The influence of patient's age on clinical decision-making about coronary heart disease in the USA and the UK

This paper examines UK and US primary care doctors' decision-making about older (aged 75 years) and midlife (aged 55 years) patients presenting with coronary heart disease (CHD). Using an analytic approach based on conceptualising clinical decision-making as a classification process, it explores the ways in which doctors' cognitive processes contribute to ageism in health-care at three key decision points during consultations. In each country, 56 randomly selected doctors were shown videotaped vignettes of actors portraying patients with CHD. The patients' ages (55 or 75 years), gender, ethnicity and social class were varied systematically. During the interviews, doctors gave free-recall accounts of their decision-making. The results do not establish that there was substantial ageism in the doctors' decisions, but rather suggest that diagnostic processes pay insufficient attention to the significance of older patients' age and its association with the likelihood of co-morbidity and atypical disease presentations. The doctors also demonstrated more limited use of 'knowledge structures' when diagnosing older than midlife patients. With respect to interventions, differences in the national health-care systems rather than patients' age accounted for the differences in doctors' decisions. US doctors were significantly more concerned about the potential for adverse outcomes if important diagnoses were untreated, while UK general practitioners cited greater difficulty in accessing diagnostic tests.

Performance management in the United States and France:four case studies in the retail and airline industries

The profusion of performance measurement models suggested by Management Accounting literature in the 1990’s is one illustration of the substantial changes in Management Accounting teaching materials since the publication of “Relevance Lost” in 1987. At the same time, in the general context of increasing competition and globalisation it is widely thought that national cultural differences are tending to disappear, meaning that management techniques used in large companies, including performance measurement and management instruments (PMS), tend to be the same, irrespective of the company nationality or location. North American management practice is traditionally described as a contractually based model, mainly focused on financial performance information and measures (FPMs), more shareholder-focused than French companies. Within France, literature historically defined performance as being broadly multidimensional, driven by the idea that there are no universal rules of management and that efficient management takes into account local culture and traditions. As opposed to their North American brethren, French companies are pressured more by the financial institutions that fund them rather than by capital markets. Therefore, they pay greater attention to the long-term because they are not subject to quarterly capital market objectives. Hence, management in France should rely more on long-term qualitative information, less financial, and more multidimensional data to assess performance than their North American counterparts. The objective of this research is to investigate whether large French and US companies’ practices have changed in the way the textbooks have changed with regards to performance measurement and management, or whether cultural differences are still driving differences in performance measurement and management between them. The research findings support the idea that large US and French companies share the same PMS features, influenced by ‘universal’ PM models.

Network effects, network structure and consumer interaction in mobile telecommunications in Europe and Asia

This paper estimates the importance of (tariff-mediated) network effects and the impact of a consumer's social network on her choice of mobile phone provider. The study uses network data obtained from surveys of students in several European and Asian countries. We use the Quadratic Assignment Procedure, a non-parametric permutation test, to adjust for the particular error structure of network data. We find that respondents strongly coordinate their choice of mobile phone providers, but only if their provider induces network effects. This suggests that this coordination depends on network effects rather than on information contagion or pressure to conform to the social environment.

‘Everything’s from the inside out with PCOS’:exploring women’s experiences of living with Polycystic Ovary Syndrome (PCOS) and co-morbidities through Skype™ interviews

Polycystic ovary syndrome is an endocrine disorder affecting 1 in 10 women. Women with polycystic ovary syndrome can experience co-morbidities, including depressive symptoms. This research explores the experience of living with polycystic ovary syndrome and co-morbidities. Totally, 10 participants with polycystic ovary syndrome took part in Skype™ interviews and analysed using thematic analysis. Four themes emerged from the data: change (to life plans and changing nature of condition); support (healthcare professionals, education and relationships); co-morbidities (living with other conditions and depression, self-harm and suicidal ideation) and identity (feminine identity and us and them). The findings highlight the need for screening of women with polycystic ovary syndrome for depressive disorders.

Rethinking change:downsizing businesses, changing behaviours and still managing to come out on top

As an indicator of global change and shifting balances of power, every September in Dalian, China, the World Economic Forum meets. The subject in 2011 – Mastering Quality Growth. On the agenda is pursuing new frontiers of growth linked to embracing disruptive innovation. With growth coming from emerging markets, and European and North American economies treading water, many firms in the West are facing the reality of having to not just downsize but actually close manufacturing operations and re-open them elsewhere, where costs are lower, to remain competitive. There are thousands of books on “change management”. Yet very few of these devote much time to downsizing preferring to talk about re-engineering or restructuring. What lessons are available from the past to achieve a positive outcome from what will inevitably be something of a human, as well as an economic, tragedy. The authors reached three fundamental conclusions from their experience and research in facility closure management within Vauxhall, UK: put your people first, make sure you keep running the business and manage your legacy. They devlop the ideas into a new business model linked to the emotions of change.

