The Paediatric Rheumatology International Trials Organisation provisional criteria for the evaluation of response to therapy in juvenile dermatomyositis.

Objective To develop a provisional definition for the evaluation of response to therapy in juvenile dermatomyositis (DM) based on the Paediatric Rheumatology International Trials Organisation juvenile DM core set of variables. Methods Thirty-seven experienced pediatric rheumatologists from 27 countries achieved consensus on 128 difficult patient profiles as clinically improved or not improved using a stepwise approach (patient's rating, statistical analysis, definition selection). Using the physicians' consensus ratings as the “gold standard measure,” chi-square, sensitivity, specificity, false-positive and-negative rates, area under the receiver operating characteristic curve, and kappa agreement for candidate definitions of improvement were calculated. Definitions with kappa values >0.8 were multiplied by the face validity score to select the top definitions. Results The top definition of improvement was at least 20% improvement from baseline in 3 of 6 core set variables with no more than 1 of the remaining worsening by more than 30%, which cannot be muscle strength. The second-highest scoring definition was at least 20% improvement from baseline in 3 of 6 core set variables with no more than 2 of the remaining worsening by more than 25%, which cannot be muscle strength (definition P1 selected by the International Myositis Assessment and Clinical Studies group). The third is similar to the second with the maximum amount of worsening set to 30%. This indicates convergent validity of the process. Conclusion We propose a provisional data-driven definition of improvement that reflects well the consensus rating of experienced clinicians, which incorporates clinically meaningful change in core set variables in a composite end point for the evaluation of global response to therapy in juvenile DM.

Organisational merger and psychiatric morbidity: a prospective study in a changing work organisation

Background Prospective studies on the relationship between organisational merger and mental health have been conducted using subjective health indicators. The objective of this prospective occupational cohort study was to examine whether a negative change during an organisational merger is an independent predictive factor of psychiatric morbidity.

Party organisation in a multi-level system: Party organisational change in Spain and the UK

This article investigates the link between regionalization of the structure of government, regional elections and regionalism on the one hand, and the organization of state-wide political parties in Spain and the UK on the other. It particularly looks at two aspects of the relations between the central and regional levels of party organization: integration of the regional branches in central decision making and autonomy of the regional branches. It argues that the party factors are the most crucial elements explaining party change and that party leaders mediate between environmental changes and party organization. The parties' history and beliefs and the strength of the central leadership condition their ability or willingness to facilitate the emergence of meso-level elites. The institutional and electoral factors are facilitating factors that constitute additional motives for or against internal party decentralization.

Re-organisation of the cytoskeleton during developmental programmed cell death in Picea abies embryos

Cell and tissue patterning in plant embryo development is well documented. Moreover, it has recently been shown that successful embryogenesis is reliant on programmed cell death (PCD). The cytoskeleton governs cell morphogenesis. However, surprisingly little is known about the role of the cytoskeleton in plant embryogenesis and associated PCD. We have used the gymnosperm, Picea abies , somatic embryogenesis model system to address this question. Formation of the apical-basal embryonic pattern in P. abies proceeds through the establishment of three major cell types: the meristematic cells of the embryonal mass on one pole and the terminally differentiated suspensor cells on the other, separated by the embryonal tube cells. The organisation of microtubules and F-actin changes successively from the embryonal mass towards the distal end of the embryo suspensor. The microtubule arrays appear normal in the embryonal mass cells, but the microtubule network is partially disorganised in the embryonal tube cells and the microtubules disrupted in the suspensor cells. In the same embryos, the microtubule-associated protein, MAP-65, is bound only to organised microtubules. In contrast, in a developmentally arrested cell line, which is incapable of normal embryonic pattern formation, MAP-65 does not bind the cortical microtubules and we suggest that this is a criterion for proembryogenic masses (PEMs) to passage into early embryogeny. In embryos, the organisation of F-actin gradually changes from a fine network in the embryonal mass cells to thick cables in the suspensor cells in which the microtubule network is completely degraded. F-actin de-polymerisation drugs abolish normal embryonic pattern formation and associated PCD in the suspensor, strongly suggesting that the actin network is vital in this PCD pathway.

