Patients and doctors working together in partnership:Birch v UCL Hospital NHS Foundation Trust [2008] EWHC 2237 (QB)

Of the myriad of pressing topics current in medical law and ethics, the issue of informed consent appears to be the ‘plainer sibling’. The decision by Cranston J in Birch v UCL Hospital NHS Foundation Trust in 2008 has brought into sharp relief that which many commentators already held to be true. Far from being the ‘plainer sibling’ when weighed against other prominent issues in medical law and ethics, the doctrine of informed consent, is one of the most significant principles to emerge in recent years.

Psychological contract breach in a Chinese context:an integrative approach

This study examined the antecedents and outcomes of psychological contract breach as well as why and how psychological contract breach is related to these outcomes. Respondents were Hong Kong Chinese employees (N=152). Results showed organizational change and history of contract breach to be related to psychological contract breach which, in turn, was related to turnover intentions, psychological withdrawal behaviour, and civic virtue. Further, trust in employer fully mediated the relationship between psychological contract breach and the work outcomes of psychological withdrawal behaviour and civic virtue but partially mediated the psychological contract breach–turnover intentions relationship. Lastly, interactional justice failed to moderate the relationship between psychological contract breach and the work outcomes.

Countering the trend towards careerist orientation in the age of downsizing:test of a social exchange model

Predicated on the assumption that employee careerist orientation resulting from organizational actions to cut costs constitutes a potential threat to their long-term profitability and success, this study proposed and tested a social exchange model of careerist orientation in the People's Republic of China. Specifically, it was hypothesized that organizational justice and career growth opportunities will be related to careerist orientation, but the relationship will be mediated by trust in employer. Structural equation modeling results provided support for the model. Trust in organization fully mediated the relationship between careerist orientation and its antecedents.

Trust as a mediator of the relationship between organizational justice and work outcomes:test of a social exchange model

Data obtained from full-time employees of a public sector organization in India were used to test a social exchange model of employee work attitudes and behaviors. LISREL results revealed that whereas the three organizational justice dimensions (distributive, procedural and interactional) were related to trust in organization only interactional justice was related to trust in supervisor. The results further revealed that relative to the hypothesized fully mediated model a partially mediated model better fitted the data. Trust in organization partially mediated the relationship between distributive and procedural justice and the work attitudes of job satisfaction, turnover intentions, and organizational commitment but fully mediated the relationship between interactional justice and these work attitudes. In contrast, trust in supervisor fully mediated the relationship between interactional justice and the work behaviors of task performance and the individually- and organizationally-oriented dimensions of citizenship behavior.

An evaluation of quinolone prescribing in a group of acute hospitals:Development of an objective measure of usage

Objectives: To develop an objective measure to enable hospital Trusts to compare their use of antibiotics. Design: Self-completion, postal questionnaire with telephone follow up. Sample: 4 hospital trusts in the English Midlands. Results: The survey showed that it was possible to collect data concerning the number of Defined Daily Doses (DDD's) of quinolone antibiotic dispensed per Finished Consultant Episode (FCE) in each Trust.. In the 4 trusts studied the mean DDD/FCE was 0.197 (range 0.117 to 0.258). This indicates that based on a typical course length of 5 days, 3.9% of patient episodes resulted in the prescription of a quinolone antibiotic. Antibiotic prescribing control measures in each Trust were found to be comparable. Conclusion: The measure will enable Trusts to objectively compare their usage of quinolone antibiotics and use this information to carry out clinical audit should differences be recorded. This is likely to be applicable to other groups of antibiotics.

