Perceptions of organisational subculture and their significance for organisational commitment

This paper investigates the relationship between perceptions of organisational culture, organisational subculture, leadership style, and commitment. The impact of culture and leadership style on commitment has been previously noted, but there is a lack of detail regarding how different types of culture and leadership styles relate to commitment. The paper particularly addresses the notion of organisational subcultures and how the perception of those cultures relates to commitment, subculture being a neglected variable in the commitment literature. These issues were addressed in a survey of 258 nurses drawn from a range of hospital settings and wards within the Sydney metropolitan region. Results indicate that perceived organisational subculture has a strong relationship with commitment. Furthermore, the results identify the relative strength of specific types of leadership style and specific types of subculture with commitment. Both innovative and supportive subcultures have a clear positive relationship, while bureaucratic subcultures have a negative relationship. In terms of leadership style, a consideration style had a stronger relationship with commitment than a structuring style. Regression analysis was used to investigate the possible role of subculture as a mediator for the influence of leadership on commitment. Both direct and indirect effects of leadership on commitment were found. Implications for practice and for further research are discussed.

Introducing evidence-based family assessment and therapy in child and youth mental health services: Applying systemic principles to maintain, sustain and build capacity

The purpose of this article is to overview the context of the mental health service in which we work, and family therapy's status prior to and after the impact of changes wrought by the introduction of the National Mental Health Policy. We then explore some key issues that we think contribute to the persistence of the occlusion of family therapy in child psychiatric services; and the strategies that we developed and are continuing to develop to support change, finally, we describe the use of a family assessment instrument that we believe is central to our change strategy.

Regulatory foci and organisational commitment

We use regulatory focus theory to derive specific predictions regarding the differential relationships between regulatory focus and commitment. We estimated a structural equation model using a sample of 520 private and public sector employees and found in line with our hypotheses that (a) promotion focus related more strongly to affective commitment than prevention focus, (b) prevention focus related more strongly to continuance commitment than promotion focus, (c) promotion and prevention focus had equally strong effects on normative commitment. Implications of these findings for the three-component model of commitment, especially the ‘dual nature’ of normative commitment, as well as implications for human resources management and leadership are discussed.

How brand attribute typicality and consumer commitment moderate the influence of comparative advertising

This study examines how product attribute typicality and brand commitment influence the effects of comparative versus non-comparative ads on brand attitudes. Employing perspectives from the literatures on typicality and commitment, the study examines the effects of commitment to the comparison brand on the effectiveness of comparative versus non-comparative advertising. A between-informants experiment uses data from 466 student informants. It is hypothesized that (a) when the attribute under consideration is typical (atypical), among comparison brand committed informants, a non-comparative ad is more (no more) persuasive than a comparative ad, (b) when the attribute under consideration is typical, among comparison brand non-committed informants, a comparative ad is more persuasive than a non-comparative ad, and (c) when the attribute under consideration is atypical, among comparison brand non-committed informants, a comparative ad is likely to be more persuasive than a non-comparative ad, but the effect will be weaker than in the case of a typical attribute. Hypothesis (a) is supported while (b) has directional support. The results support a three-way interaction between consumer commitment, attribute typicality, and type of advertisement. The findings are relevant to a variety of contexts, such as markets characterized by high levels of market share and commitment for the market leader as well as fragmented markets where market share and commitment levels are low.

Service employee clusters in banking:exploring Ind's typology considering behaviour, commitment and attitude about leadership

Purpose: Ind suggests front line employees can be segmented according to their level of brand-supporting performance. His employee typology has not been empirically tested. The paper aims to explore front line employee performance in retail banking, and profile employee types. Design/methodology/approach: Attitudinal and demographic data from a sample of 404 front line service employees in a leading Irish bank informs a typology of service employees. Findings: Champions, Outsiders and Disruptors exist within retail banking. The authors provide an employee profile for each employee type. They found Champions amongst males, and older employees. The highest proportion of female employees surveyed were Outsiders. Disruptors were more likely to complain, and rated their performance lower than any other employee type. Contrary to extant literature, Disruptors were more likely to hold a permanent contract than other employee types. Originality/value: The authors augment the literature by providing insights about the profile of three employee types: Brand Champions, Outsiders and Disruptors. Moreover, the authors postulate the influence of leadership and commitment on each employee type. The cluster profiles raise important questions for hiring, training and rewarding front line banking employees. The authors also provide guidelines for managers to encourage Champions, and curtail Disruptors. © Emerald Group Publishing Limited.

