Controlled trial of the short- and long-term effect of psychological treatment of post-partum depression 2. Impact on the mother-child relationship and child outcome

Background: Postnatal depression is associated with adverse child cognitive and socio-emotional outcome. It is not known whether psychological treatment affects the quality of the mother-child relationship and child outcome. Aims: To evaluate the effect of three psychological treatments on the mother-child relationship and child outcome. Method: Women with post-partum depression (n=193) were assigned randomly to routine primary care, non-directive counselling, cognitive-behavioural therapy or psychodynamic therapy The women and their children, were assessed at 43, [8 and 60 months post-partum. Results: Indications of a positive benefit were limited. All three treatments had a significant benefit on maternal reports of early difficulties in relationships with the infants, counselling gave better infant emotional and behaviour ratings at 18 months and more sensitive early mother-infant interactions. The treatments had no significant impact on maternal management of early infant behaviour problems, security of infant-mother attachment. Infant cognitive development or any child outcome at 5 years. Conclusions: Early intervention was of short-term benefit to the mother-child relationship and infant behaviour problems. More-prolonged intervention may be needed. Health visitors could deliver this.

Customer experience quality: an exploration in business and consumer contexts using repertory grid technique

This study proposes a conceptual model for customer experience quality and its impact on customer relationship outcomes. Customer experience is conceptualized as the customer’s subjective response to the holistic direct and indirect encounter with the firm, and customer experience quality as its perceived excellence or superiority. Using the repertory grid technique in 40 interviews in B2B and B2C contexts, the authors find that customer experience quality is judged with respect to its contribution to value-in-use, and hence propose that value-in-use mediates between experience quality and relationship outcomes. Experience quality includes evaluations not just of the firm’s products and services but also of peer-to-peer and complementary supplier encounters. In assessing experience quality in B2B contexts, customers place a greater emphasis on firm practices that focus on understanding and delivering value-in-use than is generally the case in B2C contexts. Implications for practitioners’ customer insight processes and future research directions are suggested.

Measuring quality of life in aphasia: results from two scales

Background: Although aphasia affects quality of life (QoL), the impact within specific domains (e.g., psychosocial, communication) is poorly understood. Moreover, the complex and multidimensional nature of QoL renders it difficult to measure accurately using a single global scale. Aims: Using two recently developed QoL scales, the Stroke and Aphasia Quality of Life Scale-39, (SAQOL; Hilari, Byng, Lamping, & Smith, 2003a) and the American Speech Language Hearing Association’s Quality of Communication Life Scale (QCL; Paul et al., 2004), this study aimed to document the domains of QoL that were most affected for participants with aphasia compared to control participants, as well as to determine the relationship between the two scales, their sub-domains, and linguistic variables in aphasia. Methods & Procedures: The two scales were administered to a group of 19 participants with aphasia (14 male, 5 female), ages ranging from 27 to 79 years, and 19 age- and gender-matched control participants. Various types and severity of aphasia were represented in the aphasia group. The performances of aphasia and control groups were compared, and correlation analyses examined the relationship between the two scales and their sub-domains in the aphasia group only. Outcomes & Results: Compared to control participants, QoL was lower in participants with aphasia, with the communication sub-domain of SAQOL and socialisation/ activities sub-domain of QCL being the most affected areas of functioning. Between the two scales, the communication sub-domain of SAQOL correlated with the socialisation/ activities sub-domain and the QCL mean. Moreover, linguistic variables correlated strongly with psychosocial, communication and socialisation/activities sub-domains of QoL. Conclusions: Measuring QoL using the SAQOL and the QCL captures different but equally important aspects of experiences of living with aphasia. When interpreted together, they provide a holistic picture of functioning in aphasia that includes broad overviews of QoL from the SAQOL and a finer-grained analysis of communication impairments on QoL from the QCL.

