The impact of peginterferon alfa-2a plus ribavirin combination therapy on health-related quality of life in chronic hepatitis C

Background/Aims: Peginterferon alfa-2a plus ribavirin improves sustained virological responses compared with interferon alfa-2b and ribavirin, or peginterferon alfa-2a alone in chronic hepatitis C. We examined the impact of these treatments on health related quality of life (HRQOL). Methods: Patients (n = 1121) were randomized to peginterferon alfa-2a weekly plus ribavirin or placebo, or interferon alfa-2b thrice weekly plus ribavirin. HRQOL was assessed with the SF-36 Health Survey and Fatigue Severity Scale (FSS). Results: Patients receiving peginterferon alfa-2a plus ribavirin reported better HRQOL than those receiving interferon alfa-2b plus ribavirin. These differences were statistically significant for three SF-36 domains and both FSS scores (p < = 0.05). Patients receiving peginterferon alfa-2a plus placebo had the least impairment; adding ribavirin significantly decreased five domains of the SF-36 and both FSS scores. Sustained virological response was associated with improvement at follow-up on all SF-36 and FSS scores. Conclusions: The effects of combination therapy on HRQOL and fatigue are less with peginterferon alfa-2a plus ribavirin than interferon alfa-2b plus ribavirin. Each medication in combination therapy with interferon and ribavirin, affects patients' quality of life differently. Understanding the relationship of specific therapeutic options to HRQOL may help physicians minimize the impact of therapy on HRQOL. (C) 2004 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

The role of leader-member exchanges in mediating the relationship between locus of control and work reactions

The relationship between locus of control, the quality of exchanges between subordinates and leaders (LMX), and a variety of work-related reactions (intrinsic/extrinsic job satisfaction, work-related well-being, and organizational commitment) are examined. It was predicted that people with an internal locus of control develop better quality relations with their manager and this, in turn, results in more favourable work-related reactions. Results from two different samples (N = 404, and N = 51) supported this prediction, and also showed that LMX either fully, or partially, mediated the relationship between locus of control and all the work-related reactions.

Aphasia websites: An examination of their quality and communicative accessibility

Background: Studies have examined Internet use as a source of information by various populations, however no study has examined the quality and accessibility of websites for people with aphasia, or their use of such sites. Aims: This study aimed to describe the quality, communicative accessibility, and readability of a sample of aphasia websites and to determine whether sites preferred by people with aphasia were those rated highly on measures of accessibility and quality. The perceptions of people with aphasia regarding the accessibility of the sites were compared with those of speech pathologists. The relationship between the quality and communicative accessibility of websites was analysed. Factors that may influence use of the Internet by people with aphasia and speech pathologists were explored. Methods & Procedures: Tools for measuring quality and communicative accessibility were developed and a sample of five websites was selected. Two participant groups (18 speech pathologists and 6 people with aphasia) assessed aphasia websites in terms of communicative accessibility. Speech pathologists also rated website quality. Spearman's rho was used to determine levels of agreement between variables. Outcomes & Results: People with aphasia and speech pathologists showed minimal agreement on their perceptions of communicative accessibility. However, when the preferences of websites (Aphasia Help and Speakability) were of a very high standard. There was a weak relationship between quality and communicative accessibility, however it was not statistically significant. Conclusions: Accessible websites are not necessarily of high quality, and quality websites are not guaranteed to be easily accessible. People with aphasia did not agree with speech pathologists as to what makes a good aphasia website. Therefore, people with aphasia should be involved in the design of aphasia websites since they are often the intended users. If Internet use by people with aphasia increases in line with other health populations, speech pathologist need to have the skills and confidence to recommend appropriate sites to their clients.

Between-tree variation in fruit quality and fruit mineral concentrations of Hass avocados

