Managing impressions during institutional change – The role of organisational accounts in legitimation

Public relations literature has only recently drawn on institutional theory to provide insights into legitimacy that go beyond strategic organisational level processes. Many of the existing crisis management studies are approached from a strategic perspective, which have limitations in terms of how organizations manage their legitimacy in relation to broader and often changing social agendas. This study focuses on how impression management is used to deal with legitimacy gaps between organizations and public expectations that draw on an institutional theory perspective. This qualitative study examines the use of organizational accounts through a lens that marries institutional theory and impression management in order to understand how organizations manage their legitimacy. This study of accounts around legitimacy concerns of corporate social responsibility matters shows that organizations relied on their own tangible technical attributes rather than shared norms of what is considered responsible when there are no hard or institutionalised laws and regulations in place around corporate social responsibility concerns. This study offers insights into public relations concerns around impression management during institutional change and in doing so extends existing public relations approaches to crisis management.

Regulating audit quality : restoring trust and legitimacy

The global financial crsis, corporate failures and scandals in amny countries raise significant questions audit quality. In the UK, the FRC took the unprecedented step of codifying audit quality in its ‘Audit Quality Framework’. We analyze the extent to which audit firms, professional bodies, and investors considered the FRC proposals sufficient for addressing concerns about audit quality. Using impression management and legitimacy as a framework to analyze stakeholder responses we go beyond audit quality drivers identified by the FRC. In contrast to the drivers identified by the FRC, our focus on transparency, expertise, professionalism and commercialization of the audit shows that FRC, audit firms and professional bodies have mainly focused on issues which possibly do not pose a threat to the commercial interest of audit firms. Overall, our analysis shows that regulatory and professional bodies engaged in image management and the promotion of audit quality in an attempt to remedy tarnished image and augment their legitimacy and standing. In attempting to restore trust and legitimacy regulatory bodies, such as the FRC, have to reconcile complex often contradictory stakeholder demands.

The perspectives of older drivers on the impact of feedback on their driving behaviours : a qualitative study

Self-regulation is a coping strategy that allows older drivers to drive safely for longer. Self-regulation depends largely on the ability of drivers to evaluate their own driving. Therefore the success of self-regulation, in terms of driving safety, is influenced by the ability of older drivers to have insight into their declining driving performance. In addition, previous studies suggest that providing feedback to older adults regarding their driving skills may lead them to change their driving behaviour. However, little is currently known about the impact of feedback on older drivers’ self-awareness and their subsequent driving regulatory behaviour. This study explored the process of self-regulation and driving cessation among older drivers using the PAPM as a framework. It also investigated older adults’ perceptions and opinions about receiving feedback in regards to their driving abilities. Qualitative focus groups with 27 participants aged 70 years or more were conducted. Thematic analysis resulted in the development of five main themes; the meaning of driving, changes in driving pattern, feedback, the planning process, and solutions. The analysis also resulted in an initial model of driving self-regulation among older drivers that is informed by the current research and the Precaution Adoption Process Model as the theoretical framework. It identifies a number of social, personal, and environmental factors that can either facilitate or hinder people’s transition between stages of change. The findings from this study suggest that further elaboration of the PAPM is needed to take into account the role of insight and feedback on the process of self-regulation among older drivers.

