Reducing the time before consulting with symptoms of lung cancer:a randomised controlled trial in primary care

Background: Most individuals with lung cancer have symptoms for several months before presenting to their GP. Earlier consulting may improve survival. Aim: To evaluate whether a theory-based primary care intervention increased timely consulting of individuals with symptoms of lung cancer. Design and setting: Open randomised controlled trial comparing intervention with usual care in two general practices in north-east Scotland. Method: Smokers and ex-smokers aged ≥55 years were randomised to receive a behavioural intervention or usual care. The intervention comprised a single nurse consultation at participants' general practice and a self-help manual. The main outcomes were consultations within target times for individuals with new chest symptoms (≤3 days haemoptysis, ≤3 weeks other symptoms) in the year after the intervention commenced, and intentions about consulting with chest symptoms at 1 and 6 months. Results: Two hundred and twelve participants were randomised and 206 completed the trial. The consultation rate for new chest symptoms in the intervention group was 1.19 (95% confidence interval [CI] = 0.92 to 1.53; P = 0.18) times higher than in the usual-care group and the proportion of consultations within the target time was 1.11 (95% CI = 0.41 to 3.03; P = 0.83) times higher. One month after the intervention commenced, the intervention group reported intending to consult with chest symptoms 31 days (95% CI = 7 to 54; P = 0.012) earlier than the usual care group, and at 6 months this was 25 days (95% CI = 1.5 to 48; P = 0.037) earlier. Conclusion: Behavioural intervention in primary care shortened the time individuals at high risk of lung disease intended to take before consulting with new chest symptoms (the secondary outcome of the study), but increases in consultation rates and the proportions of consultations within target times were not statistically significant. © British Journal of General Practice.

Designing in a group:how does knowing each other influence design projects

This paper presents a study of engineering design groups that seeks to explain how knowing other participants can influence processes and outcomes in design projects. Research in this paper contributes a framework to approach understanding how interpersonal relationships influence group processes and outcomes. This acknowledges that engineering design is achieved through individuals working in groups. First a temporal perspective is introduced to understand how individuals (through interpersonal relationships), group processes and outcomes influence each other; secondly identity is presented as a theme to focus on how knowing other participants identity influences group processes and outcomes. Within this framework it is recognised that engineering design has different levels of complexity of which two aspects are considered: design type and design setting. These aspects place different demands on a project group and its members and this structure provides an opportunity for cross case analysis to generalise findings.

From art for arts sake to art as means of knowing:a rationale for advancing arts-based methods in research, practice and pedagogy

This paper advances a philosophically informed rationale for the broader, reflexive and practical application of arts-based methods to benefit research, practice and pedagogy. It addresses the complexity and diversity of learning and knowing, foregrounding a cohabitative position and recognition of a plurality of research approaches, tailored and responsive to context. Appreciation of art and aesthetic experience is situated in the everyday, underpinned by multi-layered exemplars of pragmatic visual-arts narrative inquiry undertaken in the third, creative and communications sectors. Discussion considers semi-guided use of arts-based methods as a conduit for topic engagement, reflection and intersubjective agreement; alongside observation and interpretation of organically employed approaches used by participants within daily norms. Techniques span handcrafted (drawing), digital (photography), hybrid (cartooning), performance dimensions (improvised installations) and music (metaphor and structure). The process of creation, the artefact/outcome produced and experiences of consummation are all significant, with specific reflexivity impacts. Exploring methodology and epistemology, both the "doing" and its interpretation are explicated to inform method selection, replication, utility, evaluation and development of cross-media skills literacy. Approaches are found engaging, accessible and empowering, with nuanced capabilities to alter relationships with phenomena, experiences and people. By building a discursive space that reduces barriers; emancipation, interaction, polyphony, letting-go and the progressive unfolding of thoughts are supported, benefiting ways of knowing, narrative (re)construction, sensory perception and capacities to act. This can also present underexplored researcher risks in respect to emotion work, self-disclosure, identity and agenda. The paper therefore elucidates complex, intricate relationships between form and content, the represented and the representation or performance, researcher and participant, and the self and other. This benefits understanding of phenomena including personal experience, sensitive issues, empowerment, identity, transition and liminality. Observations are relevant to qualitative and mixed methods researchers and a multidisciplinary audience, with explicit identification of challenges, opportunities and implications.

