Generative acts: Family and community involvement of older Australians

The article adopts a developmental approach to successful human aging by exploring the concept of generativity in relation to a study of older Australians' lived experiences of involvement in the family and community. Qualitative data, collected through focus group interviews, were analyzed interpretively using recent developments in Erikson's theory of generativity as a framework. As a result, the present study contributes an in-depth understanding of the role of generative acts to the lives of older people. The data provide illustrative support for Erikson's contention of a generativity/stagnation crisis in later life. Involvement in the family and community is seen as a productive and generative activity, which promotes a positive experience of aging. Two further emergent themes are also explored. First, the experiences of study participants illustrate the reciprocal and cyclical nature of grand-generativity, and the importance of intergenerational relationships. Finally, the data contribute to our knowledge of cultural generativity, and in particular the passing on of cultural knowledge through narratives and modeling.

Does being against euthanasia legislation equate to being anti-euthanasia?

This study investigated issues raised in qualitative data from our previous studies of health professionals and community members, which suggested that being opposed to euthanasia legislation did not necessarily equate to being anti-euthanasia per se. A postal survey of 1002 medical practitioners, 1000 nurses and 1200 community members was undertaken. In addition to a direct question on changing the law to allow active voluntary euthanasia (AVE), four statements assessed attitudes to euthanasia with or without a change in legislation. Responses were received from 405 doctors (43%), 429 nurses (45%) and 405 community members (38%). Compared with previous studies there was a slight increase in support for a change in the law from medical practitioners, a slight decrease in support from community members and almost no change among nurses. Different interpretations of the results of the four attitude questions are possible, depending on the perspective of the interpreter.

CONSOLIDAÇÃO OU MUDANÇA? UMA ANÁLISE FEMINISTA DA PASTORAL DA CRIANÇA

O objetivo central desta tese é investigar o potencial de transformação social da organização não-governamental, ligada a CNBB(Confederação Nacional dos Bispos do Brasil).- Pastoral da Criança - para a libertação de mulheres que lá atuam, das relações de dominação e opressões inerentes ao contexto kyriarchal. Esta pesquisa procura considerar o espaço religioso subjacente à organização em decorrência das influências das CEBs (Comunidades Eclesiais de Base) e do MRCC (Movimento de Renovação Católica Carismática). É feita pesquisa de campo na região de Curitiba com observações e entrevistas semi-estruturadas com doze mulheres atuando na Pastoral da Criança, valorizando-se a relação intersubjetiva entre pesquisadora e pessoas envolvidas na pesquisa. A análise qualitativa de dados em relação ao marco teórico feminista desenvolvido em Ciências Sociais pela sociologia, psicanálise e também a teologia, mostra o discurso das representações sociais das mulheres envolvidas, a percepção de suas próprias identidades e a importância da organização na construção de suas vidas. Nos traz a conclusão que a organização reproduz o perfil tradicional de mulheres na função materna e facilita a formação de redes comunitárias. Averigua-se que a Pastoral da Criança está vinculada ao sistema neoliberal de pensamento que reproduz os discursos de dominação do sistema kyriarchal da hierarquia da Igreja Católica e da medicina higienista. Essas instituições de apropriam da vida e dos corpos das mulheres e os reduzem às suas funções meramente biológicas, reprodutivas e de cuidados. A Pastoral da Criança é caracterizada por atividades que não consideram as causas estruturais da pobreza, mas apenas tentam amenizar os seus efeitos e conseqüências. Em suas capacitações, a organização usa a forma bancária de educação que reproduz as relações de dominação e dependência de mulheres pobres. A organização, mesmo com a estrutura da ideologia religiosa analisada, não está vinculada sistematicamente em um espaço religioso. Sugere-se em relação à situação da organização, a abertura das idéias e valores feministas nos campos da saúde e religião a fim de promover a libertação e empoderamento reais de mulheres pobres. Esta recomendação está ligada com a abertura, a necessidade de reflexão e de conhecimento, mostradas pelas mulheres entrevistadas durante a pesquisa de campo. Considera-se como limitação aos resultados da pesquisa, o local pesquisado por não ter influências de movimentos sociais.(AU)

