Is Living With Psychosis Demoralizing? Insight, Self-stigma, and Clinical Outcome Among People With Schizophrenia Across 1 Year

Lack of insight is a major target in the treatment of schizophrenia. However, insight may have undesirable effects on self-concept and motivation that can hinder recovery. This study aimed to examine the link between insight, self-stigma, and demoralization as predictors of symptoms and functioning. Insight, self-stigma, depressive and psychotic symptoms, and functioning were assessed among 133 outpatients with schizophrenia at baseline and 12 months later. The data were analyzed by hierarchical multiple linear regressions. More insight at baseline and an increase in self-stigma over 12 months predicted more demoralization at follow-up. Insight at baseline was not associated with any outcome variable, but self-stigma at baseline was related to poorer functioning and more positive symptoms at follow-up. More demoralization at baseline predicted poorer functioning 12 months later. Demoralization did not mediate the relationship between self-stigma at baseline and functioning after 1 year. Given the decisive role of self-stigma regarding recovery from schizophrenia, dysfunctional beliefs related to illness and the self should be addressed in treatment. Different psychotherapeutical approaches are discussed.

Service Brand Relationship Quality: Hot or Cold?

Customers’ long-term brand relations are crucial drivers of a service brand’s sustainable competitive advantage. This research empirically examines the quality of customer-service brand relationships in the context of an airline’s frequent flyer program. The authors show that service brand relationship quality (BRQ) involves both a hot (based on emotions) and a cold (based on objectrelevant beliefs) component. They find that these two components have different implications for a service brand’s performance and are at least partially driven by different antecedents whose relative importance changes over time. Specifically, cold BRQ is important for word-of-mouth behavior and is strongly driven by partner quality (i.e., the generalized assessment of the brand in its role as a relationship counterpart). Hot BRQ, on the other hand, has a stronger impact on willingness to pay a price premium and consideration set size. In early stages of a customer-brand relationship hot BRQ is more strongly driven by self-congruence (i.e., consumer’s perception of the fit between his/her self and the brand’s personality), in later stages partner quality becomes more relevant. The authors discuss the implications of their findings for the development of BRQ and the implementation of alternative growth strategies in a services context.

Public service motivation and performance: a critical perspective

Purpose – A growing body of literature points to the importance of public service motivation (PSM) for the performance of public organizations. The purpose of this paper is to assess the method predominantly used for studying this linkage by comparing the findings it yields without and with a correction suggested by Brewer (2006), which removes the common-method bias arising from employee-specific response tendencies. Design/methodology/approach – First, the authors conduct a systematic review of published empirical research on the effects of PSM on performance and show that all studies found have been conducted at the individual level. Performance indicators in all but three studies were obtained by surveying the same employees who were also asked about their PSM. Second, the authors conduct an empirical analysis. Using survey data from 240 organizational units within the Swiss federal government, the paper compares results from an individual-level analysis (comparable to existing research) to two analyses where the data are aggregated to the organizational level, one without and one with the correction for common-method bias suggested by Brewer (2006). Findings – Looking at the Attraction to Policy-Making dimension of PSM, there is an interesting contrast: While this variable is positively correlated with performance in both the individual-level analysis and the aggregated data analysis without the correction for common-method bias, it is not statistically associated with performance in the aggregated data analysis with the correction. Originality/value – The analysis is the first to assess the robustness of the performance-PSM linkage to a correction for common-method bias. The findings place the validity of at least one part of the individual-level linkage between PSM and performance into question.

