Predictive genetic test decisions for Huntington's disease: context, appraisal and new moral imperatives

Predictive testing is one of the new genetic technologies which, in conjunction with developing fields such as pharmacogenomics, promises many benefits for preventive and population health. Understanding how individuals appraise and make genetic test decisions is increasingly relevant as the technology expands. Lay understandings of genetic risk and test decision-making, located within holistic life frameworks including family or kin relationships, may vary considerably from clinical representations of these phenomena. The predictive test for Huntington's disease (HD), whilst specific to a single-gene, serious, mature-onset but currently untreatable disorder, is regarded as a model in this context. This paper reports upon a qualitative Australian study which investigated predictive test decision-making by individuals at risk for HD, the contexts of their decisions and the appraisals which underpinned them. In-depth interviews were conducted in Australia with 16 individuals at 50% risk for HD, with variation across testing decisions, gender, age and selected characteristics. Findings suggested predictive testing was regarded as a significant life decision with important implications for self and others, while the right not to know genetic status was staunchly and unanimously defended. Multiple contexts of reference were identified within which test decisions were located, including intra- and inter-personal frameworks, family history and experience of HID, and temporality. Participants used two main criteria in appraising test options: perceived value of, or need for the test information, for self and/or significant others, and degree to which such information could be tolerated and managed, short and long-term, by self and/or others. Selected moral and ethical considerations involved in decision-making are examined, as well as the clinical and socio-political contexts in which predictive testing is located. The paper argues that psychosocial vulnerabilities generated by the availability of testing technologies and exacerbated by policy imperatives towards individual responsibility and self-governance should be addressed at broader societal levels. (C) 2003 Elsevier Science Ltd. All rights reserved.

Impact of an intensive nursing education course on nurses' knowledge, confidence, attitudes, and perceived skills in the care of patients with cancer

Purpose/Objectives: To evaluate the impact of a cancer nursing education course on RNs. Design: Quasi-experimental, longitudinal, pretest/post-test design, with a follow-up assessment six weeks after the completion of the nursing education course. Setting: Urban, nongovernment, cancer control agency in Australia. Sample: 53 RNs, of whom 93% were female, with a mean age of 44.6 years and a mean of 16.8 years of experience in nursing; 86% of the nurses resided and worked in regional areas outside of the state capital. Methods: Scales included the Intervention With Psychosocial Needs: Perceived Importance and Skill Level Scale, Palliative Care Quiz for Nurses, Breast Cancer Knowledge, Preparedness for Cancer Nursing, and Satisfaction With Learning. Data were analyzed using multiple analysis of variance and paired t tests. Main Research Variables: Cancer nursing-related knowledge, preparedness for cancer nursing, and attitudes toward and perceived skills in the psychosocial care of patients with cancer and their families. Findings: Compared to nurses in the control group, nurses who attended the nursing education course improved in their cancer nursing-related knowledge, preparedness for cancer nursing, and attitudes toward and perceived skills in the psychosocial care of patients with cancer and their families. Improvements were evident at course completion and were maintained at the six-week follow-up assessment. Conclusions: The nursing education course was effective in improving nurses' scores on all outcome variables. Implications for Nursing: Continuing nursing education courses that use intensive mode timetabling, small group learning, and a mix of teaching methods, including didactic and interactive approaches and clinical placements, are effective and have the potential to improve nursing practice in oncology.

Hurt feelings in couple relationships: Exploring the role of attachment and perceptions of personal injury

This research program focused on perceptions of the appraisals and emotions involved in hurtful events in couple relationships. Study I tested the broad proposition that hurt feelings are elicited by relational transgressions that generally imply relational devaluation and that evoke a sense of personal injury by threatening positive mental models of self and/or others. Participants (N = 224) provided retrospective accounts of an experience of being hurt by a romantic partner. These accounts, together with expert judges' ratings, showed that most hurtful events involved relational transgressions that signal both relational devaluation and threat to positive mental models; however, relational devaluation was relatively unimportant in explaining the hurt associated with partners' distrust. A sense of injury emerged as the dominant theme in open-ended accounts of emotional reactions; however, other negative emotions also featured and were related to the type of event reported. The emotion terms generated in Study I were used as stimuli in a word-sorting task (Study 2). This study confirmed that many of the terms were perceived specifically as injury related, and shed further light on the link between appraisals and emotions. Theoretical and practical implications of the findings are discussed.

