The burden of musculoskeletal disease - a global perspective

Musculoskeletal diseases are one of the major causes of disability around the world and have been a significant reason for the development of the Bone and Joint Decade. Rheumatoid arthritis, osteoarthritis and back pain are important causes of disability-adjusted-life years in both the developed and developing world. COPCORD studies in over 17 countries around the world have identified back and knee pain as common in the community and are likely to increase with the ageing population. Musculoskeletal conditions are an enormous cost to the community in economic terms, and these figures emphasise how governments need to invest in the future and look at ways of reducing the burden of musculoskeletal diseases by encouraging exercise and obesity prevention campaigns.

Perspectives on quality of life by people with aphasia and their family: Suggestions for successful living

Understanding the client's perspective is essential for good practitioner care in rehabilitation after stroke, and nothing is more relevant than enquiring directly about our clients' quality of life to inform our management. Relatively little is known about how older people with aphasia consider the quality of their current lives, and this article seeks to explore this issue. Four women's accounts of their life quality are presented, as well as their husbands' or daughter's accounts of their lives. Their stories share some common elements. Who you love or share your life with; where you live; feeling independent and/or in control; and engaging in satisfying activities mattered to these women's life quality. The impact of aphasia varies across the cases, and the need to accept change for successful living is illustrated in all accounts.

Perspective on the host response to human metapneumovirus infection: what can we learn from respiratory syncytial virus infections?

Human metapneumovirus (HMPV) is a recently discovered pathogen first identified in respiratory specimens from young children suffering from clinical respiratory syndromes ranging from mild to severe lower respiratory tract illness. HMPV has worldwide prevalence, and is a leading cause of respiratory tract infection in the first years of life, with a spectrum of disease similar to respiratory syncytial virus (RSV). The disease burden associated with HMPV infection has not been fully elucidated; however, studies indicate that HMPV may cause upper or lower respiratory tract illness in patients between ages 2 months and 87 years, may co-circulate with RSV, and HMPV infection may be associated with asthma exacerbation. The mechanisms and effector pathways contributing to immunity or disease pathogenesis following infection are not fully understood; however, given the clinical significance of HMPV, there is a need for a fundamental understanding of the immune and pathophysiological processes that occur following infection to provide the foundation necessary for the development of effective vaccine or therapeutic intervention strategies. This review provides a current perspective on the processes associated with HMPV infection, immunity, and disease pathogenesis. (c) 2005 Elsevier SAS. All rights reserved.

DA RESISTÊNCIA ÀS INVENÇÕES CRIATIVAS: Um olhar certeauniano ao movimento da prática avaliativa de professores

presente pesquisa apresenta-se em uma perspectiva qualitativa, de cunho etnográfico. Analisa o movimento da prática avaliativa de professores que participaram do curso sobre Avaliação numa perspectiva construtivista. Inicialmente, discute a hipótese de não-mudança em relação à prática avaliativa. Em uma trajetória reflexiva, a análise passa a ser inspirada nos estudos de Michel de Certeau, ao não se render à supremacia de produtos culturais impostos por uma ordem social dominante; ao não se limitar à perspectiva das teorias sobre Avaliação da aprendizagem. O foco da pesquisa direcionou-se à ação dos consumidores desses produtos os professores que, ao se apropriarem de tais teorias, o fazem à sua maneira, redimensionando-as e as resignificando, com astúcia, criatividade, inventividade. Ao entender que tais profissionais, em situações menos privilegiadas nas estruturas sociais de poder constituído, possuem uma inteligência que engendra uma multiplicidade de interpretações, abrimos nosso olhar para surpresas, possibilitando a apreciação de variados caminhos que delineiam as práticas avaliativas dos professores. No entanto, se elegêssemos um único padrão de referência para a análise das ações cotidianas, poderíamos nos fechar em apenas duas conclusões: obediências ou resistências. Optamos, todavia, por aproximarmo-nos de Certeau, e acreditar, como ele, na inteligência e criatividade também presentes nas ações dos mais fracos nas organizações sociais, que são os consumidores dos produtos culturais. Criamos, destarte, nova oportunidade para que a multidão adquira vida, evidenciando a diversidade de práticas avaliativas de um grupo de professores, focalizando a análise em ações concretas, de professores reais.

