What do we know about the experience of age related macular degeneration? A systematic review and meta-synthesis of qualitative research

Age Related Macular Degeneration (AMD) is the leading cause of registerable blindness with a high medical and societal cost burden. Much of the research examining experiences of living with AMD has been conducted independently with small sample sizes and has failed to impact on practice. Meta-synthesis of qualitative research can improve the understanding of the experience of living with AMD by drawing together findings of qualitative studies. This article presents a systematic review and meta-synthesis of qualitative studies investigating the experience of AMD (literature searched up to April 2012; published studies identified range from 1996 to 2009). The review highlights themes relating to: functional limitations, adaptation and independence; feelings about the future with vision impairment; interaction with the health service; social engagement; disclosure; and the emotional impacts of living with AMD. Attention to the experience of living with AMD can help us to better understand the needs of patients. This meta-synthesis aimed to bring together the findings of qualitative research studies and highlights important areas for consideration when caring for patients with AMD. Our findings suggest that a holistic approach to service provision and support for AMD is needed which takes into account individuals' needs and experiences when coping with and adjusting to living with AMD. This support should aim to reduce stigma, increase social engagement, and develop the psychological resources of patients with AMD.

A survey of UK selection practices across different organization sizes and industry sectors

This paper presents results of a study examining the methods used to select employees in 579 UK organizations representing a range of different organization sizes and industry sectors. Overall, a smaller proportion of organizations in this sample reported using formalized methods (e.g., assessment centres) than informal methods (e.g., unstructured interviews). The curriculum vitae (CVs) was the most commonly used selection method, followed by the traditional triad of application form, interviews, and references. Findings also indicated that the use of different selection methods was similar in both large organizations and small-to-medium-sized enterprises. Differences were found across industry sector with public and voluntary sectors being more likely to use formalized techniques (e.g., application forms rather than CVs and structured rather than unstructured interviews). The results are discussed in relation to their implications, both in terms of practice and future research.

Survey of habits and attitudes to retinoscopy by optometrists in the UK

This research suggests that although retinoscopy is considered to be an important part of the eye examination by the majority, it is being carried out less by optometrists working in multiple practices. This less frequent use of retinoscopy may be due to the greater use of non-optometric staff in prescreening and that the more 'difficult' patients (young children or adults with poor communication) may be more likely to attend independent practices or an eye clinic.

Do stressful times call for team-based working? A study of psychiatric nurses in UK mental healthcase

Background: Team-based working is now an inherent part of effective health care delivery. Previous research has identified that team working is associated with positive mental health and well-being outcomes for individuals operating in an effective team environment. This is a particularly important topic in the health services context, although little empirical attention has been paid to mental-health services. Psychiatric nurses work on a day-to-day basis with a particularly stressful and demanding client group in an environment which is characterised by high demands, uncertainty, and limited resources. This paper specifically focuses on psychiatric nurses working in National Health Service (NHS) and casts some light on the ways in which effective team-based working can help to alleviate a number of occupational stressors and strains. Method: A questionnaire method (2005 NHS Staff Survey) was employed to collect data from 6655 psychiatric nurses from 64 different NHS Trusts. The hypotheses were concerned with four overall measures from the survey; effective team working, occupational stress, work pressure and social support. Hypothesis 1 stated that effective team working will have a significant negative relationship with occupational stress and work pressure. Further, Hypothesis 2 stated that social support from supervisors and co-workers will moderate this relationship. Findings: Data was treated with a series of regression analyses. For Hypothesis 1, working in a real team did have main effects on work pressure and accounted for 1.6 per cent of the variance. Using the Nagelkerke R square value, working in a real team also had main effects on occupational stress an accounted for approximately 2.8 per cent of the variance. Further, the Exp (B) value of 0.662 suggests that the odds of suffering from occupational stress are cut by 33.8 per cent when a psychiatric nurse works in a real team. Results failed to provide support for Hypothesis 2. The analysis then went on to adopt a unique approach for assessing the extent of real team-based working, distinguishing between real teams, and a number of pseudo team typologies, as well as the absence of teamwork all together. As was hypothesised, results demonstrated that psychiatric nurses working in real teams (ones with clear objectives, where-by team members work closely with one another to achieve team objectives and meet regularly to discuss team effectiveness and how it can be improved) experienced the lowest levels of stress and work pressure of the sample. However, contrary to prediction, results indicated that psychiatric nurses working in any type of pseudo team actually experienced significantly higher levels of stress and work pressure than those who did not report as working in a team at all. Discussion: These findings have serious implications for NHS Mental Health Trusts, which may not be implementing, structuring and managing their nursing teams adequately. Indeed, results suggest that poorly-structured team work may actually facilitate stress and pressure in the workplace. Conversely, well-structured real teams serve to reduce stress and work pressure, which in turn not only enhances the working lives and well-being of psychiatric nurses, but also greatly improves the service that the NHS provides to its users.