The Thoughts Questionnaire (TQ) for family caregivers of people with dementia

Objectives: To develop a new measure of dysfunctional thoughts for family caregivers of people living with dementia. These thoughts can contribute to negative outcomes, but they may be modifiable. Method: A stepwise process was used to develop the Thoughts Questionnaire, commencing with item generation, concept mapping, and pilot testing in a sample of professional and nonprofessional caregivers of people with dementia (n = 18). Next, an independent sample of 35 family caregivers of people with dementia (30 female; M age = 64.30, standard deviation = 10.65) completed: (a) the Thoughts Questionnaire; (b) an existing measure of dysfunctional thoughts, the Dementia Thoughts Caregivers Questionnaire; and (c) separate validated measures of depressive symptoms, caregiver stress, and coping, respectively. Results: The level of agreement with dysfunctional thought statements from the Dementia Thoughts Caregivers Questionnaire and Thoughts Questionnaire was low. However, a small number of Thoughts Questionnaire statements were strongly endorsed by over 85% of the sample. Both dysfunctional thought measures had adequate reliability, but total scores were not significantly intercorrelated (r = .287, p = .095). Only the Thoughts Questionnaire was significantly, positively correlated with most caregiver stress measures. Thoughts Questionnaire items required a much lower reading level than the Dementia Thoughts Caregivers Questionnaire items. Discussion: This study provides preliminary data on a tool for assessing the negative role-related thoughts that family caregivers of people with dementia may experience. Given that these thoughts are implicated in depression but they may be modified, the capacity to identify dysfunctional thoughts may prove useful in caregiver support programs.

Tools, building blocks, and rewards : traditional media organizations learn to engage with productive audiences

This paper explores how traditional media organizations (such as magazines, music, film, books, and newspapers) develop routines for coping with an increasingly productive audience. While previous studies have reported on how such organizations have been affected by digital technologies, this study makes a contribution to this literature by being one of the first to show how organizational routines for engaging with an increasingly productive audience actually emerge and diffuse between industries. The paper explores to what extent routines employed by two traditional media organizations have been brought in from other organizational settings, specifically from so-called ‘software platform operators’. Data on routines for engaging with productive audiences have been collected from two information-rich cases in the music and the magazine industries, and from eight high-profile software platform operators. The paper concludes that the routines employed by the two traditional media organizations and by the software platform operators are based on the same set of principles: Provide the audience with (a) tools that allow them to easily generate cultural content; (b) building blocks which facilitate their creative activities; and (c) recognition and rewards based on both rationality and emotion.

Parent feeding interactions and practices during childhood cancer treatment: A qualitative investigation

In the general population it is evident that parent feeding practices can directly shape a child’s life long dietary intake. Young children undergoing childhood cancer treatment may experience feeding difficulties and limited food intake, due to the inherent side effects of their anti-cancer treatment. What is not clear is how these treatment side effects are influencing the parent–child feeding relationship during anti-cancer treatment. This retrospective qualitative study collected telephone based interview data from 38 parents of childhood cancer patients who had recently completed cancer treatment (child’s mean age: 6.98 years). Parents described a range of treatment side effects that impacted on their child’s ability to eat, often resulting in weight loss. Sixty-one percent of parents (n = 23) reported high levels of stress in regard to their child’s eating and weight loss during treatment. Parents reported stress, feelings of helplessness, and conflict and/or tension between parent and the child during feeding/eating interactions. Parents described using both positive and negative feeding practices, such as: pressuring their child to eat, threatening the insertion of a nasogastric feeding tube, encouraging the child to eat and providing home cooked meals in hospital. Results indicated that parent stress may lead to the use of coping strategies such as positive or negative feeding practices to entice their child to eat during cancer treatment. Future research is recommended to determine the implication of parent feeding practice on the long term diet quality and food preferences of childhood cancer survivors.

Never at Home? Migrants Between Societies

This chapter explores the dialectic meaning of ‘home’, and movement away from home. Movement away from home – migration – is characterized as a dynamic, dialectic, and developmental experience. We emphasize the sense of being at home and the intertwined sense of identity as interlinked and mutually defining anchors of our existence that become inevitably shaken and ruptured in the experience of migration. But when looking at how this rupture is experienced and managed, we highlight the inherently complex and dialectic nature of migration, instead of seeing it as a unidirectional sequence of rupture → shock → coping → new stable being. We discuss the complexities of migration experiences as entailing dialectics of home and non-home, rupture and continuity, novelty and everydayness, changing and remaining. The sense of being at home is simultaneously enabling and constraining, helping us to build self-continuity in a new environment, yet also holding us back and distancing us from novelty. Similarly, migration is a threat, yet also a promise; it is a painful, yet possibly exhilarating experience that makes us lose our centre of security and familiarity, yet also opens up opportunities for transformation and re-invention.