OS CONFLITOS, BARREIRAS E CONQUISTAS DAS RELAÇÕES DE GÊNERO NA EDUCAÇÃO INFANTIL - AS RELAÇÕES DOS EDUCADORES E EDUCADORAS DE UMA CRECHE

A presente pesquisa apresenta-se em uma perspectiva qualitativa, de cunho etnográfico. Analisa as relações estabelecidas entre os educadores e educadoras que trabalham com a educação infantil, sob a ótica das relações de gênero. Inicialmente, discute o percurso histórico da Educação Infantil nas principais Leis e Documentos que orientam a Educação Brasileira sob a ótica de gênero. Em seguida, em uma trajetória reflexiva, a análise passa a ser inspirada nos estudos da categoria gênero, e traz reflexões importantes acerca da sua definição, bem como do seu contexto histórico, político e social, segundo as autoras Joan Scott, Guacira Lopes Louro, Fúlvia Rosemberg e Jane Soares de Almeida. O foco da pesquisa está direcionado nas relações que se estabelecem entre os educadores e educadoras das instituições de educação infantil. E a repercussão dessas relações na educação das crianças pequenas. Muitos são os conflitos e barreiras da educação infantil sob a ótica de gênero. Porém, ao longo dos anos várias conquistas foram alcançadas na perspectiva das relações de gênero nessa modalidade de ensino. Ao se analisar as relações entre educadoras e educadores de uma creche, verificou-se que as relações estabelecidas na educação infantil apresentam-se como uma das formas de introdução de meninos e meninas na vida social. E, pensar na interação entre os pares, sejam eles grandes ou pequenos, meninos e meninas é oportunizar as mais variadas compreensões de si, do outro e da realidade.(AU)

Crossing threshold periods in the retail life cycle:Insights from Wal-Mart international

This article takes a broader theoretical perspective of the retail life cycle by incorporating threshold periods at important inflection points in the international growth process. Specifically, it considers one threshold interval between an early phase of disjointed international expansion and a more focused, accelerated international growth programme. It concludes that executives need to consider a set of threshold periods during the development and growth of international store operations, understand why these events occur, and consider in what ways to respond to them to overcome and cross the threshold. Salient lessons are extracted from Wal-Mart's experiences during the threshold period for other international managers. © 2005 Elsevier Ltd. All rights reserved.

Whole life performance assessment: critical success factors

Whole life costing (WLC) has become the best practice in construction procurement and it is likely to be a major issue in predicting whole life costs of a construction project accurately. However, different expectations from different organizations throughout a project's life and the lack of data, monitoring targets, and long-term interest for many key players are obstacles to be overcome if WLC is to be implemented. A questionnaire survey was undertaken to investigate a set of ten common factors and 188 individual factors. These were grouped into eight critical categories (project scope, time, cost, quality, contract/administration, human resource, risk, and health and safety) by project phase, as perceived by the clients, contractors and subcontractors in order to identify critical success factors for whole life performance assessment (WLPA). Using a relative importance index, the top ten critical factors for each category, from the perspective of project participants, were analyzed and ranked. Their agreement on those categories and factors were analyzed using Spearman's rank correlation. All participants identify “Type of Project” as the most common critical factor in the eight categories for WLPA. Using the relative index ranking technique and weighted average methods, it was found that the most critical individual factors in each category were: “clarity of contract” (scope); “fixed construction period” (time); “precise project budget estimate” (cost); “material quality” (quality); “mutual/trusting relationships” (contract/administration); “leadership/team management” (human resource); and “management of work safety on site” (health and safety). There was relatively a high agreement on these categories among all participants. Obviously, with 80 critical factors of WLPA, there is a stronger positive relationship between client and contactor rather than contractor and subcontractor, client and subcontractor. Putting these critical factors into a criteria matrix can facilitate an initial framework of WLPA in order to aid decision making in the public sector in South Korea for evaluation/selection process of a construction project at the bid stage.

Employee negative emotions in supervisory relationships : an attachment theory perspective