Stressful times call for team-based measures:psychiatric nursing in the UK National Health Service

Background: Team-based working is now an inherent part of effective health care delivery. Previous research has identified that team working is associated with positive mental health and well-being outcomes for individuals operating in an effective team environment. This is a particularly important topic in the health services context, although little empirical attention has been paid to mental-health services. Psychiatric nurses work on a day-to-day basis with a particularly stressful and demanding client group in an environment which is characterised by high demands, uncertainty, and limited resources. This paper specifically focuses on psychiatric nurses working in National Health Service (NHS) and casts some light on the ways in which effective team-based working can help to alleviate a number of occupational stressors and strains. Method: A questionnaire method (2005 NHS Staff Survey) was employed to collect data from 6655 psychiatric nurses from 64 different NHS Trusts. The hypotheses were concerned with four overall measures from the survey; effective team working, occupational stress, work pressure and social support. Hypothesis 1 stated that effective team working will have a significant negative relationship with occupational stress and work pressure. Further, Hypothesis 2 stated that social support from supervisors and co-workers will moderate this relationship. Findings: Data was treated with a series of regression analyses. For Hypothesis 1, working in a real team did have main effects on work pressure and accounted for 1.6 per cent of the variance. Using the Nagelkerke R square value, working in a real team also had main effects on occupational stress an accounted for approximately 2.8 per cent of the variance. Further, the Exp (B) value of 0.662 suggests that the odds of suffering from occupational stress are cut by 33.8 per cent when a psychiatric nurse works in a real team. Results failed to provide support for Hypothesis 2. The analysis then went on to adopt a unique approach for assessing the extent of real team-based working, distinguishing between real teams, and a number of pseudo team typologies, as well as the absence of teamwork all together. As was hypothesised, results demonstrated that psychiatric nurses working in real teams (ones with clear objectives, where-by team members work closely with one another to achieve team objectives and meet regularly to discuss team effectiveness and how it can be improved) experienced the lowest levels of stress and work pressure of the sample. However, contrary to prediction, results indicated that psychiatric nurses working in any type of pseudo team actually experienced significantly higher levels of stress and work pressure than those who did not report as working in a team at all. Discussion: These findings have serious implications for NHS Mental Health Trusts, which may not be implementing, structuring and managing their nursing teams adequately. Indeed, results suggest that poorly-structured team work may actually facilitate stress and pressure in the workplace. Conversely, well-structured real teams serve to reduce stress and work pressure, which in turn not only enhances the working lives and well-being of psychiatric nurses, but also greatly improves the service that the NHS provides to its users.

Internationalization of small and medium sized UK manufacturing enterprises:technology and knowledge transfer perspective

This dissertation examines internationalisation of small and medium sized enterprises. There has been a journey to achieve this. The research has started as an action research as Teaching Company Scheme Associate. This has been done in two research cycles, which investigated factors for successful internationalisation of a small and medium sized UK manufacturing enterprise. This has revealed that successful internationalisation requires good technology and knowledge transfer to the new operations. The action research is followed by a survey that has been conducted within UK manufacturing companies. The data collected was analysed under three models: entry mode selection, role of factory and level of internationalisation. The first two models explain two major aspects of internationalisation decision. The last is showing what makes successful internationalising small and medium sized companies. These models provided several important results. The small and medium sized enterprise internationalisation is harder to achieve because most of these organisations do not have experience in technology and knowledge transfer. The success of internationalisation depends on the success of the transfer. This is achieved through employee ownership of the new knowledge. There are many factors affecting this result such as the network relationships such as trust, control and commitment and cognitive distance between two organisations. The last is a product of the difference between prior knowledge and the required level of knowledge. The entry mode and role of factory are decided through these factors while the level of internationalisation can only be explained by absorptive capacity of the recipient organisation and the technology transfer ability of the host organisation.

Case study as a research strategy : investigating extreme weather resilience of construction SMEs in the UK

Determining an appropriate research methodology is considered as an important element in a research study; especially in a doctoral research study. It involves approach to the entire process of a research study, starting from theoretical underpinnings and spanning to data collection and analysis, and extending to developing the solutions for the problems investigated. Research methodology in essence is focused around the problems to be investigated in a research study and therefore varies according to the problems investigated. Thus, identifying the research methodology that best suits a research in hand is important, not only as it will benefit achieving the set objectives of a research, but also as it will serve establishing the credibility of the work. Research philosophy, approach, strategy, choice, and techniques are inherent components of the methodology. Research strategy provides the overall direction of the research including the process by which the research is conducted. Case study, experiment, survey, action research, grounded theory and ethnography are examples for such research strategies. Case study is documented as an empirical inquiry that investigates a contemporary phenomenon within its real-life context, especially when the boundaries between phenomenon and context are not clearly evident. Case study was adopted as the overarching research strategy, in a doctoral study developed to investigate the resilience of construction Small and Medium-sized Enterprises (SMEs) in the UK to extreme weather events. The research sought to investigate how construction SMEs are affected by EWEs, respond to the risk of EWEs, and means of enhancing their resilience to future EWEs. It is argued that utilising case study strategy will benefit the research study, in achieving the set objectives of the research and answering the research questions raised, by comparing and contrasting with the alternative strategies available. It is also claimed that the selected strategy will contribute towards addressing the call for improved methodological pluralism in construction management research, enhancing the understanding of complex network of relationships pertinent to the industry and the phenomenon being studied.