Solidarity and power in German : language as political action : a contribution to the socio-cultural history of the German language

Germany's latest attempt at unification raises again the question of German nationhood and nationality. The present study examines the links between the development of the German language and the political history of Germany, principally in the nineteenth and twentieth centuries. By examining the role of language in the establishment and exercise of political power and in the creation of national and group solidarity in Germany, the study both provides insights into the nature of language as political action and contributes to the socio-cultural history of the German language. The language-theoretical hypothesis on which the study is based sees language as a central factor in political action, and opposes the notion that language is a reflection of underlying political 'realities' which exist independently of language. Language is viewed as language-in-text which performs identifiable functions. Following Leech, five functions are distinguished, two of which (the regulative and the phatic) are regarded as central to political processes. The phatic function is tested against the role of the German language as a creator and symbol of national identity, with particular attention being paid to concepts of the 'purity' of the language. The regulative function (under which a persuasive function is also subsumed) is illustrated using the examples of German fascist discourse and selected cases from German history post-1945. In addition, the interactions are examined between language change and socio-economic change by postulating that language change is both a condition and consequence of socio-economic change, in that socio-economic change both requires and conditions changes in the communicative environment. Finally, three politocolinguistic case studies from the eight and ninth decades of the twentieth century are introduced in order to demonstrate specific ways in which language has been deployed in an attempt to create political realities, thus verifying the initial hypothesis of the centrality of language to the political process.

Cohesion in text differentiation : a study of English and Arabic

This thesis sets out to investigate the role of cohesion in the organisation and processing of three text types in English and Arabic. In other words, it attempts to shed some light on the descriptive and explanatory power of cohesion in different text typologies. To this effect, three text types, namely, literary fictional narrative, newspaper editorial and science were analysed to ascertain the intra- and inter-sentential trends in textual cohesion characteristic of each text type in each language. In addition, two small scale experiments which aimed at exploring the facilitatory effect of one cohesive device (i.e. lexical repetition) on the comprehension of three English text types by Arab learners were carried out. The first experiment examined this effect in an English science text; the second covered three English text types, i.e. fictional narrative, culturally-oriented and science. Some interesting and significant results have emerged from the textual analysis and the pilot studies. Most importantly, each text type tends to utilize the cohesive trends that are compatible with its readership, reader knowledge, reading style and pedagogical purpose. Whereas fictional narratives largely cohere through pronominal co-reference, editorials and science texts derive much cohesion from lexical repetition. As for cross-language differences English opts for economy in the use of cohesive devices, while Arabic largely coheres through the redundant effect created by the high frequency of most of those devices. Thus, cohesion is proved to be a variable rather than a homogeneous phenomenon which is dictated by text type among other factors. The results of the experiments suggest that lexical repetition does facilitate the comprehension of English texts by Arab learners. Fictional narratives are found to be easier to process and understand than expository texts. Consequently, cohesion can assist in the processing of text as it can in its creation.

Diversity and the perceived barriers to participation in volunteer activity by older people

The first chapter introduces the subject from a psychological and sociological perspective emphasising the basic human activity of helping those in need. Governmental prominence for policies that assist this activity is briefly discussed with special mention of the programmes that encourage volunteering. Programmes particularly directed at older people, such as the Age Concern ‘Debate of the Age’ are considered briefly. An extensive review of the extant literature is the subject of the second chapter. The pervious research is explored to discover the formulae used to define a volunteer. A definition relative to this research is created. Volunteering issues aggravated by the demographic situation of older people are explored. Empirical volunteer survey research by mutual organisations is explored to ascertain the extent and nature of the already recorded volunteer population. The penultimate section of this chapter investigates the nature of old age and the strategies that older people adopt to enjoy the benefits and contain the problems. The issue of diversity arises from consideration of the literature suggesting that, although it is an essential voluntary sector strength, it is also a further barrier to recruitment. A model diversity is proposed. Chapter three reviews the theoretical processes, procedures and technologies used to collect and analyse the data required to discover the answer to the research problem. Analysis of the questionnaire survey data received is the subject of chapter four. The discovery of the agency uniqueness of volunteer profiles is the principle finding of this part of the research. The fifth chapter is the qualitative analysis of the oral and written statements received. A content analysis of the scripts and texts provided rich data covering motivational factors. Motivational factors were the same for volunteers in the same organisation, but differed between organisations. Finally, the analysed data is collated and discussed progressively toward a theory of diversity. The individuality of each branch of each agency is progressively described culminating in the creation of a model that infers that diversity is a barrier that aggravates all other barriers. The personal realisations of the researcher are described.

