An exploratory study of the role of trust in medication management within mental health services

Objective - To develop understandings of the nature and influence of trust in the safe management of medication within mental health services. Setting - Mental health services in the UK. Method - Qualitative methods were applied through focus groups across three different categories of service user—older adult, adults living in the community and forensic services. An inductive thematic analysis was carried out, using the method of constant comparison derived from grounded theory. Main Outcome - Measure Participants’ views on the key factors influencing trust and the role of trust in safe medication management. Results - The salient factors impacting trust were: the therapeutic relationship; uncertainty and vulnerability; and social control. Users of mental health services may be particularly vulnerable to adverse events and these can damage trust. Conclusion - Safe management of medication is facilitated by trust. However, this trust may be difficult to develop and maintain, exposing service users to adverse events and worsening adherence. Practice and policy should be oriented towards developing trust.

Knowledge-based development in leading regions across the globe:an exploratory analysis of the co-evolution of resources, capabilities, and outputs

It is widely observed that the global geography of innovation is rapidly evolving. This paper presents evidence concerning the contemporary evolution of the globe's most productive regions. The paper uncovers the underlying structure and co-evolution of knowledge-based resources, capabilities and outputs across these regions. The analysis identifies two key trends by which the economic evolution and growth patterns of these regions are differentiated-namely, knowledge-based growth and labour market growth. The knowledge-based growth factor represents the underlying commonality found between the growth of economic output, earnings and a range of knowledge-based resources. The labour market growth factor represents the capability of regions to draw on their human capital. Overall, spectacular knowledge-based growth of leading Chinese regions is evident, highlighting a continued shift of knowledge-based resources to Asia. It is concluded that regional growth in knowledge production investment and the capacity to draw on regional human capital reserves are neither necessarily traded-off nor complementary to each other. © 2012 Urban Studies Journal Limited.

The atypical bilingual courtroom:an exploratory study of the interactional dynamics in interpreter-mediated trials in Hong Kong

This study investigates the communication process in the atypical bilingual Hong Kong courtroom, where, unlike in most other jurisdictions, interpreting services are routinely provided for the linguistic majority instead of the linguistic minority and the interpreter usually has to work with court actors who share his/her bilingual knowledge. It sets out to explore how the unique nature of the bilingual Hong Kong courtroom impacts on interactional dynamics in communicative process in the courtroom and potentially on the administration of justice, using authentic recordings of nine criminal trials from three court levels, supplemented by a survey administered to court interpreters. It compares the participant roles of different court actors in different court settings, monolingual and bilingual, using Goffman’s (1981) participation framework and Bell’s (1984) audience design as the conceptual framework. It is found that the notion of recipientship in the atypical bilingual Hong Kong courtroom is complicated by the presence of other bilinguals, which inevitably changes the interactional dynamics and impacts on the power of court interpreter as these bilinguals take on more participant roles in the process. The findings of this study show that the power of court actors is realised in the participant role(s) they and the other co-present court actors take on or are capable of playing. The findings also indicate that a change in the participant role of a court actor has an impact on the participation status other actors, which may in turn hamper the administration of justice. It is also found that the notion of power asymmetry in the courtroom has an effect on the footings adopted by the interpreter and thus on his/her neutrality. This thesis identifies training needs and makes recommendations for best practice in the courtroom and for institutional administrative practice.

An exploratory study of ICT usage in small logistics service providers

Information and communication technology (ICT) developments have strongly affected supply chain management (SCM) in recent years. ICT has had a great impact on all supply chain processes including planning, purchasing, production management, stock management, physical distribution and related integration management. Technology has become an important dimension of third party logistics (3PL) service supply as competitive advantage increasingly depends on the ability to create value for customers through the effective application of ICT. Within this process, while large 3PLs are gaining substantial benefits from technology usage and implementation, the magnitude of changes spurred by ICT dissemination in small logistics service providers remains unclear. This is reflected by the existing gap in literature where the role and competitive developing processes of small 3PLs are seriously underestimated. This gives rise to the need to develop research and investigation in this particular area. The objective of this paper is to narrow the knowledge gap in the field of ICT adoption in small 3PLs through an empirical investigation. It presents the results of a survey on a sample of small Italian 3PLs.