Pleasure, pain and procrastination:reflections on the experience of doing memory-work research

The focus of this article is the process of doing memory-work research. We tell the story of our experience of what it was like to use this approach. We were enthused to work collectively on a "discovery" project to explore a method with which we were unfamiliar. We hoped to build working relationships based on mutual respect and the desire to focus on methodology and its place in our psychological understanding. The empirical activities highlighted methodological and experiential challenges, which tested our adherence to the social constructionist premise of Haug's original description of memory work. Combined with practical difficulties of living across Europe, writing and analyzing the memories became contentious. We found ourselves having to address a number of tensions emanating from the work and our approach to it. We discuss some of these tensions alongside examples that illustrate the research process and the ways we negotiated the collective nature of the memory-work approach. © 2012 Copyright Taylor and Francis Group, LLC.

Coping strategies against extreme weather events:a survey of SMEs in the UK

Small and Medium-scale Enterprises (SMEs); which generate more than one half of the employment and turnover, form an important sector of the UK economy. In fact, SMEs are considered as the backbone of the UK economy due to their significant economic and societal importance. Despite SMEs being the main drivers of the UK economy, they are also said to be the most vulnerable to the impacts from various disruptions such as Extreme Weather Events (EWEs). Consequently, increased intensity and frequency of weather extremes in the UK during the recent past has created a significant impact on the SME community. As the threat of EWEs is expected to further increase in future, the need for SMEs to implement effective coping mechanisms to manage the effects of EWEs is also increasing. This paper aims to identify and evaluate the current coping mechanisms implemented by SMEs to ensure their business continuity in the event of a weather extreme. The paper presents the findings of a questionnaire survey, conducted as part of "Community Resilience to Extreme Weather - CREW" research project, addressing this issue. It is identified that SMEs mostly rely on generic business continuity strategies as opposed to property level protection measures. The paper highlights the importance of raising the uptake of coping strategies by SMEs, as many were found without adequate coping strategies to deal with the risk of EWEs.

Case study as a research strategy:investigating extreme weather resilience of construction SMEs in the UK

Determining an appropriate research methodology is considered as an important element in a research study; especially in a doctoral research study. It involves approach to the entire process of a research study, starting from theoretical underpinnings and spanning to data collection and analysis, and extending to developing the solutions for the problems investigated. Research methodology in essence is focused around the problems to be investigated in a research study and therefore varies according to the problems investigated. Thus, identifying the research methodology that best suits a research in hand is important, not only as it will benefit achieving the set objectives of a research, but also as it will serve establishing the credibility of the work. Research philosophy, approach, strategy, choice, and techniques are inherent components of the methodology. Research strategy provides the overall direction of the research including the process by which the research is conducted. Case study, experiment, survey, action research, grounded theory and ethnography are examples for such research strategies. Case study is documented as an empirical inquiry that investigates a contemporary phenomenon within its real-life context, especially when the boundaries between phenomenon and context are not clearly evident. Case study was adopted as the overarching research strategy, in a doctoral study developed to investigate the resilience of construction Small and Medium-sized Enterprises (SMEs) in the UK to extreme weather events. The research sought to investigate how construction SMEs are affected by EWEs, respond to the risk of EWEs, and means of enhancing their resilience to future EWEs. It is argued that utilising case study strategy will benefit the research study, in achieving the set objectives of the research and answering the research questions raised, by comparing and contrasting with the alternative strategies available. It is also claimed that the selected strategy will contribute towards addressing the call for improved methodological pluralism in construction management research, enhancing the understanding of complex network of relationships pertinent to the industry and the phenomenon being studied.

Intellectual property enforcement in smaller UK firms:findings from a survey in 2009-10

This report details research into the enforcement of intellectual property (IP). It considers the attitudes and practices of small and medium-sized enterprises (SMEs) and micro firms as well as the cost implications of the present IP enforcement system in the UK. According to an earlier report for SABIP, by Weatherall et al. 2009, in the Gowers Review of Intellectual Property questions of enforcement were largely addressed through assertion, rather than empirical research. This report aims to provide such research. Our study included both an online survey and a phone survey. These concentrated on SMEs and micro firms rather than being a comparative study with large firms. Further work obtained information on Patents and Registered Design cases listed for hearings in the Patents Court from 2003 to 2009. The analysis of this data provides some evidence that complements the results of the survey.

