How do older people with sight loss manage their general health? A qualitative study

Purpose: Older people with sight loss experience a number of barriers to managing their health. The purpose of this qualitative study was to explore how older people with sight loss manage their general health and explore the techniques used and strategies employed for health management. Methods: Semi-structured face-to-face interviews were conducted with 30 participants. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Results: Health management challenges experienced included: managing multiple health conditions; accessing information; engaging in health behaviours and maintaining wellbeing. Positive strategies included: joining support groups, clubs and societies; using low vision aids; seeking support from family and friends and accessing support through health and social care services. Conclusion: Healthcare professionals need to be more aware of the challenges faced by older people with sight loss. Improved promotion of group support and charity services which are best placed to share information, provide fora to learn about coping techniques and strategies, and give older people social support to prevent isolation is needed. Rehabilitation and support services and equipment can only be beneficial if patients know what is available and how to access them. Over-reliance on self-advocacy in current healthcare systems is not conducive to patient-centred care. Implications for Rehabilitation Sight loss in older people can impact on many factors including health management. This study identifies challenges to health management and highlights strategies used by older people with sight loss to manage their health. Access to support often relies on patients seeking information for themselves. However, self-advocacy is challenging due to information accessibility barriers. Informal groups and charities play an important role in educating patients about their condition and advising on available support to facilitate health management.

The planning and management of health for development:a model for Zimbabwe

In this thesis, I view the historical background of Zimbabwe to show the patterns of traditional life that existed prior to settlerism. The form, nature, pace and impact of settlerism and colonialism up to the time of independence are also discussed to show how they affected the health of the population and the pace of development of the country. The political, social and economic underdevelopment of the African people that occurred in Zimbabwe prior to independence was a result of deliberate, politically motivated and controlled policy initiatives. These led to inequatable, inadequate, inappropriate and inaccessible health care provision. It is submitted that since it was the politics that determined the pace of underdevelopment, it must be the politics that must be at the forefront of the development strategy adopted. In the face of the amed conflict that existed in Zimbabwe, existing frameworks of analyses are shown to be inadequate for planning purposes because of their inability to provide indications about the stability of future outcomes. The Metagame technique of analysis of options is proposed as a methology that can be applied in such situations. It rejects deterministic predicative models as misleading and advocates an interactive model based on objective and subjective valuation of human behaviour. In conclusion, the search for stable outcomes rather than optimal and best solutions strategies is advocated in decision making in organisations of all sizes.

Stakeholders' perceptions of corporate social reporting in Bangladesh

Recent calls in the corporate social reporting (CSRep) literature have emphasized the importance of giving voice to non-managerial stakeholder groups in the social reporting process. The research, presented in this paper, employs recent work in stakeholder theory and CSRep to examine the perceptions of a diverse set of non-managerial stakeholders in the context of a developing country, Bangladesh. A series of semi-structured interviews were conducted with individuals who identify with various non-managerial stakeholder groups. Interviewees generally believed that the motivation and practice of CSRep in Bangladesh is developing in response to pressures from international markets and is producing largely cosmetic responses. Also, they expressed concerns that, given the economic, political, and social conditions in Bangladesh, premature adoption of strict CSRep standards may lead to increased corruption and other unintended consequences. Whilst some of the interviewees sharply criticized the current process of imposing social accounting codes/standards on developing countries which fail to consider the important local socio-economic context, the findings suggest that there is overwhelming support for mandatory externally verified CSRep based on the principles of peoples' right to know, full disclosure/completeness, and relevance, which are anchored in the broader principles of transparency and stakeholder accountability. © 2010 Springer Science+Business Media B.V.

Language and peace

This study seeks to demonstrate how critical discourse analysis can elucidate the relationship between language and peace. It provides a view on the notion of peace put forward by peace researchers, namely that peace includes not only the absence of war or physical violence, but also the absence of structural violence. Approaching the topic from various perspectives, the volume argues that language is a factor to be considered together with social and economic factors in any examination of the social conditions and institutions that prevent the achievement of a comprehensive peace. It illustrates a framework of concepts and methodologies that offer to help guide future linguistic research in this area, and also calls for foreign language, second language and peace educators to include critical linguistic education into their curricula and describes an approach for doing so.

