Adherence to treatment in children and adolescents with cystic fibrosis:a cross-sectional, multi-method study investigating the influence of beliefs about treatment and parental depressive symptoms

Background: Adherence to treatment is often reported to be low in children with cystic fibrosis. Adherence in cystic fibrosis is an important research area and more research is needed to better understand family barriers to adherence in order for clinicians to provide appropriate intervention. The aim of this study was to evaluate adherence to enzyme supplements, vitamins and chest physiotherapy in children with cystic fibrosis and to determine if any modifiable risk factors are associated with adherence. Methods: A sample of 100 children (≤18 years) with cystic fibrosis (44 male; median [range] 10.1 [0.2-18.6] years) and their parents were recruited to the study from the Northern Ireland Paediatric Cystic Fibrosis Centre. Adherence to enzyme supplements, vitamins and chest physiotherapy was assessed using a multi-method approach including; Medication Adherence Report Scale, pharmacy prescription refill data and general practitioner prescription issue data. Beliefs about treatments were assessed using refined versions of the Beliefs about Medicines Questionnaire-specific. Parental depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Results: Using the multi-method approach 72% of children were classified as low-adherers to enzyme supplements, 59% low-adherers to vitamins and 49% low-adherers to chest physiotherapy. Variations in adherence were observed between measurement methods, treatments and respondents. Parental necessity beliefs and child age were significant independent predictors of child adherence to enzyme supplements and chest physiotherapy, but parental depressive symptoms were not found to be predictive of adherence. Conclusions: Child age and parental beliefs about treatments should be taken into account by clinicians when addressing adherence at routine clinic appointments. Low adherence is more likely to occur in older children, whereas, better adherence to cystic fibrosis therapies is more likely in children whose parents strongly believe the treatments are necessary. The necessity of treatments should be reinforced regularly to both parents and children.

Validation of protein carbonyl measurement:a multi-centre study

Protein carbonyls are widely analysed as a measure of protein oxidation. Several different methods exist for their determination. A previous study had described orders of magnitude variance that existed when protein carbonyls were analysed in a single laboratory by ELISA using different commercial kits. We have further explored the potential causes of variance in carbonyl analysis in a ring study. A soluble protein fraction was prepared from rat liver and exposed to 0, 5 and 15 min of UV irradiation. Lyophilised preparations were distributed to six different laboratories that routinely undertook protein carbonyl analysis across Europe. ELISA and Western blotting techniques detected an increase in protein carbonyl formation between 0 and 5 min of UV irradiation irrespective of method used. After irradiation for 15 min, less oxidation was detected by half of the laboratories than after 5 min irradiation. Three of the four ELISA carbonyl results fell within 95% confidence intervals. Likely errors in calculating absolute carbonyl values may be attributed to differences in standardisation. Out of up to 88 proteins identified as containing carbonyl groups after tryptic cleavage of irradiated and control liver proteins, only seven were common in all three liver preparations. Lysine and arginine residues modified by carbonyls are likely to be resistant to tryptic proteolysis. Use of a cocktail of proteases may increase the recovery of oxidised peptides. In conclusion, standardisation is critical for carbonyl analysis and heavily oxidised proteins may not be effectively analysed by any existing technique.

The impact of learning outcomes in business education: assessing value, relevance and graduate ability in a multi-country study of employers and business graduates

This paper discusses critical findings from a two-year EU-funded research project involving four European countries: Austria, England, Slovenia and Romania. The project had two primary aims. The first of these was to develop a systematic procedure for assessing the balance between learning outcomes acquired in education and the specific needs of the labour market. The second aim was to develop and test a set of meta-level quality indicators aimed at evaluating the linkages between education and employment. The project was distinctive in that it combined different partners from Higher Education, Vocational Training, Industry and Quality Assurance. One of the key emergent themes identified in exploratory interviews was that employers and recent business graduates in all four countries want a well-rounded education which delivers a broad foundation of key business knowledge across the various disciplines. Both groups also identified the need for personal development in critical skills and competencies. Following the exploratory study, a questionnaire was designed to address five functional business areas, as well as a cluster of 8 business competencies. Within the survey, questions relating to the meta-level quality indicators assessed the impact of these learning outcomes on the workplace, in terms of the following: 1) value, 2) relevance and 3) graduate ability. This paper provides an overview of the study findings from a sample of 900 business graduates and employers. Two theoretical models are proposed as tools for predicting satisfaction with work performance and satisfaction with business education. The implications of the study findings for education, employment and European public policy are discussed.

