28 resultados para Post-traumatic stress disorder - Case studies


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Ethosuximide is the drug of choice for treating generalized absence seizures, but its mechanism of action is still a matter of debate. It has long been thought to act by disrupting a thalamic focus via blockade of T-type channels and, thus, generation of spike-wave activity in thalamocortical pathways. However, there is now good evidence that generalized absence seizures may be initiated at a cortical focus and that ethosuximide may target this focus. In the present study we have looked at the effect ethosuximide on glutamate and GABA release at synapses in the rat entorhinal cortex in vitro, using two experimental approaches. Whole-cell patch-clamp studies revealed an increase in spontaneous GABA release by ethosuximide concurrent with no change in glutamate release. This was reflected in studies that estimated global background inhibition and excitation from intracellularly recorded membrane potential fluctuations, where there was a substantial rise in the ratio of network inhibition to excitation, and a concurrent decrease in excitability of neurones embedded in this network. These studies suggest that, in addition to well-characterised effects on ion channels, ethosuximide may directly elevate synaptic inhibition in the cortex and that this could contribute to its anti-absence effects. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.

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Objective. To examine children's knowledge, understanding and experience of stress from 4 to 11 years of age across four age groups (4–5, 6–7, 8–9, and 10–11 years old). Methods. A semi-structured interview format was used to elicit information from 50 children about their understanding and experience of stress. Results. Most children were able to define stress, with older children providing more complex responses. Many children had indirect and/or personal experience of stress. Younger children were more likely than older children to report that there was nothing people could do to stop stress; children reported using both adaptive and maladaptive coping strategies to deal with stress. Conclusion. Some young children have a basic understanding of stress and many have experience of stress; both understanding and experience develop with age. Practice Implications. The research has potential implications for provider-patient communication, particularly within preventative health education and clinically within the field of childhood post-traumatic stress disorder (PTSD).

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Objective: To explore fathers' experiences of the resuscitation of their baby at delivery. Design: A descriptive, retrospective design using tape-recorded semistructured interviews with fathers present during the resuscitation of their baby at delivery. Fathers described what happened, their interactions with healthcare professionals, their feelings at the time and afterwards. Setting: Participants were recruited from a large teaching hospital in the UK. Participants: A purposive sample of 20 fathers whose baby required resuscitation at delivery. Results: Participant responses were analysed using thematic analysis. Four broad themes were identified: 'preparation', 'knowing what happened', 'his response' and 'impact on him'. Fathers had no difficulty recalling their emotions during the resuscitation. These feelings remained vivid and were mostly negative. Most fathers wanted to go to their baby during the resuscitation but did not do so. They felt they should stay with their partner, did not want to impede the resuscitation or felt they were not 'allowed' to go to their baby. The fathers' position in the room and the extent to which they were focusing on their partner had an impact on their recollection of what happened. Fathers had no opportunity to discuss the resuscitation with healthcare professionals afterwards. Several fathers felt they had not yet recovered from the experience and a few had symptoms synonymous with post-traumatic stress disorder. Conclusion: This is the first study to specifically explore fathers' experiences of newborn resuscitation. The findings should inform healthcare education, policy development and the provision of support to fathers.

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We conducted a systematic literature review on psychological and behavioral comorbidities in patients with inflammatory neuropathies. In Guillain-Barré syndrome (GBS), psychotic symptoms are reported during early stages in 30% of patients. Typical associations include mechanical ventilation, autonomic dysfunction, inability to communicate, and severe weakness. Anxiety and depression are frequent comorbidities. Anxiety may increase post-hospital admissions and be a predictor of mechanical ventilation. Post-traumatic stress disorder may affect up to 20% of ventilated patients. Sleep disturbances are common in early-stage GBS, affecting up to 50% of patients. In chronic inflammatory demyelinating polyradiculoneuropathy, memory and quality of sleep may be impaired. An independent link between depression and pre-treatment upper limb disability and ascites was reported in POEMS (Polyneuropathy, Organomegaly, Endocrinopathy, M-protein, Skin) syndrome, with an association with early death. Hematological treatment of POEMS appears effective on depression. Published literature on psychological/behavioral manifestations in inflammatory neuropathies remains scarce, and further research is needed. This article is protected by copyright. All rights reserved.