Acceptability of Lean Six Sigma in a developing economy:results from exploratory research in Nigerian consulting companies

The application of Lean Six Sigma (LSS) varies in different regions of the world in terms of both level of understanding and acceptability. Employing a qualitative methodological approach, this paper aims to explore factors hindering the acceptability of the LSS initiative in organizations and list factors required for successful application and implementation in a developing economy from the perspective of LSS consultants. Using Nigeria as a case study, primary data were collected though a number of semi-structured interviews with representatives of leading continuous improvement consultancy firms in Nigeria. Finding draws out links between major factors such as drivers and motivation, LSS performance, marketability and challenges to the acceptability and applicability of LSS in Nigeria. Further findings highlight major factors such as lack of management buy-in, level of awareness, certification driven market, Nigerian environment and culture, etc as problems that hinder successful implementation of LSS in Nigeria. This paper contributes to the theoretical foundation of critical success factors required for the implementation of Lean Six Sigma, with results from the experience of a developing economy.

The development of color categories in two languages: a longitudinal study

This study unites investigations into the linguistic relativity of color categories with research on children's category acquisition. Naming, comprehension, and memory for colors were tracked in 2 populations over a 3-year period. Children from a seminomadic equatorial African culture, whose language contains 5 color terms, were compared with a group of English children. Despite differences in visual environment, language, and education, they showed similar patterns of term acquisition. Both groups acquired color vocabulary slowly and with great individual variation. Those knowing no color terms made recognition errors based on perceptual distance, and the influence of naming on memory increased with age. An initial perceptually driven color continuum appears to be progressively organized into sets appropriate to each culture and language. PsycINFO Database Record (c) 2009 APA, all rights reserved

Development of a computerised library system in the construction industry

This thesis examines the ways that libraries have employed computers to assist with housekeeping operations. It considers the relevance of such applications to company libraries in the construction industry, and describes more specifically the development of an integrated cataloguing and loan system. A review of the main features in the development of computerised ordering, cataloguing and circulation control systems shows that fully integrated packages are beginning to be completed, and that some libraries are introducing second generation programs. Cataloguing is the most common activity to be computerised, both at national and company level. Results from a sample of libraries in the construction industry suggest that the only computerised housekeeping system is at Taylor Woodrow. Most of the firms have access to an in-house computer, and some of the libraries, particularly those in firms of consulting engineers, might benefit from computerisation, but there are differing attitudes amongst the librarians towards the computer. A detailed study of the library at Taylor Woodrow resulted in a feasibility report covering all the areas of its activities. One of the main suggestions was the possible use of a computerised loans and cataloguing system. An integrated system to cover these two areas was programmed in Fortran and implemented. This new system provides certain benefits and saves staff time, but at the cost of time on the computer. Some improvements could be made by reprogramming, but it provides a general system for small technical libraries. A general equation comparing costs for manual and computerised operations is progressively simplified to a form where the annual saving from the computerised system is expressed in terms of staff and computer costs and the size of the library. This equation gives any library an indication of the savings or extra cost which would result from using the computerised system.

Management consulting firms as institutional agents:strategies for creating and sustaining institutional capital

We classify the strategies by which management consultancies can create and sustain the institutional capital that makes it possible for them to extract competitive resources from their institutional context. Using examples from the German consulting industry, we show how localized competitive actions can enhance both individual firms’ positions, and also strengthen the collective institutional capital of the consulting industry thus legitimizing consulting services in broader sectors of society and facilitating access to requisite resources. Our findings counter the image of institutional entrepreneurship as individualistic, “heroic” action. We demonstrate how distributed, embedded actors can collectively shape the institutional context from within to enhance their institutional capital.

Institutional entrepreneurship:a literature review and analysis of the maturing consulting field

With few exceptions (e.g. Fincham & Clark, 2002; Lounsbury, 2002, 2007; Montgomery & Oliver, 2007), we know little about how emerging professions, such as management consulting, professionalize and establish their services as a taken-for-granted element of social life. This is surprising given that professionals have long been recognized as “institutional agents” (DiMaggio & Powell, 1983; Scott, 2008) (see Chapter 17) and professionalization projects have been closely associated with institutionalization (DiMaggio, 1991). Therefore, in this chapter we take a closer look at a specific type of entrepreneurship in PSFs; drawing on the concept of “institutional entrepreneurship” (DiMaggio, 1988; Garud, Hardy, & Maguire, 2007; Hardy & Maguire, 2008) we describe some generic strategies by which proto-professions can enhance their “institutional capital” (Oliver, 1997), that is, their capacity to extract institutionally contingent resources such as legitimacy, reputation, or client relationships from their environment.

