Transfer of patients from health care centres to special care services:analysis of travel distances in Nordic countries

Objectives: This paper highlights the importance of analysing patient transportation in Nordic circumpolar areas. The research questions we asked are as follows: How many Finnish patients have been transferred to special care intra-country and inter-country in 2009? Does it make any difference to health care policymakers if patients are transferred inter-country? Study design: We analysed the differences in distances from health care centres to special care services within Finland, Sweden and Norway and considered the health care policy implica tions. Methods: An analysis of the time required to drive between service providers using the "Google distance meter" (http://maps.google.com/); conducting interviews with key Finnish stakeholders; and undertaking a quantitative analyses of referral data from the Lapland Hospital District. Results: Finnish patients are generally not transferred for health care services across national borders even if the distances are shorter. Conclusion: Finnish patients have limited access to health care services in circumpolar are as across the Nordic countries for 2 reasons. First, health professionals in Norway and Sweden do not speak Finnish, which presents a language problem. Second, The Social Insurance Institution of Finland does not cover the expenditures of travel or the costs of medicine. In addition, it seems that in circumpolar areas the density of Finnish service providers is greater than Swedish ones, causing many Swedish citizens to transfer to Finnish health care providers every year. However, future research is needed to determine the precise reasons for this.

Decision support and the criminal justice system:an assessment of the potential for utilising technological decision support in undertaking the prosecutorial decision

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War words:language, history and the disciplining of English

Debates about the nature of literacy and literacy practices have been conducted extensively in the last fifteen years or so. The fact that both previous and current British governments have effectively suppressed any real debate makes the publication of this book both timely and important. Here, Urszula Clark stresses the underlying ideological character of such debates and shows that they have deep historical roots. She also makes the point that issues regarding the relationship between language and identity, especially national identity, become sharply focused at times of crisis in that identity. By undertaking a comparison with other major English-speaking countries, most notably Australia, New Zealand and the USA, Clark shows how these times of crisis reverberate around the globe.

Taking strategy seriously:responsibility and reform for an important social practice

Strategy is a pervasive and consequential practice in most Western societies. We respond to strategy's importance by drawing an initial map of strategy as an organizational field that embraces not just firms, but consultancies, business schools, the state and financial institutions. Using the example of Enron, we show how the strategy field is prone to manipulations in which other actors in the field can easily become entrapped, with grave consequences. Given these consequences, we argue that it is time to take strategy seriously in three senses: undertaking systematic research on the field itself; developing appropriate responses to recent failures in the field; and building more heedful interrelationships between actors within the field, particularly between business schools and practitioners.

Comparing different approach and avoidance models of learning and personality in the prediction of work, university, and leadership outcomes

Jackson (2005) developed a hybrid model of personality and learning, known as the learning styles profiler (LSP) which was designed to span biological, socio-cognitive, and experiential research foci of personality and learning research. The hybrid model argues that functional and dysfunctional learning outcomes can be best understood in terms of how cognitions and experiences control, discipline, and re-express the biologically based scale of sensation-seeking. In two studies with part-time workers undertaking tertiary education (N=137 and 58), established models of approach and avoidance from each of the three different research foci were compared with Jackson's hybrid model in their predictiveness of leadership, work, and university outcomes using self-report and supervisor ratings. Results showed that the hybrid model was generally optimal and, as hypothesized, that goal orientation was a mediator of sensation-seeking on outcomes (work performance, university performance, leader behaviours, and counterproductive work behaviour). Our studies suggest that the hybrid model has considerable promise as a predictor of work and educational outcomes as well as dysfunctional outcomes.