Citizens and social media in times of natural disaster: Exploring information experience

Introduction. Social media is becoming a vital source of information in disaster or emergency situations. While a growing number of studies have explored the use of social media in natural disasters by emergency staff, military personnel, medial and other professionals, very few studies have investigated the use of social media by members of the public. The purpose of this paper is to explore citizens’ information experiences in social media during times of natural disaster. Method. A qualitative research approach was applied. Data was collected via in-depth interviews. Twenty-five people who used social media during a natural disaster in Australia participated in the study. Analysis. Audio recordings of interviews and interview transcripts provided the empirical material for data analysis. Data was analysed using structural and focussed coding methods. Results. Eight key themes depicting various aspects of participants’ information experience during a natural disaster were uncovered by the study: connected; wellbeing; coping; help; brokerage; journalism; supplementary and characteristics. Conclusion. This study contributes insights into social media’s potential for developing community disaster resilience and promotes discussion about the value of civic participation in social media when such circumstances occur. These findings also contribute to our understanding of information experiences as a new informational research object.

Can larger-bodied cemented femoral components reduce periprosthetic fractures? A biomechanical study

Introduction: The risk for late periprosthetic femoral fractures is higher in patients treated for a neck of femur fracture compared to osteoarthritis. It has been hypothesised that osteopenia and consequent decreased stiffness of the proximal femur are responsible for this. We investigated whether a femoral component with a bigger body would increase the torque to failure in a biaxially loaded composite Sawbone model. Material and methods: A biomechanical bone analogue was used. Two different body sizes (Exeter 44-1 vs 44-4) of a polished tapered cemented femoral stem were implanted by an experienced surgeon in 7 bone analogues each and internally rotated at 40°/s until failure. Torque to fracture and fracture energy were measured using a biaxial materials testing device (Instron 8874, MI, USA). The data were non-parametric and therefore tested with the Mann-Whitney U-test. Results: The median torque to fracture was 156.7 Nm (IQR 19.7) for the 44-1 stem and 237.1 Nm (IQR 52.9) for the 44-4 stem (p=0.001). The median fracture energy was 8.5J (IQR 7.3) for the 44-1 stem and 19.5J (IQR 8.8) for the 44-4 stem (p=0.014). Conclusions: The use of a large body polished tapered cemented stems for neck of femur fractures increases the torque to failure in a biomechanical model and therefore is likely to reduce late periprosthetic fracture risk in this vulnerable cohort.

Why are haemodialysis nurses satisfied also experiencing burnout?

Background Haemodialysis nurses work in a technological environment caring for patients over a prolonged period of time leading to the development of unique nurse-patient relationships. In order to improve retention of nurses in this specialised area of nursing it is important to know the factors that affect job satisfaction, stress and burnout and understand how these experiences are conceptualised by haemodialysis nurses. Aim To explore the factors contributing to satisfaction with the work environment, job satisfaction, job stress and burnout in haemodialysis nurses in Australia and New Zealand. Method A quantitative dominant sequential explanatory mixed method design was used. Quantitative data was collected using an on-line questionnaire containing demographic questions and pre-existing instruments examining job satisfaction, stress, burnout and satisfaction with the work environment. The qualitative phase involved semi-structured interviews. Results 417 nurses completed the questionnaire. Overall, nurses were satisfied with their work environment and the job that they performed but there were stressors in the haemodialysis setting that led to high levels of burnout. Key themes emerged from the qualitative data related to the physical environment, intensity of nurse-patient relationships, workloads, and coping with death and dying. The qualitative findings also provide possible explanations for the high level of burnout identified in the quantitative findings. Conclusion Explanation of areas where specific nurse and patient outcomes were affected will support the development of appropriate interventions to sustain a work environment conducive to job satisfaction that also alleviates stress and burnout in these nurses.

What do most Americans think of cost-effectiveness research in health care?

