The power of the powerless:neighbourhood based self-help networks of the poor in Istanbul

Recent poverty research focuses on the household responses to poverty through structure vs. agency perspectives. The human agency perspective, however, provides us important insights for looking beyond these simplistic tendencies which assume poor people as inherently passive, or envision them as helpless victims. In Turkey, politicians view poverty as a temporary and manageable problem which can be dealt with the provision of more charity or community support. Migrant networks, informal sector work and social assistance are considered to be important mechanisms that would provide resources for the poor. This paper argues that for some of the poor households none of these mechanisms provide sufficient resources. Instead, neighbourhood-based small-group solidarities and self-help networks enable those poor to develop collective capabilities and make ends meet. The paper also reveals that in Turkey, the implementation of social policies for poverty reduction could bring about relationships of patronage and in some cases contribute to existing inequalities.

'They cooperate with us, so they are like me': perceived intergroup relationship moderates projection from self to outgroups

Whereas projection of self-attributes to ingroups is ubiquitous, projection of self-attributes to outgroups (outgroup projection) is an elusive phenomenon. Two experiments examined the moderating effect of perceived intergroup relationship on outgroup projection and explored underlying mechanisms. Perceived cooperation versus competition between ingroup and outgroup was manipulated using fictitious (Experiment 1) or natural groups (Experiment 2). In both experiments, participants judged the outgroup as more similar to the self in the cooperation condition than in the competition condition. This effect was independent of recategorization, perceived intergroup similarity, and ingroup-to-outgroup projection. These studies demonstrate the very existence of outgroup projection and extend previous work on moderators of projection from self to groups.

Developing a complex intervention to reduce time to presentation with symptoms of lung cancer

Background - Lung cancer is the commonest cause of cancer in Scotland and is usually advanced at diagnosis. Median time between symptom onset and consultation is 14 weeks, so an intervention to prompt earlier presentation could support earlier diagnosis and enable curative treatment in more cases. Aim - To develop and optimise an intervention to reduce the time between onset and first consultation with symptoms that might indicate lung cancer. Design and setting - Iterative development of complex healthcare intervention according to the MRC Framework conducted in Northeast Scotland. Method - The study produced a complex intervention to promote early presentation of lung cancer symptoms. An expert multidisciplinary group developed the first draft of the intervention based on theory and existing evidence. This was refined following focus groups with health professionals and high-risk patients. Results - First draft intervention components included: information communicated persuasively, demonstrations of early consultation and its benefits, behaviour change techniques, and involvement of spouses/partners. Focus groups identified patient engagement, achieving behavioural change, and conflict at the patient–general practice interface as challenges and measures were incorporated to tackle these. Final intervention delivery included a detailed self-help manual and extended consultation with a trained research nurse at which specific action plans were devised. Conclusion -The study has developed an intervention that appeals to patients and health professionals and has theoretical potential for benefit. Now it requires evaluation.

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.

Integrating group Delphi, fuzzy logic and expert systems for marketing strategy development:the hybridisation and its effectiveness

A hybrid approach for integrating group Delphi, fuzzy logic and expert systems for developing marketing strategies is proposed in this paper. Within this approach, the group Delphi method is employed to help groups of managers undertake SWOT analysis. Fuzzy logic is applied to fuzzify the results of SWOT analysis. Expert systems are utilised to formulate marketing strategies based upon the fuzzified strategic inputs. In addition, guidelines are also provided to help users link the hybrid approach with managerial judgement and intuition. The effectiveness of the hybrid approach has been validated with MBA and MA marketing students. It is concluded that the hybrid approach is more effective in terms of decision confidence, group consensus, helping to understand strategic factors, helping strategic thinking, and coupling analysis with judgement, etc.

Beyond the formal/informal economy binary hierarchy

Purpose – This paper aims to evaluate critically the conventional binary hierarchical representation of the formal/informal economy dualism which reads informal employment as a residual and marginal sphere that has largely negative consequences for economic development and needs to be deterred. Design/methodology/approach – To contest this depiction, the results of 600 household interviews conducted in Ukraine during 2005/2006 on the extent and nature of their informal employment are reported. Findings – Informal employment is revealed to be an extensively used form of work and, through a richer and more textured understanding of the multiple roles that different forms of informal employment play, a form of work that positively contributes to economic and social development, acting both as an important seedbed for enterprise creation and development and as a primary vehicle through which community self-help is delivered in contemporary Ukraine. Research limitations/implications – This survey reveals that depicting informal employment as a hindrance to development and deterring engagement in this sphere results in state authorities destroying the entrepreneurial endeavour and active citizenship that other public policies are seeking to nurture. The paper concludes by addressing how this public policy paradox might start to be resolved. Originality/value – This paper is one of the first to document the role of informal employment in nurturing enterprise creation and development as well as community exchange.

