How do Swiss family physicians treat subclinical hypothyroidism?

Subclinical hypothyroidism is a common condition, and its prevalence increases with age. Currently, guidelines regarding the screening and treatment of subclinical hypothyroidism are controversial. An international survey of general practitioners (GPs), to which Swiss GPs also contributed, showed large inter-country variations in treatment strategies for subclinical hypothyroidism. These differences are mainly explained by the lack of strong evidence for the management of this condition. The European randomized-controlled clinical trial TRUST should help clarify recommendations for screening and thyroxin replacement for the elderly with subclinical hypothyroidism. Working in close collaboration with GPs in Switzerland for the recruitment of patients will ensure that the findings from this study will be applicable to primary care settings.

La movilidad social de los emigrantes españoles en Europa

La migración española de la segunda mitad del siglo XX se ha caracterizado en un primer momento por su carácter masivo y poco cualificado, seguido por un interregno de procesos de retorno y finalmente por una migración estable, no masiva pero altamente cualificada. La atención prestada a la inmigración masiva que recibe España a finales del siglo XX relegó a un segundo plano esta emigración cualificada de españoles. En este artículo se considera la relación entre movilidad espacial (migración de españoles) y su posible consecuencia sobre la movilidad social ascendente que experimentan. Para ello se utilizan los datos procedentes de la encuesta internacional EIMSS (European Internal Migrations Social Survey) y los procedimientos de escalamiento de clase social basados en la ocupación de Goldthorpe. El análisis se complementa con una simulación sobre la movilidad de clase, con la finalidad de visualizar y comparar los efectos sobre la movilidad social de la emigración de españoles a Francia, Alemania, Italia y Gran Bretaña.

Measuring Returns to Education and Human Capital in the Southern Mediterranean. MEDPRO Technical Report No. 17/September 2012

Measuring human capital has been a significant challenge for economists because the main variable of interest is intangible and not directly observable. In the Middle Eastern and Northern African region the task is further complicated by the general scarcity of comparable and reliable data. This study overcomes these challenges by relying on a unique international survey that covers most of the region and by deriving a market-based measure that uses returns to education and various labour market factors as guidance. The results show that private returns to schooling are relatively low in most southern Mediterranean countries (SMC). Israel and Turkey are clear outliers, surpassing even the EU-MED averages. In Algeria and Jordan, the returns are almost flat, implying that earnings do not respond significantly to education levels. Despite high attainment levels, Greece, Spain and Portugal also perform badly; only marginally surpassing some of the bottom-ranked SMC, providing evidence of problems in absorption capacity. The baseline scenarios for 2030 show substantial sensitivity to current estimates on returns to education. In particular, improving attainment levels can produce measurable gains in the future only when the returns to education are already high. Such is the case for Egypt, Morocco and Turkey, which substantially improve their human capital stocks under the baseline scenarios, surpassing several EU-MED countries with little or no room for improvement.

National travel surveys. FHWA study tour.

Mode of access: Internet.

Environmental factors that influence the community participation of adults with aphasia: The perspective of service industry workers

Background: The loss of language and the inability to communicate effectively as a result of aphasia often affects community participation. Within the World Health Organisation International Classification of Functioning, Disability and Health, disability is recognised as a dynamic interaction between the individual's health condition, such as aphasia, and his or her personal and environmental factors. There has been little research identifying the environmental facilitators and barriers to participation for people with aphasia in the community, and no research focusing on the perspective of service industry workers. Aims: This study aimed to identify barriers and facilitators to community participation for adults with aphasia from the perspective of service industry workers. Methods & Procedures: Eight focus groups were conducted with 24 service industry employees. Transcripts of the focus group discussions were analysed using qualitative content analysis procedures, and barriers to and facilitators for participation of people with aphasia were identified. Outcomes & Results: Results revealed that the participation of people with aphasia in the community can be affected by many environmental factors within three broad categories: (1) people environmental factors, (2) physical environmental factors, and (3) business or organisational environmental factors. Conclusions: Service industry employees were able to identify a range of factors that would act as barriers and facilitators for people with aphasia. Some of the more significant findings include the lack of other people's awareness about aphasia, the willingness of service industry workers at the individual level to accommodate people with aphasia, and the difficulty in making the necessary system, policy, and procedural changes at the organisational level. Speech pathologists are encouraged to assist service industry providers to be more aphasia-friendly through education and training, in addition to assisting people with aphasia to become self-advocates.