Inhaled human insulin (Exubera®):clinical profile and patient considerations

Inhaled human insulin (Exubera®) is a rapid-acting regular human insulin administered by oral inhalation before meals. It provides a non-invasive alternative to multiple subcutaneous injections for the treatment of hyperglycemia in adult patients with type 1 and type 2 diabetes. Compared with subcutaneous rapid-acting insulin analogs, Exubera provides equivalent HbA1c control. As a monotherapy or in combination with oral agents, Exubera also provides greater glycemic control than oral agents alone, at least in patients with high levels of HbA1c. Exubera demonstrates improved patient satisfaction compared with subcutaneous insulin or oral agents alone. When offered as a treatment option together with standard treatments in uncontrolled patients naive to insulin, Exubera increases acceptance of insulin therapy three-fold compared with patients offered standard regimens only. Exubera is well tolerated in comparison to subcutaneous insulin, with a similar incidence of mild to moderate hypoglycemia. Although cough is a common adverse effect early in therapy, this leads to treatment discontinuations in less than 1% of patients. Despite an increased incidence of insulin antibodies compared with subcutaneous administration, and a consistent but minor impact on pulmonary function, long-term safety data of up to 4 years continue to support the safety profile of Exubera.

The role of enduring involvement in the relationship between reference price and price acceptance in the context of multichannel choice

Understanding online price acceptance and its determining factors can be essential if the companies try to manage different type of channels. The paper aimed to reveal the role of enduring involvement in price acceptance in a multichannel (online and offline) context. The study revealed that the hedonic value of shopping can increase the negative intention of price acceptance in the online channel, but also explored that for the segment without shopping motivations a similar price level can be applied both in the online and in the offline environment.

Az információterjedés szerepe az innováció-elfogadásban. Az okostelefonok és az on-line kollektív intelligencia (Role of informationspread in the innovation acceptance: the smart phones and the online collective intelligence)

A tanulmány célja az innováció-terjedés marketingvonzatú irodalmának bemutatása, valamint betekintés az exploratív tartalomelemzés módszerével az informális, kollektív intelligenciát generáló on-line felületek, nevesül a blogok és fórumok kutathatóságába. Az okostelefonok innováció-elfogadásának példáján keresztül a szerzők megpróbálják felderíteni az információterjedés elméletének megvalósulását az elemzett felületeken. Bemutatnak három, a mintára jellemző információterjedési és felvett szerep mintát, melyek alapul szolgálhatnak a további célirányú kutatások számára. / === / Adaptive smart phones that give space for user-added functions create active online discussions. Committed users are ready to share information, advise others, while less expert users seek this information. In their paper the authors show that related user-generated content i.e. blogs and bulletin boards provide a rich data source for analysis, which gives them the opportunity to further elaborate on the diffusion of information in the case of smart phone usage among online Hungarian users. Online collective intelligence may well contribute to the diffusion of innovations through diffusing information. Following a thorough review on the literature on the diffusion of innovations, in their exploratory content analysis, they found two categories of users on the analyzed boards: a first group we dubbed "experts" (corresponding to innovators in Bass's typology) that made a special effort trying to solve particular problems thus contributing to collective intelligence, thus reducing (among others) the perceived complexity of these phones and adding to their trialability, both factors influencing users' innovation acceptance, and a second group, "simple users" (or imitators in Bass's typology), uninterested in product innovation, still asking questions and searching for solutions concerning extant technology. Manufacturers do not seem yet to regard these boards as a source of valuable data, even though these clearly serve as an important pool of information and a growing factor of decision for their potential customers.