A political economy of the ethnic chinese catering industry

The present political climate in which the ideals of entrepreneurship and self-help are strongly encouraged has drawn attention to those ethnic minorities noted for their entrepreneurial activity. Since the Chinese appear to be an exemplary case in point, this thesis focusses upon the historical material conditions which have led to the formation of a Chinese 'business* community in Britain, both past and present As such, it rejects the theories of cultural determinism which characterise most studies of the Chinese. For rather than representing the endurance of cultural norms, the existence of the contemporary Chinese 'niche' of ethnically exclusive firms in the catering industry is due to the conjunction of a number of historical processes. The first is the imperialist expansion into China of Britain's capitalist empire during the nineteenth century which established a relationship of dependency upon the interests of British capital by colonial Chinese labour. The second is the post war development of the catering industry and its demand for cheap labour as administered by the British state together with the contemporaneous development of the agricultural economy of colonial Hong Kong. Far from representing a source of material benefit to all, the ethnic Chinese 'niche' in catering is highly exploitative and merely underlines the racial oppression of Chinese in Britain. Attempts to promote business interests within the ethnic community therefore serve merely to entrench the structures of oppression.

Effective leadership in salient groups:revisiting leader-member exchange theory from the perspective of the social identity theory of leadership

Two studies compared leader-member exchange (LMX) theory and the social identity theory of leadership. Study 1 surveyed 439 employees of organizations in Wales, measuring work group salience, leader-member relations, and perceived leadership effectiveness. Study 2 surveyed 128 members of organizations in India, measuring identification not salience and also individualism/collectivism. Both studies provided good support for social identity predictions. Depersonalized leader-member relations were associated with greater leadership effectiveness among high-than low-salient groups (Study 1) and among high than low identifiers (Study 2). Personalized leadership effectiveness was less affected by salience (Study 1) and unaffected by identification (Study 2). Low-salience groups preferred personalized leadership more than did high-salience groups (Study 1). Low identifiers showed no preference but high identifiers preferred depersonalized leadership (Study 2). In Study 2, collectivists did not prefer depersonalized as opposed to personalized leadership, whereas individualists did, probably because collectivists focus more on the relational self.

Use of complementary and alternative medicine and self-tests by coronary heart disease patients

Background: Coronary heart disease patients have to learn to manage their condition to maximise quality of life and prevent recurrence or deterioration. They may develop their own informal methods of self-management in addition to the advice they receive as part of formal cardiac rehabilitation programmes. This study aimed to explore the use of complementary and alternative medicines and therapies (CAM), self-test kits and attitudes towards health of UK patients one year after referral to cardiac rehabilitation. Method: Questionnaire given to 463 patients attending an assessment clinic for 12 month follow up in four West Midlands hospitals. Results: 91.1% completed a questionnaire. 29.1% of patients used CAM and/or self-test kits for self-management but few (8.9%) used both methods. CAM was more often used for treating other illnesses than for CHD management. Self-test kit use (77.2%,) was more common than CAM (31.7%,) with BP monitors being the most prevalent (80.0%). Patients obtained self-test kits from a wide range of sources, for the most part (89.5%) purchased entirely on their own initiative. Predictors of self-management were post revascularisation status and higher scores on 'holism', 'rejection of authority' and 'individual responsibility'. Predictors of self-test kit use were higher `holism' and 'individual responsibility' scores. Conclusion: Patients are independently using new technologies to monitor their cardiovascular health, a role formerly carried out only by healthcare practitioners. Post-rehabilitation patients reported using CAM for self-management less frequently than they reported using self-test kits. Reports of CAM use were less frequent than in previous surveys of similar patient groups. Automatic assumptions cannot be made by clinicians about which CHD patients are most likely to self-manage. In order to increase trust and compliance it is important for doctors to encourage all CHD patients to disclose their self-management practices and to continue to address this in follow up consultations.