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.

Alliance behaviour, absorptive capacity and competitive advantage: a comparative study of biopharmaceutical firms in Europe and the US

In this thesis, we explore the relationship between absorptive capacity and alliances, and their influence on firms’ competitive advantage in the US and European biopharmaceutical sectors. The study undertaken in this thesis is based on data from a large-scale international survey of over 2,500 biopharmaceutical firms in the US, the UK, Germany, France and Ireland. The thesis advanced a conceptual framework, which integrated the multi-dimensions of absorptive capacity, exploration-exploitation alliances, and competitive advantage, into a biopharmaceutical firm’s new product development process. The proposed framework is then tested in the empirical analysis, using truncated models to estimate firms’ sales growth, with zero-inflated negative binominal models capturing the number of alliances in which firms engage, and aspects of realised absorptive capacity analysed by ordinal probit models. The empirical results suggest that both skill-based and exploitation-based absorptive capacity play crucial roles in shaping firms’ competitive advantage, while neither exploratory nor exploitation alliances contribute to the improvement in firms’ competitive position. In terms of the interaction between firms’ absorptive capacity and alliance behaviour, the results suggest that engagement with exploratory alliances depends more strongly on firms’ assimilation capability (skills levels and continuity of R&D activities), while participation in exploitation alliances is more conditional on firms’ relevant knowledge monitoring capability. The results highlight the major differences between the determinants of firms’ alliance behaviour, and competitive advantage in the US and Europe – in the US firms’ skill levels prove more significant in determining firms’ engagement with exploratory alliances, whereas in Europe continuity of R&D proves more important. Correspondingly, while US firms’ engagement with exploitation alliances depends on market monitoring capability, that in Europe is more strongly linked to exploitation-based absorptive capacity. In respect of the determinants of firms’ competitive advantage – in Europe, market monitoring capability, engagement with exploitation alliances, and continuous R&D activities, prove more important, while in the US, it is firms’ market characteristics that matter most.

The role of line managers in employee career management:an attachment theory perspective

Line managers increasingly play a key role in organizational career development systems, yet few studies have examined the nature of this role or its implications for employee career attitudes and behaviors. In two studies, we used attachment theory to explore this issue. In Study 1, in-depth interviews (N = 20) showed that employees viewed career management as a relational process in which line managers are expected to act as ‘caregiver’ to support individualized career development. Study 2 was a large-scale international survey (N = 891). Participants scoring higher on attachment avoidance in their line manager relationships reported more negative perceptions of career growth opportunities, lower participation in organizational career development activities and higher turnover intentions. Trust in the organization partially mediated the relationship. Theoretical and practical implications for HRM are discussed.

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 (BSC), upon the strategy process. Recently, it has been suggested that as a strategy tool, the BSC 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 BSC and those that have not, the impact is not comprehensive.

Exploring the experiences of nurses who care for children who have Acute Life Threatening Events (ALTE) in hospital

This thesis presents a program of work designed to explore and describe what the experience of caring for a child who has an Acute Life Threatening Event (ALTE) is like for the nurses. An ALTE may include a cardiac arrest, respiratory arrest or unplanned admission for a ward to the Paediatric Intensive Care unit. Using the MRC framework for the development of complex interventions, this information was then coupled with theory to develop the PREPARE and SUPPORT interventions. Given the wide-ranging and exploratory nature of this research, a pragmatic, mixed design approach was used to address the aims and objectives of the thesis. The mixed design approach included: a systematic literature review; international survey of practice; interviews with nurses and doctors using Interpretative Phenomenological Analysis; development, refinement and evaluation of interventions during a feasibility study. Two studies were identified through the systematic review which aimed to evaluate the effectiveness of debriefing. The studies did not provide evidence to support the use of these interventions within healthcare. The international survey of practice demonstrated hospitals were using interventions to both prepare and support nurses for these events. The preparatory interventions were clinically focused and the majority of the supportive interventions included a debrief. The interventions were not being evaluated for effectiveness. The interviews conducted with nurses and doctors provided insight into what that experience was like for the participants. Using the MRC framework, this evidence was coupled with theory to develop the PREPARE and SUPPORT interventions. A multidisciplinary working party used an iterative process to refine and evaluate the interventions and study procedures were explored through a feasibility study. The pragmatic, mixed design approach demonstrated how the empirical evidence was coupled with theory and clinical expertise to develop interventions for use within the healthcare environment.