Strategic Human Resources Management Performance Metrics for Unit-Level Managers: An Exploratory Study of U.S Casual Restaurants

Many restaurant organizations have committed a substantial amount of effort to studying the relationship between a firm’s performance and its effort to develop an effective human resources management reward-and-retention system. These studies have produced various metrics for determining the efficacy of restaurant management and human resources management systems. This paper explores the best metrics to use when calculating the overall unit performance of casual restaurant managers. These metrics were identified through an exploratory qualitative case study method that included interviews with executives and a Delphi study. Experts proposed several diverse metrics for measuring management value and performance. These factors seem to represent all stakeholders’interest.

Taking risks in the face of uncertainty:an exploratory analysis of green innovation

The relationship between uncertainty and firms’ risk-taking behaviour has been a focus of investigation since early discussion of the nature of enterprise activity. Here, we focus on how firms’ perceptions of environmental uncertainty and their perceptions of the risks involved impact on their willingness to undertake green innovation. Analysis is based on a cross-sectional survey of UK food companies undertaken in 2008. The results reinforce the relationship between perceived environmental uncertainty and perceived innovation risk and emphasise the importance of macro-uncertainty in shaping firms’ willingness to undertake green innovation. The perceived (market-related) riskiness of innovation also positively influences the probability of innovating, suggesting either a proactive approach to stimulating market disruption or an opportunistic approach to innovation leadership.

An exploratory study of orthoptic student satisfaction in a blended learning environment

Purpose: To describe orthoptic student satisfaction in a blended learning environment. Methods: Blended learning and teaching approaches that include a mix of sessions with elearning are being used since 2011/2012 involving final year (4th year) students from an orthoptic program. This approach is used in the module of research in orthoptics during the 1 semester. Students experienced different teaching approaches, which include seminars, tutorial group discussions and e-learning activities using the moodle platform. The Constructivist OnLine Learning Environment Survey (COLLES ) was applied at the end of the semester with 24 questions grouped in 6 dimensions with 4 items each: Relevance to professional practice, Reflection, Interactivity, Tutor support, Peer support and Interpretation. A 5-point Likert scale was used to score each individual item of the questionnaire (1 - almost never to 5 – almost always). The sum of items in each dimension ranged between 4 (negative perception) and 20 (positive perception). Results: Twenty-four students replied to the questionnaire. Positive points were related with Relevance (16.13±2.63), Reflection (16.46±2.45), Tutor support (16.29±2.10) and Interpretation (15.38±2.16). The majority of the students (n=18; 75%) think that the on-line learning is relevant to students’ professional practice. Critical reflections about learning contents were frequent (n=19; 79.17%). The tutor was able to stimulate critical thinking (n=21; 87.50%), encouraged students to participate (n=18; 75%) and understood well the student’s contributions (n=15; 62.50%). Less positive points were related with Interactivity (14.13±2.77) and Peer support (13.29±2.60). Response from the colleagues to ideas (n=11; 45.83%) and valorization of individual contributions (n=10; 41.67%) scored lower than other items. Conclusions: The flow back and forth between face-to-face and online learning situations helps the students to make critical reflections. The majority of the students are satisfied with a blended e-learning system environment. However, more work needs to be done to improve interactivity and peer support.

Occupational therapists’ perceptions of occupation in practice : an exploratory study

An exploratory study of the relationship between psychosocial hazard and ambulatory physiological response in higher education employees.