Evaluation of options for energy recovery from municipal solid waste in India using the hierarchical analytical network process

In this paper a Hierarchical Analytical Network Process (HANP) model is demonstrated for evaluating alternative technologies for generating electricity from MSW in India. The technological alternatives and evaluation criteria for the HANP study are characterised by reviewing the literature and consulting experts in the field of waste management. Technologies reviewed in the context of India include landfill, anaerobic digestion, incineration, pelletisation and gasification. To investigate the sensitivity of the result, we examine variations in expert opinions and carry out an Analytical Hierarchy Process (AHP) analysis for comparison. We find that anaerobic digestion is the preferred technology for generating electricity from MSW in India. Gasification is indicated as the preferred technology in an AHP model due to the exclusion of criteria dependencies and in an HANP analysis when placing a high priority on net output and retention time. We conclude that HANP successfully provides a structured framework for recommending which technologies to pursue in India, and the adoption of such tools is critical at a time when key investments in infrastructure are being made. Therefore the presented methodology is thought to have a wider potential for investors, policy makers, researchers and plant developers in India and elsewhere. © 2013 Elsevier Ltd. All rights reserved.

Managing risk in enterprise resource planning projects

Enterprise Resource Planning (ERP) projects are strategic and capital intensive, so failure may be costly and even cause bankruptcy of companies. Previous studies have proposed ways for improving implementation, but they are mostly generic and follow standardized project management practices as specified in various standards (e.g. the “project management body of knowledge” of the Project Management Institute). Because ERP is interdisciplinary (involving change management, project management and information technology management), it warrants a customized approach to managing risks throughout the life cycle of implementation and operation. Through a practical case study, this paper demonstrates a qualitative, user friendly approach to ERP project risk management. Firstly, through a literature review it identifies various risk factors in ERP implementation. Secondly, the risk management practices of a UK-based multinational consulting company in one of its clients are evaluated. The risk factors from the case study organization and literature are then compared and discussed.

The role of suicide risk in the decision for psychiatric hospitalization after a suicide attempt

BACKGROUND: Suicide prevention can be improved by knowing which variables physicians take into account when considering hospitalization or discharge of patients who have attempted suicide. AIMS: To test whether suicide risk is an adequate explanatory variable for predicting admission to a psychiatric unit after a suicide attempt. METHODS: Analyses of 840 clinical records of patients who had attempted suicide (66.3% women) at four public general hospitals in Madrid (Spain). RESULTS: 180 (21.4%) patients were admitted to psychiatric units. Logistic regression analyses showed that explanatory variables predicting admission were: male gender; previous psychiatric hospitalization; psychiatric disorder; not having a substance-related disorder; use of a lethal method; delay until discovery of more than one hour; previous attempts; suicidal ideation; high suicidal planning; and lack of verbalization of adequate criticism of the attempt. CONCLUSIONS: Suicide risk appears to be an adequate explanatory variable for predicting the decision to admit a patient to a psychiatric ward after a suicide attempt, although the introduction of other variables improves the model. These results provide additional information regarding factors involved in everyday medical practice in emergency settings.

Duppying yoots in a dog eat dog world, kmt:determining the senses of slang terms for the Courts

I describe and discuss a series of court cases which focus upon on decoding the meaning of slang terms. Examples include sexual slang used in a description by a child and an Internet Relay Chat containing a conspiracy to murder. I consider the task presented by these cases for the forensic linguist and the roles the linguist may assume in determining the meaning of slang terms for the Courts. These roles are identified as linguist as naïve interpreter, lexicographer, case researcher and cultural mediator. Each of these roles is suggestive of different strategies that might be used from consulting formal slang dictionaries and less formal Internet sources, to collecting case specific corpora and examining all the extraneous material in a particular case. Each strategy is evaluated both in terms of the strength of evidence provided and its applicability to the forensic context.