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This thesis is concerned with the means by which the state in Britain has attempted to influence the technological development of private industry in the period 1945-1979. Particular emphasis is laid on assessing the abilities of technology policy measures to promote innovation. With that objective, the innovation literature is selectively reviewed to draw up an analytical framework to evaluate the innovation content of policy (Chapter 2). Technology policy is taken to consist of the specific measures utilised by government and its agents that affect the technological behaviour of firms. The broad sweep of policy during the period under consideration is described in Chapter 3 which concentrates on elucidating its institutional structure and the activities of the bodies involved. The empirical core of the thesis consists of three parallel case studies of policy toward the computer, machine tool and textile machinery industries (Chapters 4-6). The studies provide detailed historical accounts of the development and composition of policy, relating it to its specific institutional and industrial contexts. Each reveals a different pattern and level of state intervention. The thesis concludes with a comparative review of the findings of the case studies within a discussion centred on the arguments presented in Chapter 2. Topics arising include the state's differential support for the range of activities involved in innovation, the location of state-funded R&D, the encouragement of supplier-user contact, and the difficulties raised in adoption and diffusion.

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The thesis compares two contrasting strategies employed with the aim of combating particular forms of racism within contemporary Britain. Both are assessed as political strategies in their own right and placed within the broader context of reformist and revolutionary political traditions. The sociology of social movements is examined critically, as are Marxist and post-Marxist writings on the role of human agency within social structures and on the nature of social movements. The history of the Anti Nazi League (ANL) in the late 1970s and its opposition to the National Front is considered as an example of anti-racist social movement based on the Trotskyist model of the United Front. The degree to which the Anti Nazi League corresponded to such a model is analysed as are the potential broader applications for such a strategy. The strategy with which the ANL is compared is the development of anti-racist and equal opportunities policies within local government in the 1980s, primarily by Labour-controlled local authorities. The theory of the local state and the political phenomenon of municipal socialism are discussed, specifically the role of various groups operating in and around local authorities in the formation and implementation of anti-racist policy and practice. Following this general discussion, two case studies in each of the areas of local authority housing, education and employment are explored to consider in depth the problems of specific anti-racist policies. In summation the efficacy of the two strategies are considered as parts of wider political currents in tandem with their declared specific objectives.

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This is a multiple case study of the leadership language of three senior women working in a large corporation in Bahrain. The study’s main aim is to explore the linguistic practices the women leaders use with their colleagues and subordinates in corporate meetings. Adopting a Foucauldian (1972) notion of ‘discourses’ as social practices and a view of gender as socially constructed and discursively performed (Butler 1990), this research aims to unveil the competing discourses which may shape the leadership language of senior women in their communities of practice. The research is situated within the broader field of Sociolinguistics and the specific field of Language and Gender. To address the research aim, a case study approach incorporating multiple methods of qualitative data collection (observation, interviews, and shadowing) was utilised to gather information about the three women leaders and produce a rich description of their use of language in and out of meeting contexts. For analysis, principles of Qualitative Data Analysis (QDA) were used to organise and sort the large amount of data. Also, Feminist Post- Structuralist Discourse Analysis (FPDA) was adopted to produce a multi-faceted analysis of the subjects, their language leadership, power relations, and competing discourses in the context. It was found that the three senior women enact leadership differently making variable use of a repertoire of conventionally masculine and feminine linguistic practices. However, they all appear to have limited language resources and even more limiting subject positions; and they all have to exercise considerable linguistic expertise to police and modify their language in order to avoid the ‘double bind’. Yet, the extent of this limitation and constraints depends on the community of practice with its prevailing discourses, which appear to have their roots in Islamic and cultural practices as well as some Western influences acquired throughout the company’s history. It is concluded that it may be particularly challenging for Middle Eastern women to achieve any degree of equality with men in the workplace because discourses of Gender difference lie at the core of Islamic teaching and ideology.