Instructional change through collaboration and reflection

The purpose of this study was to investigate the effectiveness of the Facilitator-Collaborative-Reflective Model, a strategic plan for changing teachers' practices and beliefs, on a selected group of middle school teachers. This model of staff development training was based on Corey's (1953) Cooperative-Action-Research Model and Anders and Richardson (1994) Collaborative-Reflective Model. It supports the notion that earning a teachers' commitment to change by focusing on collaboration, reflection and the normative-re-educative process aids in altering teachers' beliefs and practices especially crucial to the change process. The year-long training provided for reflection, inquiry, and learning that was useful to teachers as they pursued their goals with their students. The lead teacher, as a change agent and transformational leader, assisted in this commitment to change by improving the teachers' self-concepts as they slowly changed. The collaborative and receptive environment of the staff development fostered acceptance and stimulation of ideas.^ Given the collaborative nature of the change process, qualitative research methods were used in the investigation. The research process was based on Stufflebeam's Context, Input, Process and Product (CIPP) Evaluation Model (Madaus, Scriven & Stufflebeam, 1983). This allowed for all three factors of the staff development model to be evaluated. The case studies and focus group were effective in discerning any actual change in practices or beliefs.^ The findings of the qualitative evaluation, consisting of a baseline survey, case studies, questionnaire and modified focus group interviews, concluded that all of the teachers were strongly influenced by the intervention model which was the subject of this study. From this evaluation, three distinct indicators were looked at to determine if any change in the teachers' practices and beliefs emerged: (1) change in practice and belief, (2) reflective feedback and (3) collaborative reflection. These indicators were common throughout the teacher responses thus substantiating the infusion of the Facilitator-Collaborative-Reflective Model at the school level for effective staff development. ^

Individual child cognitive behavioral treatment versus child-parent cognitive behavioral treatments for anxiety disorders in children and adolescents: Comparative outcomes

Anxiety disorders; such as separation anxiety disorder, generalized anxiety disorder, social phobia and specific phobia, are widespread in children and adolescents. Cognitive behavioral therapy (CBT) has been shown to be effective in reducing excessive fears and anxieties in children and adolescents. Research has produced equivocal findings that involving parents in treatment of child anxiety enhances effects over individual CBT (ICBT). The present dissertation study examined whether parental involvement can enhance individual treatment effect if the parent conditions are streamlined by targeting specific parental variables. The first parent condition, Parent Reinforcement Skills Training (RFST), involved increasing mothers' use of positive reinforcement and decreasing use of negative reinforcement. The second parent condition, Parent Relationship Skill Training (RLST), involved increasing maternal child acceptance and decreasing maternal control (or increasing autonomy granting). Results of the present dissertation findings support the use of all three treatment conditions (ICBT, RLST, RFST) for child anxiety; that is, significant reductions in anxiety were found in each of the three treatment conditions. No significant differences were found between treatment conditions with respect to diagnostic recovery rate, clinician rating, and parent rating of child anxiety. Significant differences between conditions were found on child self rating of anxiety, with some evidence to support the superiority of RLST and RFST to ICBT. These findings support the efficacy of individual, as well as parent involved CBT, and provide mixed evidence with respect to the superiority of parent involved CBT over ICBT. The conceptual, empirical, and clinical implications of the findings are discussed. ^

Development of Plasmonic Nanoplatforms for Diagnostics, Therapy, and Sensing

Recent advances in nanotechnology have led to the application of nanoparticles in a wide variety of fields. In the field of nanomedicine, there is great emphasis on combining diagnostic and therapeutic modalities into a single nanoparticle construct (theranostics). In particular, anisotropic nanoparticles have shown great potential for surface-enhanced Raman scattering (SERS) detection due to their unique optical properties. Gold nanostars are a type of anisotropic nanoparticle with one of the highest SERS enhancement factors in a non-aggregated state. By utilizing the distinct characteristics of gold nanostars, new plasmonic materials for diagnostics, therapy, and sensing can be synthesized. The work described herein is divided into two main themes. The first half presents a novel, theranostic nanoplatform that can be used for both SERS detection and photodynamic therapy (PDT). The second half involves the rational design of silver-coated gold nanostars for increasing SERS signal intensity and improving reproducibility and quantification in SERS measurements.

