Are HRM practices related with patient mortality in NHS hospitals?:A study examining the underlying reasons for such an association

This thesis will report details of two studies conducted within the National Health Service in the UK that examined the association between HRM practices related to training and appraisal with health outcomes within NHS Trusts. Study one represents the organisational analysis of 61 NHS Trusts, and will report training and appraisal practices were significantly associated with lower patient mortality. Specifically, the research will show significantly lower patient mortality within NHS Trusts that: a) had achieved Investors in People accreditation; b) had a formal strategy document relating to training; c) had tailored training policy documents across occupational groups; d) had integrated training and appraisal practices; e) had a high percentage of staff receiving either an appraisal or updated personal development plan. There was also evidence of an additive effect where NHS Trusts that displayed more of these characteristics had significantly lower patient mortality. Study one in this thesis will also report significantly lower patient mortality within the NHS Trusts where there was broad level representation for the HR function. Study two will report details of a study conducted to examine the potential reasons why HR practices may be related to hospital performance. Details are given of the results of a staff attitudinal survey within five NHS Trusts. This study examined will show that a range of developmental activity, the favourability of the immediate work environment (in relation to social support and role stressors) and motivational outcomes are important antecedents to citizenship behaviours. Furthermore, the thesis will report that principles of the demand-control model were adopted to examine the relationship between workplace support and role stressors, and workplace support, influence, and an understanding of role expectation help mitigate against the negative effects of work demands upon motivational outcomes.

Person-oriented and process-oriented teachers : an investigation of the links between ESOL teachers' personal belief systems and approaches to teaching

This thesis looks to two traditions in research into language teaching, teacher beliefs and classroom interaction, in order to investigate the question: Do teachers of ESOL have an identifiable and coherent system of beliefs about teaching and learning that may account for different approaches to teaching? A qualitative approach to research is taken, following a case study tradition, in order to carry out an in-depth study into the beliefs of six ESOL teachers. Five teachers participated in an initial pilot study and two subsequently became the main case studies for the research. The beliefs of a sixth teacher were then investigated to verify the findings. Semi-structured interviews and classroom observations were carried out with all the teachers. The teachers in the study were found to have personal belief systems that cohere around two orientations to teaching and learning - a person orientation and a process orientation. Moreover, the findings suggest that underlying the orientations is the perception that teachers have of their teacher identity, in terms of whether this is seen as a separate identity or as part of their personality. It is suggested that the two orientations may offer a powerful tool for teacher education as it is increasingly recognised that, in order to be effective, teacher educators must take into account the beliefs that teachers bring with them to training and development programmes. An initial investigations into the teachers’ classroom behaviour suggests that while their methodologies approach may be very similar there are fundamental differences in their interactions patterns and these differences may be a result of their own orientation. However, while teachers’ personal belief systems undoubtedly underlie their approach to teaching, further research is needed to establish the extent and the nature of the relationship between orientation and classroom interaction.

An investigation into the synaptic conditions and celluar mechanisms underlying cerebellar synaptic plasticity

The direction of synaptic plasticity at the connection between parallel fibres (PFs) and Purkinje cells can be modified by PF stimulation alone. Strong activation (Hartell, 1996) or high frequency stimulation (Schreurs and Alkon, 1993) of PFs induced a long-term depression (LTD) of PF-mediated excitatory postsynaptic currents. Brief raised frequency molecular layer stimulation produced a cAMP-dependent long-temi potentiation (LTP) of field potential (FP) responses (Salin et al., 1998). Thin slices of cerebellar vermis were prepared from 14-21 day old male Wistar rats decapitated under Halothane anaesthesia. FP's were recorded from the Purkinje cell layer in response to alternate 0.2Hz activation of stimulating electrodes placed in the molecular layer. In the presence of picrotoxin, FPs displayed two tetrodotoxin-sensitive, negative-going components termed N1 and N2. EPs were graded responses with paired pulse facilitation and were selectively blocked by 101AM 6-cyano-7-nitroquinoxaline-2,3-dicne (CNQX) an antagonist at iy,-amino-3-hydroxy-5-methyl-4-isoxazolepropionate-type ionotropic glutamate receptors (AMPAR) suggesting that they were primarily PE-mediated. The effects of raised stimulus intensity (RS) and/or increased frequency (IF) activation of the molecular layer on FP responses were examined. In sagittai and transverse slices combined RS and IF molecular layer activation induced a LTD of the N2 component of FP responses. RSIF stimulation produced fewer incidences of LTD in sagittal slices when an inhibitor of nitric oxide synthase (NOS), guanylate cyclase (GC), protein kinase G (PKG) or the GABAB receptor antagonist CGP62349 was included into the perfusion medium. Application of a nitric oxide (NO) donor, a cyclic guanosine monophosphate (cGMP) analogue or a phosphodiesterase (PDE) type V inhibitor to prevent cGMP breakdown paired with IF stimulation produced an acute depression, Raised frequency (RF) molecular layer stimulation produced a slowly emerging LTD of N2 in sagittal slices that was largely blocked in the presence of NOS, cGMP or PKG inhibitors. In transverse slices RE stimulation produced a LTP of the N2 component that was prevented by an inhibitor of protein kinase A or NOS. Inhibition of cGMP-signalling frequently revealed an underlying potentiation suggesting that cGMP activity might mask the effects of cAMP. In sagittal slices RE stimulation resulted in a potentiation of FPs when the cAMP-specific PDE type IV inhibitor rolipram was incorporated into the perfusion medium. In summary, raised levels of PE stimulation can alter the synaptic efficacy at PF-Purkinje cell synapses. The results provide support for a role of NO/cGMP/PKG signalling in the induction of LTD in the cerebellar cortex and suggest that activation of GABAa receptors might also be important. The level of cyclic nucleotide-specific PDE activities may be crucial in determining the level of cGMP and CAMP activity and hence the direction of synaptic plasticity.