Innovation in teams : a qualitative and quantitative study of team behaviours

This thesis explores the processes of team innovation. It utilises two studies, an organisationally based pilot and an experimental study, to examine and identify aspects of teams' behaviours that are important for successful innovative outcome. The pilot study, based in two automotive manufacturers, involved the collection of team members' experiences through semi-structured interviews, and identified a number of factors that affected teams' innovative performance. These included: the application of ideative & dissemination processes; the importance of good team relationships, especially those of a more informal nature, in facilitating information and ideative processes; the role of external linkages in enhancing quality and radicality of innovations; and the potential attenuation of innovative ideas by time deadlines. This study revealed a number key team behaviours that may be important in successful innovation outcomes. These included; goal setting, idea generation and development, external contact, task and personal information exchange, leadership, positive feedback and resource deployment. These behaviours formed the basis of a coding system used in the second part of the research. Building on the results from the field based research, an experimental study was undertaken to examine the behavioural differences between three groups of sixteen teams undertaking innovative an task to produce an anti-drugs poster. They were randomly assigned to one of three innovation category conditions suggested by King and Anderson (1990), emergent, imported and imposed. These conditions determined the teams level of access to additional information on previously successful campaigns and the degree of freedom they had with regarding to the design of the poster. In addition, a further experimental condition was imposed on half of the teams per category which involved a formal time deadline for task completion. The teams were video taped for the duration of their innovation and their behaviours analysed and coded in five main aspects including; ideation, external focus, goal setting, interpersonal, directive and resource related activities. A panel of experts, utilising five scales developed from West and Anderson's (1996) innovation outcome measures, assessed the teams' outputs. ANOVAs and repeated measure ANOVAs were deployed to identify whether there were significant differences between the different conditions. The results indicated that there were some behavioural differences between the categories and that over the duration of the task behavioural changes were identified. The results, however, revealed a complex picture and suggested limited support for three distinctive innovation categories. There were many differences in behaviours, but rarely between more than two of the categories. A main finding was the impact that different levels of constraint had in changing teams' focus of attention. For example, emergent teams were found to use both their own team and external resources, whilst those who could import information about other successful campaigns were likely to concentrate outside the team and pay limited attention to the internal resources available within the team. In contrast, those operating under task constraints with aspects of the task imposed onto them were more likely to attend to internal team resources and pay limited attention to the external world. As indicated by the earlier field study, time deadlines did significantly change teams' behaviour, reducing ideative and information exchange behaviours. The model shows an important behavioural progression related to innovate teams. This progression involved the teams' openness initially to external sources, and then to the intra-team environment. Premature closure on the final idea before their mid-point was found to have a detrimental impact on team's innovation. Ideative behaviour per se was not significant for innovation outcome, instead the development of intra-team support and trust emerged as crucial. Analysis of variance revealed some limited differentiation between the behaviours of teams operating under the aforementioned three innovation categories. There were also distinct detrimental differences in the behaviour of those operating under a time deadline. Overall, the study identified the complex interrelationships of team behaviours and outcomes, and between teams and their context.

A study of performance and regulation in telecommunications in the European Union

This thesis looks at two issues. Firstly, statistical work was undertaken examining profit margins, labour productivity and total factor productivity in telecommunications in ten member states of the EU over a 21-year period (not all member states of the EU could be included due to data inadequacy). Also, three non-members, namely Switzerland, Japan and US, were included for comparison. This research was to provide an understanding of how telecoms in the European Union (EU) have developed. There are two propositions in this part of the thesis: (i) privatisation and market liberalisation improve performance; (ii) countries that liberalised their telecoms sectors first show a better productivity growth than countries that liberalised later. In sum, a mixed picture is revealed. Some countries performed better than others over time, but there is no apparent relationship between productivity performance and the two propositions. Some of the results from this part of the thesis were published in Dabler et al. (2002). Secondly, the remainder of the tests the proposition that the telecoms directives of the European Commission created harmonised regulatory systems in the member states of the EU. By undertaking explanatory research, this thesis not only seeks to establish whether harmonisation has been achieved, but also tries to find an explanation as to why this is so. To accomplish this, as a first stage to questionnaire survey was administered to the fifteen telecoms regulators in the EU. The purpose of the survey was to provide knowledge of methods, rationales and approaches adopted by the regulatory offices across the EU. This allowed for the decision as to whether harmonisation in telecoms regulation has been achieved. Stemming from the results of the questionnaire analysis, follow-up case studies with four telecoms regulators were undertaken, in a second stage of this research. The objective of these case studies was to take into account the country-specific circumstances of telecoms regulation in the EU. To undertake the case studies, several sources of evidence were combined. More specifically, the annual Implementation Reports of the European Commission were reviewed, alongside the findings from the questionnaire. Then, interviews with senior members of staff in the four regulatory authorities were conducted. Finally, the evidence from the questionnaire survey and from the case studies was corroborated to provide an explanation as to why telecoms regulation in the EU has reached or has not reached a state of harmonisation. In addition to testing whether harmonisation has been achieved and why, this research has found evidence of different approaches to control over telecoms regulators and to market intervention administered by telecoms regulators within the EU. Regarding regulatory control, it was found that some member states have adopted mainly a proceduralist model, some have implemented more of a substantive model, and others have adopted a mix between both. Some findings from the second stage of the research were published in Dabler and Parker (2004). Similarly, regarding market intervention by regulatory authorities, different member states treat market intervention differently, namely according to market-driven or non-market-driven models, or a mix between both approaches.