Medicines reconciliation in comparison with NICE guidelines across secondary care mental health organisations

Background Medicines reconciliation-identifying and maintaining an accurate list of a patient's current medications-should be undertaken at all transitions of care and available to all patients. Objective A self-completion web survey was conducted for chief pharmacists (or equivalent) to evaluate medicines reconciliation levels in secondary care mental health organisations. Setting The survey was sent to secondary care mental health organisations in England, Scotland, Northern Ireland and Wales. Method The survey was launched via Bristol Online Surveys. Quantitative data was analysed using descriptive statistics and qualitative data was collected through respondents free-text answers to specific questions. Main outcomes measure Investigate how medicines reconciliation is delivered, incorporate a clear description of the role of pharmacy staff and identify areas of concern. Results Forty-two (52 % response rate) surveys were completed. Thirty-seven (88.1 %) organisations have a formal policy for medicines reconciliation with defined steps. Results show that the pharmacy team (pharmacists and pharmacy technicians) are the main professionals involved in medicines reconciliation with a high rate of doctors also involved. Training procedures frequently include an induction by pharmacy for doctors whilst the pharmacy team are generally trained by another member of pharmacy. Mental health organisations estimate that nearly 80 % of medicines reconciliation is carried out within 24 h of admission. A full medicines reconciliation is not carried out on patient transfer between mental health wards; instead quicker and less exhaustive variations are implemented. 71.4 % of organisations estimate that pharmacy staff conduct daily medicine reconciliations for acute admission wards (Monday to Friday). However, only 38 % of organisations self-report to pharmacy reconciling patients' medication for other teams that admit from primary care. Conclusion Most mental health organisations appear to be complying with NICE guidance on medicines reconciliation for their acute admission wards. However, medicines reconciliation is conducted less frequently on other units that admit from primary care and rarely completed on transfer when it significantly differs to that on admission. Formal training and competency assessments on medicines reconciliation should be considered as current training varies and adherence to best practice is questionable.

Chronic illness in non-heterosexual contexts: towards a critical LGBTQ health psychology

In this thesis, I contribute to the expansion of lesbian, gay, bisexual, trans and queer (LGBTQ) psychology by examining chronic illness within non-heterosexual contexts. Chronic illness, beyond the confines of HIV/AIDS, has been a neglected topic in LGBTQ psychology and sexual identity is often overlooked within health psychology. When the health of lesbian, gay and bisexual (LGB) people has been considered there has been an over-reliance on quantitative methods and comparative approaches which seek to compare LGB people?s health to their heterosexual counterparts. In contrast, I adopt a critical perspective and qualitative methods to explore LGBTQ health. My research brings together ideas from LGBTQ psychology and critical health psychology to explore non-heterosexuals? experiences of chronic illness and the discursive contexts within which LGB people live with chronic health conditions. I also highlight the heteronormativity which pervades academic health psychology as well as the „lay? health literature. The research presented in this thesis draws on three different sources of qualitative data: a qualitative online questionnaire (n=190), an online discussion within a newsgroup for people with diabetes, and semi-structured interviews with 20 LGB people with diabetes. These data are analysed using critical realist forms of thematic analysis and discourse analysis. In the first analytic chapter (Chapter 3), I report the perspectives of LGB people living with many different chronic illnesses and how they felt their sexuality shapes their experiences of illness. In Chapter 4, I examine heterosexism within an online discussion and consider the ways in which sexuality is constructed as (ir)relevant to a diabetes support forum. In Chapter 5, I analyse LGB people?s talk about the support family and partners provide in relation to their diabetes and how they negotiate wider discourses of gender, sexuality and individualism. In Chapter 6 I explore how diabetes intersects with gay and bisexual men?s sex lives. In the concluding chapter, I discuss the contributions of my research for a critical LGBTQ health psychology and identify some possible areas for future research.