Urban conservation areas and sustainable development: exploring the relationship

With increasing emphasis being placed on concentrating development in urban areas and improving the quality of life in British cities and towns, the importance of accommodating necessary development without compromising the valued heritage and architectural quality of urban areas is now becoming central to sustainable urban development. Urban conservation policy and practice has the potential to contribute to this and other aspects of sustainability. This paper explores this contribution and develops an analytical framework which draws out the key linkages between conservation area policy and sustainable development. The framework is then used to research the potential and actual contribution of urban conservation policy and practice in England, using a selective survey and two case studies (i.e. Winchester and Basingstoke). The main conclusions from the research are that: Conservation area policy can make a significant contribution to the principles of sustainable development; Most local planning authorities in England have not fully woken-up to this potential and have not developed policies or practices to address it; and Urban conservation policy needs to develop a more proactive approach in which local planning authorities actively guide and encourage new development with regard to use, design, layout, methods of construction, materials and energy efficiency.

Continuity of care for people with psychotic illness: its relationship to clinical and social functioning.

Background: The relationship between continuity of care and user characteristics or outcomes has rarely been explored. The ECHO study operationalized and tested a multi-axial definition of continuity of care, producing a seven-factor model used here. Aims: To assess the relationship between user characteristics and established components of continuity of care, and the impact of continuity on clinical and social functioning. Methods: The sample comprised 180 community mental health team users with psychotic disorders who were interviewed at three annual time-points, to assess their experiences of continuity of care and clinical and social functioning. Scores on seven continuity factors were tested for association with user-level variables. Results: Improvement in quality of life was associated with better Experience & Relationship continuity scores (better user-rated continuity and therapeutic relationship) and with lower Meeting Needs continuity factor scores. Higher Meeting Needs scores were associated with a decrease in symptoms. Conclusion: Continuity is a dynamic process, influenced significantly by care structures and organizational change.

Adapted customer relationship management implementation framework:facilitating value creation in nursing homes

This paper proposes a framework to support Customer Relationship Management (CRM) implementation in nursing homes. The work extends research by Cheng et al. (2005) who conducted in-depth questionnaires to identify critical features (termed value-characteristics), which are areas identified as adding the most value if implemented. Although Cheng et al. did proposed an implementation framework, summary of, and inconsistent inclusion of value-characteristics, limits the practical use of this contribution during implementation. In this paper we adapt the original framework to correct perceived deficiencies. We link the value characteristics to operational, analytical, strategic and/or collaborative CRM solution types, to allow consideration in context of practical implementation solutions. The outcome of this paper shows that, practically, a 'one solution meets all characteristic' approach to CRM implementation within nursing homes is inappropriate. Our framework, however, supports implementers in identifying how value can be gained when implementing a specific CRM solution within nursing homes; which subsequently support project management and expectation management.

Apheresis donors and platelet function: inherent platelet responsiveness influences platelet quality

BACKGROUND: Process-induced platelet (PLT) activation occurs with all production methods, including apheresis. Recent studies have highlighted the range and consistence of interindividual variation in the PLT response, but little is known about the contribution of a donors' inherent PLT responsiveness to the activation state of the apheresis PLTs or the effect of frequent apheresis on donors' PLTs. STUDY DESIGN AND METHODS: The relationship between the donors' PLT response on the apheresis PLTs was studied in 47 individuals selected as having PLTs with inherently low, intermediate, or high responsiveness. Whole-blood flow cytometry was used to measure PLT activation (levels of bound fibrinogen) before donation and in the apheresis PLTs. The effects of regular apheresis on the activation status of donors' PLTs were studied by comparing the in vivo activation status of PLTs from apheresis (n = 349) and whole-blood donors (n = 157), before donation. The effect of apheresis per se on PLT activation was measured in 10 apheresis donors before and after donation. RESULTS: The level of PLT activation in the apheresis packs was generally higher than in the donor, and the most activated PLTs were from high-responder donors. There was no significant difference in PLT activation before donation between the apheresis and whole-blood donors (p = 0.697), and there was no consistent evidence of activation in the donors immediately after apheresis. CONCLUSION: The most activated apheresis PLTs were obtained from donors with more responsive PLTs. Regular apheresis, however, does not lead to PLT activation in the donors.

Made in Italy. Made in Britain. Quality, brands and innovation in the European poultry market, 1950-1980.

This paper compares the development of the poultry industry in Italy with the UK. Earlier research has suggested that the UK poultry industry developed a symbiotic relationship with the emerging supermarket retailers. Italy had a retarded supermarket sector. Its distribution system favoured small-scale, independent butchers rather than chains of self-service supermarkets. Despite this the Italian poultry industry also modernised, adopting US technologies. The catalyst for this modernisation was technological innovation in refrigeration technologies that enabled Italian consumers and independent retailers to be persuaded of the merits of the new ‘technological’ chicken. While the Italian market has become dominated by AIA and Amadori in recent years, the key innovators were the entrepreneurs that created the company called Arena.