Inconsistent internal fruit quality in Hass avocados affects consumer confidence. To determine the influence of individual trees on fruit quality, Hass avocado fruit were harvested from adjacent trees of similar external appearance in 3 commercial orchards in 1998 and 1 orchard in 1999. The trees in each orchard were grown with similar commercial practices and in similar soil types. Within each location, there were significant (P < 0.05) differences in the mean ripe fruit quality between trees with respect to fruit body rot severity ( mainly anthracnose) with and without cold storage, internal disorders severity due to diffuse discolouration and vascular browning ( after cold storage), days to ripen, percentage dry matter, and the percentage of the skin area with purple-black colour when ripe. These effects were also noted in the same orchard in 1999. There were significant (P < 0.05) differences in fruit flesh calcium, magnesium, potassium, boron and zinc concentrations between trees. Significant (P < 0.05) correlations were observed between average fruit mineral concentrations in each tree ( particularly calcium, magnesium and potassium) and body rot severity, percentage dry matter and fruit mass. There was little conclusive evidence that characteristics such as the growth of the non-suberised roots or the degree of scion under- or overgrowth was involved in these tree effects; however, differences between trees with respect to other rootstock characteristics may be involved. The inconsistency of the correlations across sites and years suggested that other factors apart from tree influences could also affect the relationship between fruit minerals and fruit quality.

Parental attachment and conflict behavior: Implications for offspring's attachment, loneliness, and relationship satisfaction

This study assessed the implications of parental attachment security and parental conflict behavior for offspring's relational adjustment (attachment security, loneliness, and relationship satisfaction). Further, reports of parental conflict behavior were obtained from both parents and offspring, addressing questions regarding agreement between reporters and the origin and extent of discrepant perceptions. Results revealed consistent patterns of conflict behavior and moderate agreement between reporters. However, offspring reported parental conflict behavior more negatively than parents, especially when offspring or parents were anxious about relationships. Parental attachment security had direct associations with offspring's relationship anxiety, whereas associations between parental attachment and offspring's loneliness and discomfort with closeness were mediated by parental conflict behavior. Parental conflict behavior was also associated with offspring's relationship satisfaction. The results are discussed in terms of the mechanisms involved in the intergenerational transmission of relationship difficulties.

Quality-of-life in children and adolescents with cystic fibrosis managed in both regional outreach and cystic fibrosis center settings in Queensland

To assess the health-related quality-of-life (HRQOL) of children/adolescents with cystic fibrosis (CF) and compare HRQOL in children managed by cystic fibrosis outreach service (CFOS) with those treated in a cystic fibrosis center (CFC). To compare HRQOL of children with CF in Queensland with previously published HRQOL data from the United States and examine the relationship between HRQOL scores and pulmonary function. Study design: Participants were children/adolescents with CF and their parents managed by the Royal Children’s Hospital Queensland at a CFC or CFOS. Two HRQOL surveys were used: PedsQL™ and Cystic Fibrosis Questionnaire (CFQ). Results: There were 91 CFC and 71 CFOS participants with similar demographics. PedsQL™ total summary score was statistically higher in CFOS, P = .05. There was no significant difference in CFQ scores between groups. Queensland parents reported lower HRQOL for their children compared with US parents (P

The relationship between media reporting of suicide and actual suicide in Australia

This study aimed to determine whether media items about suicide were associated with differential increases in actual suicides. Data were available on 4635 suicide-related items appearing in Australian newspapers and on radio and television news and current affairs shows between March 2000 and February 2001. These data were combined with national data on completed suicides occurring during the same period, by a process that involved identifying the date and geographical reach of the media items and determining the number of suicides occurring in the same location in selected weeks pre- and post-item. Regression analyses were conducted to determine whether the likelihood of an increase in post-item suicides could be explained by particular item characteristics. We found that 39% of media items were followed by an increase in mate suicides, and 31% by an increase in female suicides. Media items were more likely to be associated with increases in both male and female suicides if they occurred in the context of multiple other reports on suicide (versus occurring in isolation), if they were broadcast on television (versus other media), and if they were about completed suicide (versus attempted suicide or suicidal ideation). Different item content appeared to be influential for males and females, with an increase in male suicides being associated with items about an individual's experience of suicide and opinion pieces, and an increase in female suicides being associated with items about mass- or murder-suicide. Item prominence and quality were not differentially associated with increases in male or female suicides. Further research on this topic is required, but in the meantime there is a need to remain vigilant about how suicide news is reported. Mental health professionals and suicide experts should collaborate with media professionals to try to balance 'public interest' against the risk of harm. (c) 2005 Published by Elsevier Ltd.