Purpose: as exposure to psychosocial hazard at work represents a substantial risk factor for employee health in many modern occupations, being able to accurately assess how employees cope with their working environment is crucial. As the workplace is generally accepted as being a dynamic environment consideration should be given to the interaction between employees and the acute environmental characteristics of their workplace. The aim of this study was to investigate the effects of both acute demand and chronic work-related psychosocial hazard upon employees through ambulatory assessment of heart rate variability and blood pressure. Design: a within-subjects repeated measures design was used to investigate the relationship between exposure to work-related psychosocial hazard and ambulatory heart rate variability and blood pressure in a cohort of higher education employees. Additionally the effect of acute variation in perceived work-related demand was investigated. Results: two dimensions of the Management Standards were found to demonstrate an association with heart rate variability; more hazardous levels of “demand” and “relationships” were associated with decreased SDNN. Significant changes in blood pressure and indices of heart rate variability were observed with increased acute demand.

An exploratory analysis of relationships between socioeconomic, land use, activity participation variables and travel patterns

This paper aims to find relations between the socioeconomic characteristics, activity participation, land use patterns and travel behavior of the residents in the Sao Paulo Metropolitan Area (SPMA) by using Exploratory Multivariate Data Analysis (EMDA) techniques. The variables influencing travel pattern choices are investigated using: (a) Cluster Analysis (CA), grouping and characterizing the Traffic Zones (17), proposing the independent variable called Origin Cluster and, (b) Decision Tree (DT) to find a priori unknown relations among socioeconomic characteristics, land use attributes of the origin TZ and destination choices. The analysis was based on the origin-destination home-interview survey carried out in SPMA in 1997. The DT application revealed the variables of greatest influence on the travel pattern choice. The most important independent variable considered by DT is car ownership, followed by the Use of Transportation ""credits"" for Transit tariff, and, finally, activity participation variables and Origin Cluster. With these results, it was possible to analyze the influence of a family income, car ownership, position of the individual in the family, use of transportation ""credits"" for transit tariff (mainly for travel mode sequence choice), activities participation (activity sequence choice) and Origin Cluster (destination/travel distance choice). (c) 2010 Elsevier Ltd. All rights reserved.

Tissue-specific expression of head-to-tail cyclized miniproteins in Violaceae and structure determination of the root cyclotide Viola hederacea root cyclotide1

The plant cyclotides are a family of 28 to 37 amino acid miniproteins characterized by their head-to-tail cyclized peptide backbone and six absolutely conserved Cys residues arranged in a cystine knot motif: two disulfide bonds and the connecting backbone segments form a loop that is penetrated by the third disulfide bond. This knotted disulfide arrangement, together with the cyclic peptide backbone, renders the cyclotides extremely stable against enzymatic digest as well as thermal degradation, making them interesting targets for both pharmaceutical and agrochemical applications. We have examined the expression patterns of these fascinating peptides in various Viola species (Violaceae). All tissue types examined contained complex mixtures of cyclotides, with individual profiles differing significantly. We provide evidence for at least 57 novel cyclotides present in a single Viola species (Viola hederacea). Furthermore, we have isolated one cyclotide expressed only in underground parts of V, hederacea and characterized its primary and three-dimensional structure. We propose that cyclotides constitute a new family of plant defense peptides, which might constitute an even larger and, in their biological function, more diverse family than the well-known plant defensins.

The impact of night work on subjective reports of well-being: an exploratory study of health care workers from five nations

OBJECTIVE: To carry out a survey data collection from health care workers in Brazil, Croatia, Poland, Ukraine and the USA with two primary goals: (1) to provide information about which aspects of well-being are most likely to need attention when shiftwork management solutions are being developed, and (2) to explore whether nations are likely to differ with respect to the impacts of night work on the well-being of workers involved in health care work. METHODS: The respondents from each nation were sorted into night worker and non-night worker groups. Worker perceptions of being physically tired, mentally tired, and tense at the end of the workday were examined. Subjective reports of perceived felt age were also studied. For each of these four dependent variables, an ANCOVA analysis was carried out. Hours worked per week, stability of weekly work schedule, and chronological age were the covariates for these analyses. RESULTS: The results clearly support the general proposal that nations differ significantly in worker perceptions of well-being. In addition, perceptions of physical and mental tiredness at the end of the workday were higher for night workers. For the perception of being physically tired at the end of a workday, the manner and degree to which the night shift impacts the workers varies by nation. CONCLUSIONS: Additional research is needed to determine if the nation and work schedule differences observed are related to differences in job tasks, work schedule structure, off-the-job variables, and/or other worker demographic variables.