My impression is that explicit data on the cost-effectiveness of different health care services are not valued highly by US policy makers. An example is a recent decision to approve ipilimumab for the treatment of metastatic melanoma. The extra health benefit over standard treatment is 2.1 months in previously untreated patients and the cost is $120,000 for 4 doses. This is poor value for money. Had $120,000 been allocated to an intensive lifestyle modification programme for diabetes risk (Diabet Med. 2004 Nov;21(11):1229-36) then 67 years of life or 800 months could have been returned. A massive increase in health benefits for the same costs.

Stress, the hippocampus and the HPA axis: Implications for the development of psychotic disorders

The experience of stress is commonly implicated in models of the onset of psychotic disorders. However, prospective studies investigating associations between biological markers of stress and the emergence of psychotic disorders are limited and inconclusive. One biological system proposed as the link between the psychological experience of stress and the development of psychosis is the Hypothalamic-Pituitary-Adrenal (HPA) axis. This paper summarizes and discusses evidence supporting a role for HPA-axis dysfunction in the early phase of schizophrenia and related disorders. METHOD A selective review of psychiatric and psychological research on stress, coping, HPA-axis, the hippocampus and psychotic disorders was performed, with a particular focus on the relationship between HPA-axis dysfunction and the onset of psychotic disorders. RESULTS Individual strands of past research have suggested that the HPA-axis is dysfunctional in at least some individuals with established psychotic disorders; that the hippocampus is an area of the brain that appears to be implicated in the onset and maintenance of psychotic disorders; and that an increase in the experience of stress precedes the onset of a psychotic episode in some individuals. Models of the onset and maintenance of psychotic disorders that link these individual strands of research and strategies for examining these models are proposed in this paper. CONCLUSIONS The current literature provides some evidence that the onset of psychotic disorders may be associated with a higher rate of stress and changes to the hippocampus. It is suggested that future research should investigate whether a relationship exists between psychological stress, HPA-axis functioning and the hippocampus in the onset of these disorders. Longitudinal assessment of these factors in young people at 'ultra' high risk of psychosis and first-episode psychosis cohorts may enhance understanding of the possible interaction between them in the early phases of illness.

Using culture to manage the transition into university: Conceptualising the dynamics of withdrawal and engagement

This conceptual paper explored the purposes of using culture in the process of coping with stress by looking how first year undergraduate students used cultural elements and activities to aid their transition into university. Results supported two key conceptualisations of the use of culture. Firstly, results indicated that students used culture either for withdrawal purposes, i.e., for escaping from the stressful situation, or for engagement purposes, i.e., for actively engaging with the stressful situation. Secondly, the results suggested three different forms of using culture to engage with stressful situations: mood management, learning, and personal interaction. While the results of the study resonate with the distinction between avoidance versus approach-oriented coping strategies that are widely explored in the stress and coping literature, they also suggest that the relationship between withdrawal and engagement might be dynamic with those two strategies serving distinct purposes in the process of coping with stress. The paper thus suggests that there is a need to develop process-oriented models of coping that would allow identifying patterns in the way people fluctuate between withdrawal and engagement that support and facilitate their personal growth and development.

International students' perceptions of their experience of higher education in Australia: A focus on Saudi Arabian students in their first year of a business course in a major Australian university

This study examined perceptions of international students from Saudi Arabia living and studying in Australia. As a qualitative study that featured case study methodology, the thesis discusses the experiences of Saudi Arabian students in the light of two important factors: students' expectations prior to coming to Australia and the impact of intercultural competency on students' experiences. The study found that while study participants reported mostly positive experiences, there were challenges faced such as coping with English language and culture shock. The thesis culminates in a comprehensive list of implications for educators in the light of the study's findings.

Factors associated with mental health of medical students in Vietnam: A national study

This project was the first national study of the health and wellbeing of medical students in Vietnam. Data from over 2,000 students from eight universities indicate that, while the majority are healthy, significant proportions have poor mental and/or physical health and other life adversities. For many students, heavy academic demands were not a major stressor; rather, difficulties within their family, interpersonal relations, dissatisfaction with career choice and housing and financial problems appear to cause the most strain. This study provides evidence that will be useful for the development of professional counseling services in Vietnamese universities.