Prevalence of the use of cancer related self-tests by members of the public:A community survey

Background: Self-tests are those where an individual can obtain a result without recourse to a health professional, by getting a result immediately or by sending a sample to a laboratory that returns the result directly. Self-tests can be diagnostic, for disease monitoring, or both. There are currently tests for more than 20 different conditions available to the UK public, and self-testing is marketed as a way of alerting people to serious health problems so they can seek medical help. Almost nothing is known about the extent to which people self-test for cancer or why they do this. Self-tests for cancer could alter perceptions of risk and health behaviour, cause psychological morbidity and have a significant impact on the demand for healthcare. This study aims to gain an understanding of the frequency of self-testing for cancer and characteristics of users. Methods: Cross-sectional survey. Adults registered in participating general practices in the West Midlands Region, will be asked to complete a questionnaire that will collect socio-demographic information and basic data regarding previous and potential future use of self-test kits. The only exclusions will be people who the GP feels it would be inappropriate to send a questionnaire, for example because they are unable to give informed consent. Freepost envelopes will be included and non-responders will receive one reminder. Standardised prevalence rates will be estimated. Discussion: Cancer related self-tests, currently available from pharmacies or over the Internet, include faecal occult blood tests (related to bowel cancer), prostate specific antigen tests (related to prostate cancer), breast cancer kits (self examination guide) and haematuria tests (related to urinary tract cancers). The effect of an increase in self-testing for cancer is unknown but may be considerable: it may affect the delivery of population based screening programmes; empower patients or cause unnecessary anxiety; reduce costs on existing healthcare services or increase demand to investigate patients with positive test results. It is important that more is known about the characteristics of those who are using self-tests if we are to determine the potential impact on health services and the public. © 2006 Wilson et al; licensee BioMed Central Ltd.

Stepping Stones to Information Literacy: a PebblePad case study

Aston University has recently made PebblePad, an e-portfolio or personal learning system, available to all students within the University. The customisable Profiles within PebblePad allow students to self-declare their skills in particular areas, attaching evidence of their skills or an action plan for improvement to each statement. Formal Information Literacy (IL) teaching within Aston University is currently limited to Library & Information Services (LIS) Information Specialists delivering a maximum of one session to each student during each level of their degree. However, many of the skills are continually developed by students during the course of their academic studies. For this project, an IL skills profile was created within PebblePad, which was then promoted to groups of staff and students to complete during the academic session 2009-10. Functionality within PebblePad allowed students to share their IL skills profile, evidence, action plans or any other items they felt were appropriate with an LIS Information Specialist who was able to add comments and offer suggestions for activities to help the student to develop further. Activities were closely related to students’ coursework where possible: suggesting a student kept a short reflective log of their information searching and evaluating process for an upcoming essay, for example. Feedback on the usefulness of the IL Profile will be sought from students through focus groups and the communication tools in PebblePad. In this way, we hope to make students more aware of their IL skills and to offer IL skills support over a longer period of time than a single session can provide. We will present preliminary conclusions about the practicalities and benefits of a self-declaration approach to developing IL skills in students at Aston University.

Targets and self monitoring in hypertension: randomised controlled trial and cost effectiveness analysis

OBJECTIVES: To assess whether blood pressure control in primary care could be improved with the use of patient held targets and self monitoring in a practice setting, and to assess the impact of these on health behaviours, anxiety, prescribed antihypertensive drugs, patients' preferences, and costs. DESIGN: Randomised controlled trial. SETTING: Eight general practices in south Birmingham. PARTICIPANTS: 441 people receiving treatment in primary care for hypertension but not controlled below the target of < 140/85 mm Hg. INTERVENTIONS: Patients in the intervention group received treatment targets along with facilities to measure their own blood pressure at their general practice; they were also asked to visit their general practitioner or practice nurse if their blood pressure was repeatedly above the target level. Patients in the control group received usual care (blood pressure monitoring by their practice). MAIN OUTCOME MEASURES: Primary outcome: change in systolic blood pressure at six months and one year in both intervention and control groups. Secondary outcomes: change in health behaviours, anxiety, prescribed antihypertensive drugs, patients' preferences of method of blood pressure monitoring, and costs. RESULTS: 400 (91%) patients attended follow up at one year. Systolic blood pressure in the intervention group had significantly reduced after six months (mean difference 4.3 mm Hg (95% confidence interval 0.8 mm Hg to 7.9 mm Hg)) but not after one year (mean difference 2.7 mm Hg (- 1.2 mm Hg to 6.6 mm Hg)). No overall difference was found in diastolic blood pressure, anxiety, health behaviours, or number of prescribed drugs. Patients who self monitored lost more weight than controls (as evidenced by a drop in body mass index), rated self monitoring above monitoring by a doctor or nurse, and consulted less often. Overall, self monitoring did not cost significantly more than usual care (251 pounds sterling (437 dollars; 364 euros) (95% confidence interval 233 pounds sterling to 275 pounds sterling) versus 240 pounds sterling (217 pounds sterling to 263 pounds sterling). CONCLUSIONS: Practice based self monitoring resulted in small but significant improvements of blood pressure at six months, which were not sustained after a year. Self monitoring was well received by patients, anxiety did not increase, and there was no appreciable additional cost. Practice based self monitoring is feasible and results in blood pressure control that is similar to that in usual care.

