Preoperative predictors for postoperative problems in heart transplantation: psychiatric and psychosocial considerations

The psychiatric and psychosocial evaluation of the heart transplant candidate can identify particular predictors for postoperative problems. These factors, as identified during the comprehensive evaluation phase, provide an assessment of the candidate in context of the proposed transplantation protocol. Previous issues with compliance, substance abuse, and psychosis are clear indictors of postoperative problems. The prolonged waiting list time provides an additional period to evaluate and provide support to patients having a terminal disease who need a heart transplant, and are undergoing prolonged hospitalization. Following transplantation, the patient is faced with additional challenges of a new self-image, multiple concerns, anxiety, and depression. Ultimately, the success of the heart transplantation remains dependent upon the recipient's ability to cope psychologically and comply with the medication regimen. The limited resource of donor hearts and the high emotional and financial cost of heart transplantation lead to an exhaustive effort to select those patients who will benefit from the improved physical health the heart transplant confers.

Developing social skills in autistic children through ‘Relaxed Performances’

Families living with autism often feel unable to attend social and cultural events largely due to the fear of their child attracting negative or even aggressive reactions from others. The ‘joint attention’ that is part of the theatre experience however may be a powerful factor in the development of social and communication skills for such children. ‘Relaxed performances’ offer an opportunity for them to access and engage with theatre by making special arrangements designed to reduce tensions associated with visits to public places. Aspects of the production such as the use of lighting and sound effects which may trigger adverse reactions are also adjusted. This paper reports on how one local theatre drew on the findings of a national project to mount a ‘relaxed performance’ of their annual pantomime. It discusses the theatre’s preparations and presents evidence of the impact the event had on local children with autism and their families. The success of both the national and this local project marks a new beginning for improved access to the theatre for an audience that has hitherto felt largely excluded.

Applying robust control theory to solve problems in bio-medical sciences: study of an apoptotic model

Biological models of an apoptotic process are studied using models describing a system of differential equations derived from reaction kinetics information. The mathematical model is re-formulated in a state-space robust control theory framework where parametric and dynamic uncertainty can be modelled to account for variations naturally occurring in biological processes. We propose to handle the nonlinearities using neural networks.

State capitalism and social responsibility in China's banking industry

China’s financial system has experienced a series of major reforms in recent years. Efforts have been made towards introducing the shareholding system in state-owned commercial banks, restructuring of securities firms, re-organising equity of joint venture insurance companies, further improving the corporate governance structure, managing financial risks and ultimately establishing a system to protect investors (Xinhua, 2010). Financial product innovation, with the further opening up of financial markets and the development of the insurance and bond market, has increased liquidity as well as reduced financial risks. The U.S. subprime crisis indicated the benefit of financial innovations for the economy, but without proper control, they may lead to unexpected consequences. Kirkpatrick (2009) argues that failures and weaknesses in corporate governance arrangements and insufficient accounting standards and regulatory requirements attributed to the financial crisis. Similar to the financial crises of the last decade, the global financial crisis which sparked in 2008, surfaced a variety of significant corporate governance failures: the dysfunction of market mechanisms, the lack of transparency and accountability, misaligned compensation arrangements and the late response of government, all which encouraged management short-termism, poor risk management, as well as some fraudulent schemes. The unique characteristics of the Chinese banking system are an interesting point for studying post-crisis corporate governance reform. Considering that China modelled its governance system on the Anglo-American system, this paper examines the impact of the financial crisis on corporate governance reform in developed economies, and particularly, China’s reform of its financial sector. The paper further analyses the Chinese government’s role in bank supervision and risk management. In this regard, the paper contributes to the corporate governance literature within the Chinese context by providing insights into the contributing factors to the corporate governance failure that led to the global financial crisis. It also provides policy recommendations for China’s policy makers to seriously consider. The results suggest a need for the re-examination of corporate governance adequacy and the institutionalisation of business ethics. The paper’s next section provides a review of China’s financial system with reference to the financial crisis, followed by a critical evaluation of a capitalistic system and a review of Anglo-American and Continental European models. It then analyses the need for a new corporate governance model in China by considering the bank failures in developed economies and the potential risks and inefficiencies in a current State controlled system. The paper closes by reflecting the need for Chinese policy makers to continually develop, adapt and rewrite corporate governance practices capable of meeting the new challenge, and to pay attention to business ethics, an issue which goes beyond regulation.

