Organisational justice and smoking: the Finnish Public Sector Study

Study Objective: To examine the extent to which justice of decision-making procedures and interpersonal relations is associated with smoking. Setting: Ten municipalities and 21 hospitals in Finland. Design and Participants: Cross-sectional data derived from the Finnish Public Sector Study were analysed with logistic regression analysis models with generalized estimating equations. Analyses of smoking status were based on 34 021 employees. Separate models for heavy smoking (>20 cigarettes per day) were calculated for 6295 current smokers. Main results: After adjustment for age, education, socio-economic position, marital status, job contract, and negative affectivity, smokers who reported low procedural justice were about 1.4 times more likely to smoke >20 cigarettes per day compared with their counterparts with high justice. In a similar way, after adjustments, low justice in interpersonal treatment was significantly associated with an elevated prevalence of heavy smoking (odds ratio (OR) = 1.35, 95% CI = 1.03 to 1.77 for men and OR = 1.41, 95% CI = 1.09 to 1.83 for women). Further adjustment for job strain and effort-reward imbalance had little effect on these results. There were no associations between justice components and smoking status or ex-smoking. Conclusions: The extent to which employees are treated with justice in the workplace seems to be associated with smoking intensity independently of established stressors at work.

"Ordinary people only": knowledge, representativeness and the publics of public participation in healthcare

Public involvement in healthcare is a prominent policy in countries across the economically developed world. A growing body of academic literature has focused on public participation, often presenting dichotomies between good and bad practice: between initiatives that offer empowerment and those constrained by consumerism, or between those which rely for recruitment on self-selecting members of the public, and those including a more broad-based, statistically representative group. In this paper I discuss the apparent tensions between differing rationales for participation, relating recent discussions about the nature of representation in public involvement to parallel writings about the contribution of laypeople’s expertise and experience. In the academic literature, there is, I suggest, a thin line between democratic justifications for involvement, suggesting a representative role for involved publics, and technocratic ideas about the potential ‘expert’ contributions of particular subgroups of the public. Analysing recent policy documents on participation in healthcare in England, I seek moreover to show how contemporary policy transcends both categories, demanding complex roles of involved publics which invoke various qualities seen as important in governing the interface between state and society. I relate this to social-theoretical perspectives on the relationship between governmental authority and citizens in late-modern society.

Public and user participation in public service delivery: tensions in policy and practice

Social-scientific analysis of public-participation initiatives has proliferated in recent years. This review article discusses some key aspects of recent work. Firstly, it analyses some of the justifications put forward for public participation, drawing attention to differences and overlaps between rationales premised on democratic representation/representativeness and those based on more technocratic ideas about the knowledge that the public can offer. Secondly, it considers certain tensions in policy discourses on participation, focusing in particular on policy relating to the National Health Service and other British public services. Thirdly, it examines the challenges of putting a coherent vision for public participation into practice, noting the impediments that derive from the often-competing ideas about the remit of participation held by different groups of stakeholders. Finally, it analyses the gap between policy and practice, and the consequences of this for the prospects for the enactment of active citizenship through participation initiatives.

The roles of community pharmacists and other pharmacy staff:public perceptions

Introduction: The focus of the community pharmacist’s (CP’s) activities continues to move away from traditional dispensing activities towards the provision of health services. Current functions of CPs cover a combination of roles including prescription matters, counselling and service provision. These expanding roles, along with raised prescription volume, have increased CP workload. Therefore, it has become commonplace to delegate certain activities to other pharmacy staff (PS). This research aimed to examine public perceptions of CPs and other PS functions. Methodology: A self-completion postal questionnaire was sent to a random sample of 9769 members of the general public in England. Participants were asked to indicate which functions they believed CPs and other PS perform. Data were imported into SPSS 22 for analysis. Results: A response rate of 15.7% (n = 1537) was achieved. The roles most commonly attributed to CPs were monitoring prescription appropriateness (90.4%, n = 1390) and counselling patients on prescribed medicines (90.4%, n = 1389). The role most commonly attributed to other PS was sales transactions (92.4%, n = 1420). Similar numbers of responders agreed that the delivery of health services was the role of both CPs and other PS (58.9%, n = 906; 57.0%, n = 876). Conclusion: Despite a move towards more service based practice, the public still primarily associate the CP’s role with activities centred on dispensing. The provision of health services was seen to be equally carried out by CPs and other PS. As the CP’s service-based activities continue to develop, promotional activities may be required to ensure developments in CP functions are recognised by the public