Relational diversity, social integration and individual effectiveness: a social self-regulation perspective

Relational demographers and dissimilarity researchers contend that group members who are dissimilar (vs. similar) to their peers in terms of a given diversity attribute (e.g. demographics, attitudes, values or traits) feel less attached to their work group, experience less satisfying and more conflicted relationships with their colleagues, and consequently are less effective. However, qualitative reviews suggest empirical findings tend to be weak and inconsistent (Chattopadhyay, Tluchowska and George, 2004; Riordan, 2000; Tsui and Gutek, 1999), and that it remains unclear when, how and to what extent such differences (i.e. relational diversity) affect group members social integration (i.e. attachment with their work group, satisfaction and conflicted relationships with their peers) and effectiveness (Riordan, 2000). This absence of meta-analytically derived effect size estimates and the lack of an integrative theoretical framework leave practitioners with inconclusive advice regarding whether the effects elicited by relational diversity are practically relevant, and if so how these should be managed. The current research develops an integrative theoretical framework, which it tests by using meta-analysis techniques and adding two further empirical studies to the literature. The first study reports a meta-analytic integration of the results of 129 tests of the relationship between relational diversity with social integration and individual effectiveness. Using meta-analytic and structural equation modelling techniques, it shows different effects of surface- and deep-level relational diversity on social integration Specifically, low levels of interdependence accentuated the negative effects of surface-level relational diversity on social integration, while high levels of interdependence accentuated the negative effects of deep-level relational diversity on social integration. The second study builds on a social self-regulation framework (Abrams, 1994) and suggests that under high levels of interdependence relational diversity is not one but two things: visibility and separation. Using ethnicity as a prominent example it was proposed that separation has a negative effect on group members effectiveness leading for those high in visibility and low in separation to overall positive additive effects, while to overall negative additive effects for those low in visibility and high in separation. These propositions were sustained in a sample of 621 business students working in 135 ethnically diverse work groups in a business simulation course over a period of 24 weeks. The third study suggests visibility has a positive effect on group members self-monitoring, while separation has a negative effect. The study proposed that high levels of visibility and low levels of separation lead to overall positive additive effects on self-monitoring but overall negative additive effects for those low in visibility and high in separation. Results from four waves of data on 261 business students working in 69 ethnically diverse work groups in a business simulation course held over a period of 24 weeks support these propositions.

Self-assembly of trehalose molecules on a lysozyme surface: the broken glass hypothesis

To help understand how sugar interactions with proteins stabilise biomolecular structures, we compare the three main hypotheses for the phenomenon with the results of long molecular dynamics simulations on lysozyme in aqueous trehalose solution (0.75 M). We show that the water replacement and water entrapment hypotheses need not be mutually exclusive, because the trehalose molecules assemble in distinctive clusters on the surface of the protein. The flexibility of the protein backbone is reduced under the sugar patches supporting earlier findings that link reduced flexibility of the protein with its higher stability. The results explain the apparent contradiction between different experimental and theoretical results for trehalose effects on proteins.

The effect of age, gender and attitudes on self-regulation in driving

Self-regulation in driving has primarily been studied as a precursor to driving cessation in older people, who minimise driving risk and compensate for physical and cognitive decline by avoiding driving in challenging circumstances, e.g. poor weather conditions, in the dark and at busy times. This research explores whether other demographic groups of drivers adopt self-regulatory behaviours and examines the effects of affective and instrumental attitudes on self-regulation across the lifespan. Quantitative data were collected from 395 drivers. Women were significantly more likely than men to engage in self-regulation, and to be negatively influenced by their emotions (affective attitude). A quadratic effect of age on self-regulation was determined such that younger and older drivers reported higher scores for self-regulation than middle-years' drivers. However, this effect was affected by experience such that when experience was controlled for, self-regulation increased with age. Nevertheless, anxious driving style and negative affective attitude were independent predictors of self-regulation behaviours. Results suggest that self-regulation behaviours are present across the driving lifespan and may occur as a result of driving anxiety or low confidence rather than as an effect of ageing.