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What motivates a university lecturer to consider introducing a new e-learning approach to their educational practice? Accounts of e-learning practice can invite discussion and reflection on the approaches taken, reinforcement of a particular model, connection with the experience of others, vicarious learning opportunities and glimpses into tacit knowledge. If these examples provoke thinking, could they have the ‘sticky qualities’, the memorable inspiration and ideas that move us to action, when we observe the practice of others? (Szulanski, 2003) “Case studies have the capacity to inspire but also to provoke and to challenge.” (JISC, 2004) This paper will discuss a process followed for sharing best practices of e-learning. It will explain how good practices were identified and gathered by the EUNIS E-Learning Task Force collaboration, using a database and a weblog (EUNIC, 2008). It will examine the methods used for the developing and compiling of the practices and the communication of these. Actual examples of some of the case studies gathered will be included in an appendix. Suggestions of ways to develop this process further and the tangible benefits identified will be examined to ask if effective practice can also become embedded practice.

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With the globalisation of world business, the border-crossing activities between organisations have substantially increased. Organisations not only need to handle supply functions, but also play a tremendous role in demand simulation through integration both inside the firm and outside with business partners and customers. Logistics has become more and more mature and sophisticated by taking on an external focus, incorporating suppliers and customers in the business processes, with all the supply chain functions integrated into a whole. By minimising the costs in the value chain or providing customised services, logistics acts as a major source of competitive advantages and profitability. To meet this goal, it would require the integration of activities to focus on customer-oriented measures. Customer service and logistics activities are a chain of interdependent activities that supplement each other to facilitate the flow of information, goods and cash within the value chain. The absence of one activity may imply some specific channels need to supplement another unit. Generally, this paper is to study the impact of corporate strategy, technology and customer satisfaction on the firm’s performance, filling the gap of good customer service effects on long-term profits. Two international delivery providers, UPS and FedEx, are studied to realise the critical success factors of express logistics.

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One of the most significant paradigm shifts of modern business management is that individual businesses no longer compete as solely autonomous entities, but rather as supply chains. Firms worldwide have embraced the concept of supply chain management as important and sometimes critical to their business. The idea of a collaborative supply chain is to gain a competitive advantage by improving overall performance through measuring a holistic perspective of the supply chain. However, contemporary performance measurement theory is somewhat fragmented and fails to support this idea. Therefore, this research develops and applies an integrated supply chain performance measurement framework that provides a more holistic approach to the study of supply chain performance measurement by combining both supply chain macro processes and decision making levels. Therefore, the proposed framework can provide a balanced horizontal (cross-process) and vertical (hierarchical decision) view and measure the performance of the entire supply chain system. Firstly, literature on performance measurement frameworks and performance measurement factors of supply chain management will help to develop a conceptual framework. Next the proposed framework will be presented. The framework will be validated through in-depth interviews with three Thai manufacturing companies. The fieldwork combined varied sources in order to understand the views of manufacturers on supply chain performance in the three case study companies. The collected data were analyzed, interpreted, and reported using thematic analysis and analysis hierarchy process (AHP), which was influenced by the study’s conceptual framework. This research contributes a new theory of supply chain performance measurement and knowledge on supply chain characteristics of a developing country, Thailand. The research also affects organisations by preparing decision makers to make strategic, tactical and operational level decisions with respect to supply chain macro processes. The results from the case studies also indicate the similarities and differences in their supply chain performance. Furthermore, the implications of the study are offered for both academic and practical use.