Chemical and physical methods of enhancing the percutaneous absorption of antimicrobial agents

Contrary to previously held beliefs, it is now known that bacteria exist not only on the surface of the skin but they are also distributed at varying depths beneath the skin surface. Hence, in order to sterilise the skin, antimicrobial agents are required to penetrate across the skin and eliminate the bacteria residing at all depths. Chlorhexidine is an antimicrobial agent with the widest use for skin sterilisation. However, due to its poor permeation rate across the skin, sterilisation of the skin cannot be achieved and, therefore, the remaining bacteria can act as a source of infection during an operation or insertion of catheters. The underlying theme of this study is to enhance the permeation of this antimicrobial agent in the skin by employing chemical (enhancers and supersaturated systems) or physical (iontophoresis) techniques. The hydrochloride salt of chlorhexidine (CHX), a poorly soluble salt, was used throughout this study. The effect of ionisation on in vitro permeation rate across the excised human epidennis was investigated using Franz-type diffusion cells. Saturated solutions of CHX were used as donor and the variable studied was vehicle pH. Permeation rate was increased with increasing vehicle pH. The pH effect was not related to the level of ionisation of the drug. The effect of donor vehicle was also studied using saturated solutions of CHX in 10% and 20% ethanol as the donor solutions. Permeation of CHX was enhanced by increasing the concentration of ethanol which could be due to the higher concentration of CHX in the donor phase and the effect of ethanol itself on the membrane. The interplay between drug diffusion and enhancer pretreatment of the epidennis was studied. Pretreatment of the membrane with 10% Azone/PG demonstrated the highest diffusion rate followed by 10% olcic acid/PG pretreatment compared to other pretreatment regimens (ethanol, dimethyl sulfoxide (DMSO), propylene glycol (PG), sodium dodecyl sulphate (SDS) and dodecyl trimethyl ammonium bromide (DT AB). Differential Scanning Calorimetry (DSC) was also employed to study the mode of action of these enhancers. The potential of supersaturated solutions in enhancing percutaneous absorption of CHX was investigated. Various anti-nucleating polymers were screened in order to establish the most effective agent. Polyvinylpyrrolidone (PVP, K30) was found to be a better candidate than its lower molecular weight counterpart (K25) and hydroxypropyl methyleellulose (HPMC). The permeation studies showed an increase in diffusion rate by increasing the degree of saturation. Iontophoresis is a physical means of transdemal drug delivery enhancement that causes an increased penetration of molecules into or through the skin by the application of an electric field. This technique was employed in conjunction with chemical enhancers to assess the effect on CHX permeation across the human epidermis. An improved transport of CHX, which was pH dependant was observed upon application of the current. Combined use of iontophoresis and chemical enhancers further increased the CHX transport indicating a synergistic effect. Pretreatment of the membrane with 10% Azone/PG demonstrated the greatest effect.

A social psychological analysis of strikes

A participant observation method was employed :in the study of a 20-week stoppage at Ansells Brewery Limited, a constituent company of Allied Breweries (U.K.). The strike, :involving 1,000 workers, began :in opposition to the implementation of a four-day working week and culminated in the permanent closure of the brewery. The three main phases of the strike's development (i.e., its :initiation, maintenance and termination) were analysed according to a social-cognitive approach, based on the psychological imagery, beliefs, values and perceptions underlying the employees' behaviour. Previous psychological treatments of strikes have tended to ignore many of the aspects of social definition, planning and coordination that are an integral part of industrial action. The present study is, therefore, unique in concentrating on the thought processes by which striking workers .make sense of their current situation and collectively formulate an appropriate response. The Ansells strike provides an especially vivid illustration of the ways in which the seminal insights of a small number of individuals are developed, via processes of communication and:influence, into a consensual interpretation of reality. By adopting a historical perspective, it has been possible to demonstrate how contemporary definitions are shaped by the prior history of union-management relations, particularly with regard to: (a) the way that previous events were subjectively interpreted, and (b) the lessons that were learned on the basis of that experience. The present approach is psychological insofar as it deals with the cognitive elements of strike action. However, to the extent that it draws from relevant sections of the industrial relations, organizational behaviour, sociology, anthropology and linguistics literatures, it can claim to be truly interdisciplinary.

