Effectiveness of hospital-based smoking cessation

Study objectives: Smoking cessation for current smokers is a health-care imperative. It is not clear which approaches to smoking cessation are the most effective in the hospital setting and which factors predict long-term abstinence. We hypothesized that a hospital-based smoking cessation program involving behavioral modification and support would provide an effective intervention for smoking cessation. Design: Prospective cohort study. Setting: Smoking cessation clinics in a tertiary referral, cardiothoracic hospital. Patients or participants: Two hundred forty-three smokers and 187 never-smoker control subjects. Interventions: Smokers underwent specific sessions of individual counseling on behavioral modification, including written information, advice about quit aids, and support during the quit attempt. Abstinence was confirmed by exhaled carbon monoxide measurements. Measurements and results: Compared to never-smoker control subjects, smokers were more likely to have grown up with a smoking father or siblings, and to currently live or socialize with other smokers. Two hundred sixteen smokers attended at least two sessions of the smoking cessation program. Of these, 25% were unavailable for follow-up at 12 months and were assumed to be smoking. The point prevalence abstinence rate at 12 months was 32%. Independent factors associated with abstinence at 12 months were self-belief in quitting ability, having a heart condition, growing up without siblings who smoked, and increasing number of pack-years. Conclusions: This prospective study has demonstrated that this hospital-based smoking cessation program was as effective as programs in other settings. Social and psychological factors were associated with a greater chance of abstinence.

Memory for emotional faces in major depression following judgement of physical facial characteristics at encoding

The aim of the present study was to establish if patients with major depression (MD) exhibit a memory bias for sad faces, relative to happy and neutral, when the affective element of the faces is not explicitly processed at encoding. To this end, 16 psychiatric out-patients with MD and 18 healthy, never-depressed controls (HC) were presented with a series of emotional faces and were required to identify the gender of the individuals featured in the photographs. Participants were subsequently given a recognition memory test for these faces. At encoding, patients with MD exhibited a non-significant tendency towards slower gender identification (GI) times, relative to HC, for happy faces. However, the GI times of the two groups did not differ for sad or neutral faces. At memory testing, patients with MD did not exhibit the expected memory bias for sad faces. Similarly, HC did not demonstrate enhanced memory for happy faces. Overall, patients with MD were impaired in their memory for the faces relative to the HC. The current findings are consistent with the proposal that mood-congruent memory biases are contingent upon explicit processing of the emotional element of the to-be-remembered material at encoding.

Watch that space! The county hierarchy in firm births and deaths in the UK, 1980-1999

The paper investigates the relationships between registrations, de-registrations and population density at county level in the UK using VAT data for 20 years over the period 1980–1999. The rationale for this is based on the need to understand how the extent to which, in different parts of the UK, differences in the relationship between birth rates and death rates combine to produce an interpretable pattern in net birth rates. The analysis of the net birth rate shows that a strategy aimed at the net birth rate might, in principle, just as well aim at reducing business failure, rather than raising the birth rate. Indeed this might be more efficient, since it implies that less start-ups are ‘‘wasted’’ as it would avoid the necessity, if targets are to be reached, of encouraging those individuals who are patently unsuited to running their own business into business ownership.

The impact of the performance measurement systems in setting the 'direction' in the University of Warwick

This paper presents a case study examining the role of performance measurement systems in setting organizational ‘direction’. There is a growing concern in the existing literature to link the development of organizational ‘direction’ with performance measurement systems. Furthermore, the alignment between organizational ‘direction’, strategy and performance measurement is an area of increasing interest for both academics and practitioners. However, there is no adequate research recorded in the literature on the use of the performance measurement systems and the potential impact that performance measurement can have in setting the organizational ‘direction’. This study reports the findings of a case study from one of the leading academic institutions in the UK, the University of Warwick, presenting the main characteristics of its performance measurement system and attempting to explain the connection with setting the university’s ‘direction’.

Does the balanced scorecard make a difference to the strategy development process?

A great number of strategy tools are being taught in strategic management modules. These tools are available to managers for use in facilitating strategic decision-making and enhancing the strategy development process in their organisations. A number of studies have been published examining which are the most popular tools; however there is little empirical evidence on how their utilisation influences the strategy process. This paper is based on a large scale international survey on the strategy development process, and seeks to examine the impact of a particular strategy tool, the Balanced Scorecard, upon the strategy process. The Balanced Scorecard is one of the most popular strategy tools whose use has evolved since its introduction in the 1990’s. Recently, it has been suggested that as a strategy tool, Balanced Scorecard can influence all elements of the strategy process. The results of this study indicate that although there are significant differences in some elements of the strategy process between the organisations that have implemented the Balanced Scorecard and those that have not, the impact is not comprehensive.

Determining the influence of strategic planning's elements in its success

This paper presents the results of a multinational large-scale survey, investigating the current trends in strategic planning. The survey was conducted online using the Warwick Business School alumni database. Considering the development and implementation of strategy within a multi-process framework, the 'Strategic Development Process' model by Dyson and O'Brien (1998), using factor analysis, four distinct factors of strategic planning have been produced and with regression analysis, their impact on the success of strategic planning from a process point of view has been assessed. The results indicate that significant variation in practices involved is created by complexity either of the organizational size or environmental turbulence.

Pre-conception care : current practice and methods of provision

This thesis examines the present provisions for pre-conception care and the views of the providers of services. Pre-conception care is seen by some clinicians and health educators as a means of making any necessary changes in life style, corrections to imbalances in the nutritional status of the prospective mother (and father) and the assessment of any medical problems, thus maximizing the likelihood of the normal development of the baby. Pre-conception care may be described as a service to bridge the gap between the family planning clinic and the first ante-natal booking appointment. There were three separate foci for the empirical research - the Foresight organisation (a charity which has pioneered pre-conception care in Britain); the pre-conception care clinic at the West London Hospital, Hammersmith; and the West Midlands Regional Health Authority. The six main sources of data were: twenty five clinicians operating Foresight pre-conception clinics, couples attending pre-conception clinics, committee members of the Foresight organisation, staff of the West London Hospital pre-conception clinic, Hammersmith, District Health Education Officers working in the West Midlands Regional Health Authority and the members of the Ante-Natal Care Action Group, a sub-group of the Regional Health Advisory Group on Health Promotion and Preventive Medicine. A range of research methods were adopted. These were as follows: questionnaires and report forms used in co-operation with the Foresight clinicians, interviews, participant observation discussions and informal meetings and, finally, literature and official documentation. The research findings illustrated that pre-conception care services provided at the predominantly private Foresight clinics were of a rather `ad hoc' nature. The type of provision varied considerably and clearly reflected the views held by its providers. The protocol which had been developed to assist in the standardization of results was not followed by the clinicians. The pre-conception service provided at the West London Hospital shared some similarities in its approach with the Foresight provision; a major difference was that it did not advocate the use of routine hair trace metal analysis. Interviews with District Health Education Officers and with members of the Ante Natal Care Action Group revealed a tentative and cautious approach to pre-conception care generally and to the Foresight approach in particular. The thesis concludes with a consideration of the future of pre-conception care and the prospects for the establishment of a comprehensive pre-conception care service.