literature reveals a wide range of factors that may contribute to project complexity. We argue that these factors contributing to project complexity may define in terms of dimensions, or source characteristics, which are in turn subject to a range of severity factors. In addition to investigating definitions and models of complexity from the literature and in the field, this study also explores the problematic issues of ‘measuring’ or assessing complexity. A research agenda is proposed to further the investigation of phenomena reported in this initial study.

Socio-cultural dimensions of Active Futures : Importance of studying migrants’ perspectives of wellness

In this paper we provide a migrant perspective on how women and men from a different culture perceive wellness while settling down in a new country. We are discussing the texts of research interviews with Indian migrant women and men that illuminate their perception of lifestyle enhancement in their adopted country Australia. Our purpose is to show how socio-cultural factors influence the migrants‟ perspective of lifestyle enhancement, and to what extent they direct their wellness. Personal development, both in theory and practice, is a huge concept in Australia. Concerted efforts are made towards increasing public awareness about health literacy leading to a better understanding and practice of wellness. However, as research studies have pointed out, lifestyle enhancement leading to holistic wellness is not void of socio-cultural factors. The number of women and men migrating to Australia from India has increased greatly in the present decade. As migrants their participation in developing Australian society is significant. So what is their socio-cultural perception of wellness including nutrition and physical exercises as active citizens? How do young Indian migrants participate in lifestyle enhancement programmes? As parents what are their socio-cultural beliefs, attitudes, practices and values, and how do they influence their children‟s participation in personal development and PE progammes? To what extent gender differences exist in such participation levels? What is the space available in State school curriculum to learn from the migrants‟ cultures towards enhancing lifestyles including nutrition and personal development?The findings may sensitise Australian researchers, academics, school teachers and practitioners of wellness therapies. Long term research studies may inform the governments and HPE practitioners of the changes occurring in such values, beliefs and practices as they incorporate nutrition and lifestyles of Australian society.