Getting the most out of multidisciplinary teams: a multi-sample study of team innovation in health care

Driven by the assumption that multidisciplinarity contributes positively to team outcomes teams are often deliberately staffed such that they comprise multiple disciplines. However, the diversity literature suggests that multidisciplinarity may not always benefit a team. This study departs from the notion of a linear, positive effect of multidisciplinarity and tests its contingency on the quality of team processes. It was assumed that multidisciplinarity only contributes to team outcomes if the quality of team processes is high. This hypothesis was tested in two independent samples of health care workers (N = 66 and N = 95 teams), using team innovation as the outcome variable. Results support the hypothesis for the quality of innovation, rather than the number of innovations introduced by the teams.

Offshoring:a multi-country study of FDI in high-technology sectors

This paper examines what is still a relatively new phenomenon in the literature, the outsourcing / offshoring of high technology manufacturing and services. This has become a concern for both policy makers and academics for two reasons. Firstly, policy makers have become concerned that the offshoring of high technology sectors in the West will follow the more labour intensive sectors, and move to lower cost locations. Secondly, international business theory has tended to view low costs, and high levels of indigenous technological development as being the two main drivers of location advantage in the attraction of FDI. We show that this may not be the case for offshored high technology manufacturing or services.

Satisfaction with knowledge and competencies:a multi-country study of employers and business graduates

This study critically discusses findings from a research project involving four European countries. The project had two main aims. The first was to develop a systematic procedure for assessing the balance between knowledge and competencies acquired in higher, further and vocational education and the specific needs of the labor market. The second aim was to develop and test a set of meta-level quality indicators aimed at evaluating the linkages between education and employment. The project was designed to address the lack of employer input concerning the requirements of business graduates for successful workplace performance and the need for more specific industry-driven feedback to guide administrative heads at universities and personnel at quality assurance agencies in curriculum development and revision. Approach: The project was distinctive in that it combined different partners from higher education, vocational training, industry and quality assurance. Project partners designed and implemented an innovative approach, based on literature review, qualitative interviews and surveys in the four countries, in order to identify and confirm key knowledge and competency requirements. This study presents this step-by-step approach, as well as survey findings from a sample of 900 business graduates and employers. In addition, it introduces two Partial Least Squares (PLS) path models for predicting satisfaction with work performance and satisfaction with business education. Results: Survey findings revealed that employers were not very confident regarding business graduates’ abilities in key knowledge areas and in key generic competencies. In subsequent analysis, these graduate abilities were tested and identified as important predictors of employers’ satisfaction with graduates’ work performance. Conclusion: The industry-driven approach introduced in this study can serve as a guide to assist different types of educational institutions to better align study programs with changing labor market requirements. Recommendations for curriculum improvement are discussed.

Learning with a strategic management simulation game:a case study

The use of simulation games as a pedagogic method is well established though its effective use is context-driven. This study adds to the increasing growing body of empirical evidence of the effectiveness of simulation games but more importantly emphasises why by explaining the instructional design implemented reflecting best practices. This multi-method study finds evidence that student learning was enhanced through the use of simulation games, reflected in the two key themes; simulation games as a catalyst for learning and simulation games as a vehicle for learning. In so doing the research provides one of the few empirically based studies that support simulation games in enhancing learning and, more importantly, contextualizes the enhancement in terms of the instructional design of the curriculum. This research should prove valuable for those with an academic interest in the use of simulation games and management educators who use, or are considering its use. Further, the findings contribute to the academic debate concerning the effective implementation of simulation game-based training in business and management education.

Justice source and justice content:evaluating the fairness of organizational career management practices

This article presents part of the findings of a multi-method study into employee perceptions of fairness in relation to the organisational career management (OCM) practices of a large financial retailer. It focuses on exploring how employees construct fairness judgements of their career experiences and the role played by the organisational context and, in particular, OCM practices in forming these judgements. It concludes that individuals can, and do, separate the source and content of (in)justice when it comes to evaluating these experiences. The relative roles of the employer, line manager and career development opportunities in influencing employee fairness evaluations are discussed. Conceptual links with organisational justice theory are proposed, and it is argued that the academic and practitioner populations are provided with empirical evidence for a new theoretical framework for evaluating employee perceptions of, and reactions to, OCM practices.

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.