Organizational Culture in Cooperatives: an exploratory approach

In recent years, organizational culture has become one of the common themes of interest of scientific and academic research. Each organization has its own unique cultural identity. Based on the recognition that organizational culture is considered important to an organization’s results, and social economy organizations are concerned with improving managerial practices and results, our objective is to study organizational culture in cooperatives: identifying their organizational culture as a specific type of organization of the social economy, recognized as increasingly important economic agents; and in doing so, explore the usage of a widely known model, the Competing Values Framework (Quinn & Rohrbaugh 1983). Three cooperatives were studied. Their presidents were interviewed, and a questionnaire was applied to cooperative members to obtain demographic and organizational culture data. Differences between the cooperatives’ cultural profiles seem to be consistent with both the circumstances of Portuguese social economy organizations (SEOs), and to the organizations’ uniqueness regarding their trade, focuses, and history. International firm trends were compared with this study’s results, and also appear to be explained by the SEO’s management practices evolution standpoint: lack of structured way of working, and the need to improvise and innovate in order to get things done. The importance of our research is held in the fact that social economy, and the cooperative movement in particular, has a developing importance in the expansion of many economies, the lack of literature on culture in SEOs, and the exploratory usage of a well-known model of management literature in cooperatives.

Organizational culture in cooperatives: an exploratory approach

In recent years, organizational culture has become one of the common themes of interest of scientific and academic research. Each organization has its own unique cultural identity. Based on the recognition that organizational culture is considered important to an organization’s results, and social economy organizations are concerned with improving managerial practices and results, our objective is to study organizational culture in cooperatives: identifying their organizational culture as a specific type of organization of the social economy, recognized as increasingly important economic agents; and in doing so, explore the usage of a widely known model, the Competing Values Framework (Quinn & Rohrbaugh 1983). Three cooperatives were studied. Their presidents were interviewed, and a questionnaire was applied to cooperative members to obtain demographic and organizational culture data. Differences between the cooperatives’ cultural profiles seem to be consistent with both the circumstances of Portuguese social economy organizations (SEOs), and to the organizations’ uniqueness regarding their trade, focuses, and history. International firm trends were compared with this study’s results, and also appear to be explained by the SEO’s management practices evolution standpoint: lack of structured way of working, and the need to improvise and innovate in order to get things done. The importance of our research is held in the fact that social economy, and the cooperative movement in particular, has a developing importance in the expansion of many economies, the lack of literature on culture in SEOs, and the exploratory usage of a well-known model of management literature in cooperatives.

Automated systems in the identification and determination of methicillin resistance among coagulase negative staphylococci

Coagulase-negative staphylococci (CoNS) are an important cause of nosocomial bacteremia, specially in patients with indwelling devices or those submitted to invasive medical procedures. The identification of species and the accurate and rapid detection of methicillin resistance are directly dependent on the quality of the identification and susceptibility tests used, either manual or automated. The objective of this study was to evaluate the accuracy of two automated systems MicroScan and Vitek - in the identification of CoNS species and determination of susceptibility to methicillin, considering as gold standard the biochemical tests and the characterization of the mecA gene by polymerase chain reaction, respectively. MicroScan presented better results in the identification of CoNS species (accuracy of 96.8 vs 78.8%, respectively); isolates from the following species had no precise identification: Staphylococcus haemolyticus, S. simulans, and S. capitis. Both systems were similar in the characterization of methicillin resistance. The higher discrepancies for gene mec detection were observed among species other than S. epidermidis (S. hominis, S. saprophyticus, S. sciuri, S. haemolyticus, S. warneri, S. cohnii), and those with borderline MICs.