Employee social responsibility:development of an ESR measure and a multi-level investigation of antecedent and boundary conditions

The following thesis instigates the discussion on corporate social responsibility (CSR) through a review of literature on the conceptualisation, determinants, and remunerations of organisational CSR engagement. The case is made for the need to draw attention to the micro-levels of CSR, and consequently focus on employee social responsibility at multiple levels of analysis. In order to further research efforts in this area, the prerequisite of an employee social responsibility behavioural measurement tool is acknowledged. Accordingly, the subsequent chapters outline the process of scale development and validation, resulting in a robust, reliable and valid employee social responsibility scale. This scale is then put to use in a field study, and the noteworthy roles of the antecedent and boundary conditions of transformational leadership, assigned CSR priority, and CSR climate are confirmed at the group and individual level. Directionality of these relationships is subsequently alluded to in a time-lagged investigation, set within a simulated business environment. The thesis collates and discusses the contributions of the findings from the research series, which highlight a consistent three-way interaction effect of transformational leadership, assigned CSR priority and CSR climate. Specifically, efforts are made to outline various avenues for future research, given the infancy of the micro-level study of employee social responsibility.

The directions taken by young people on leaving compulsory education:a study in two Birmingham schools

The thesis addresses the relative importance of factors affecting working-class school-leavers' post-compulsory education transitions into post-sixteen education, training, employment and unemployment. It focuses on school-leavers choosing to enter the labour market, whether successfully or not and the influences affecting this choice. Methodologically, the longitudinal approach followed young people from before they left school to a period of months after. Discrepancies between young people's intended and actual destinations emphasised the diverse influences on post-sixteen transitions. These influences were investigated through a dynamic multi-method approach, drawing from quantitative and qualitative methodologies providing depth and insight while locating the research within a structural framework, allowing a comparison with local and national trends. Two crucial factors of school and gender affected young people's intended and actual post-sixteen directions. School policy, including treatment of disaffected pupils and recruitment to a large, on-site sixth form, influenced the number of pupils opting to continue their education. Girls were more likely to continue education after the end of compulsory schooling and gave different reasons to boys for doing so. Family and peer groups were influential, helping young people develop a 'horizon for action' incorporating habitus and subjective preferences that specified acceptable post-sixteen directions. These influences operated within the context of the local labour market. Perception of the latter rather than actual conditions informed post-sixteen decisions; however, labour market reality influenced the success of the school-leavers' endeavours. The research found that the economics-based rational choice model of decision-making did not apply to many working class school-leavers. The cohort made pragmatically rational decisions dependent on their 'horizon for action'. based on partial, occasionally inaccurate information. Policy recommendations consider the careers service and structure or school sixth forms as aiding successful transitions from compulsory education into education, employment or training. The maintenance allowance may be ineffectual in tackling its objective of social inclusion.

Legitimacy building strategies in conditions of discretionary legal enforcement:a logic of social action approach

The present study explores strategies used to legitimize the transfer of organizational practices in a situation of institutional upheaval. We apply the logic of social action (Risse, 2000) to analyze the effectiveness of consequence-based action and communication-based action, in terms of higher coordination, lower conflict, and overall higher economic performance. Consequence-based legitimation is obtained by using a system of distributor incentives tied to performance of specific tasks, while communicative legitimation can be achieved by recommendations and warnings. Our setting is an export channel to European emerging economies. Our results indicate that in the absence of legitimacy, as manifested in discretionary legal enforcement, consequence-based legitimation is more effective than communicative legitimation in reducing conflict, increasing coordination, and ultimately in improving the performance of the export dyad. © 2014 Elsevier Inc.

The importance of detecting and managing comorbidities in people with dementia?

Dementia is a debilitating condition characterised by global loss of cognitive and intellectual functioning, which gradually interferes with social and occupational performance. It is a common worldwide condition with a significant impact on society. There are currently 36 million people worldwide with Alzheimer's disease (AD) and other dementias [1]. This is expected to more than double by 2030 (65 million) and reach ∼115 million in 2050, unless a major breakthrough is made. The worldwide societal costs were estimated at USD 604 billion in 2010 and rising [2]. To date research on the specific physical healthcare needs of people with dementia has been neglected. Yet, physical comorbidities are reported as common in people with dementia [3] and have been shown to lead to increased disability and reduced quality of life for the affected person and their carer [4]. Dementia is most frequently associated with older people who often present with other medical conditions, known as co-morbidities. Such co-morbidities include diabetes, chronic obstructive pulmonary disorder, musculoskeletal disorders and chronic cardiac failure and are common, 61% of people with …

Business-driven social change:a systematic review of the evidence

How can companies help change people's behaviour in order to benefit society? Organizations have the resources and market influence to effect positive change. Through product labeling, supply chain management, cause marketing, corporate philanthropy, employee volunteerism and NGO (non-government organization) partnerships, companies are helping society get active, eat healthy foods, dispose of products properly, use less energy and generally live more sustainable lives. This report reveals the three conditions necessary for changing people's behaviour that create benefits for society. The report also includes 19 mechanisms companies can use to motivate people to change and to create the capabilities and opportunities for change.

