Are clinical documents optimised for patient safety? A critical analysis of patient safety outcomes using the EDA error model

Iatrogenic errors and patient safety in clinical processes are an increasing concern. The quality of process information in hardcopy or electronic form can heavily influence clinical behaviour and decision making errors. Little work has been undertaken to assess the safety impact of clinical process planning documents guiding the clinical actions and decisions. This paper investigates the clinical process documents used in elective surgery and their impact on latent and active clinical errors. Eight clinicians from a large health trust underwent extensive semi- structured interviews to understand their use of clinical documents, and their perceived impact on errors and patient safety. Samples of the key types of document used were analysed. Theories of latent organisational and active errors from the literature were combined with the EDA semiotics model of behaviour and decision making to propose the EDA Error Model. This model enabled us to identify perceptual, evaluation, knowledge and action error types and approaches to reducing their causes. The EDA error model was then used to analyse sample documents and identify error sources and controls. Types of knowledge artefact structures used in the documents were identified and assessed in terms of safety impact. This approach was combined with analysis of the questionnaire findings using existing error knowledge from the literature. The results identified a number of document and knowledge artefact issues that give rise to latent and active errors and also issues concerning medical culture and teamwork together with recommendations for further work.

Trust and relational embeddedness: exploring a paradox of trust pattern development in key supplier relationships

This paper explores the role of trust as an enabler and constraint between buyers and suppliers engaged in long-term relationships. According to the relational view, cooperative strategies require trust-based mutual commitments to co-create value. However, complete pictures of the positive and negative outcomes from trust development have yet to be fully developed. In particular, trust as an originator of path dependent constraints resulting from over embeddedness is yet to be integrated into the relational view. We use a case-based methodology to explore whether trust is an optimizing phenomenon in key supplier relationships. Two cases where trust development processes demonstrate a paradox of trust-building behaviors cultivate different outcomes constraining value co-creation.

Perceived helplessness is associated with individual differences in the central motor output system

Learned helplessness is a maladaptive response to uncontrollable stress characterized by impaired motor escape responses, reduced motivation and learning deficits. There are important individual differences in the likelihood of becoming helpless following exposure to uncontrollable stress but little is known about the neural mechanisms underlying these individual differences. Here we used structural MRI to measure gray and white matter in individuals with chronic pain, a population at high risk for helplessness due to prolonged exposure to a poorly controlled stressor (pain). Given that self-reported helplessness is predictive of treatment outcomes in chronic pain, understanding such differences might provide valuable clinical insight. We found that the magnitude of self-reported helplessness correlated with cortical thickness in the supplementary motor area (SMA) and midcingulate cortex, regions implicated in cognitive aspects of motor behavior. We then examined the white matter connectivity of these regions and found that fractional anisotropy of connected white matter tracts along the corticospinal tract was associated with helplessness and mediated the relationship between SMA cortical thickness and helplessness. These data provide novel evidence that links individual differences in the motor output pathway with perceived helplessness over a chronic and poorly controlled stressor.

Are informed citizens more trusting? Transparency of performance data and trust towards a British police force

In Britain, substantial cuts in police budgets alongside controversial handling of incidents such as politically sensitive enquiries, public disorder and relations with the media have recently triggered much debate about public knowledge and trust in the police. To date, however, little academic research has investigated how knowledge of police performance impacts citizens’ trust. We address this long-standing lacuna by exploring citizens’ trust before and after exposure to real performance data in the context of a British police force. The results reveal that being informed of performance data affects citizens’ trust significantly. Furthermore, direction and degree of change in trust are related to variations across the different elements of the reported performance criteria. Interestingly, the volatility of citizens’ trust is related to initial performance perceptions (such that citizens with low initial perceptions of police performance react more significantly to evidence of both good and bad performance than citizens with high initial perceptions), and citizens’ intentions to support the police do not always correlate with their cognitive and affective trust towards the police. In discussing our findings, we explore the implications of how being transparent with performance data can both hinder and be helpful in developing citizens’ trust towards a public organisation such as the police. From our study, we pose a number of ethical challenges that practitioners face when deciding what data to highlight, to whom, and for what purpose.

The end of the opportunism vs trust debate: bounded reliability as a new envelope concept in research on MNE governance

Modern transaction cost economics (TCE) thinking has developed into a key intellectual foundation of international business (IB) research, but the Williamsonian version has faced substantial criticism for adopting the behavioral assumption of opportunism. In this paper we assess both the opportunism concept and existing alternatives such as trust within the context of IB research, especially work on multinational enterprise (MNE) governance. Case analyses of nine global MNEs illustrate an alternative to the opportunism assumption that captures more fully the mechanisms underlying failed commitments inside the MNE. As a substitute for the often-criticized assumption of opportunism, we propose the envelope concept of bounded reliability (BRel), an assumption that represents more accurately and more completely the reasons for failed commitments, without invalidating the other critical assumption in conventional TCE (and internalization theory) thinking, namely the widely accepted envelope concept of bounded rationality (BRat). Bounded reliability as an envelope concept includes two main components, within the context of global MNE management: opportunism as intentional deceit, and benevolent preference reversal. The implications for IB research of adopting the bounded reliability concept are far reaching, as this concept may increase the legitimacy of comparative institutional analysis in the social sciences.