Using system dynamics in a discrete-event simulation study of a manufacturing plant

Purpose - To provide an example of the use of system dynamics within the context of a discrete-event simulation study. Design/methodology/approach - A discrete-event simulation study of a production-planning facility in a gas cylinder-manufacturing plant is presented. The case study evidence incorporates questionnaire responses from sales managers involved in the order-scheduling process. Findings - As the project progressed it became clear that, although the discrete-event simulation would meet the objectives of the study in a technical sense, the organizational problem of "delivery performance" would not be solved by the discrete-event simulation study alone. The case shows how the qualitative outcomes of the discrete-event simulation study led to an analysis using the system dynamics technique. The system dynamics technique was able to model the decision-makers in the sales and production process and provide a deeper understanding of the performance of the system. Research limitations/implications - The case study describes a traditional discrete-event simulation study which incorporated an unplanned investigation using system dynamics. Further, case studies using a planned approach to showing consideration of organizational issues in discrete-event simulation studies are required. Then the role of both qualitative data in a discrete-event simulation study and the use of supplementary tools which incorporate organizational aspects may help generate a methodology for discrete-event simulation that incorporates human aspects and so improve its relevance for decision making. Practical implications - It is argued that system dynamics can provide a useful addition to the toolkit of the discrete-event simulation practitioner in helping them incorporate a human aspect in their analysis. Originality/value - Helps decision makers gain a broader perspective on the tools available to them by showing the use of system dynamics to supplement the use of discrete-event simulation. © Emerald Group Publishing Limited.

Science or practice? UK undergraduate experiences and attitudes to the MPharm degree

Objective: The debate surrounding the science/practice balance in the teaching of undergraduate pharmacy has been played out in the professional literature for years. The objective of this work was to explore the attitudes of pharmacy undergraduates on the practice-science debate. Setting: The study was undertaken as part of a national study of teaching, learning and assessment methods in United Kingdom (UK) schools of pharmacy. Method: Six focus groups were carried out. The sample was 44 volunteer students from nine UK schools of pharmacy, representing all 4 years of the MPharm programme. Groups were tape recorded and transcribed. Analysis of the transcripts was theme based by topic. Main Outcome Measure: Qualitative data on student attitudes and experiences. Results: Most students thought that there was too strong an emphasis placed on the science components of the course in the early part of their studies. Later in the course they realised that the majority of the science was necessary; it just had not been apparent to them at the time. There were strongly held attitudes across all 4 years that it would be beneficial to include more practice-related material at the beginning of their studies. This would be beneficial for three reasons: to make the course more interesting, to aid in the contextualisation of the science component and to assist the students in any early placement or vacational work. Conclusion: Internationally, changes to the role of the pharmacist from a traditional supply function to a more clinical role has resulted in differing educational needs for the pharmacist of the future. Pharmacy will remain a degree built on a strong scientific background, but students advise that the contextualisation and sequencing of material within the degree could make a considerable improvement to their learning. Consulting students helps us to understand the teaching, learning and assessment experience better by giving insights into ways of improving the delivery. In the case of the UK, there are legislative changes impending which may provide an opportunity to review the balance of practice-and science in the curriculum. © 2006 Springer Science+Business Media B.V.

Comparing knowledge management between organisations:searching for good practice

This paper reports ongoing work that is attempting to find out ‘what is good practice for knowledge management’. The data we have to analyse this issue is 109 maps of knowledge (on knowledge management) which were built during 18 group workshops with 152 people from 15 different organisations. The maps contain data on the aspirations and action plans which UK managers have to improve knowledge management practices in their organisation. So far we have attempted a number of approaches to analysing this data, both inductive and deductive, but we still feel there is more to be learned from the rich data set we have. The paper presents a flavour of the work we have done, have considered doing, and have resisted doing. The aim of the paper is to stimulate debate on the strengths of our analyses and, more importantly, on amassing views of how it can be further strengthened, and the difficulties and dilemmas which might need to be overcome.