An evaluation of pharmacy education and pre-registration training

This thesis covers two major aspects of pharmacy education; undergraduate education and pre-registration training. A cohort of pharmacy graduates were surveyed over a period of four years, on issues related to undergraduate education, pre-registration training and continuing education. These graduates were the first-ever to sit the pre-registration examination. In addition, the opinions of pre-registration tutors were obtained on pre-registration training, during the year that competence-based assessment was introduced. It was concluded that although the undergraduate course provided a broad base of knowledge suitable for graduates in all branches of pharmacy, several issues were identified which would require attention in future developments of the course. These were: 1. the strong support for the expansion of clinical, social and practice-based teaching. 2. the strong support to retain the scientific content to the same extent as in the three-year course. 3. a greater use of problem-based learning methods. The graduates supported the provision of a pre-registration continuing education course to help prepare for the examination and in areas inadequately covered in the undergraduate course. There was also support for the introduction of some form of split branch training. There was no strong evidence to suggest that the training had been an application of undergraduate education. In general, competence-based training was well regarded by tutors as an appropriate and effective method of skill assessment. However, community tutors felt it was difficult to carry out effectively due to day-to-day time constraints. The assistant tutors in hospital pharmacy were found to have a very important role in provision of training, and should be adequately trained and supported. The study recommends the introduction of uniform training and a quality assurance mechanism for all tutors and assistants undertaking this role.

Accessibility indices and linked trips: a case study of the elderly

The confusion over the concept of accessibility in transport planning and the deficiencies of existing accessibility indices are examined by developing a conceptual framework of accessibility with a fundamental distinction being drawn between the, often conflicting, theoretical and practical dimensions. The theoretical validity of alternative indices is assessed with reference to the problems and assumptions implicit in defining, measuring, valuing and aggregating the variables and components comprising accessibility. The major deficiencies of existing indices are identified as the inability of indices to take account of the potential to link trips between more than one activity location and the level of assumptions implicit in valuing and aggregating accessibility information. In this context, it is argued that accessibility information is more appropriately expressed on a comparative basis in the form of a profile rather than as a composite single-unit index and that the present confines of accessibility measurement must be extended in line with current developments in disaggregate travel and activity modelling. The sensitivity of accessibility levels to the use of alternative value judgements, alternative forms and levels of aggregation and the inclusion of information on the potential to link trips is examined by undertaking a case study. Accessibility profiles are developed for 23 zones in the London Borough of Hammersmith and Fulham showing the accessibility of the elderly to post offices and grocers. In a practical context, the profiles assist in identifying areas and individuals with relatively poor accessibility. The incidence and nature of linked trip-making and its significance and implications for accessibility measurement are explored further by analysing the results of a survey of the elderly's travel patterns. It is concluded that future accessibility analysis should be undertaken at a disaggregate level, taking account of the potential opportunity available from nonhome as well as home origins.

Autonomic, biometric and oculomotor correlates of myopia in young adults

The principal work reported in this thesis is the examination of autonomic profile of ciliary muscle innervation as a risk factor in myopia development. Deficiency in sympathetic inhibitory control of accommodation has been proposed as a contributory factor in the development of late onset myopia (LOM). Complementary measurements of ocular biometry, oculomotor function and dynamic accommodation response were carried out on the same subject cohort, thus allowing cross-correlation of these factors with. autonomic profile. Subjects were undergraduate and postgraduate students of Aston University. A 2.5 year longitudinal study of refractive error progression in 40 subjects revealed the onset of LOM in 10, initially emmetropic, young adult subjects (age range 18-24 years) undertaking substantial amounts of near work. A controlled, double blind experimental protocol was conducted concurrently to measure post-task open-loop accommodative regression following distance (0 D) or near (3 D above baseline tonic accommodation) closed-loop tasks of short (10 second) or long (3 minute) duration. Closed-loop tasks consisted of observation of a high contrast Maltese cross target; open-loop conditions were imposed by observation of a 0.2 c/deg Difference of Gaussian target. Accommodation responses were recorded continuously at 42 Hz using a modified Shin-Nippon SRW-5000 open-view infra-red optometer. Blockade of the sympathetic branch of accommodative control was achieved by topical instillation of the non-selective b-adrenoceptor antagonist timolol maleate. Betaxolol hydrochloride (non-selective b1-adrenoceptor antagonist) and normal saline were employed as control agents. Retarded open-loop accommodative regression under b2 blockade following the 3 minute near task indicated the presence of sympathetic facility. Sympathetic inhibitory facility in accommodation control was found in similar proportions between LOM and stable emmetropic subjects. A cross-sectional study (N=60) of autonomic profile showed that sympathetic innervation of ciliary muscle is present in similar proportions between emmetropes, early-, and late-onset myopes. Sympathetic facility was identified in 27% of emmetropes, 21% of EOMs and 29% of LOMs.