Perceived competence moderates the relation between performance-approach and performance-avoidance goals

In the present research, we conducted 4 studies designed to examine the hypothesis that perceived competence moderates the relation between performance-approach and performance-avoidance goals. Each study yielded supportive data, indicating that the correlation between the 2 goals is lower when perceived competence is high. This pattern was observed at the between- and within-subject level of analysis, with correlational and experimental methods and using both standard and novel achievement goal assessments, multiple operationalizations of perceived competence, and several different types of focal tasks. The findings from this research contribute to the achievement goal literature on theoretical, applied, and methodological fronts and highlight the importance of and need for additional empirical work in this area. (PsycINFO Database Record (c) 2012 APA, all rights reserved)(journal abstract)

Squirmish at the Oasis: an evening of performance and rant hosted by Agency of Noise at the Kinsgate Workshsops Trust in affiliation with Camden Arts Centre

Squirmish at the Oasis takes its name from Luigi Russolo's fourth noise network 'Skirmish at the Oasis' performed in Milan in 1913. 100 years on the Agency of Noise contemplate changes in technology and the culture industry that provoke new questions around the deliberate use of noise within music and art. Through live acts of enquiry and experimentation five artists unravel paradoxes associated with the use of noise in art, music and the gallery space. The works challenge tensions, contradictions and possible oxymorons that emerge through the use and acceptance of noise within an artistic framework. Featuring: DAISY DIXON / GRAHAM DUNNING / POLLYFIBRE / DANE SUTHERLAND / MARNIE WATTS

Residential investment and sustainable communities

This research examines the scope for more private rented housing as part of securing housing choice and affordability. A comprehensive review covers the current UK planning, housing and investment framework. It examines UK valuation practice and draws lessons from the Netherlands and Canada. UK case studies illustrate how private companies and social organisations are challenging commonly perceived barriers to mixed-use, mixed-tenure and rented housing through imaginative developments and investments. Additionally, the case studies incorporate financial appraisals of actual schemes and illustrate the reasons for different approaches by private and social organisations to assessing financial feasibility, based on their individual objectives. The report provides a practical resource for property professionals, investors and developers as well as an aid to policy makers in understanding property and investment market responses. The research was funded through the Pat Allsop Education Trust.

Consumers' attitudes, trust and willingness to pay for food information

Market failure can be corrected using different regulatory approaches ranging from high to low intervention. Recently, classic regulations have been criticized as costly and economically irrational and thus policy makers are giving more consideration to soft regulatory techniques such as information remedies. However, despite the plethora of food information conveyed by different media there appears to be a lack of studies exploring how consumers evaluate this information and how trust towards publishers influence their choices for food information. In order to fill such a gap, this study investigates questions related to topics which are more relevant to consumers, who should disseminate trustful food information, and how communication should be conveyed and segmented. Primary data were collected both through qualitative (in depth interviews and focus groups) and quantitative research (web and mail surveys). Attitudes, willingness to pay for food information and trust towards public and private sources conveying information through a new food magazine were assessed using both multivariate statistical methods and econometric analysis. The study shows that consumer attitudes towards food information topics can be summarized along three cognitive-affective dimensions: the agro-food system, enjoyment and wellness. Information related to health risks caused by nutritional disorders and food safety issues caused by bacteria and chemical substances is the most important for about 90% of respondents. Food information related to regulations and traditions is also considered important for more than two thirds of respondents, while information about food production and processing techniques, life style and food fads are considered less important by the majority of respondents. Trust towards food information disseminated by public bodies is higher than that observed for private bodies. This behavior directly affects willingness to pay (WTP) for food information provided by public and private publishers when markets are shocked by a food safety incident. WTP for consumer association (€ 1.80) and the European Food Safety Authority (€ 1.30) are higher than WTP for the independent and food industry publishers which cluster around zero euro. Furthermore, trust towards the type of publisher also plays a key role in food information market segmentation together with socio-demographic and economic variables such as gender, age, presence of children and income. These findings invite policy makers to reflect on the possibility of using information remedies conveyed using trusted sources of information to specific segments of consumers as an interesting soft alternative to the classic way of regulating modern food markets.

The four pillars of corporate responsibility: ethics, leadership, personal responsibility and trust

Purpose – This paper aims to examine how to further embed CSR thinking and practice into corporations, particularly in emerging markets, by reviewing and drawing similarities between key issues faced by all senior managers, namely ethics, leadership, personal responsibility and trust. Design/methodology/approach – This paper presents a conceptual exploration of global CSR practices using social psychology and overlays this concept with strategic and institutional theory in order to encourage new ways of thinking about CSR adoption, especially in emerging markets. Findings – The paper reveals the importance of shareholder needs on global corporate decision making and applies alternative conceptual models to help businesses to devise better CSR practices and individuals to align their actions to their own values. Originality/value – This paper strongly argues for blending different theoretical foundations from the management and organization literature in order to draw comparisons between current global CSR practice and the potential for its further adoption in emerging markets.

Persuasive technology and users acceptance of e-commerce: exploring perceived persuasiveness

This paper reviews theories and models of users’ acceptance and use in relation to “persuasive technology”, to justify the need to add consideration of ‘perceived persuasiveness’. We conclude by identifying variables associated with perceived persuasiveness, and highlight important future research directions in this domain.

Persuasive technology and users acceptance of e-commerce: users perceptions of website persuasiveness

Persuasive technologies have been extensively applied in the context of e-commerce for the purpose of marketing, enhancing system credibility, and motivating users to adopt the systems. Recognising that persuasion impacts on consumer behaviour to purchase online have not been investigated previously. This study reviews theories of technology acceptance, and identifies their limitation in not considering the effect of persuasive technologies when determining user online technology acceptance. The study proposes a theoretical model that considers the effect of persuasive technologies on consumer acceptance of e-commerce websites; with consideration of other related variables, i.e. trust and technological attributes. Moreover the paper proposes a model based on the UTAUT2, which contains relevant contributing factors; including the concept of perceived persuasiveness.