Working at the interface : the descriptive relevance of Grunig and Hunt’s theories to public relations practices in south east Queensland schools

This article examines the relevance of James Grunig and Todd Hunt’s (1984) theories to public relations practitioners’ roles in south east Queensland schools. It focuses in particular on the two-way symmetric model in this context. The geographical boundaries of the research mean that this article is intended primarily as an exploratory, descriptive analysis of a specific area rather than an exhaustive treatise on the general topic of public relations in Australian schools. However, it is hoped that it will prove useful in identifying bases for further study and discussion.

Edge of Danger: electric light and the negotiation of public and private domestic space in Philip Johnson's Glass and Guest House

In the first half of the twentieth century the dematerializing of boundaries between enclosure and exposure problematized traditional expectations of the domestic environment. At the same time, as a space of escalating technological control, the modern domestic interior also offered new potential to redefine the meaning and means of habitation. The inherent tension between these opposing forces is particularly evident in the introduction of new electric lighting technology and applications into the modern domestic interior in the mid-twentieth century. Addressing this nexus of technology and domestic psychology, this article examines the critical role of electric lighting in regulating and framing both the public and private occupation of Philip Johnson's New Canaan estate. Exploring the dialectically paired transparent Glass House and opaque Guest House, this study illustrates how Johnson employed electric light to negotiate the visual environment of the estate as well as to help sustain a highly aestheticized domestic lifestyle. Contextualized within the existing literature, this analysis provides a more nuanced understanding of the New Canaan estate as an expression of Johnson's interests as a designer as well as a subversion of traditional suburban conventions.

Pathophysiology of feline hyperadrenocorticism clinical. Case presentation

Hyperadrenocorticism is a rare endocrine disease in the cat; it is characterized by elevated blood cortisol level that generates numerous clinical signs including hyperglycemia, polyuria, polydipsia, polyphagia and skin diseases. The average age of onset is around 10 years. This disease usually occurs link with other endocrine disorders such as diabetes mellitus.The disease can be produced by functional alteration of the pituitary gland or the adrenal. A case report, with differential diagnosis and review of the literature, is presented.

Medical versus surgical interventions for open angle glaucoma.

BACKGROUND: Open angle glaucoma (OAG) is the commonest cause of irreversible blindness worldwide. OBJECTIVES: To study the relative effects of medical and surgical treatment of OAG. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2005), MEDLINE (1966 to February 2005), EMBASE (1988 to February 2005), and reference lists of articles. We also contacted researchers in the field. SELECTION CRITERIA: Randomised controlled trials comparing medications to surgery in adults. DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial quality and extracted data. We contacted trial investigators for missing information. MAIN RESULTS: Four trials involving 888 participants with previously untreated OAG were included. Surgery was Scheie's procedure in one trial and trabeculectomy in three trials. In three trials, primary medication was usually pilocarpine, in one trial a beta-blocker.In the most recent trial, participants with mild OAG, progressive visual field (VF) loss, after adjustment for cataract surgery, was not significantly different for medications compared to trabeculectomy (Odds ratio (OR) 0.74; 95% CI 0.54 to 1.01). Reduction of vision, with a higher risk of developing cataract (OR 2.69, 95%% CI 1.64 to 4.42), and more patient discomfort was more likely with trabeculectomy than medication.There is some evidence, from three trials, for people with moderately advanced glaucoma that medication is associated with more progressive VF loss and 6 to 8 mmHg less intraocular pressure (IOP) lowering than surgery, either by a Scheie's procedure or trabeculectomy. There was a trend towards an increased risk of failed IOP control over time for initial pilocarpine treatment compared to trabeculectomy. In the longer-term (two trials) the risk of failure was significantly greater with medication than trabeculectomy (OR 3.90, 95% CI 1.60 to 9.53; HR 7.27, 95% CI 2.23 to 25.71). Medicine and surgery have evolved since these trials were undertaken, and additionally the evidence is potentially subject to detection and attrition bias. AUTHORS' CONCLUSIONS: Evidence from one trial suggests, for mild OAG, that VF deterioration up to five-years is not significantly different whether treatment is initiated with medication or trabeculectomy. Reduced vision, cataract and eye discomfort are more likely with trabeculectomy. There is some evidence, for more severe OAG, that initial medication (pilocarpine, now rarely used as first line medication) is associated with greater VF deterioration than surgery. In general, surgery lowers IOP more than medication.There was no evidence to determine the effectiveness of contemporary medication (prostaglandin analogues, alpha2-agonists and topical carbonic anhydrase inhibitors) compared to surgery in severe OAG, and in people of black African ethnic origin who have a greater risk of more severe open angle glaucoma. More research is required.