Relationships with supervisors are a major source of negative emotions at work, but little is known about why this is so. The aim of the research was to use attachment theory (Bowlby, 1969, 1973; 1980) as a framework for investigating the nature and causes of employee negative emotional experiences, in the context of their supervisory relationships. The research was conducted in three stages. In Stage 1 two studies were conducted to develop a measure of employee perceptions of supervisor caregiving (SCS). Results indicated that the 20-item scale had good reliability and validity. Stage 2 required participants (N=183) to complete a questionnaire that was designed to examine the roles of supervisor caregiving and working models (specific and global) in determining cognitive and emotional responses to hypothetical supervisor behaviours. The results provided partial support for an Independent Effects Model. Supervisor caregiving predicted specific anxiety and avoidance. In tum, both dimensions of attachment predicted negative emotions, but this relationship was mediated by event interpretation only in the case of avoidance. Global models made a smaller but significant contribution to negative emotions overall. There was no support for an interaction effect between specific and global models in determining event interpretation. In stage 3 a sub-sample of questionnaire respondents (N=24) were interviewed about 'real-life' caregiving and negative emotional experiences in their supervisory relationships. Secure individuals experienced supervisors as consistently warm, available, and responsive. They reported few negative events or emotions. Individuals with insecure specific working models experienced rejecting or inconsistent supervisor caregiving. They were sensitised to trust and closeness issues in their relationships, and reported negative events and emotions underpinned by these themes. Overall, results broadly supported attachment theory predictions. It is concluded that an attachment theory perspective provides new insight into the nature and causes of employee negative emotions in supervisory relationships.

An institutional perspective on management accounting change in the public sector : a case study from Canada

This thesis reports on a four-year field study conducted at the Saskatchewan regional office of the Department of Indian Affairs and Northern Development, a large department of the Government of Canada. Over the course of the study, a sweeping government-wide accounting reform took place entitled the Financial Information Strategy. An ethnographic study was conducted that documented the management accounting processes in place at the regional office prior to the Financial Information Strategy reform, the organization’s adoption of the new accounting system associated with this initiative, and the state of the organization’s management accounting system once the implementation was complete. This research, therefore, captures in detail a management accounting change process in a public sector organization. This study employs an interpretive perspective and draws on institution theory as a theoretical framework. The concept of loose coupling and insights from the literature on professions were also employed in the explanation-building process for the case. This research contributes to institution theory and the study of management accounting change by recognizing conflicting institutional forces at the organizational level. An existing Old Institutional Economics-based conceptual framework for management accounting change is advanced and improved upon through the development of a new conceptual framework that incorporates the influence of wider institutional forces, the concepts of open and closed organizational systems and loose coupling, and the recognition of varying rates of change and institutionalization of organizational activity sets. Our understanding of loose coupling is enhanced by the interpretation of institutional influences developed in this study as is the role of professionalization as a normative influence in public sector organizations.

The knowledge-based perspective of risk management in healthcare organisations

The aim of this research is to investigate how risk management in a healthcare organisation can be supported by knowledge management. The subject of research is the development and management of existing logs called "risk registers", through specific risk management processes employed in a N.H.S. (Foundation) Trust in England, in the U.K. Existing literature on organisational risk management stresses the importance of knowledge for the effective implementation of risk management programmes, claiming that knowledge used to perceive risk is biased by the beliefs of individuals and groups involved in risk management and therefore is considered incomplete. Further, literature on organisational knowledge management presents several definitions and categorisations of knowledge and approaches for knowledge manipulation in the organisational context as a whole. However, there is no specific approach regarding "how to deal" with knowledge in the course of organisational risk management. The research is based on a single case study, on a N.H.S. (Foundation) Trust, is influenced by principles of interpretivism and the frame of mind of Soft Systems Methodology (S.S.M.) to investigate the management of risk registers, from the viewpoint of people involved in the situation. Data revealed that knowledge about risks and about the existing risk management policy and procedures is situated in several locations in the Trust and is neither consolidated nor present where and when required. This study proposes a framework that identifies required knowledge for each of the risk management processes and outlines methods for conversion of this knowledge, based on the SECI knowledge conversion model, and activities to facilitate knowledge conversion so that knowledge is effectively used for the development of risk registers and the monitoring of risks throughout the whole Trust under study. This study has theoretical impact in the management science literature as it addresses the issue of incomplete knowledge raised in the risk management literature using concepts of the knowledge management literature, such as the knowledge conversion model. In essence, the combination of required risk and risk management related knowledge with the required type of communication for risk management creates the proposed methods for the support of each risk management process for the risk registers. Further, the indication of the importance of knowledge in risk management and the presentation of a framework that consolidates knowledge required for the risk management processes and proposes way(s) for the communication of this knowledge within a healthcare organisation have practical impact in the management of healthcare organisations.