Information management for viable organisations

The recent global „credit crunch? has brought sharply into focus the need for better understanding of what it takes for organisations to survive. This research seeks to help organisations maintain their „viability? – the ability to maintain a separate existence and survive on their own. Whilst there are a multitude of factors that contribute to organisational viability, information can be viewed as the lifeblood of organisations. This research increases our understanding of how organisations can manage information effectively to help maintain their viability. The viable systems model (VSM) is an established modelling technique that enables the detailed analysis of organisational activity to examine how the structure and functions performed in an organisation contribute to its „viability?. The VSM has been widely applied, in small/large companies, industries and governments. However, whilst the VSM concentrates on the structure and functions necessary for an organisation to be viable, it pays much less attention to information deployment in organisations. Indeed, the VSM is criticised in the literature for being unable to provide much help with detailed information and communication structures and new theories are called for to explore the way people interact and what information they need in the VSM. This research analyses qualitative data collected from four case studies to contribute to our understanding of the role that information plays in organisational viability, making three key contributions to the academic literature. In the information management literature, this research provides new insight into the roles that specific information plays in organisations. In the systems thinking literature, this research extends our understanding of the VSM and builds on its powerful diagnostic capability to provide further criteria to aid in the diagnosis of viable organisations. In the information systems literature, this research develops a framework that can be used to help organisations design more effective information systems.

Determinants of sales performance in insurance industry:a cross-cultural comparison between the UK and Malaysia

This thesis is concerned with an empirical investigation of the factors that predict a successful salesperson, using a cross-cultural comparison of two countries: the UK and Malaysia. Besides collecting quantitative data, qualitative data on organisational, environmental and cultural factors were also collected through interviews, personal and case observations. The quantitative data consist of sixteen independent factors and three dependent factors. The independent variables include self-efficacy, self-esteem, locus of control, self-monitoring, extrinsic motivation, intrinsic motivation, experience, training perception, role ambiguity, role conflict, role inaccuracy, gender, age, education, race and religion. The dependent variables are performance target achieved, performance earnings and performance ratings. Questionnaires were distributed to about 500 salespersons in each country, from three insurance companies in the UK and two insurance companies in Malaysia. Response rates were 75 and 50 percent from the UK and Malaysia respectively. The survey results indicated that a salesperson's performance in the UK is predicted by self-efficacy, internal locus of control, self-esteem, extrinsic motivation, experience, training perceptions, role conflict and gender. In Malaysia, a salesperson's performance is predicted by self-efficacy, self-monitoring, experience, role conflict, role ambiguity, education, gender, race and religion. Self-efficacy, experience, role conflict and gender are common predictors of salespersons' performance in both cultures. The likely explanation for these results is culture differences, i.e. UK has a homogeneous culture, while Malaysia has a heterogeneous one. Results from the case observations, such as organisational and environmental factors, give supporting evidence in explaining the empirical results. Implications from the findings are discussed from two aspects: (1) theoretical implications for divergence/convergence theory, Hofstede's model, Churchill's model, and (2) managerial implications for selection, training, motivation and appraisal.

Third sector organisations and social welfare : a study of the role of social service and charitable organisations in Taiwan

This study is about the role and operation of ‘third sector’ organisations (TSOs) within the Taiwanese social welfare context. TSOs have increased dramatically and become actively involved in social service provision. This phenomenon has not only had significant impact on the development and operation of TSOs in Taiwan but it is also of increasing interest to public policy academics. The latter are especially interested in the implications for the government-third sector relationship. This research examines the reasons why TSOs have been established, why they actively participate in social service provision, and their role and operation within the social welfare context of Taiwan. The study has both quantitative and qualitative data. It sampled ‘social service’ and ‘charitable’ organisations (SSCOs), which are the main type of TSOs in Taiwan, to examine their role, operation and interaction with government. Questionnaires were mailed to collect quantitative data first. After the quantitative data were collected and analysed, semi-structured interviews were undertaken to collect qualitative data. The study found that TSOs in Taiwan exist in a highly institutionalised environment, which is affected by traditional Confucian ideas and contemporary Western ideas such as social justice and civil rights. The rapid growth of TSOs has a strong connection with the desire to fill social service gaps left by government and family. TSOs mainly play the role of service provider rather than that of advocate. They cooperate with government in social service provision and have developed different types of symbiotic relationships with government. A ‘resonance effect’ between government and TSOs was also found as they implement social policy.