Perceptual processes underlying speech

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Using the theory of planned behaviour to understand binge drinking:the importance of beliefs for developing interventions

Objectives. To elicit students' salient beliefs in relation to binge drinking, and to examine the extent to which individual salient beliefs predict theory of planned behaviour (TPB) constructs in relation to binge drink, and actual drinking behaviour assessed later that evening. Design. Longitudinal, over a single evening. Methods. 192 students were recruited as they entered a campus bar at the beginning of the evening. They completed questionnaires with open-ended questions eliciting beliefs concerning binge drinking, and ratings scales assessing standard TPB constructs in relation to binge drinking. At the end of the evening, 181 completed a second questionnaire and recorded the number of alcoholic drinks they had consumed. Results. Beliefs were reliably coded (all kappas =0.79). Students with higher intentions to binge drink were more likely to believe that their friends approved of binge drinking, and that (lack of) money would make it difficult. Students who reported drinking more alcohol at the end of the evening were more likely to believe that getting drunk is an advantage/what they would like about binge drinking tonight, that their sports teams would approve, and that celebrating, drinking patterns, and environment would make it easy to binge drink. Conclusions. The present study has identified the individually salient beliefs relating to drinking behaviour that the TPB states should be addressed by interventions to alter behaviour, and which that should be assessed as mediators in intervention research. As a whole, these findings highlight the importance of perceived peer norms in binge drinking in this population, and support the idea of interventions to challenge the perception of social pressure to binge drink. ©2011 The British Psychological Society.

Investigating central mechanisms underlying the effects of action observation and imagery through transcranial magnetic stimulation

Sport and exercise psychologists provide some interventions for clients based on limited direct evidence and partial understanding of the mechanisms that underpin their efficacy. The authors review a recent technique, transcranial magnetic stimulation (TMS), which offers a tested procedure for investigating cortical activity during observation and imagery processes. They provide a detailed description of the TMS protocol and highlight some of the key studies that inform sport and exercise psychology research. Finally, the authors offer some thoughts on the direct application to practice.

Modelling the underlying principles of human aesthetic preference in evolutionary art

Our understanding of creativity is limited, yet there is substantial research trying to mimic human creativity in artificial systems and in particular to produce systems that automatically evolve art appreciated by humans. We propose here to study human visual preference through observation of nearly 500 user sessions with a simple evolutionary art system. The progress of a set of aesthetic measures throughout each interactive user session is monitored and subsequently mimicked by automatic evolution in an attempt to produce an image to the liking of the human user.

A probabilistic model for trust and reputation

This paper concerns the problem of agent trust in an electronic market place. We maintain that agent trust involves making decisions under uncertainty and therefore the phenomenon should be modelled probabilistically. We therefore propose a probabilistic framework that models agent interactions as a Hidden Markov Model (HMM). The observations of the HMM are the interaction outcomes and the hidden state is the underlying probability of a good outcome. The task of deciding whether to interact with another agent reduces to probabilistic inference of the current state of that agent given all previous interaction outcomes. The model is extended to include a probabilistic reputation system which involves agents gathering opinions about other agents and fusing them with their own beliefs. Our system is fully probabilistic and hence delivers the following improvements with respect to previous work: (a) the model assumptions are faithfully translated into algorithms; our system is optimal under those assumptions, (b) It can account for agents whose behaviour is not static with time (c) it can estimate the rate with which an agent's behaviour changes. The system is shown to significantly outperform previous state-of-the-art methods in several numerical experiments. Copyright © 2010, International Foundation for Autonomous Agents and Multiagent Systems (www.ifaamas.org). All rights reserved.

Influence of ethical beliefs, national culture and institutions on preferences for HRM in Oman

Purpose – The paper seeks to investigate the association between ethical beliefs, aspects of national culture and national institutions, and preferences for specific human resource management practices in the Sultanate of Oman. Design/methodology/approach – A total of 712 individuals working in six organisations (both private and public sectors) responded to a self-administered questionnaire in the Sultanate of Oman. To test the raised research questions of the proposed framework, the methodology of structural equation models was used. Findings – The results highlight significant differences in the belief systems on the basis of different demographic characteristics. The findings also confirm impact of ethical beliefs, and aspects of national culture and national institutions on preferences for human resource management (HRM) practices. Research limitations/implications – Although the goodness-of-fit indexes confirmed the validity of the proposed operational model, some indices were attained at rather flexible levels. Practical implications – Studies on managerial beliefs and values can offer important insights into the extent that work is viewed as an integral life activity. Such information can help differentiate among managerial styles in various cultures, and in predicting managerial behaviour such as ethical decision-making. Based on such understanding, the findings can be used to educate government officials and outside consultants interested in Oman. Originality/value – The study contributes to the accumulation of knowledge about under-researched developing countries such as Oman, as limited data are available on HRM, value orientations and ethical beliefs' issues in this region.