Copyright law as a matter of (inter)national security? – The attempt to securitise commercial infringement and its spill-over onto individual liability

This article evaluates the way in which copyright infringement has been gradually shifting from an area of civil liability to one of criminal penalty. Traditionally, consideration of copyright issues has been undertaken from a predominantly legal and/or economic perspectives. Whereas traditional legal analysis can explain what legal changes are occurring, and what impact these changes may have, they may not effectively explain ‘how’ these changes have come to occur. The authors propose an alternative inter-disciplinary approach, combining legal analysis with critical security studies, which may help to explain in greater detail how policies in this field have developed. In particular, through applied securitisation theory, this article intends to demonstrate the appropriation of this field by a security discourse, and its consequences for societal and legal developments. In order to explore how the securitisation framework may be a valid approach to a subject such as copyright law and to determine the extent to which copyright law may be said to have been securitised, this article will begin by explaining the origins and main features of securitisation theory, and its applicability to legal study. The authors will then attempt to apply this framework to the development of a criminal law approach to copyright infringement, by focusing on the security escalation it has undergone, developing from an economic issue into one of international security. The analysis of this evolution will be mainly characterised by the securitisation moves taking place at national, European and international levels. Finally, a general reflection will be carried out on whether the securitisation of copyright has indeed been successful and on what the consequences of such a success could be.

French linguistics research and teaching in UK and Irish HE institutions

Introduction: The research and teaching of French linguistics in UK higher education (HE) institutions have a venerable history; a number of universities have traditionally offered philology or history of the language courses, which complement literary study. A deeper understanding of the way that the phonology, syntax and semantics of the French language have evolved gives students linguistic insights that dovetail with their study of the Roman de Renart, Rabelais, Racine or the nouveau roman. There was, in the past, some coverage of contemporary French phonetics but little on sociolinguistic issues. More recently, new areas of research and teaching have been developed, with a particular focus on contemporary spoken French and on sociolinguistics. Well supported by funding councils, UK researchers are also making an important contribution in other areas: phonetics and phonology, syntax, pragmatics and second-language acquisition. A fair proportion of French linguistics research occurs outside French sections in psychology or applied linguistics departments. In addition, the UK plays a particular role in bringing together European and North American intellectual traditions and methodologies and in promoting the internationalisation of French linguistics research through the strength of its subject associations, and that of the Journal of French Language Studies. The following sections treat each of these areas in turn. History of the French Language There is a long and distinguished tradition in Britain of teaching and research on the history of the French language, particularly, but by no means exclusively, at the universities of Cambridge, Manchester and Oxford.

Towards conflict or cooperation? The Ukraine crisis and EU-Russia relations

The Ukraine crisis and Russia’s contribution to it have raised numerous concerns regarding the possible emergence of a new ‘Cold War’ in Europe. At the same time, Ukraine’s popular choice and enthusiasm for European integration expressed clearly on the streets of Kyiv seem to have caused Russia to adopt a (neo)revisionist attitude. In this context, relations between Russia and the EU (and the West for that matter) have been limited, frozen and directed on path towards conflict. This article analyses how the traditional dichotomy between conflict and cooperation in EU–Russia relations was replaced by conflict in the context of the Ukraine crisis. The article contends that the breakdown of the symbolic and peaceful cohabitation between the EU and Russia has been influenced by the fact that both actors have chosen to ignore key tensions that characterized their post-Cold War interactions. The article identifies three such tensions: the first emphasizes divisions between EU member states and their impact on coagulating a common EU approach towards Russia; the second (geopolitical) tension highlights the almost mutually exclusive way in which the EU and Russia’s security interests have developed in the post-Soviet space; finally, the third contends that a clash of values and worldviews between the EU and Russia makes conflict virtually unavoidable.

Trade-offs in customer–employee focus:implications on boundary-spanning capabilities

In pursuing their particular strategic goals, organisations place differential emphasis in their activities on employees and customers. Those who focus predominantly on employees see them as key resources contributing to successful achievement of goals, while those who focus on customers believe that customer commitment is the prime source of financial prosperity and competitive advantage. In all firms, there is potential for conflict and subsequent trade-offs in the emphasis placed on employee resources and customers. This paper investigates the implications of these potential trade-offs on firms’ boundary-spanning capabilities (those capabilities that enable firms to interact effectively with their customers, their suppliers, their strategic allies and others in their business networks) in European and Australasian markets. The results suggest that those companies which achieve a strong but balanced focus on both employees and customers have heightened boundary-spanning capabilities. The comparison between UK and Australian businesses indicates that the balance is more highly developed in Australasian than European (UK) markets.