Police interviews with women reporting rape: a critical discourse analysis

This study investigates the discursive patterns of interactions between police interviewers and women reporting rape in significant witness interviews. Data in the form of video recorded interviews were obtained from a UK police force for the purposes of this study. The data are analysed using a multi-method approach, incorporating tools from micro-sociology, Conversation Analysis and Discursive Psychology, to reveal patterns of interactional control, negotiation, and interpretation. The study adopts a critical approach, which is to say that as well as describing discursive patterns, it explains them in light of the discourse processes involved in the production and consumption of police interview talk, and comments on the relationship between these discourse processes and the social context in which they occur. A central focus of the study is how interviewers draw on particular interactional resources to shape interviewees? accounts in particular ways, and this is discussed in relation to the institutional role of the significant witness interview. The discussion is also extended to the ways in which mainstream rape ideology is both reflected in, and maintained by, the discursive choices of participants. The findings of this study indicate that there are a number of issues to be addressed in terms of the training currently offered to officers at Level 2 of the Professionalising Investigation Programme (PIP) (NPIA, 2009) who intend to conduct significant witness interviews. Furthermore, a need is identified to bring the linguistic and discursive processes of negotiation and transformation identified by the study to the attention of the justice system as a whole. This is a particularly pressing need in light of judicial reluctance to replace written witness statements, the current „end product? of significant witness interviews, with the video recorded interview in place of direct examination in cases of rape.

An analysis of police interview discourse and its role(s) in the judicial process

This study analyses the current role of police-suspect interview discourse in the England & Wales criminal justice system, with a focus on its use as evidence. A central premise is that the interview should be viewed not as an isolated and self-contained discursive event, but as one link in a chain of events which together constitute the criminal justice process. It examines: (1) the format changes undergone by interview data after the interview has taken place, and (2) how the other links in the chain – both before and after the interview – affect the interview-room interaction itself. It thus examines the police interview as a multi-format, multi-purpose and multi-audience mode of discourse. An interdisciplinary and multi-method discourse-analytic approach is taken, combining elements of conversation analysis, pragmatics, sociolinguistics and critical discourse analysis. Data from a new corpus of recent police-suspect interviews, collected for this study, are used to illustrate previously unaddressed problems with the current process, mainly in the form of two detailed case studies. Additional data are taken from the case of Dr. Harold Shipman. The analysis reveals several causes for concern, both in aspects of the interaction in the interview room, and in the subsequent treatment of interview material as evidence, especially in the light of s.34 of the Criminal Justice and Public Order Act 1994. The implications of the findings for criminal justice are considered, along with some practical recommendations for improvements. Overall, this study demonstrates the need for increased awareness within the criminal justice system of the many linguistic factors affecting interview evidence.

Balancing push and pull information management within the supply chain

The aim of this paper is to explore the management of information in an aerospace manufacturer's supply chain by analysing supply chain disruption risks. The social network perspective will be used to examine the flows of information in the supply chain. The examination of information flows will also be explored in terms of push and pull information management. The supply chain risk management (SCRM) strategy is to assess the management of information that allows companies to gather information which will allow them to mitigate that risk before any disruption to the supply chain occurs. There is a shortage of models in analysing the supply chain risk associated with information flows, possibly due to the omission of appropriate modelling techniques in this area (Tang and Nurmaya, 2011). This paper uses an exploratory case study consisting of a multi method qualitative approach using fifteen interviews and four focus groups.

Managing careers and managing fairness : an organisational justice theory perspective on employee evaluations of, and reactions to, organisational career management practices

This thesis presents the results of a multi-method investigation of employee perceptions of fairness in relation to their career management experiences. Organisational justice theory (OJT) was developed as a theoretical framework and data were gathered via 325 quantitative questionnaires, 20 semi-structured interviews and the analysis of a variety of company documents and materials. The results of the questionnaire survey provided strong support for the salience of employee perceptions of justice in regard to their evaluations of organisational career management (OCM) practices, with statistical support emerging for both an agent-systems and interaction model of organisational justice. The qualitative semi-structured interviews provided more detailed analysis of how fairness was experienced in practice, and confirmed the importance of the OJT constructs of fairness within this career management context. Fairness themes to emerge from this analysis included, equity, needs, voice, bias suppression, consistency, ethicality, respect and feedback drawing on many of the central tenants of distributive, procedural, interpersonal and information justice. For the career management literature there is empirical confirmation of a new theoretical framework for understanding employee evaluations of, and reactions to, OCM practices. For the justice literatures a new contextual domain is explored and confirmed, thus extending further the influence and applicability of the theory. For practitioners a new framework for developing, delivering and evaluating their own OCM policies and systems is presented.