Tradesperson or artist? A critical exploration of chefs' job satisfaction and turnover

The interest in experiential and embodied aspects of brand and other product usage is under-represented in tourism orientated research, which generally falls to develop a contextualised understanding of the relationships between products and consumers, and within this in particular, considerations of individuality and self, embodiment, emotion and sensation. Aiming to `reverse the causality' (Lannon and Cooper 1983:201) of consumption focused tourism research, in this paper, I draw on the tourism experiences of Audrey, a participant in a larger study to reveal how, rather than just `consuming', tourism consumers interpret the meaning and values in a wide range of products and objects, weaving individual, rich, sensory, embodied experiences which are informed by the interactions and relationships with activities and products, and by their own personalities, past experiences and aspirations. Audrey is highly conscious of her self and of elsewhereness, hers are fragile, self-indulgent, tactile experiences which offer the freedom to step out of everyday life roles into other time and situational spheres where environment, objects and sensory stimulation are paramount. [ABSTRACT FROM AUTHOR]

Levinasian ethics and the representation of the other in international and cross-cultural management

In this paper, we seek to further the discussion, problematization and critique of west/east identity relations in ICM studies by considering the ethics of the relationship – an issue never far beneath the surface in discussions of Orientalism. In particular we seek to both examine and question the ethics of representation in relation to a critique of what has come to be known as international and cross-cultural management (ICM). To pursue such a discussion, we draw specifically on the ethical elaborations of Emmanuel Levinas as well as his chief interlocutors Jacques Derrida and Zygmunt Bauman. The value of this discussion, we propose, is that Levinas offers a philosophy that holds as its central concept the relationship between the self and Other as the primary ethical and pre-ontological relation. Levinas’ philosophy provides a means of extending the post-colonial critique of ICM, and ICM provides a context in which the Levinasian ethics can be brought to bear on a significant issue on contemporary business and management.

Biochemical markers and contact lens wear

The project objective was to develop a reliable selection procedure to match contact lens materials with individual wearers by the identification of a biochemical marker for assessment of in-eye performance of contact lenses. There is a need for such a procedure as one of the main reasons for contact lens wearers ceasing wearing contact lenses is poor end of day comfort i.e. the lenses become intolerable to the wearer as the day progresses. The selection of an optimal material for individual wearers has the potential benefit to reduce drop Qut, hence increasing the overall contact lens population, and to improve contact lens comfort for established wearers. Using novel analytical methods and statistical techniques, we were able to investigate the interactions between the composition of the tear film and of the biofilm deposited on the contact lenses and contact lens performance. The investigations were limited to studying the lipid components of the tear film; the lipid layer, which plays a key role in preventing evaporation and stabilising the tear film, has been reported to be significantly thinner and of different mixing characteristics during contact lens wear. Different lipid families were found to influence symptomatology, in vivo tear film structure and stability as well as ocular integrity. Whereas the symptomatology was affected by both the tear film lipid composition and the nature of the lipid deposition, the structure of the tear film and its stability were mainly influenced by the tear film lipid composition. The ocular integrity also appeared to be influenced by the nature of the lipid deposition. Potential markers within the lipid species have been identified and could be applied as follows: When required in order to identify a problematic wearer or to match the contact lens material to the contact lens wearer, tear samples collected by the clinician could be dispatched to an analytical laboratory where lipid analysis could be carried out by HPLC. A colorimetric kit based on the lipid markers could also be developed and used by clinician directly in the practice; such a kit would involve tear sampling and classification according to the colour into "Problem", "Border line" and "Good" contact lens wearers groups. A test kit would also have wider scope for marketing in other areas such as general dry-eye pathology.

Comparison and characterisation of ribozyme delivery in cultured glial and neuronal cells in vivo and in vitro