Social entrepreneurship in Sub-Saharan Africa

Responding to calls for a better understanding of the relationship between social enterprises and their environments, this article focuses on contextual influences on social entrepreneurship in sub-Saharan Africa. We identify four predominantly African contextual dimensions, i.e., acute poverty, informality, colonial history, and ethnic group identity, and explore their influence on the way social ventures perceive themselves and on their choice of activities. Our empirical study of 384 social enterprises from 19 sub-Saharan African countries suggests that ethnic group identity and high poverty levels influence both self-perception and activity choices, while the country’s colonial history only influences self-perception and informality has no significant influence on either. These findings point to the need to consider both self-perception and the choice of activities in defining social entrepreneurship. Our study also highlights the importance of African contextual dimensions for understanding social entrepreneurship, and underlines the added value of incorporating insights from African data into management research more broadly.

Evolving corporate social responsibility in China

With a unique cultural background and fast economic development, China’s adoption of corporate social responsibility (CSR) has become the center of discussion worldwide, and its successful implementation will have great significance for global sustainability. This paper aims to explore how CSR has given way to economic growth in China since the start of economic transition and its cultural, historical and political background, and how this has affected or been affected by the economic performance of firms. Thus, the recent calls for China to adopt CSR in its industries follow a period where the country arguably had one of the strongest implementations of CSR approaches in the world. This transition is considered in the context of a case study of a Chinese state-owned enterprise (SOE) and a group of small private firms in the same industrial sector in Zhengzhou City, Henan Province over a time span of eight years. While the CSR of the SOE has been steadily decreasing along with the change of ownership structure, its economic performance did not improve as expected. On the other hand, with a steady improvement in economic performance, the small private firms are showing a great reluctance to engage in CSR. The results indicate that implementation of CSR in China needs both the manager’s ethical awareness and the change of institutional framework. The results also raise the question as to whether CSR is a universal concept with a desired means of implementation across the developed and developing world.

Social entrepreneurship in South Africa: exploring the influence of environment

The influence of environment on social entrepreneurship requires more concerted examination. This paper contributes to emerging discussions in this area through consideration of social entrepreneurship in South Africa. Drawing upon qualitative case study research with six social enterprises, and examined through a framework of new institutional theories and writing on new venture creation, this research explores the significance of environment for the process of social entrepreneurship, for social enterprises, and for social entrepreneurs. Our findings provide insights on institutional environments, social entrepreneurship, and the interplay between them in the South African context, with implications for wider social entrepreneurship scholarship.

Oxytocin increases eye contact during a real-time, naturalistic social interaction in males with and without autism

Autism spectrum conditions (autism) affect ~1% of the population and are characterized by deficits in social communication. Oxytocin has been widely reported to affect social-communicative function and its neural underpinnings. Here we report the first evidence that intranasal oxytocin administration improves a core problem that individuals with autism have in using eye contact appropriately in real-world social settings. A randomized double-blind, placebo-controlled, within-subjects design is used to examine how intranasal administration of 24 IU of oxytocin affects gaze behavior for 32 adult males with autism and 34 controls in a real-time interaction with a researcher. This interactive paradigm bypasses many of the limitations encountered with conventional static or computer-based stimuli. Eye movements are recorded using eye tracking, providing an objective measurement of looking patterns. The measure is shown to be sensitive to the reduced eye contact commonly reported in autism, with the autism group spending less time looking to the eye region of the face than controls. Oxytocin administration selectively enhanced gaze to the eyes in both the autism and control groups (transformed mean eye-fixation difference per second=0.082; 95% CI:0.025–0.14, P=0.006). Within the autism group, oxytocin has the most effect on fixation duration in individuals with impaired levels of eye contact at baseline (Cohen’s d=0.86). These findings demonstrate that the potential benefits of oxytocin in autism extend to a real-time interaction, providing evidence of a therapeutic effect in a key aspect of social communication.

Social housing in Latin America: Red Road flats of tomorrow?

The article revises latest social housing developments in Brazil and Chile and questions their ability to deliver liveable places.