An investigation into the relationship between pupil and accommodation responses during near vision

A Hamamatsu Video Area Analyser has been coupled with a modified Canon IR automatic optometer. This has allowed simultaneous recording of pupil diameter and accommodation response to be made both statically and continuously, a feature not common in previous studies. Experimental work concerned pupil and accommodation responses during near vision tasks under a variety of conditions. The effects of sustained near vision tasks on accommodation have usually been demonstrated by taking post-task measures under darkroom conditions. The possibility of similar effects on pupil diameter was assessed using static and continuous recordings following a near vision task. Results showed that is luminance levels remained unchanged by using a pre-and post-task bright-empty field then, although accommodation regressed to pre-task levels,pupil diameter remained for several minutes at the contstricted level induced by the task. An investigation into the effect of a sinusoidally-modulated blur-only accommodative stimulus on pupil response demonstrated that response may be reduced or absent despite robust accommodation responses. This suggests that blur-driven acommodation alone may not be sufficient to produce a pupil near response and that the presence of other cues may be necessary. Pupil response was investigated using a looming stimulus which produced an inferred-proximity cue. It was found that a pupil response could be induced which was in synchrony with the stimulus while closed-loop accommodation response was kept constant by the constraints of optical blur. The pupil diameter of young and elderly subjects undertaking a 5 minute reading task was measured to assess the contribution of pupil constriction to near vision function in terms of depth-of-focus. Results showed that in the young subjects pupil diameter was too large to have a significant effect on depth-of-focus although it may be increased in the elderly subjects. Pupil and accommodation reponses to a temporally-modulated stimulus containing all cues present in a normal visual environment was assessed and results showed that as stimulus temporal frequency increased, pupil response showed increasing phase lag relative to closed-loop accommodation. The results of this study suggest that it may be necessary to change the accepted view of the function of pupil response as part of the near vision triad and that further study would be of benefit in particular to designers of vision aids such as, for example, bifocal contact lenses.

Handbook of research on user interface design and evaluation for mobile technology

In recent years, mobile technology has been one of the major growth areas in computing. Designing the user interface for mobile applications, however, is a very complex undertaking which is made even more challenging by the rapid technological developments in mobile hardware. Mobile human-computer interaction, unlike desktop-based interaction, must be cognizant of a variety of complex contextual factors affecting both users and technology. The Handbook of Research on User Interface Design and Evaluation provides students, researchers, educators, and practitioners with a compendium of research on the key issues surrounding the design and evaluation of mobile user interfaces, such as the physical environment and social context in which a mobile device is being used and the impact of multitasking behavior typically exhibited by mobile-device users. Compiling the expertise of over 150 leading experts from 26 countries, this exemplary reference tool will make an indispensable addition to every library collection.

Inequality, fiscal capacity and the political regime: lessons from the post-communist transition

Using panel data for twenty-seven post-communist economies between 1987-2003, we examine the nexus of relationships between inequality, fiscal capacity (defined as the ability to raise taxes efficiently) and the political regime. Investigating the impact of political reform we find that full political freedom is associated with lower levels of income inequality. Under more oligarchic (authoritarian) regimes, the level of inequality is conditioned by the state’s fiscal capacity. Specifically, oligarchic regimes with more developed fiscal systems are able to defend the prevailing vested interests at a lower cost in terms of social injustice. This empirical finding is consistent with the model developed by Acemoglu (2006). We also find that transition countries undertaking early macroeconomic stabilisation now enjoy lower levels of inequality; we confirm that education fosters equality and the suggestion of Commander et al (1999) that larger countries are prone to higher levels of inequality.

Placements and degree performance:do placements lead to better marks, or do better students choose placements?

There has been a strong move recently to make degrees more applicable to employment; including work placements as part of the programme is one way of achieving this. Such placements are advocated to increase employability, but also for improving academic performance. This paper examines the relationship between undertaking a work placement and the class of degree achieved. It challenges earlier findings that undertaking a placement increases degree results. Studying seven cohorts of students, a well tested approach was employed that allows for sample selection – i.e. whether better students do placements rather than whether placements produce better students. The paper concludes that the sample selection is much stronger, i.e. placement students do better because they are better students. The results highlight that it is not merely doing a placement that matters, but a successful placement adds significantly to subsequent performance. The paper concludes with advice to students and policy makers.