Making sense of the ‘difficult’ past:transmission of political heritage and memory-work among young people across Europe

This article considers young people’s socialization into mnemonic communities in 14 European countries. It argues that such socialization is an intersubjective and selective process that, to a great degree, depends on the particular social environment that conditions the discourses on pasts available to young people. Drawing on memory studies, it recognizes memory as a valid alternative to the institutionalized past (history) but envisages the two as inextricably connected. Given this, it identifies several strategies adopted by young people in order to socialize understandings of the past. While these strategies vary, some reveal receptivity to populist and far right ideologies. Our study demonstrates how internalization of political heritage via mnemonic socialization within families is conditioned by both the national political agenda and socio-economic situation experienced across Europe.

Medicines optimisation for young people with juvenile arthritis and other long-term conditions:system-level barriers to engagement

To explore the views of pharmacy and rheumatology stakeholders about system-related barriers to medicines optimisation activities with young people with long-term conditions. A three-phase consensus-building study comprising (1) focus groups with community and hospital pharmacists; (2) semi-structured telephone interviews with lay and professional adolescent rheumatology stakeholders and pharmacy policymakers, and (3) multidisciplinary discussion groups with community and hospital pharmacists and rheumatology staff. Qualitative verbatim transcripts from phases 1 and 2 were subjected to framework analysis. Themes from phase 1 underpinned a briefing for phase 2 interviewees. Themes from phases 1 and 2 generated elements of good pharmacy practice and current/future pharmacy roles for ranking in phase 3. Results from phase 3 prioritisation and ranking exercises were captured on self-completion data collection forms, entered into an Excel spreadsheet and subjected to descriptive statistical analysis. Institutional ethical approval was given by Aston University Health and Life Sciences Research Ethics Committee. Four focus groups were conducted with 18 pharmacists across England, Scotland and Wales (7 hospital, 10 community and 1 community/public health). Fifteen stakeholders took part in telephone interviews (3 pharmacist commissioners; 2 pharmacist policymakers; 2 pharmacy staff members (1 community and 1 hospital); 4 rheumatologists; 1 specialist nurse, and 3 lay juvenile arthritis advocates). Twenty-five participants took part in three discussion groups in adolescent rheumatology centres across England and Scotland (9 community pharmacists; 4 hospital pharmacists; 6 rheumatologists; 5 specialist nurses, and 1 physiotherapist). In all phases of the study, system-level issues were acknowledged as barriers to more engagement with young people and families. Community pharmacists in the focus groups reported that opportunities for engaging with young people were low if parents collected prescriptions alone, which was agreed by other stakeholders. Moreover, institutional/company prescription collection policies – an activity largely disallowed for a young person under 16 without an accompanying parent - were identified by hospital and community pharmacists as barriers to open discussion and engagement. Few community pharmacists reported using Medicines Use Review (England/Wales) or Chronic Medication Service (Scotland) as a medicines optimisation activity with young people; many were unsure about consent procedures. Despite these limitations, rheumatology stakeholders ranked highly the potential of pharmacists empowering young people with general health care skills, such as repeat prescription ordering. The pharmacy profession lacks vision for its role in the care of young people with long-term conditions. Pharmacists and rheumatology stakeholders identified system-level barriers to more engagement with young people who take medicines regularly. We acknowledge that the modest number of participants may have had a specific interest and thus bias for the topic, but this underscores their frank admission of the challenges. Professional guidance and policy, practice frameworks and institutional/company policies must promote flexibility for pharmacy staff to recognise and empower young people who are able to give consent and take responsibility for medicines activities. This will increase mutual confidence and trust, and foster pharmacy’s role in teaching general health care skills. In this way, pharmacists will be able to build long-term relationships with young people and families.