Gender comparisons in non-acute cardiac symptom recognition and subsequent help-seeking decisions: a mixed methods study protocol

Introduction: Coronary heart disease (CHD) is one of the leading causes of death in both men and women worldwide. Despite the common misconception that CHD is a ‘man's disease’, it is now well accepted that women endure worse clinical outcomes than men following CHD-related events. A number of studies have explored whether or not gender differences exist in patients presenting with CHD, and specifically whether women delay seeking help for cardiac conditions. UK and overseas studies on help-seeking for emergency cardiac events are contradictory, yet suggest that women often delay help-seeking. In addition, no studies have looked at presumed cardiac symptoms outside an emergency situation. Given the lack of understanding in this area, an explorative qualitative study on the gender differences in help-seeking for a non-emergency cardiac events is needed. Methods and analysis: A purposive sample of 20–30 participants of different ethnic backgrounds and ages attending a rapid access chest pain clinic will be recruited to achieve saturation. Semistructured interviews focusing on help-seeking decision-making for apparent cardiac symptoms will be undertaken. Interview data will be analysed thematically using qualitative software (NVivo) to understand any similarities and differences between the way men and women construct help-seeking. Findings will also be used to inform the preliminary development of a cardiac help-seeking intentions questionnaire. Ethics and dissemination: Ethical approvals were sought and granted. Namely, the University of Westminster (sponsor) and St Georges NHS Trust REC, and the Trust Research and Development Office granted approval to host the study on the Queen Mary's Roehampton site. The study is low risk, with interviews being conducted on hospital premises during working hours. Investigators will disseminate findings via presentations and publications. Participants will receive a written summary of the key findings.

Cross-National Differences in Managerial Discretion: Insights from the Middle East

Our study examines the effect of cultural practices on CEO discretion across six Middle Eastern countries. Using a panel of senior management consultants, we extend the national-level framework of managerial discretion and find that an encompassing array of cultural practices play a crucial role in shaping the degree of discretion provided to CEOs’ of public firms headquartered in these countries. We empirically demonstrate that power distance, future and performance orientation along with gender egalitarianism and assertiveness have positive relationships with managerial discretion. However, institutional collectivism, uncertainty avoidance and humane orientation negatively affect the degree of discretion provided to CEOs. As such, our results indicate that executives are able to take idiosyncratic and bold actions to the extent to which the cultural environment allows them to do so. As such, we contribute to the strategic leadership literature by finding new national-level antecedents of managerial discretion that haven’t been considered in earlier studies and confirm the context dependency of the discretion construct.

Just noticeable differences in perceived image contrast with changes in displayed image size

An evaluation of the change in perceived image contrast with changes in displayed image size was carried out. This was achieved using data from four psychophysical investigations, which employed techniques to match the perceived contrast of displayed images of five different sizes. A total of twenty-four S-shape polynomial functions were created and applied to every original test image to produce images with different contrast levels. The objective contrast related to each function was evaluated from the gradient of the mid-section of the curve (gamma). The manipulation technique took into account published gamma differences that produced a just-noticeable-difference (JND) in perceived contrast. The filters were designed to achieve approximately half a JND, whilst keeping the mean image luminance unaltered. The processed images were then used as test series in a contrast matching experiment. Sixty-four natural scenes, with varying scene content acquired under various illumination conditions, were selected from a larger set captured for the purpose. Results showed that the degree of change in contrast between images of different sizes varied with scene content but was not as important as equivalent perceived changes in sharpness.