Relational diversity, social integration and individual effectiveness: a social self-regulation perspective

Relational demographers and dissimilarity researchers contend that group members who are dissimilar (vs. similar) to their peers in terms of a given diversity attribute (e.g. demographics, attitudes, values or traits) feel less attached to their work group, experience less satisfying and more conflicted relationships with their colleagues, and consequently are less effective. However, qualitative reviews suggest empirical findings tend to be weak and inconsistent (Chattopadhyay, Tluchowska and George, 2004; Riordan, 2000; Tsui and Gutek, 1999), and that it remains unclear when, how and to what extent such differences (i.e. relational diversity) affect group members social integration (i.e. attachment with their work group, satisfaction and conflicted relationships with their peers) and effectiveness (Riordan, 2000). This absence of meta-analytically derived effect size estimates and the lack of an integrative theoretical framework leave practitioners with inconclusive advice regarding whether the effects elicited by relational diversity are practically relevant, and if so how these should be managed. The current research develops an integrative theoretical framework, which it tests by using meta-analysis techniques and adding two further empirical studies to the literature. The first study reports a meta-analytic integration of the results of 129 tests of the relationship between relational diversity with social integration and individual effectiveness. Using meta-analytic and structural equation modelling techniques, it shows different effects of surface- and deep-level relational diversity on social integration Specifically, low levels of interdependence accentuated the negative effects of surface-level relational diversity on social integration, while high levels of interdependence accentuated the negative effects of deep-level relational diversity on social integration. The second study builds on a social self-regulation framework (Abrams, 1994) and suggests that under high levels of interdependence relational diversity is not one but two things: visibility and separation. Using ethnicity as a prominent example it was proposed that separation has a negative effect on group members effectiveness leading for those high in visibility and low in separation to overall positive additive effects, while to overall negative additive effects for those low in visibility and high in separation. These propositions were sustained in a sample of 621 business students working in 135 ethnically diverse work groups in a business simulation course over a period of 24 weeks. The third study suggests visibility has a positive effect on group members self-monitoring, while separation has a negative effect. The study proposed that high levels of visibility and low levels of separation lead to overall positive additive effects on self-monitoring but overall negative additive effects for those low in visibility and high in separation. Results from four waves of data on 261 business students working in 69 ethnically diverse work groups in a business simulation course held over a period of 24 weeks support these propositions.

Teamwork for product innovation in Taiwanese family firms:an indigenous psychology perspective: An indigenous psychology

As the existing team literature mostly excludes context and culture, little is known about how these elements affect real-life team working (Engestrom, 2008; Salas & Wildman, 2009), and how teams work in non-Western settings, such as in Chinese firms (Phan, Zhou, & Abrahamson, 2010).This research addresses this issue by investigating how new product design (NPD) teams use team working to carry out product innovation in the context of Chinese family businesses (CFBs) via an indigenous psychology perspective. Unlike mainstream teamwork literature which mostly employs an etic design, an indigenous psychology perspective adopts an emic approach which places emphasis on understanding real-life phenomena in context through a cultural-insider perspective (Kim, 2000). Compatible with this theoretical position, a multiple qualitative case study approach was used as the research methodology. Three qualitative case studies were carried out in three longstanding family-run manufacturing firms in Taiwan, where family firms have been the pillars of high economic growth in the past five decades (W.-w. Chu, 2009). Two salient findings were established across the three case studies. First, the team processes identified across the three family firms are very similar with the exception of owners’ involvement and on-the-job training. All three family firms’ NPD teams are managed in a highly hierarchical manner, with considerable emphasis placed on hierarchical ranking, cost-effectiveness, efficiency, practicability, and interpersonal harmony. Second, new products developed by CFBNPD teams are mostly incremental innovation or copycat innovation, while radical or original products are rare. In many ways, CFBNPD teams may not be the ideal incubators for innovation. This is because several aspects of their unique context can cast constraints on how they work and innovate, and thus limit the ratio of radical innovation. A multi-level review into the facilitators and inhibitors of creativity or innovation in CFBNPD teams is provided. The theoretical and practical implications of the findings and the limitations of the study are also addressed.

Entrepreneurial intention and entrepreneurial behaviour:a social psychological perspective