The diversity of activation markets in Europe

Purpose – The purpose of this article is to analyse the diversity of markets for the provision of activation services. Design/methodology/approach – The article is based on the outcomes of a project involving nine European countries. The project investigated changing forms of governance of income protection schemes and activation services for unemployed people. Diversity is investigated by focusing on five dimensions of diversity derived from the quasi‐market concept as developed by Le Grand: the purchasers, the providers, the customers, the purchaser‐provider split and the purchaser‐customer split. Findings – The paper finds considerable diversity in the design of markets for the provision of activation. Diversity is visible in all dimensions involved in the analysis. One interesting finding is that a full split between purchasers and providers hardly exists, although some countries have introduced a stricter split than others. Another finding concerns the voice and choice of service consumers, which seems hardly affected by the introduction of market mechanisms in the provision of activation. Finally, marketisation does not seem to be an irreversible project, as de‐marketisation processes were identified as well. Originality/value – Most current research into activation markets and their effects pays little attention to the issue of diversity in the design and functioning of markets. This article argues in favour of more systematic research of market diversity and of the variety of effects of various market models. Rather than comparing marketised with public service provision, a stronger focus on various market models may strengthen our insight into how service provision models affect the effectiveness of activation services.

A Case for CDN-as-a-Service in the Cloud: A Mobile Cloud Networking Argument

Content Distribution Networks are mandatory components of modern web architectures, with plenty of vendors offering their services. Despite its maturity, new paradigms and architecture models are still being developed in this area. Cloud Computing, on the other hand, is a more recent concept which has expanded extremely quickly, with new services being regularly added to cloud management software suites such as OpenStack. The main contribution of this paper is the architecture and the development of an open source CDN that can be provisioned in an on-demand, pay-as-you-go model thereby enabling the CDN as a Service paradigm. We describe our experience with integration of CDNaaS framework in a cloud environment, as a service for enterprise users. We emphasize the flexibility and elasticity of such a model, with each CDN instance being delivered on-demand and associated to personalized caching policies as well as an optimized choice of Points of Presence based on exact requirements of an enterprise customer. Our development is based on the framework developed in the Mobile Cloud Networking EU FP7 project, which offers its enterprise users a common framework to instantiate and control services. CDNaaS is one of the core support components in this project as is tasked to deliver different type of multimedia content to several thousands of users geographically distributed. It integrates seamlessly in the MCN service life-cycle and as such enjoys all benefits of a common design environment, allowing for an improved interoperability with the rest of the services within the MCN ecosystem.

Illegitimate tasks, feelings of resentment, and recovery – longitudinal mediation model

Illegitimate tasks are a relatively new stressor concept, referring to tasks that an employee cannot appropriately expect to carry out. This study tested the hypothesis that illegitimate tasks predicted recovery, mediated by feelings of resentment. The hypothesis was confirmed in a longitudinal study with three waves of measurement.

Immune recovery in HIV-infected patients after candida esophagitis is impaired despite long-term antiretroviral therapy.

OBJECTIVE Candida esophagitis belongs to the most common AIDS-defining diseases, however, a comprehensive immune pathogenic concept is lacking. DESIGN We investigated the immune status of 37 HIV-1-infected patients from the Swiss HIV cohort study at diagnosis of Candida esophagitis, 1 year before, 1 year later and after 2 years of suppressed HIV RNA. We compared these patients to 3 groups: 37 HIV-1-infected patients without Candida esophagitis but similar CD4 counts as the patients at diagnosis (advanced HIV group), 15 HIV-1-infected patients with CD4 counts >500 cells/μl, CD4 nadir >350 cells/μl and suppressed HIV RNA under combination antiretroviral therapy (cART) (early cART group), and 20 healthy individuals. METHODS We investigated phenotype, cytokine production and proliferative capacity of different immune cells by flow cytometry and ELISpot. RESULTS We found that patients with Candida esophagitis had nearly abolished CD4 proliferation in response to C. albicans, significantly increased percentages of dysfunctional CD4 cells, significantly decreased cytotoxic NK-cell counts and peripheral innate lymphoid cells and significantly reduced IFN-γ and IL-17 production compared to the early cART group and healthy individuals. Most of these defects remained for more than 2 years despite viral suppression. The advanced HIV group without opportunistic infection showed partly improved immune recovery. CONCLUSIONS Our data indicate that Candida esophagitis in HIV-1-infected patients is caused by an accumulation of multiple, partly Candida-specific immunological defects. Long-term immune recovery is impaired, illustrating that specific immunological gaps persist despite cART. These data also support the rationale for early cART initiation to prevent irreversible immune defects.