The theranostic nanoplatforms consist of Raman-labeled gold nanostars coated with a silica shell. Photosensitizer molecules for PDT can be loaded into the silica matrix, while retaining the SERS signal of the gold nanostar core. SERS detection and PDT are performed at different wavelengths, so there is no interference between the diagnostic and therapeutic modalities. Singlet oxygen generation (a measure of PDT effectiveness) was demonstrated from the drug-loaded nanocomposites. In vitro testing with breast cancer cells showed that the nanoplatform could be successfully used for PDT. When further conjugating the nanoplatform with a cell-penetrating peptide (CPP), efficacy of both SERS detection and PDT is enhanced.

The rational design of plasmonic nanoparticles for SERS sensing involved the synthesis of silver-coated gold nanostars. Investigation of the silver coating process revealed that preservation of the gold nanostar tips was necessary to achieve the increased SERS intensity. At the optimal amount of silver coating, the SERS intensity is increased by over an order of magnitude. It was determined that a majority of the increased SERS signal can be attributed to reducing the inner filter effect, as the silver coating process moves the extinction of the particles far away from the laser excitation line. To improve reproducibility and quantitative SERS detection, an internal standard was incorporated into the particles. By embedding a small-molecule dye between the gold and silver surfaces, SERS signal was obtained both from the internal dye and external analyte on the particle surface. By normalizing the external analyte signal to the internal reference signal, reproducibility and quantitative analysis are improved in a variety of experimental conditions.

Development of tumour imaging and therapy strategies utilising unengineered bacteria

The ability of systemically administered bacteria to target and replicate to high numbers within solid tumours is well established. Tumour localising bacteria can be exploited as biological vehicles for the delivery of nucleic acid, protein or therapeutic payloads to tumour sites and present researchers with a highly targeted and safe vehicle for tumour imaging and cancer therapy. This work aimed to utilise bacteria to activate imaging probes or prodrugs specifically within target tissue in order to facilitate the development of novel imaging and therapeutic strategies. The vast majority of existing bacterial-mediated cancer therapy strategies rely on the use of bacteria that have been genetically modified (GM) to express genes of interest. While these approaches have been shown to be effective in a preclinical setting, GM presents extra regulatory hurdles in a clinical context. Also, many strains of bacteria are not genetically tractably and hence cannot currently be engineered to express genes of interest. For this reason, the development of imaging and therapeutic systems that utilise unengineered bacteria for the activation of probes or drugs represents a significant improvement on the current gold standard. Endogenously expressed bacterial enzymes that are not found in mammalian cells can be used for the targeted activation of imaging probes or prodrugs whose activation is only achieved in the presence of these enzymes. Exploitation of the intrinsic enzymatic activity of bacteria allows the use of a wider range of bacteria and presents a more clinically relevant system than those that are currently in use. The nitroreductase (NTR) enzymes, found only in bacteria, represent one such option. Chapter 2 introduces the novel concept of utilising native bacterial NTRs for the targeted activation of the fluorophore CytoCy5S. Bacterial-mediated probe activation allowed for non-invasive fluorescence imaging of in vivo bacteria in models of infection and cancer. Chapter 3 extends the concept of using native bacterial enzymes to activate a novel luminescent, NTR activated probe. The use of luminescence based imaging improved the sensitivity of the system and provides researchers with a more accessible modality for preclinical imaging. It also represents an improvement over existing caged luciferin probe systems described to date. Chapter 4 focuses on the employment of endogenous bacterial enzymes for use in a therapeutic setting. Native bacterial enzymatic activity (including NTR enzymes) was shown to be capable of activating multiple prodrugs, in isolation and in combination, and eliciting therapeutic responses in murine models of cancer. Overall, the data presented in this thesis advance the fields of bacterial therapy and imaging and introduce novel strategies for disease diagnosis and treatment. These preclinical studies demonstrate potential for clinical translation in multiple fields of research and medicine.

Biomarker Testing and Pre-emptive Therapy in Preventing Heart Failure

In an attempt to reduce the heart failure epidemic,screening and prevention will become an increasing focus ofmanagement in the wider at-risk population. Refining riskprediction through the use of biomarkers in isolation or incombination is emerging as a critical step in this process.The utility of biomarkers to identify disease manifestationsbefore the onset of symptoms and detrimental myocardialdamage is proving to be valuable. In addition, biomarkers thatpredict the likelihood and rate of disease progression over timewill help streamline and focus clinical efforts and therapeuticstrategies. Importantly, several recent early intervention studiesusing biomarker strategies are promising and indicate thatnot only can new-onset heart failure be reduced but also thedevelopment of other cardiovascular conditions.