Increasing the supply of entrepreneurs reduces unemployment and accelerates economic growth (Acs, 2006; Audretsch, 2007; Santarelli et el. 2009; Campbell, 1996; Carree & Thurik, 1996). The supply of entrepreneurs depends on the entrepreneurial intention and activity of the people (Kruger & Brazeal, 1994). Existing behavioural theories explain that entrepreneurial activity is an attitude driven process which is mediated by intention and regulated by behavioural control. These theories are: Theory of Planned Behaviour (Ajzen, 1991; 2002, 2012); Entrepreneurial Event Model (Shapiro & Shokol, 1982), and Social Cognitive Theory (Bandura, 1977; 1986; 2012). Meta-analysis of existing behavioural theories in different fields found that the theories are more effective to analyse behavioural intention and habitual behaviour, but less effective to analyse long-term and risky behaviour (McEachan et al., 2011). The objective of this dissertation is to improve entrepreneurship behaviour theory to advance our understanding of the determinants of the entrepreneurial intention and activity. To achieve this objective we asked three compelling questions in our research. These are: Firstly, why do differences exist in entrepreneurship among age groups. Secondly, how can we improve the theory to analyse entrepreneurial intention and behaviour? And, thirdly, is there any relationship between counterfactual or regretful thinking and entrepreneurial intention? We address these three questions in Chapters 2, 3 and 4 of the dissertation. Earlier studies have identified that there is an inverse U shaped relationship between age and entrepreneurship (Parker, 2004; Hart et al., 2004). In our study, we explain the reasons for this inverse U shape (Chapter 2). To analyse the reasons we use Cognitive Life Cycle theory and Disuse theory. We assume that the stage in the life cycle of an individual moderates the influence of opportunity identification and skill to start a business. In our study, we analyse the moderation effect in early stage entrepreneurship and in serial entrepreneurship. In Chapter 3, the limitations of existing psychological theories are discussed, and a competency value theory of entrepreneurship (CVTE) is proposed to overcome the limitations and extend existing theories. We use a ‘weighted competency’ variable instead of a ‘perceived behavioural control’ variable for the theory of planned behaviour (TPB) and self-efficacy variable for social cognitive theory. Weighted competency is the perceived competency ranking assigned by an individual for his total competencies to be an entrepreneur. The proposed theory was tested in a pilot survey in the UK and in a national adult population survey in a South Asian Country. The results show a significant relationship between competencies and entrepreneurial intention, and weighted competencies and entrepreneurial behaviour as per CVTE. To improve the theory further, in Chapter 4, we test the relationship between counterfactual thinking and entrepreneurial intention. Studies in cognitive psychology identify that ‘upward counterfactual thinking’ influences intention and behaviour (Epstude & Rose, 2008; Smallman & Roese, 2009). Upward counterfactual thinking is regretful thinking for missed opportunities of a problem. This study addresses the question of how an individual’s regretful thinking affects his or her future entrepreneurial career intention. To do so, we conducted a study among students in a business school in the UK, and we found that counterfactual thinking modifies the influence of attitude and opportunity identification in entrepreneurial career intention.

Connecting a sociology of childhood perspective with the study of child health, illness and wellbeing:introduction

This chapter focuses on concepts and theoretical points of departure found in child health and wellbeing studies. Firstly, seeing children as a social group draws attention to the ways this group is placed and perceived in the structures of societies. Children as a social group need to be understood in relation to other social groups. Secondly, understanding children as social agents and as co-constructors of their social worlds is fundamental to studying their experiences and ways of dealing with health and wellbeing in everyday life. Thirdly, in recent years, there has been a turn towards seeing children as beings. The chapter discusses the child health issues and concerns in contemporary society. Children are diagnosed with an increasing range of conditions and are subject to more and more elaborate child health and welfare interventions, reflecting a medical perspective on the changing panorama of illness and health risks in the 21st century.

Patients' and physicians' experiences of atrial fibrillation consultations and anticoagulation decision-making:a multi-perspective IPA design

OBJECTIVE: To explore patients' and physicians' experiences of atrial fibrillation consultations and oral anticoagulation decision-making. DESIGN: Multi-perspective interpretative phenomenological analyses. METHODS: Participants included small homogeneous subgroups: AF patients who accepted (n=4), refused (n=4), or discontinued (n=3) warfarin, and four physician subgroups (n=4 each group): consultant cardiologists, consultant general physicians, general practitioners and cardiology registrars. Semi-structured interviews were conducted. Transcripts were analysed using multi-perspective IPA analyses to attend to individuals within subgroups and making comparisons within and between groups. RESULTS: Three themes represented patients' experiences: Positioning within the physician-patient dyad, Health-life balance, and Drug myths and fear of stroke. Physicians' accounts generated three themes: Mechanised metaphors and probabilities, Navigating toward the 'right' decision, and Negotiating systemic factors. CONCLUSIONS: This multi-perspective IPA design facilitated an understanding of the diagnostic consultation and treatment decision-making which foregrounded patients' and physicians' experiences. We drew on Habermas' theory of communicative action to recommend broadening the content within consultations and shifting the focus to patients' life contexts. Interventions including specialist multidisciplinary teams, flexible management in primary care, and multifaceted interventions for information provision may enable the creation of an environment that supports genuine patient involvement and participatory decision-making.