The UK MPharm (2) - Do we over assess?

Introduction-The pace of structural change in the UK health economies, the new focus on regulation and the breaking down of professional boundaries means that the Royal Pharmaceutical Society of Great Britain (RPSGB) has to continually review the scope, range and outputs of education provided by schools of pharmacy (SOPs). In SOPs, the focus is on equipping students with the knowledge, skills and attitudes necessary to successfully engage with the pre-registration year. The aim of this study [1] was to map current programmes and undergraduate experiences to inform the RPSGB debate. The specific objectives of this paper are to describe elements of the survey of final year undergraduates, to explore student opinions and experiences of their workload, teaching, learning and assessment. Material and methods-The three main research techniques were: (1) quantitative course document review, (2) qualitative staff interview and (3) quantitative student self completion survey. The questions in the survey were based on findings from exploratory focus group work with BPSA (British Pharmaceutical Students’ Association) members and were designed to ascertain if views expressed in the focus groups on the volume and format of assessments were held by the general student cohort. The student self completion questionnaire consisting of 31 questions, was administered in 2005 to all (n=1847) final year undergraduates, using a pragmatic mixture of methods. The sample was 15 SOPs within the UK (1 SOP opted out). The total response rate was 50.62% (n=935): it varied by SOP from 14.42% to 84.62%. The survey data were analysed (n=741) using SPSS, excluding non-UK students who may have undertaken part of their studies within a non-UK university. Results and discussion • 76% (n=562) respondents considered that the amount of formal assessment was about right, 21% (n=158) thought it was too much. • There was agreement that the MPharm seems to have more assessment than other courses, with 63% (n=463) strongly agreeing or agreeing. • The majority considered the balance between examinations and coursework was about right (67%, n=498), with 27% (n=198) agreeing that the balance was too far weighted towards examinations. • 57% (n=421) agreed that the focus of MPharm assessment was too much towards memorised knowledge, 40% (n=290) that it was about right. • 78% (n= 575) agreed with the statement “Assessments don’t measure the skills for being a pharmacist they just measure your knowledge base”. Only 10% (n=77) disagreed. • Similarly 49% (n=358) disagreed with, and 35% (n=256) were not sure about the statement “I consider that the assessments used in the MPharm course adequately measure the skills necessary to be a pharmacist”. Only 17% (n=124) agreed. Experience from this study shows the difficulty of administering survey instruments through UK Schools of Pharmacy. It is heavily dependent on timing, goodwill and finding the right person. The variability of the response rate between SOPs precluded any detailed analysis by School. Nevertheless, there are some interesting results. Issues raised in the exploratory focus group work about amount of assessment and over reliance on knowledge have been confirmed. There is a real debate to be had about the extent to which the undergraduate course, which must instil scientific knowledge, can provide students with the requisite qualities, skills, attitudes and behaviour that are more easily acquired in the pre-registration year. References [1] Wilson K, Jesson J, Langley C, Clarke L, Hatfield K. MPharm Programmes: Where are we now? Report commissioned by the Pharmacy Practice Research Trust., 2005.

Postgraduate study and managers' subsequent work experience:an exploratory evaluation

Drawing on an exploratory qualitative study, this article considers the link between business school teaching at graduate level and subsequent work behaviour and experiences of former students. It evaluates the student experience some time after graduation. The findings of the retrospective evaluation point to the value of classroom peer discussion, the testing of ideas against prior work experience and the opportunity to make sense of organisational issues by setting them into broader context. The importance of andragogical approaches to teaching is discussed as well as the implications of the study findings for teaching quality enhancement. © 2009 Taylor & Francis.

All change? Managers' experience of organizational change in theory and practice

Purpose - This paper aims to examine the usefulness of organizational change theory for management practice. Design/methodology/approach - The authors present an exploratory, empirical study of managers who were taught organizational change theory as part of a postgraduate degree. Building on the study findings, they analyse managers' subsequent experiences of organizational change; of how they use change theory in practice and the impact on their practice of their earlier formal study. Findings - The paper finds that the complexities of managing change in practice reflect distinctive organizational environments and cultures. The skills and knowledge which managers found most useful were those that enabled them to "make sense" of the organizational change they subsequently experienced. The main impact of their earlier studies was to prompt informative, discursive and reflective approaches to change management. Practical implications - The paper discusses the implications for future teaching of organizational change and the development of organizational change theory. Originality/value - The qualitative findings of the study add to, and help to explain, earlier research findings on the questions of how managers' experience change, how they use organizational change theory and its impact on their practice. © Emerald Group Publishing Limited.