Mapping the mind for the modern market researcher

Purpose - To describe the utility of three of the main cognitive neuroscientific techniques currently in use within the neuroscience community, and how they can be applied to the emerging field of neuromarket research. Design/methodology/approach - A brief development of functional magnetic resonance imaging, magnetoencephalography and transcranial magnetic stimulation are described, as the core principles are behind their respective use. Examples of actual data from each of the brain imaging techniques are provided to assist the neuromarketer with subsequent data for interpretation. Finally, to ensure the neuromarketer has an understanding of the experience of neuroimaging, qualitative data from a questionnaire exploring attitudes about neuroimaging techniques are included which summarize participants' experiences of having a brain scan. Findings - Cognitive neuroscientific techniques have great utility in market research and can provide more "honest" indicators of consumer preference where traditional methods such as focus groups can be unreliable. These techniques come with complementary strengths which allow the market researcher to converge onto a specific research question. In general, participants considered brain imaging techniques to be relatively safe. However, care is urged to ensure that participants are positioned correctly in the scanner as incorrect positioning is a stressful factor during an imaging procedure that can impact data quality. Originality/value - This paper is an important and comprehensive resource to the market researcher who wishes to use cognitive neuroscientific techniques.

Medicines non-use in primary care

This study expands the current knowledge base on the nature, causes and fate of unused medicines in primary care. Three methodologies were used and participants for each element were sampled from the population of Eastern Birmingham PCT. A detailed assessment was made of medicines returned to pharmacies and GP surgeries for destruction and a postal questionnaire covering medicines use and disposal was used to patients randomly selected from the electoral roll. The content of this questionnaire was informed by qualitative data from a group interview on the subject. By use of these three methods it was possible to triangulate the data, providing a comprehensive assessment of unused medicines. Unused medicines were found to be ubiquitous in primary care and cardiovascular, diabetic and respiratory medicines are unused in substantial quantities, accounting for a considerable proportion of the total financial value of all unused medicines. Additionally, analgesic and psychoactive medicines were highlighted as being unused in sufficient quantities for concern. Anti-infective medicines also appear to be present and unused in a substantial proportion of patients’ homes. Changes to prescribed therapy and non-compliance were identified as important factors leading to the generation of unused medicines. However, a wide array of other elements influence the quantities and types of medicines that are unused including the concordancy of GP consultations and medication reviews and patient factors such as age, sex or ethnicity. Medicines were appropriately discarded by 1 in 3 patients through return to a medical or pharmaceutical establishment. Inappropriate disposal was by placing in household refuse or through grey and black water with the possibility of hoarding or diversion also being identified. No correlations wre found between the weight of unused medicines and any clinical or financial factor. The study has highlighted unused medicines to be an issue of some concern and one that requires further study.

The academic conference evolves: the fMRI experience

The fMRI Experience began as a postgraduate organised conference, to enable novice access to expertise in a developing and technically complex area, and for mutual support. This article investigates the seventh annual iteration of this emergent conference and evaluates its educational value. Key features are free attendance supported by sponsorship, a clear focus on student needs and a strong social programme and participation ethos to facilitate interaction. Predominantly qualitative data suggests that the event is of value to postgraduate participants and is also successful in attracting the participation of internationally leading researchers. The implications and value of the event for postgraduate education and for developing new fields of enquiry are discussed.