Ribozymes are short strands of RNA that possess a huge potential as biological tools for studying gene expression and as therapeutic agents to down-regulate undesirable gene expression. Successful application of ribozymes requires delivery to the target site in sufficient amounts for an adequate duration. However, due to their large size and polyanionic character ribozymes are not amenable to transport across biological membranes. In this study a chemically modified ribozyme with enhanced biological stability, targeted against the EGFR mRNA has been evaluated for cellular delivery to cultured glial and neuronal cells with a view to developing treatments for brain tumours. Cellular delivery of free ribozyme was characterised in cultured glial and neuronal cells from the human and rat. Delivery was very limited and time dependent with no consistent difference observed between glial and neuronal cells in both species. Cellular association was largely temperature and energy-dependent with a small component of non-energy dependent association. Further studies showed that ribozyme cellular association was inhibited with self and cross competition with nucleic and non-nucleic acid polyanions indicating the presence of cell surface ribozyme-binding molecules. Trypsin washing experiments further implied that the ribozyme binding surface molecules were protein by nature. Dependence of cellular association on pH indicated that interaction of ribozyme with cell surface molecules was based on ionic interactions. Fluoresence studies indicated that, post cell association, ribozymes were sequestered in sub-cellular vesicles. South-Western blots identified several cell surface proteins which bind to ribozymes and could facilitate cellular association. The limited cellular association observed with free ribozyme required the development and evaluation of polylactide-co-glycolide microspheres incorporating ribozyme for enhanced cellular delivery. Characterisation of microsphere mediated delivery of ribozyme in cultured glial and neuronal cells showed that association increased by 18 to 27-fold in all cell types with no differences observed between cell lines and species. Microsphere mediated delivery was temperature and energy dependent and independent of pH. In order to assess the potential of PLGA micro spheres for the CNS delivery of ribozyme the distribution of ribozyme entrapping microspheres was investigated in rat CNS after intracerebroventricular injection. Distribution studies demonstrated that after 24 hours there was no free ribozyme present in the brain parenchyma, however microsphere entrapped ribozyme was found in the CNS. Microspheres remained in the ventricular system after deposition and passed from the lateral ventricles to the third and fourth ventricle and in the subarachnoid space. Investigation of the influence of microsphere size on the distribution in CNS demonstrated that particles up to 2.5 and O.5f.lm remained in the ventricles around the choroid plexus and ependymal lining.

What do we know about the experience of age related macular degeneration? A systematic review and meta-synthesis of qualitative research

Age Related Macular Degeneration (AMD) is the leading cause of registerable blindness with a high medical and societal cost burden. Much of the research examining experiences of living with AMD has been conducted independently with small sample sizes and has failed to impact on practice. Meta-synthesis of qualitative research can improve the understanding of the experience of living with AMD by drawing together findings of qualitative studies. This article presents a systematic review and meta-synthesis of qualitative studies investigating the experience of AMD (literature searched up to April 2012; published studies identified range from 1996 to 2009). The review highlights themes relating to: functional limitations, adaptation and independence; feelings about the future with vision impairment; interaction with the health service; social engagement; disclosure; and the emotional impacts of living with AMD. Attention to the experience of living with AMD can help us to better understand the needs of patients. This meta-synthesis aimed to bring together the findings of qualitative research studies and highlights important areas for consideration when caring for patients with AMD. Our findings suggest that a holistic approach to service provision and support for AMD is needed which takes into account individuals' needs and experiences when coping with and adjusting to living with AMD. This support should aim to reduce stigma, increase social engagement, and develop the psychological resources of patients with AMD.

Satisfaction with knowledge and competencies:a multi-country study of employers and business graduates

This study critically discusses findings from a research project involving four European countries. The project had two main aims. The first was to develop a systematic procedure for assessing the balance between knowledge and competencies acquired in higher, further and vocational education and the specific needs of the labor market. The second aim was to develop and test a set of meta-level quality indicators aimed at evaluating the linkages between education and employment. The project was designed to address the lack of employer input concerning the requirements of business graduates for successful workplace performance and the need for more specific industry-driven feedback to guide administrative heads at universities and personnel at quality assurance agencies in curriculum development and revision. Approach: The project was distinctive in that it combined different partners from higher education, vocational training, industry and quality assurance. Project partners designed and implemented an innovative approach, based on literature review, qualitative interviews and surveys in the four countries, in order to identify and confirm key knowledge and competency requirements. This study presents this step-by-step approach, as well as survey findings from a sample of 900 business graduates and employers. In addition, it introduces two Partial Least Squares (PLS) path models for predicting satisfaction with work performance and satisfaction with business education. Results: Survey findings revealed that employers were not very confident regarding business graduates’ abilities in key knowledge areas and in key generic competencies. In subsequent analysis, these graduate abilities were tested and identified as important predictors of employers’ satisfaction with graduates’ work performance. Conclusion: The industry-driven approach introduced in this study can serve as a guide to assist different types of educational institutions to better align study programs with changing labor market requirements. Recommendations for curriculum improvement are discussed.