Trade-offs in customer-employee focus:Implications on boundary-spanning capabilities

In pursuing their particular strategic goals, organisations place differential emphasis in their activities on employees and customers. Those who focus predominantly on employees see them as key resources contributing to successful achievement of goals, while those who focus on customers believe that customer commitment is the prime source of financial prosperity and competitive advantage. In all firms, there is potential for conflict and subsequent trade-offs in the emphasis placed on employee resources and customers. This paper investigates the implications of these potential trade-offs on firms' boundary-spanning capabilities (those capabilities that enable firms to interact effectively with their customers, their suppliers, their strategic allies and others in their business networks) in European and Australasian markets. The results suggest that those companies which achieve a strong but balanced focus on both employees and customers have heightened boundary-spanning capabilities. The comparison between UK and Australian businesses indicates that the balance is more highly developed in Australasian than European (UK) markets. © 2004 by The Haworth Press, Inc. All rights reserved.

The politics of the new Germany

The Politics of the New Germany continues to provide the most comprehensive, authoritative and up-to-date textbook on contemporary German Politics. The text takes a new approach to understanding politics in the post-unification Federal Republic. Assuming only elementary knowledge, it focuses on a series of the most important debates and issues in Germany today with the aim of helping students understand both the workings of the country's key institutions and some of the most important policy challenges facing German politicians. For this second edition, the content has been comprehensively updated throughout, augmented by additional factboxes and data, and features new material on: •Grand coalition •Lisbon treaty •Constitutional court •Financial crisis •Reform of social policy •Afghanistan. Written in a straightforward style by three experts, each of the chapters draws on a rich variety of real-world examples. In doing so, it highlights both the challenges and opportunities facing policy-makers in such areas as foreign affairs, economic policy, immigration, identity politics and institutional reform. The book also takes a bird’s-eye view of the big debates that have defined German politics over time, regardless of which political parties happened to be in power. It pinpoints three key themes that have characterised German politics over the last sixty years; reconciliation, consensus and transformation. The book is a comprehensive, yet highly accessible, overview of politics in 21st Century Germany and should be essential reading for students of politics and international relations, as well as of European and German studies.

Europa i świat zachodni:szkodliwe dla gospodarki niedostrzegane lub lekceważone zjawiska

The paper presents an abbreviated version of the second part of the report on problems of Europe, prepared by a team of teachers at the University of Information Technology and Management in Rzeszow, Poland. We stress therein that the hotly debated problems of the Eurozone and the global financial crisis and its aftermath are, at best, medium-term ones, while real issues Europe faces are of the long-term nature and result from policies pursued for decades. Their consequences are also long-term – and increasingly harmful. Our diagnosis is as follows. Long-term problems related to the increasing burden of the welfare state and its side effects, like the slowing economic growth rate, are not subject to serious policy debates. It applies to both traditional elites from parties belonging to the moderate political spectrum, and to anti-elites on both extremes. Both elites and anti-elites reject the reality as a starting point to developing corrective policy measures. Our economic analysis has revealed that incentives to create wealth in old Western countries have been weakening for a long time. Yet, without deep cuts in public (especially welfare) expenditures and accompanying institutional reforms, economic performance of European (and generally Western) economies is going to worsen over time. The chances of continued stagnation in the next 5–10 years are very high. Finally, we look at the socio-psychological behavioral framework of the ever-expanding welfare state. We point at the phenomenon of the learned helplessness which appears as a result of the people’s lacking perception of linkages between their actions and economic results of these actions. We interpret it as a consequence of the welfare state. It further weakens the prospects for successful reforms and the resultant avoidance of the long-term stagnation.

What the newspapers say about medication adherence:a content analysis

Background - This study investigates the coverage of adherence to medicine by the UK and US newsprint media. Adherence to medicine is recognised as an important issue facing healthcare professionals and the newsprint media is a key source of health information, however, little is known about newspaper coverage of medication adherence. Methods - A search of the newspaper database Nexis®UK from 2004–2011 was performed. Content analysis of newspaper articles which referenced medication adherence from the twelve highest circulating UK and US daily newspapers and their Sunday equivalents was carried out. A second researcher coded a 15% sample of newspaper articles to establish the inter-rater reliability of coding. Results - Searches of newspaper coverage of medication adherence in the UK and US yielded 181 relevant articles for each country. There was a large increase in the number of scientific articles on medication adherence in PubMed® over the study period, however, this was not reflected in the frequency of newspaper articles published on medication adherence. UK newspaper articles were significantly more likely to report the benefits of adherence (p = 0.005), whereas US newspaper articles were significantly more likely to report adherence issues in the elderly population (p = 0.004) and adherence associated with diseases of the central nervous system (p = 0.046). The most commonly reported barriers to adherence were patient factors e.g. poor memory, beliefs and age, whereas, the most commonly reported facilitators to adherence were medication factors including simplified regimens, shorter treatment duration and combination tablets. HIV/AIDS was the single most frequently cited disease (reported in 20% of newspaper articles). Poor quality reporting of medication adherence was identified in 62% of newspaper articles. Conclusion - Adherence is not well covered in the newspaper media despite a significant presence in the medical literature. The mass media have the potential to help educate and shape the public’s knowledge regarding the importance of medication adherence; this potential is not being realised at present.