Nations and organizations:a comparative study of English and Indian work-related attitudes and values in matched manufacturing firms

This thesis reports a cross-national study carried out in England and India in an attempt to clarify the association of certain cultural and non-cultural characteristics with people's work-related attitudes and values, and with the structure of their work organizations. Three perspectives are considered to be relevant to the objectives of the study. The contingency perspective suggests that a 'fit' between an organization's context and its structural arrangements will be fundamentally necessary for achieving success and survival. The political economy perspective argues for the determining role of the social and economic structures within which the organization operates. The culturalist perspective looks to cultural attitudes and values of organizational members for an explanation for their organization's structure. The empirical investigation was carried out in three stages in each of the two countries involved by means of surveys of cultural attitudes, work-related attitudes and organizational structures and systems. The cultural surveys suggested that Indian and English people were different from one another with regard to fear of, and respect and obedience to, their seniors, ability to cope with ambiguity, honesty, independence, expression of emotions, fatalism, reserve, and care for others; they were similar with regard to tolerance, friendliness, attitude to change, attitude to law, self-control and self-confidence, and attitude to social differentiation. The second stage of the study, involving the employees of fourteen organizations, found that the English ones perceived themselves to have more power at work, expressed more tolerance for ambiguity, and had different expectations from their job than did the Indian equivalents. The two samples were similar with respect to commitment to their company and trust in their colleagues. The findings also suggested that employees' occupations, education and age had some influences on their work-related attitudes. The final stage of the research was a study of structures, control systems, and reward and punishment policies of the same fourteen organizations which were matched almost completely on their contextual factors across the two countries. English and Indian organizations were found to be similar in terms of centralization, specialization, chief executive's span of control, height and management control strategies. English organizations, however, were far more formalized, spent more time on consultation and their managers delegated authority lower down the hierarchy than Indian organizations. The major finding of the study was the multiple association that cultural, national and contingency factors had with the structural characteristics of the organizations and with the work-related attitudes of their members. On the basis of this finding, a multi-perspective model for understanding organizational structures and systems is proposed in which the contributions made by contingency, political economy and cultural perspectives are recognized and incorporated.

The knowledge-based perspective of risk management in healthcare organisations

The aim of this research is to investigate how risk management in a healthcare organisation can be supported by knowledge management. The subject of research is the development and management of existing logs called "risk registers", through specific risk management processes employed in a N.H.S. (Foundation) Trust in England, in the U.K. Existing literature on organisational risk management stresses the importance of knowledge for the effective implementation of risk management programmes, claiming that knowledge used to perceive risk is biased by the beliefs of individuals and groups involved in risk management and therefore is considered incomplete. Further, literature on organisational knowledge management presents several definitions and categorisations of knowledge and approaches for knowledge manipulation in the organisational context as a whole. However, there is no specific approach regarding "how to deal" with knowledge in the course of organisational risk management. The research is based on a single case study, on a N.H.S. (Foundation) Trust, is influenced by principles of interpretivism and the frame of mind of Soft Systems Methodology (S.S.M.) to investigate the management of risk registers, from the viewpoint of people involved in the situation. Data revealed that knowledge about risks and about the existing risk management policy and procedures is situated in several locations in the Trust and is neither consolidated nor present where and when required. This study proposes a framework that identifies required knowledge for each of the risk management processes and outlines methods for conversion of this knowledge, based on the SECI knowledge conversion model, and activities to facilitate knowledge conversion so that knowledge is effectively used for the development of risk registers and the monitoring of risks throughout the whole Trust under study. This study has theoretical impact in the management science literature as it addresses the issue of incomplete knowledge raised in the risk management literature using concepts of the knowledge management literature, such as the knowledge conversion model. In essence, the combination of required risk and risk management related knowledge with the required type of communication for risk management creates the proposed methods for the support of each risk management process for the risk registers. Further, the indication of the importance of knowledge in risk management and the presentation of a framework that consolidates knowledge required for the risk management processes and proposes way(s) for the communication of this knowledge within a healthcare organisation have practical impact in the management of healthcare organisations.