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The role of the production system as a key determinant of competitive performance of business operations- has long been the subject of industrial organization research, even predating the .explicit conceptua1isation of manufacturing, strategy in the literature. Particular emergent production issues such as the globalisation of production, global supply chain management, management of integrated manufacturing and a growing e~busjness environment are expected to critically influence the overall competitive performance and therefore the strategic success of the organization. More than ever, there is a critical need to configure and improve production system and operations competence in a strategic way so as to contribute to the long-term competitiveness of the organization. In order to operate competitively and profitably, manufacturing companies, no matter how well managed, all need a long-term 'strategic direction' for the development of operations competence in order to consistently produce more market value with less cost towards a leadership position. As to the long-term competitiveness, it is more important to establish a dynamic 'strategic perspective' for continuous operational improvements in pursuit of this direction, as well as ongoing reviews of the direction in relation to the overall operating context. However, it also clear that the 'existing paradigm of manufacturing strategy development' is incapable of adequately responding to the increasing complexities and variations of contemporary business operations. This has been factually reflected as many manufacturing companies are finding that methodologies advocated in the existing paradigm for developing manufacturing strategy have very limited scale and scope for contextual contingency in empirical application. More importantly, there has also emerged a deficiency in the multidimensional and integrative profile from a theoretical perspective when operationalising the underlying concept of strategic manufacturing management established in the literature. The point of departure for this study was a recognition of such contextual and unitary limitations in the existing paradigm of manufacturing strategy development when applied to contemporary industrial organizations in general, and Chinese State Owned Enterprises (SOEs) in particular. As China gradually becomes integrated into the world economy, the relevance of Western management theory and its paradigm becomes a practical matter as much as a theoretical issue. Since China markedly differs from Western countries in terms of culture, society, and political and economic systems, it presents promising grounds to test and refine existing management theories and paradigms with greater contextual contingency and wider theoretical perspective. Under China's ongoing programmes of SOE reform, there has been an increased recognition that strategy development is the very essence of the management task for managers of manufacturing companies in the same way as it is for their counterparts in Western economies. However, the Western paradigm often displays a rather naive and unitary perspective of the nature of strategic management decision-making, one which largely overlooks context-embedded factors and social/political influences on the development of manufacturing strategy. This thesis studies the successful experiences of developing manufacturing strategy from five high-performing large-scale SOEs within China’s petrochemical industry. China’s petrochemical industry constitutes a basic heavy industrial sector, which has always been a strategic focus for reform and development by the Chinese government. Using a confirmation approach, the study has focused on exploring and conceptualising the empirical paradigm of manufacturing strategy development practiced by management. That is examining the ‘empirical specifics’ and surfacing the ‘managerial perceptions’ of content configuration, context of consideration, and process organization for developing a manufacturing strategy during the practice. The research investigation adopts a qualitative exploratory case study methodology with a semi-structural front-end research design. Data collection follows a longitudinal and multiple-case design and triangulates case evidence from sources including qualitative interviews, direct observation, and a search of documentations and archival records. Data analysis follows an investigative progression from a within-case preliminary interpretation of facts to a cross-case search for patterns through theoretical comparison and analytical generalization. The underlying conceptions in both the literature of manufacturing strategy and related studies in business strategy were used to develop theoretical framework and analytical templates applied during data collection and analysis. The thesis makes both empirical and theoretical contributions to our understanding of 'contemporary management paradigm of manufacturing strategy development'. First, it provides a valuable contextual contingency of the 'subject' using the business setting of China's SOEs in petrochemical industry. This has been unpacked into empirical configurations developed for its context of consideration, its content and process respectively. Of special note, a lean paradigm of business operations and production management discovered at case companies has significant implications as an emerging alternative for high-volume capital intensive state manufacturing in China. Second, it provides a multidimensional and integrative theoretical profile of the 'subject' based upon managerial perspectives conceptualised at case companies when operationalising manufacturing strategy. This has been unpacked into conceptual frameworks developed for its context of consideration, its content constructs, and its process patterns respectively. Notably, a synergies perspective towards the operating context, competitive priorities and competence development of business operations and production management has significant implications for implementing a lean manufacturing paradigm. As a whole, in so doing, the thesis established a theoretical platform for future refinement and development of context-specific methodologies for developing manufacturing strategy.