Measurement of implicit leadership theories and their effect on leadership processes and outcomes

The leadership categorisation theory suggests that followers rely on a hierarchical cognitive structure in perceiving leaders and the leadership process, which consists of three levels; superordinate, basic and subordinate. The predominant view is that followers rely on Implicit Leadership Theories (ILTs) at the basic level in making judgments about managers. The thesis examines whether this presumption is true by proposing and testing two competing conceptualisations; namely the congruence between the basic level ILTs (general leader) and actual manager perceptions, and subordinate level ILTs (job-specific leader) and actual manager. The conceptualisation at the job-specific level builds on context-related assertions of the ILT explanatory models: leadership categorisation, information processing and connectionist network theories. Further, the thesis addresses the effects of ILT congruence at the group level. The hypothesised model suggests that Leader-Member Exchange (LMX) will act as a mediator between ILT congruence and outcomes. Three studies examined the proposed model. The first was cross-sectional with 175 students reporting on work experience during a 1-year industrial placement. The second was longitudinal and had a sample of 343 students engaging in a business simulation in groups with formal leadership. The final study was a cross-sectional survey in several organisations with a sample of 178. A novel approach was taken to congruence analysis; the hypothesised models were tested using Latent Congruence Modelling (LCM), which accounts for measurement error and overcomes the majority of limitations of traditional approaches. The first two studies confirm the traditional theorised view that employees rely on basic-level ILTs in making judgments about their managers with important implications, and show that LMX mediates the relationship between ILT congruence and work-related outcomes (performance, job satisfaction, well-being, task satisfaction, intragroup conflict, group satisfaction, team realness, team-member exchange, group performance). The third study confirms this with conflict, well-being, self-rated performance and commitment as outcomes.

The link between HR practices, psychological contract fulfillment, and organizational performance:the case of the Greek services sector

The purpose of this study is to investigate the impact of human resource (HR) practices on organizational performance through the mediating role of psychological contract (expressed by the influence of employer on employee promises fulfillment through employee attitudes). The study is based on a national sample of 78 organizations from the public and private services sector in Greece, including education, health, and banking, and on data obtained from 348 employees. The statistical method employed is structural equation modeling, via LISREL and bootstrapping estimation. The findings of the study suggest that employee incentives, performance appraisal, and employee promotion are three major HR practices that must be extensively employed. Furthermore, the study suggests that the organization must primarily keep its promises about a pleasant and safe working environment, respectful treatment, and feedback for performance, in order for employees to largely keep their own promises about showing loyalty to the organization, maintaining high levels of attendance, and upholding company reputation. Additionally, the study argues that the employee attitudes of motivation, satisfaction, and commitment constitute the nested epicenter mediating construct in both the HR practices–performance and employer–employee promise fulfillment relationships, resulting in superior organizational performance. © 2012 Wiley Periodicals, Inc.

Negative brand personality:the construct, its antecedents and outcome variables

By evolving brands and building on the importance of self-expression, Aaker (1997) developed the brand personality framework as a means to understand brand-consumer relationships. The brand personality framework captures the core values and characteristics described in human personality research in an attempt to humanize brands. Although influential across many streams of brand personality research, the current conceptualization of brand personality only offers a positively-framed approach. To date, no research, both conceptually and empirically, has thoroughly incorporated factors reflective of Negative Brand Personality, despite the fact that almost all researchers in personality are in agreement that factors akin to Extraversion (positive) and Neuroticism (negative) should be in a comprehensive personality scale to accommodate consumers’ expressions. As a result, the study of brand personality is only half complete since the current research trend is to position brand personality under brand image. However, with the brand personality concept being confused with brand identity at the empirical stage, factors reflective of Negative Brand Personality have been neglected. Accordingly, this thesis extends the current conceptualization of brand personality by demarcating the existing typologies of desirable brand personality and incorporating the characteristics reflective of consumers’ discrepant self-meaning to provide a more complete understanding of brand personality. However, it is not enough to interpret negative factors as the absence of positive factors. Negative factors reflect consumers’ anxious and frustrated feelings. Therefore, this thesis contributes to the current conceptualization of brand personality by, firstly, presenting a conceptual definition of Negative Brand Personality in order to provide a theoretical basis for the development of a Negative Brand Personality scale, then, secondly, identifying what constitutes Negative Brand Personality and to what extent consumers’ cognitive dissonance explains the nature of Negative Brand Personality, and, thirdly, ascertaining the impact Negative Brand Personality has on attitudinal constructs, namely: Negative Attitude, Detachment, Brand Loyalty and Satisfaction, which have proven to predict behaviors such as choice and (re-)purchasing. In order to deliver on the three main contributions, two comprehensive studies were conducted to a) develop a valid, parsimonious, yet relatively short measure of Negative Brand Personality, and b) ascertain how the Negative Brand Personality measure behaves within a network of related constructs. The mixed methods approach, grounded in theoretical and empirical development, provides evidence to suggest that there are four factors to Negative Brand Personality and, tested through use of a structural equation modeling technique, that these are influenced by Brand Confusion, Price Unfairness, Self- Incongruence and Corporate Hypocrisy. Negative Brand Personality factors mainly determined Consumers Negative Attitudes and Brand Detachment. The research contributes to the literature on brand personality by improving the consumer-brand relationship by means of engaging in a brandconsumer conversation in order to reduce consumers’ cognitive strain. The study concludes with a discussion on the theoretical and practical implications of the findings, its limitations, and potential directions for future research.