Knowledge and acceptance of Human Papillomavirus (HPV) and HPV vaccination in adolescent boys worldwide: a systematic review

Aim

To determine HPV and HPV vaccine awareness, knowledge and acceptance in male adolescents worldwide.

Methods

A mixed methods systematic review was conducted. In accordance with PRISMA guidelines, relevant literature was identified through an electronic database search using specified keywords from inception to September 2015. Non-interventional studies presented in English that assessed HPV knowledge and provided data on male adolescents were included. If available, data on HPV and HPV vaccine perceptions, attitudes and/or HPV vaccine acceptance were also extracted. All studies were critically appraised to provide an indication of methodological quality. Results were compiled using a convergent synthesis.

Results

22 papers were included. The majority of studies were cross-sectional and conducted in the US and Europe. Across continents, regardless of a country’s HPV vaccination programme status, boys’ knowledge of HPV and/or HPV vaccination was generally low to moderate and significantly lower than female knowledge or awareness. There was a disagreement in the association of knowledge and vaccine acceptance, with higher knowledge not always being predictive of acceptance.

Conclusions

Comparison and synthesis of research concerning HPV knowledge and attitudes was made difficult due to the lack of universal definition of vaccine acceptance, and no universally accepted tool for its measurement or for the measurement of HPV knowledge. It is imperative that future research utilises consistent measures of HPV knowledge and attitudes to facilitate interpretation and comparison across studies internationally. Prospective longitudinal studies would be more informative providing data on factors that influenced the move from vaccine intention to uptake.

Mobile Technologies: Expectancy, Usage, and Acceptance of Clinical Staff and Patients at a University Medical Center

BACKGROUND: Despite their increasing popularity, little is known about how users perceive mobile devices such as smartphones and tablet PCs in medical contexts. Available studies are often restricted to evaluating the success of specific interventions and do not adequately cover the users' basic attitudes, for example, their expectations or concerns toward using mobile devices in medical settings. OBJECTIVE: The objective of the study was to obtain a comprehensive picture, both from the perspective of the patients, as well as the doctors, regarding the use and acceptance of mobile devices within medical contexts in general well as the perceived challenges when introducing the technology. METHODS: Doctors working at Hannover Medical School (206/1151, response 17.90%), as well as patients being admitted to this facility (213/279, utilization 76.3%) were surveyed about their acceptance and use of mobile devices in medical settings. Regarding demographics, both samples were representative of the respective study population. GNU R (version 3.1.1) was used for statistical testing. Fisher's exact test, two-sided, alpha=.05 with Monte Carlo approximation, 2000 replicates, was applied to determine dependencies between two variables. RESULTS: The majority of participants already own mobile devices (doctors, 168/206, 81.6%; patients, 110/213, 51.6%). For doctors, use in a professional context does not depend on age (P=.66), professional experience (P=.80), or function (P=.34); gender was a factor (P=.009), and use was more common among male (61/135, 45.2%) than female doctors (17/67, 25%). A correlation between use of mobile devices and age (P=.001) as well as education (P=.002) was seen for patients. Minor differences regarding how mobile devices are perceived in sensitive medical contexts mostly relate to data security, patients are more critical of the devices being used for storing and processing patient data; every fifth patient opposed this, but nevertheless, 4.8% of doctors (10/206) use their devices for this purpose. Both groups voiced only minor concerns about the credibility of the provided content or the technical reliability of the devices. While 8.3% of the doctors (17/206) avoided use during patient contact because they thought patients might be unfamiliar with the devices, (25/213) 11.7% of patients expressed concerns about the technology being too complicated to be used in a health context. CONCLUSIONS: Differences in how patients and doctors perceive the use of mobile devices can be attributed to age and level of education; these factors are often mentioned as contributors of the problems with (mobile) technologies. To fully realize the potential of mobile technologies in a health care context, the needs of both the elderly as well as those who are educationally disadvantaged need to be carefully addressed in all strategies relating to mobile technology in a health context.