A study of the effects of orally administered female hormones on the volume and composition of lacrimal fluid related to the toleration of corneal contact lenses

This study was designed to evaluate the effects of certain orally active contraceptive steroids on the eye, related to the tolerance of a corneal contact lens. An oestrogen, ethinyloestradiol BP. 0.05 mg, a progestogen, norethisterone acetate BP. 2.50 mg and a control tablet (vitamin C, 50 mg) were utilised. The effect of these preparations on corneal curvature, lacrimal fluid volume and protein composition and directly on corneal lens tolerance was monitored in a group of 23 volunteer patients. The progestogen was found to produce a significant (P≥ 0.05) decrease in tear volume as measured by a 3 minute Schirmer test. A smaller volume reduction was observed with ethinyloestradiol. A normal cornea appears unaffected, within the measurement limits available, by the use of either hormone. However, in the presence of a corneal lens, oestrogen was found to induce substantial corneal steepening, indicative of tissue oedema, during the initial 2-3 weeks of medication. Progestogen occasionally produced a similar effect, which could recur with either hormone shortly after the end of the treatment period. A new method of acrylamide gel electrophoresis was developed for examination of the protein concentration and composition of lacrimal fluid. This allowed much greater resolution of microquantities of unconcentrated fluid than anything previously reported. Quantitation by densitometry has permitted the recording of medication and lens-induced changes in the protein pattern. Tear albumin has been shown to differ from serum albumin and to consist of up to 3 subfractions, 7 further protein fractions may also be resolved. The concentration and probable origin of these proteins have been established and the overall effects of hormone administration described. Individual idiosyncratic responses are also discussed. The study has established tbenature of some effects of contraceptive steroids on the anterior eye, and the probable reasons for resultant corneal lens intolerance.

Are HRM practices related with patient mortality in NHS hospitals?:A study examining the underlying reasons for such an association

This thesis will report details of two studies conducted within the National Health Service in the UK that examined the association between HRM practices related to training and appraisal with health outcomes within NHS Trusts. Study one represents the organisational analysis of 61 NHS Trusts, and will report training and appraisal practices were significantly associated with lower patient mortality. Specifically, the research will show significantly lower patient mortality within NHS Trusts that: a) had achieved Investors in People accreditation; b) had a formal strategy document relating to training; c) had tailored training policy documents across occupational groups; d) had integrated training and appraisal practices; e) had a high percentage of staff receiving either an appraisal or updated personal development plan. There was also evidence of an additive effect where NHS Trusts that displayed more of these characteristics had significantly lower patient mortality. Study one in this thesis will also report significantly lower patient mortality within the NHS Trusts where there was broad level representation for the HR function. Study two will report details of a study conducted to examine the potential reasons why HR practices may be related to hospital performance. Details are given of the results of a staff attitudinal survey within five NHS Trusts. This study examined will show that a range of developmental activity, the favourability of the immediate work environment (in relation to social support and role stressors) and motivational outcomes are important antecedents to citizenship behaviours. Furthermore, the thesis will report that principles of the demand-control model were adopted to examine the relationship between workplace support and role stressors, and workplace support, influence, and an understanding of role expectation help mitigate against the negative effects of work demands upon motivational outcomes.

Expatriate managers adjustment and its impact on subordinates reactions: a cross cultural leadership study of Kenya and Ethiopia

Research on culture, leadership and adjustment shows that societal culture influences leadership in such a way that it can impact on expatriate managers' effectiveness and adjustment in a new culture. In previous research, cultural background, personality, motives or behaviour of expatriate managers and their followers' reactions to them have been investigated in Europe, America and Asia. However, little attention has been paid on research on expatriate managers in African cultures especially in Eastern Africa. The present study represents an attempt to address the gap by examining how societal culture, leadership and adjustment success are interrelated for expatriate managers in Kenya and Ethiopia. Questionnaire data were obtained from a) local middle managers (N=160) for studying societal culture and leadership in Kenya and Ethiopia, b) expatriate managers in non-governmental organizations - NGOs (N=28) for studying expatriate managers' personality, motives and adjustment success and c) their immediate subordinates (N=125) for studying the expatriate managers' behaviours and their subordinates' reactions to them. Additionally, expatriate managers were interviewed and responses were coded for implicit motives, experiences and adjustment. SPSS was used to analyse data from questionnaires to obtain cultural and leadership dimensions, leader behaviour and subordinate reactions. The NVIVO computer based disclosure analysis package was used to analyse interview data. Findings indicate that societal culture influences leadership behaviours and leadership perceptions while the expatriate managers' motives, behaviours, personality and the cross cultural training they received prior to their assignment impact on the expatriates' adjustment success and on subordinates' reactions to them. The cultural fit between expatriate managers' home country (19 countries) and the target country (Kenya or Ethiopia) had no significant association with adjustment success but was positively related to expatriate behaviour and negatively associated with subordinates reactions. However, some particular societal practices - obviously adopted by expatriates and transferred to their target country - did predict subordinates' commitment, motivation and job satisfaction. Furthermore, expatriates' responsibility motivation was positively related to their adjustment success. Regarding leadership behaviours and effectiveness, expatriate' supportive behaviours predicted subordinates' job satisfaction most strongly. Expatriate managers expressing their management philosophies and experience shed light on the various aspects of adjustment and management of NGOs. In addition, review of Kenyan and Ethiopian cultures and the NGO context in these countries offers valuable information for expatriate managers. This study's general imphcation for Cross Cultural Management and lnternational Human Resources Management is that the combination of culture general and culture specific knowledge and reflections on Eastern Africa countries can inform senior management and international HR staff about the critical issue of what to include in training, coaching, and actual experience in a particular host country in order to ensure effective leadership. Furthennore, this knowledge is expected to influence expatriate managers' behaviour modification to enhance positive subordinate reactions. Questions about how to prepare expatriate managers and subordinates to work more competently and sensitively across cultures are addressed. Further theoretical implications, limitations of the study and directions for future research are also addressed.

Maternal symptoms of depression are related to observations of controlling feeding practices in mothers of young children

Maternal depression can impair parenting practices and has been linked with less sensitive feeding interactions with children, but existing research is based on self-reports of feeding practices. This study examined relationships between maternal self-reported symptoms of depression with observations of mothers' child feeding practices during a mealtime. Fifty-eight mothers of 3-and 4-year-old children were video recorded eating a standardized lunch. The recording was then coded for instances of maternal controlling feeding practices and maternal vocalizations using the Family Mealtime Coding System. Mothers also provided information on current symptoms of depression and anxiety. Mothers who reported greater symptoms of depression were observed to use more verbal and physical pressure for their child to eat and to offer more incentives or conditions in exchange for their child eating. Mothers also used more vocalizations with their child about food during the observed mealtime when they had greater symptoms of depression. There was no link between symptoms of depression and observations of maternal use of restriction. Symptoms of depression are linked with observations of mothers implementing a more controlling, less sensitive feeding style with their child. Health professionals working with families in which mothers have symptoms of depression may benefit from receiving training about the possible impact of maternal depression on child-feeding practices, and mothers with symptoms of depression may benefit from guidance regarding its potential impact on their child-feeding interactions ©2013 American Psychological Association.