Fairness quality: the role of fairness in a social and ethically oriented marketing landscape

Research into the dark side of customer management and marketing is progressively growing. The marketing landscape today is dominated with suspicion and distrust as a result of practices that include hidden fees, deception and information mishandling. In such a pessimistic economy, marketers must reconceptualise the notion of fairness in marketing and customer management, so that the progress of sophisticated customisation schemes and advancements in marketing can flourish, avoiding further control and imposed regulation. In this article, emerging research is drawn to suggest that existing quality measures of marketing activities, including service, relationships and experiences may not be comprehensive in measuring the relevant things in the social and ethically oriented marketing landscape, and on that basis does not measure the fairness which truly is important in such an economy. The paper puts forward the concept of Fairness Quality (FAIRQUAL), which includes as well as extends on existing thinking behind relationship building, experience creation and other types of customer management practices that are believed to predict consumer intentions. It is proposed that a fairness quality measure will aid marketers in this challenging landscape and economy.

Effect of blending Jersey and Holstein-Friesian milk on Cheddar cheese processing, composition and quality

The aim of this study was to investigate the effects of numerous milk compositional factors on milk coagulation properties using Partial Least Squares (PLS). Milk from herds of Jersey and Holstein- Friesian cattle was collected across the year and blended (n=55), to maximise variation in composition and coagulation. The milk was analysed for casein, protein, fat, titratable acidity, lactose, Ca2+, urea content, micelles size, fat globule size, somatic cell count and pH. Milk coagulation properties were defined as coagulation time, curd firmness and curd firmness rate measured by a controlled strain rheometer. The models derived from PLS had higher predictive power than previous models demonstrating the value of measuring more milk components. In addition to the well-established relationships with casein and protein levels, CMS and fat globule size were found to have as strong impact on all of the three models. The study also found a positive impact of fat on milk coagulation properties and a strong relationship between lactose and curd firmness, and urea and curd firmness rate, all of which warrant further investigation due to current lack of knowledge of the underlying mechanism. These findings demonstrate the importance of using a wider range of milk compositional variables for the prediction of the milk coagulation properties, and hence as indicators of milk suitability for cheese making.

Impact of socioeconomic and clinical factors on child oral health-related quality of life (COHRQoL)

Child oral health-related quality of life (COHRQoL) has been increasingly assessed; however, few studies appraised the influence of socioeconomic status on COHRQoL in developing countries. This study assessed the relationship of COHRQoL with socioeconomic backgrounds and clinical factors. This study followed a cross-sectional design, with a multistage random sample of 792 schoolchildren aged 12 years, representative of Santa Maria, a southern city in Brazil. Participants completed the Brazilian version of the Child Perceptions Questionnaire (CPQ(11-14)), their parents or guardians answered questions on socioeconomic status, and a dental examination provided information on the prevalence of caries, dental trauma and occlusion. The assessment of association used hierarchically adjusted Poisson regression models. Higher impacts on COHRQoL were observed for children presenting with untreated dental caries (RR 1.20; 95% CI 1.07-1.35) and maxillary overjet (RR 1.19; 95% CI 1.02-1.40). Socioeconomic factors also associated with COHRQoL; poorer scores were reported by children whose mothers have not completed primary education (RR 1.30; 95% CI 1.17-1.44) and those with lower household income (RR 1.13; 95% CI 1.02-1.26). Poor socioeconomic standings and poor dental status have a negative impact on COHRQoL; reducing health inequalities may demand dental programmes and policies targeting deprived population.