The influence of face and group orientation on the perception of luxury goods:a four market study of East Asian consumers

Purpose: The paper aims to further extend our understanding by assessing the extent to which two prominent cultural values in East Asia i.e. face saving and group orientation drive consumers' perceptions of luxury goods across four East Asian markets. Design/methodology/approach: A multi-methods research approach was adopted consisting of: an expert panel of close to 70 participants, group discussions with five extended East Asian families, personal interviews with eight East Asian scholars, a pilot test with over 50 East Asian graduate students and a multi-market survey of 443 consumer respondents in Beijing, Tokyo, Singapore and Hanoi. Findings: The authors extend previous conceptual studies by empirically investigating the impact of these two cultural values on the perception of luxury among East Asian societies. Specifically the study reveals that across all four markets face saving has the strongest influence on the conspicuous and hedonistic dimensions of luxury, group orientation meanwhile is the strongest predictor of the quality, extended self and exclusivity dimensions of luxury. Collectively these two cultural values significantly influence East Asian perceptions of luxury. Overall, the findings reiterate the importance of understanding different cultural values and their influence across different East Asian societies. Practical implications: The findings have important implications for managers of western luxury branded goods that are seeking to penetrate East Asian markets or seek to serve East Asian consumers. Specifically, to assist with developing suitable brand positioning, products, services, communications and pricing strategies. Originality/value: This study contributes to our understanding of the subject by exploring the impact of face saving and group orientation on the perception of luxury goods across four East Asian countries. Several directions for future research are suggested. © Emerald Group Publishing Limited.

Co-constructed caring research and intellectual disability:an exploration of friendship, intimacy and being human

For this paper, emotional and socio-political questions lie at the heart of relationships in understanding intellectual disability and what it is to be a human. While the sexual and intimate is more often than not based on a private and personal relationship with the self and (an)other, the sexual and intimate life of intellectually disabled people is more often a ‘public’ affair governed by parents and/or carers, destabilizing what we might consider ethical and caring practices. In the socio-political sphere, as an all-encompassing ‘care space’, social intolerance and aversion to difficult differences are played out, impacting upon the intimate lives of intellectually disabled people. As co-researchers (one intellectually disabled and one ‘non-disabled’), we discuss narratives from a small scale research project and our personal reflections. In sociological research and more specifically within disability research it is clear that we need to keep sex and intimacy on the agenda, yet also find ways of doing research in a meaningful, caring and co-constructed way.

Equity policy, educational practice, and limited English proficient (LEP) students in two high schools in Miami

Most studies of language minority students' performance focus on students' characteristics. This study uses qualitative methodology to examine instead how educational policies and practices affect the tracking of language minority students who are classified as limited English proficient (LEP). The placement of LEP students in core courses (English, Math, Social Studies, and Science) is seen as resulting from the interaction between school context and student characteristics. The school context includes factors such as equity policy requirements, overcrowding, attitudes regarding immigrants' academic potential, tracking, and testing practices. Interaction among these factors frequently leads to placement in lower track courses. It was found that the absence of formal tracks could be misleading to immigrant students, particularly those with high aspirations who do not understand the implications of the informal tracking system. Findings are discussed in relation to current theoretical explanations for minority student performance. ^