Real estate and social inequality in Latin America: approaches in Argentina, Brazil, Chile and Colombia

Latin America is known as the most unequal region in the world, where extreme displays of wealth and exposure to scarcity lay bare in the urban landscape. Inequality is not just a social issue; it has considerable impact on economic development. This is because social inequality generates instability and conflict, which can create unsettling conditions for investment. At the macro level, social inequality can also present barriers to economic development, as most government policies and resources tend to be directed in solving social conflict rather than to promote and generate growth. This is one of the reasons usually cited in explaining the development gap between Latin America and other emerging economies, take East Asia for example - they have similar policies to those applied recently in Latin America, but are achieving better growth. The other reason cited is institutional; this includes governance as well as property rights and enforcement of contracts. The latter is the focus of this chapter.

The application of social marketing in reducing road traffic accidents amoung young male drivers: an investigation using physical fear threat appeals

There were 338 road fatalities on Irish roads in 2007. Research in 2007 by the Road Safety Authority in Ireland states that young male drivers (17 – 25 years) are seven times more likely to be killed on Irish roads than other road users. The car driver fatality rate was found to be approximately 10 times higher for young male drivers than for female drivers in 2000. Young male drivers in particular demonstrate a high proclivity for risky driving behaviours. These risky behaviours include drink driving, speeding, rug-driving and engaging in aggressive driving. Speed is the single largest contributing factor to road deaths in Ireland. Approximately 40% of fatal accidents are caused by excessive or inappropriate speed. This study focuses on how dangerous driving behaviours may be addressed through social marketing. This study analyses the appropriate level of fear that needs to be induced in order to change young male driving behaviour.

Maternal antenatal anxiety, postnatal stroking and emotional problems in children: outcomes predicted from pre and postnatal programming hypotheses

Background Mothers' self-reported stroking of their infants over the first weeks of life modifies the association between prenatal depression and physiological and emotional reactivity at 7 months, consistent with animal studies of the effects of tactile stimulation. We now investigate whether the effects of maternal stroking persist to 2.5 years. Given animal and human evidence for sex differences in the effects of prenatal stress we compare associations in boys and girls. Method From a general population sample of 1233 first-time mothers recruited at 20 weeks gestation we drew a random sample of 316 for assessment at 32 weeks, stratified by reported inter-partner psychological abuse, a risk indicator for child development. Of these mothers, 243 reported at 5 and 9 weeks how often they stroked their infants, and completed the Child Behavior Checklist (CBCL) at 2.5 years post-delivery. Results There was a significant interaction between prenatal anxiety and maternal stroking in the prediction of CBCL internalizing (p = 0.001) and anxious/depressed scores (p < 0.001). The effects were stronger in females than males, and the three-way interaction prenatal anxiety × maternal stroking × sex of infant was significant for internalizing symptoms (p = 0.003). The interactions arose from an association between prenatal anxiety and internalizing symptoms only in the presence of low maternal stroking. Conclusions The findings are consistent with stable epigenetic effects, many sex specific, reported in animal studies. While epigenetic mechanisms may be underlying the associations, it remains to be established whether stroking affects gene expression in humans.

Factors that influence the detection of psychological problems in adolescents attending general practices

Background Epidemiological studies indicate that the prevalence of psychological problems in patients attending primary care services may be as high as 25%. Aim To identify factors that influence the detection of psychological difficulties in adolescent patients receiving primary care in the UK. Design of study A prospective study of 13-16 year olds consecutively attending general practices. Setting General practices, Norfolk, UK. Method Information was obtained from adolescents and parents using the validated Strengths and Difficulties Questionnaire (SDQ) and from GF`s using the consultation assessment form. Results Ninety-eight adolescents were recruited by 13 GPs in Norfolk (mean age = 14.4 years, SD = 1.08; 38 males, 60 females). The study identified psychological difficulties in almost one-third of adolescents (31/98, 31.6%). Three factors significant to the detection of psychological disorders in adolescents were identified: adolescents' perceptions of difficulties according to the self-report SDQ, the severity of their problems as indicated by the self-report SDQ, and whether psychological issues were discussed in the consultation. GPs did not always explore psychological problems with adolescents, even if GPs perceived these to be present. Nineteen of 31 adolescents with psychological difficulties were identified by GPs (sensitivity = 61.2%, specificity = 85.1%). A management plan or follow-up was made for only seven of 19 adolescents identified, suggesting that ongoing psychological difficulties in many patients are not being addressed. Conclusions GPs are in a good position to identify psychological issues in adolescents, but GPs and adolescents seem reluctant to explore these openly. Open discussion of psychological issues in GP consultations was found to be the most important factor in determining whether psychological difficulties in adolescents are detected by GPs.