Yesterday’s Games: Contingency Learning and the Growth of Public Spending, 1890-1938

Neither democracy nor globalization can explain the doubling of the peacetime public share in many Western countries between World Wars I and II. Here we examine two other explanations that are consistent with the timing of the observed changes, namely, (1) a shift in the demand for public goods and (2) the effect of war on the willingness to share. We first model each of these approaches as a contingency-learning phenomenon within Schelling’s Multi-Person Dilemma. We then derive verifiable propositions from each hypothesis. National time series of public spending as a share of GNP reveal no unit root but a break in trend, a result shown to favor explanation (2) over (1).

Gel vs aceite mineral en el tratamiento del fotoenvejecimiento de manos con luz pulsada intensa

Introducción: En el tratamiento con Luz Pulsada Intensa (LPI) para el fotoenvejecimiento de las manos no se encuentran estudios que evidencien si existe alguna diferencia estadísticamente significativa en el grado de efectividad y seguridad al utilizar gel o aceite mineral como medios de acople. Objetivo: Determinar la efectividad y seguridad terapéutica en el uso de gel vs aceite mineral. Materiales y Métodos: Estudio observacional analítico de cohorte retrospectivo que involucró 29 pacientes. Realizado en tres fases; selección y recolección de las historias clínicas, evaluación fotográfica de registros pre tratamiento y pos tratamiento con determinación del grado de mejoría global en el fotoenvejecimiento de las manos por parte de tres evaluadores cegados, y análisis estadístico de los datos obtenidos por medio de las pruebas de Mann Whitney y Wilcoxon. Resultados: Se encontró mejoría dada por disminución en un grado del fotoenvejecimiento para los dos medios de acople con la misma significancia estadística. La percepción subjetiva mostró mejoría en todos los pacientes evaluados. La seguridad es similar en los dos grupos pero se evidenció mayor severidad en los efectos secundarios con el uso de aceite, con diferencias estadísticamente significativas en los efectos moderados y severos. Conclusión: La efectividad es la misma independiente del medio de acople que se use. La seguridad a pesar de evidenciar un perfil similar es mayor con el uso de gel en cuanto a la menor severidad de los efectos presentados. Se requieren más estudios de tipo ensayos clínicos controlados que permitan determinar una mayor evidencia.

Treatment of Acral Persistent Papular Mucinosis with Electrocoagulation

Background: Acral persistent papular mucinosis is a rare localized form of lichen myxedematosus with few case reports and no documented therapeutic options.Objective: To report full resolution of acral persistent papular mucinosis after electrocoagulation.Methods: Case report of a 51-year-old white female diagnosed with an acral persistent papular mucinosis. The clinical and histopathologic features, treatment provided, and response to treatment are detailed.Results: Acral persistent papular mucinosis presented as multiple asymptomatic normochromic papules on the wrists. Treatment with topical and intralesional steroids was unsatisfactory. Gentle electrocoagulation led to complete resolution of the lesions and negligible scarring. The favorable results remained for 6 months of follow-up, and no new lesions have emerged.Conclusion: Our case of acral persistent papular mucinosis was successfully treated with electrocoagulation and long-lasting, excellent cosmetic results.