The role of line managers in employee career management:an attachment theory perspective

Line managers increasingly play a key role in organizational career development systems, yet few studies have examined the nature of this role or its implications for employee career attitudes and behaviors. In two studies, we used attachment theory to explore this issue. In Study 1, in-depth interviews (N = 20) showed that employees viewed career management as a relational process in which line managers are expected to act as ‘caregiver’ to support individualized career development. Study 2 was a large-scale international survey (N = 891). Participants scoring higher on attachment avoidance in their line manager relationships reported more negative perceptions of career growth opportunities, lower participation in organizational career development activities and higher turnover intentions. Trust in the organization partially mediated the relationship. Theoretical and practical implications for HRM are discussed.

State-of-the-art in integrated vehicle health management

Cranfield University in collaboration with The Boeing Company have set up a Centre of Excellence in IVHM on the University?s technology park. Sponsored by the East of England Development Agency (EEDA), the Centre carries out pre-competitive research and development of IVHM technologies for the benefit of industrial partners. In addition, the dedicated facilities and university staff provide an unparalleled educational environment for learning and applying IVHM technologies. Boeing is actively involved in the creation and work of the Centre through its enterprise-wide Phantom Works technology organization. This paper will describe the organisation and operation of the Centre and will illustrate its activities by describing a research project being carried out in the Centre. This project is a demonstration of an end to end IVHM system beginning with cost/benefit analysis and extending to maintenance, logistics and operations decision support.

A probabilistic model for trust and reputation

This paper concerns the problem of agent trust in an electronic market place. We maintain that agent trust involves making decisions under uncertainty and therefore the phenomenon should be modelled probabilistically. We therefore propose a probabilistic framework that models agent interactions as a Hidden Markov Model (HMM). The observations of the HMM are the interaction outcomes and the hidden state is the underlying probability of a good outcome. The task of deciding whether to interact with another agent reduces to probabilistic inference of the current state of that agent given all previous interaction outcomes. The model is extended to include a probabilistic reputation system which involves agents gathering opinions about other agents and fusing them with their own beliefs. Our system is fully probabilistic and hence delivers the following improvements with respect to previous work: (a) the model assumptions are faithfully translated into algorithms; our system is optimal under those assumptions, (b) It can account for agents whose behaviour is not static with time (c) it can estimate the rate with which an agent's behaviour changes. The system is shown to significantly outperform previous state-of-the-art methods in several numerical experiments. Copyright © 2010, International Foundation for Autonomous Agents and Multiagent Systems (www.ifaamas.org). All rights reserved.

Reflections on assessing academic quality in marketing, and the UK REF

Purpose – The purpose of this editorial is to comment on the paper by Saunders and Wong in this issue. In doing so, the paper reflects on the notion of academic quality within marketing research, along with the systems in place to evaluate and reward it. Design/methodology/approach – The paper takes a reflective, discursive approach. Findings – The author finds that, while Saunders and Wong make a number of pertinent observations, and come up with interesting solutions, the notion of academic quality espoused in their paper is based on a logically flawed set of arguments. Research limitations/implications – The paper is primarily a personal view, and thus does not rely on any empirical research. Practical implications – There are key implications for many parties involved in the creation and assessment of marketing knowledge. In particular, scholars would be well advised to consider notions of quality in relation to their own work, rather than rely unquestioningly on existing definitions. Policy makers and research managers (e.g. business school deans) also need to consider what quality in academic research really is, and how to appropriately direct and reward it. Originality/value – The paper provides another perspective on the well-established debate regarding quality, and thus it is hoped will stimulate further thinking.