Habits and attitudes towards retinoscopy and the relative accuracy of dedicated and combined retinoscopes

The studies presented in this thesis were carried out because of a lack of previous research with respect to (a) the habits and attitudes towards retinoscopy and (b) the relative accuracy of dedicated retinoscopes compared to combined types in which changing the bulb allows use in spot or streak mode. An online British survey received responses from 298 optometrists. Decision tree analyses revealed that optometrists working in multiple practices tended to rely less on retinoscopy than those in the independent sector. Only half of the respondents used dynamic retinoscopy. The majority, however, agreed that retinoscopy was an important test. The University attended also influenced the type of retinoscope used and the use of autorefractors. Combined retinoscopes were used most by the more recently qualified optometrists and few agreed that combined retinoscopes were less accurate. A trial indicated that combined and dedicated retinoscopes were equally accurate. Here, 4 optometrists (2 using spot and 2 using streak retinoscopes) tested one eye of 6 patients using combined and dedicated retinoscopes. This trial also demonstrated the utility of the relatively unknown ’15 degrees of freedom’ rule that exploits replication in factorial ANOVA designs to achieve sufficient statistical power when recruitment is limited. An opportunistic international survey explored the use of retinoscopy by 468 practitioners (134 ophthalmologists, 334 optometrists) attending contact related courses. Decision tree analyses found (a) no differences in the habits of optometrists and ophthalmologists, (b) differences in the reliance on retinoscopy and use of dynamic techniques across the participating countries and (c) some evidence that younger practitioners were using static and dynamic retinoscopy least often. In conclusion, this study has revealed infrequent use of static and dynamic retinoscopy by some optometrists, which may be the only means of determining refractive error and evaluating accommodation in patients with communication difficulties.

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 (BSC), upon the strategy process. Recently, it has been suggested that as a strategy tool, the BSC 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 BSC and those that have not, the impact is not comprehensive. © 2011 Operational Research Society Ltd. All rights reserved.

Labour productivity change: drivers, business impact and macroeconomic moderators

This paper focuses on the operational drivers of labour productivity changes. We consider two sets of drivers: a) current working practices b) changes in working practices through management programs. The relationship between these two sets of drivers and productivity changes are analysed. We also investigate the importance of productivity growth by looking at the impact of labour productivity changes on business performance changes. Finally, the moderating effects of industry and country on the use of drivers of productivity changes are examined. Data from an international survey, IMSS-IV, are used for the analysis.

Consumer behaviour and lifestyle patterns of Hungarian students in view of environmental awareness

The aim of this paper is to describe the consumer behaviour and everyday lifestyle patterns of Hungarian university and college students. The results are gained from an international survey, carried out by the Department of Environmental Economics and Technology at the Corvinus University of Budapest, supported by the Norwegian Financial Mechanism. As background literature, characteristics of the consumer society and the development of sustainable consumption as a concept are interpreted in the paper. The empirical analysis aims to describe the most important clusters of students, based on the factors of their consumer behaviour, environmental activism and pro-environmental everyday habits. Our results identify two extreme clusters which most significantly differ from each other: the environmental activists and the indifferent group. However, a third cluster has the most modest consumer behaviour, namely the group which considers product features, energy consumption and the behaviour of producers. They spend the least on consumer goods. The three other clusters show quite mixed lifestyle patterns.