Relationship between the somatic cell count in raw milk and the casein fractions of UHT milk

The relationship between somatic cell count (SCC) in raw milk and casein fractions of 15 batches of the corresponding ultra-high-temperature (UHT) milk was examined. Raw milk was collected, pasteurised and submitted to UHT treatment. Samples of the UHT milk were taken on days 8, 30, 60, 90 and 120 of storage at room temperature and their casein fractions analysed by high performance liquid chromatography. SCC ranged from 197,000 to 800,000 cells/mL. No correlation (p>0.05) was found between SCC and K-casein concentrations in raw or UHT milks. The alpha(s2) and P-casein concentrations in raw milk were negatively correlated with SCC (p<0.05). In UHT milk, negative correlations were observed for a,1-casein (p<0.05) and beta-casein (p<0.05) on the 8th day, and for alpha S-2-casein (p<0.01) on the 60th day of storage. Results indicate that higher SSC in raw milk is associated with substantial degradation of beta-casein and alpha(s)-casein, which may lead to quality defects in UHT milk during storage. Aust. J. Dairy Technol. 63, 45-49

Reactivity of Nellore steers in two feedlot housing systems and its relationship with plasmatic cortisol

To evaluate reactivity to assess the temperament of Nellore steers in two feedlot housing systems (group pen or individual pen) and its relationship with plasmatic cortisol, 36 experimental units were observed five times at 28-day intervals of weight management during a 112-day feedlot confinement. A reactivity score scale ranging from 1 to 5 was applied when an animal was in the chute system. To the calmest animal, a reactivity score of 1 was ascribed and to the most agitated, 5. Blood samples were collected for cortisol analysis. No differences were found in reactivity and feedlot system. There was a relationship noted between reactivity and feedlot time in both housing systems (P < 0.01). There was a relation between reactivity and cortisol levels for group animals (P = 0.0616) and for individual ones (P < 0.01). Cortisol levels varied among housing systems (P < 0.01). Feedlot time influenced the cortisol levels (P < 0.09 individual; P < 0.01 group) and when variable time was included, these levels changed, decreasing in the group pen and increasing in individual pens. The continuous handling reduces reactivity and plasmatic cortisol, and group pen system seems to be less stressfully than individual pens. (C) 2010 Elsevier B.V. All rights reserved.

Facilitators and barriers to applying a national quality registry for quality improvement in stroke care

BACKGROUND: National quality registries (NQRs) purportedly facilitate quality improvement, while neither the extent nor the mechanisms of such a relationship are fully known. The aim of this case study is to describe the experiences of local stakeholders to determine those elements that facilitate and hinder clinical quality improvement in relation to participation in a well-known and established NQR on stroke in Sweden. METHODS: A strategic sample was drawn of 8 hospitals in 4 county councils, representing a variety of settings and outcomes according to the NQR's criteria. Semi-structured telephone interviews were conducted with 25 managers, physicians in charge of the Riks-Stroke, and registered nurses registering local data at the hospitals. Interviews, including aspects of barriers and facilitators within the NQR and the local context, were analysed with content analysis. RESULTS: An NQR can provide vital aspects for facilitating evidence-based practice, for example, local data drawn from national guidelines which can be used for comparisons over time within the organisation or with other hospitals. Major effort is required to ensure that data entries are accurate and valid, and thus the trustworthiness of local data output competes with resources needed for everyday clinical stroke care and quality improvement initiatives. Local stakeholders with knowledge of and interest in both the medical area (in this case stroke) and quality improvement can apply the NQR data to effectively initiate, carry out, and evaluate quality improvement, if supported by managers and co-workers, a common stroke care process and an operational management system that embraces and engages with the NQR data. CONCLUSION: While quality registries are assumed to support adherence to evidence-based guidelines around the world, this study proposes that a NQR can facilitate improvement of care but neither the registry itself nor the reporting of data initiates quality improvement. Rather, the local and general evidence provided by the NQR must be considered relevant and must be applied in the local context. Further, the quality improvement process needs to be facilitated by stakeholders collaborating within and outside the context, who know how to initiate, perform, and evaluate quality improvement, and who have the resources to do so.

Learners' perceptions about the relationship between music education and generic skills development : a case study within the Australian higher education sector

A major issue emerging from the research and debate concerning quality in higher education has been an emphasis on the value of the acquisition of generic skills by undergraduate students, as indicators of quality in education. Music educators have long recognised the contribution music makes to the general education of learners. Learning in and through music can present varied and complex means for the acquisition of generic life skills such as: problem solving, decision-making, critical thinking, oral and written communication and teamwork. This paper documents one particular course of action that was implemented within a university undergraduate primary teacher education program, to systematically gauge learner perceptions about generic skill development/enhancement before and after participation in the music component of the core arts education subject.