Learning transfer in multinational companies:Explaining inter-organisation variation

This article addresses the extent to which multinational companies (MNCs) in Ireland deploy practices aimed at the transfer of learning in their operations and the factors explaining inter-organisation variation in so doing. Using data from 260 MNCs, we find that comparatively large numbers of firms deploy practices to transfer learning in their Irish operations. Most notably, we find that almost half of all MNCs have a formal policy on organisational learning, while more than six in every ten MNCs in Ireland utilise three or more learning transfer mechanisms. In investigating inter-organisation variation with respect to these, we test a number of hypotheses involving nationality, sectoral, MNC (e.g. organisation structure) and HR factors. Our results show that the presence of international HR structures is a significant factor in explaining learning transfer in MNCs. We also find support that employment size, sector and integration between the MNC's global operations are useful variables in explaining variation in the deployment of practices on learning transfer in MNCs. © 2009 Blackwell Publishing Ltd.

The link between the learning organisation and curriculum innovation:A comparative study of public and private primary schools in Greece

This article examines the relationship between the learning organisation and the implementation of curriculum innovation within schools. It also compares the extent of innovative activity undertaken by schools in the public and the private sectors. A learning organisation is characterised by long-term goals, participatory decision-making processes, collaboration with external stakeholders, effective mechanisms for the internal communication of knowledge and information, and the use of rewards for its members. These characteristics are expected to promote curriculum innovation, once a number of control factors have been taken into account. The article reports on a study carried out in 197 Greek public and private primary schools in the 1999-2000 school year. Structured interviews with school principals were used as a method of data collection. According to the statistical results, the most important determinants of the innovative activity of a school are the extent of its collaboration with other organisations (i.e. openness to society), and the implementation of development programmes for teachers and parents (i.e. communication of knowledge and information). Contrary to expectations, the existence of long-term goals, the extent of shared decision-making, and the use of teacher rewards had no impact on curriculum innovation. The study also suggests that the private sector, as such, has an additional positive effect on the implementation of curriculum innovation, once a number of human, financial, material, and management resources have been controlled for. The study concludes by making recommendations for future research that would shed more light on unexpected outcomes and would help explore the causal link between variables in the research model.

Technology, work organisation and job quality in the service sector: an introduction’

This special issue volume is concerned with how technology is changing the nature of work and working conditions while generating new products and new forms of service delivery. The five articles included in this volume cover service work, from the routine and clerical through to highly credentialed and professional work. Although some of the established challenges concerning the impact of Information and Communication Technology (ICT) on work and workplaces are evident in the articles, it is also clear that new service delivery processes demand new skills and training to some extent. Overall findings indicate that while ICT competencies are important, they need to be supplemented by the soft skills that are crucial for effective customer interactions and more open work systems with greater autonomy and participation whereby flexible work teams can have a positive impact on job quality outcomes. This introductory article examines technology and the changing nature of work through three strands of interpretation, prior to introducing the five articles in this special issue.

The Role and Effectiveness of Public – Private Partnerships (NHS LIFT) in the Development of Enhanced Primary Care Premises and Services:Report for the National Institute for Health Research Service Delivery and Organisation programme

The research project analysed the role and effectiveness of LIFT via a multi-method study which included semi-structured interviews with policy elites and users, as well as case studies and an exploratory analysis of the financial characteristics of three LIFT Companies. While the team felt that it was able to identify key aspects relating to the advantages and drawbacks surrounding LIFT, some aspects relating to the representativeness of the study was adversely affected by a reluctance of PCTs to participate in the case study analysis and commercial confidentiality restrictions. The study was nonetheless able to identify important issues in relation to the funding and procurement of primary care premises and services.