Design of high quality doped CeO2 solid electrolytes with nanohetero structure

Doped ceria (CeO2) compounds are fluorite related oxides which show oxide ionic conductivity higher than yttria-stabilized zirconia in oxidizing atmosphere. As a consequence of this, a considerable interest has been shown in application of these materials for low (400-650 degrees C) temperature operation of solid oxide fuel cells (SOFCs). In this paper, our experimental data about the influence of microstructure at the atomic level on electrochemical properties were reviewed in order to develop high quality doped CeO2 electrolytes in fuel cell applications. Using this data in the present paper, our original idea for a design of nanodomain structure in doped CeO2 electrolytes was suggested. The nanosized powders and dense sintered bodies of M doped CeO2 (M:Sm,Gd,La,Y,Yb, and Dy) compounds were fabricated. Also nanostiructural features in these specimens were introduced for conclusion of relationship between electrolytic properties and domain structure in doped CeO2. It is essential that the electrolytic properties in doped CeO2 solid electrolytes reflect in changes of microstructure even down to the atomic scale. Accordingly, a combined approach of nanostructure fabrication, electrical measurement and structure characterization was required to develop superior quality doped CeO2 electrolytes in the fuel cells.

The relationship between extra-role behaviours and job burnout for primary school teachers: A preliminary model and development of an organisational citizenship behaviour scale

Recent research on teacher stress in primary schools (e.g. Leonard, Bourke & Schofield, 1999) has shown that higher levels of teacher exhaustion are associated with higher levels of student satisfaction. This paper seeks to explain this surprising finding by considering a construct discussed widely in the organisational literature known as extra-role or organisational citizenship behaviour (OCB). Teacher OCB may include extra efforts to make lessons enjoyable and interesting, organising extra-curricular activities and spending personal time talking with students. The proposed model of analysis also draws on literature relating to job burnout (Maslach, 1982), which generally suggests that the three components of chronic occupational stress - exhaustion, depersonalisation and reduced accomplishment - occur together. However, this paper proposes that although teachers who engage in more OCB experience more exhaustion, they may simultaneously increase their feelings of personal accomplishment and work identification, which may in turn help to avert burnout. It is argued that only with this particular set of job attitudes are the effects of exhaustion caused by high levels of OCB sufficiently buffered to avoid job burnout, and thus positively affect students' quality of school life. The development and piloting of an instrument to measure teachers' OCB will be discussed. The preliminary findings reported herein are part of a larger ongoing study investigating the consequences of stress and OCB in primary school teachers.

Comparison of the effect of pre-treatment and catalysts on liquid quality from fast pyrolysis of biomass

The overall objective of this work was to compare the effect of pre-treatment and catalysts on the quality of liquid products from fast pyrolysis of biomass. This study investigated the upgrading of bio-oil in terms of its quality as a bio-fuel and/or source of chemicals. Bio-oil used directly as a biofuel for heat or power needs to be improved particularly in terms of temperature sensitivity, oxygen content, chemical instability, solid content, and heating values. Chemicals produced from bio-oil need to be able to meet product specifications for market acceptability. There were two main objectives in this research. The first was to examine the influence of pre-treatment of biomass on the fast pyrolysis process and liquid quality. The relationship between the method of pre-treatment of biomass feedstock to fast pyrolysis oil quality was studied. The thermal decomposition behaviour of untreated and pretreated feedstocks was studied by using a TGA (thermogravimetric analysis) and a Py-GC/MS (pyroprobe-gas chromatography/mass spectrometry). Laboratory scale reactors (100g/h, 300g/h, 1kg/h) were used to process untreated and pretreated feedstocks by fast pyrolysis. The second objective was to study the influence of numerous catalysts on fast pyrolysis liquids from wheat straw. The first step applied analytical pyrolysis (Py-GC/MS) to determine which catalysts had an effect on fast pyrolysis liquid, in order to select catalysts for further laboratory fast pyrolysis. The effect of activation, temperature, and biomass pre-treatment on catalysts were also investigated. Laboratory experiments were also conducted using the existing 300g/h fluidised bed reactor system with a secondary catalytic fixed bed reactor. The screening of catalysts showed that CoMo was a highly active catalyst, which particularly reduced the higher molecular weight products of fast pyrolysis. From these screening tests, CoMo catalyst was selected for larger scale laboratory experiments. With reference to the effect of pre-treatment work on fast pyrolysis process, a significant effect occurred on the thermal decomposition of biomass, as well as the pyrolysis products composition, and the proportion of key components in bio-oil. Torrefaction proved to have a mild influence on pyrolysis products, when compared to aquathermolysis and steam pre-treatment.

The quality of sales manager:salesperson exchanges perspective under problem resolution conditions

Building on social exchange theory and qualitative inquiry, managerial responsiveness, caring, and aggressiveness were uncovered as three key social exchange dimensions used by sales managers when dealing with problem situations in the salesforce. We used Australian data to develop measures of these three constructs. Results of the development process indicate that the measures show good validity. Further to this, we also provide examination of the relationship of the three exchange dimensions with key organizational outcomes. Overall the findings suggest that the three constructs are important in sales manager problem resolution exchanges, and that they may ultimately influence the success of sales organizations.

Beyond personal Leader Member Exchange (LMX) quality:the effects of perceived LMX variability on employee reactions

A fundamental tenet of Leader–Member Exchange (LMX) theory is that leaders develop different quality relationships with their employees; however, little research has investigated the impact of LMX differentiation on employee reactions. The current research investigates whether perceptions of LMX variability (the extent to which LMX relationships are perceived to vary within a team) affects employee job satisfaction and wellbeing beyond the effects of personal LMX quality. As LMX variability runs counter to principles of equality and consistency, which are important for maintaining social harmony in groups, it is hypothesized that perceptions of LMX variability will have a negative effect on employee reactions, via its negative impact on perceived team relations. Two samples of employed individuals were used to investigate the hypothesized relationships. In both samples, an individual's perception of LMX variability in their team was negatively related to employee job satisfaction and wellbeing (above the effects of LMX), and this relationship was mediated by reports of relational team conflict.

The role of leader-member exchanges in mediating the relationship between locus of control and work reactions

The relationship between locus of control, the quality of exchanges between subordinates and leaders (LMX), and a variety of work-related reactions (intrinsic/extrinsic job satisfaction, work-related well-being, and organizational commitment) are examined. It was predicted that people with an internal locus of control develop better quality relations with their manager and this, in turn, results in more favourable work-related reactions. Results from two different samples (N=404, and N=51) supported this prediction, and also showed that LMX either fully, or partially, mediated the relationship between locus of control and all the work-related reactions.

The impact of leadership and quality climate on hospital performance

Objective. To explore the relationship between leadership effectiveness and health-care trust performance, taking into account external quality measures and the number of patient complaints; also, to examine the role of care quality climate as a mediator. Design. We developed scales for rating leadership effectiveness and care quality climate. We then drew upon UK national indices of health-care trust performance—Commission for Health Improvement star ratings, Clinical Governance Review ratings and the number of patient complaints per thousand. We conducted statistical analysis to examine any significant relationships between predictor and outcome variables. Setting. The study is based on 86 hospital trusts run by the National Health Service (NHS) in the UK. The data collection is part of an annual staff survey commissioned by the NHS to explore the quality of working life. Participants. A total of 17 949 employees were randomly surveyed (41% of the total sample). Results. Leadership effectiveness is associated with higher Clinical Governance Review ratings and Commission for Health Improvement star ratings for our sample (ß = 0.42, P < 0.05; ß = 0.37, P < 0.05, respectively), and lower patient complaints (ß = –0.57, P < 0.05). In addition, 98% of the relationship between leadership and patient complaints is explained by care quality climate. Conclusions. Results offer insight into how non-clinical leadership may foster performance outcomes for health-care organizations. A frequently neglected area—patient complaints—may be a valid measure to consider when assessing leadership and quality in a health-care context.

An investigation of the relationships between service quality, customer satisfaction, perceived value and behavioural intentions

Customer satisfaction and service quality are two important concepts in the marketing literature. However, there has been some confusion about the conceptualisation and measurement of these two concepts and the nature of the relationship between them. The primary objective of this research was to develop a more thorough understanding of these concepts, and a model that could help to explain the links between them and their relationships with post-purchase behaviour. A preliminary theoretical model was developed, based on an exhaustive review of the literature. Following exploratory research, the model was revised by incorporating "Perceived Value" and "Perceived Sacrifice" to help explain customer's post-purchase behaviour. A longitudinal survey was conducted in the context of the restaurant industry, and the data were analysed using structural equation modelling. The results provided evidence to support the main research hypotheses. However, the effect of "Normative Expectations" on "Encounter Quality" was insignificant, and "Perceived Value" had a direct effect on "Behavioural Intentions" despite expectations that such an effect would be mediated through "Customer Satisfaction". It was also found that "Normative Expectations" were relatively more stable than "Predictive Expectations". It is argued that the present research significantly contributes to the marketing literature, and in particular the role of perceived value in the formation of customers' post-purchase behaviour. Further research efforts in this area are warranted.