Single anodes The galvanic anodes in common use are the metals magnesium and zinc. Magnesium anodes are alloys of aluminium (ca 6%), zinc (ca 3%), manganese (ca 0·2%) and…
Abstract
Single anodes The galvanic anodes in common use are the metals magnesium and zinc. Magnesium anodes are alloys of aluminium (ca 6%), zinc (ca 3%), manganese (ca 0·2%) and magnesium. Zinc anodes are made from high purity zinc, 99·99% or better.
Routine general practice (GP) care is rarely comprehensively described in clinical trials. This paper examines routine GP care within the lifestyle approach to managing panic…
Abstract
Routine general practice (GP) care is rarely comprehensively described in clinical trials. This paper examines routine GP care within the lifestyle approach to managing panic (LAMP) study. The aim of this paper is to describe/discuss routine GP care for panic disorder (PD) patients within both study arms in the LAMP study. An unblinded pragmatic randomised controlled trial in 15 East of England GP practices (2 primary care trusts). Participants met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for PD with/without agoraphobia. Follow-up measures recorded at 20 weeks/10 months following randomisation. Control arm, unrestricted routine GP care (practice appointments, referrals and prescriptions). Trial arm, occupational therapy-led lifestyle treatment comprising lifestyle review of fluid intake, diet pattern, exercise, caffeine, alcohol and nicotine. Primary outcome measure: beck anxiety inventory. At baseline, participants attended 2-3 times more GP appointments than population average, reducing at 10 months to 1.6 times population average for routine GP care and 0.97 population average for lifestyle arm. At 10 months, 33% fewer referrals (6 referrals; 0 mental health) than at baseline (9 referrals; 2 mental health) were made for lifestyle arm patients compared with 42% increase (from 12 referrals; 8 mental health at baseline to 17 referrals; 7 mental health) in GP care arm. Selective serotonin reuptake inhibitors were prescribed most often. Benzodiazepines and beta-blockers were prescribed more often than tricyclic against current clinical guidelines. In conclusion, we found that PD patients at baseline were high healthcare resource users. Treatment in both study arms reduced resource use. Routine GP care requires further review for this patient group.
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This study is a considered interpretation of the National Registration and Accreditation Scheme for the health professions, which commenced operations in Australia in 2010. The…
Abstract
This study is a considered interpretation of the National Registration and Accreditation Scheme for the health professions, which commenced operations in Australia in 2010. The development of the Scheme and its operational elements (namely the Australian Health Practitioner Regulation Agency and 14 profession-specific national Boards) are positioned within the context of regulatory capitalism. Regulatory capitalism merges the experience of neoliberalism with an attentiveness to risk, particularly by the State. Nationally consistent legislation put in place a new set of arrangements that enabled the continuity of governments’ role in health workforce governance. The new arrangements resulted in an entity which is neither exclusively subservient to nor independent of the State, but rather “quasi-independent.” In exploring this arrangement, specific consideration is given to how the regulatory response matched the existing reality of a global (and national) health workforce market. This study considers this activity by the State as one of consolidation, as opposed to fracturing, against a backdrop of purposeful regulatory reform.
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Angus Corbett, Jo Travaglia and Jeffrey Braithwaite
This paper aims to be a theoretical examination of the role of individuals in sponsoring and facilitating effective, systemic change in organisations. Using reports of a number of…
Abstract
Purpose
This paper aims to be a theoretical examination of the role of individuals in sponsoring and facilitating effective, systemic change in organisations. Using reports of a number of high‐profile initiatives to improve patient safety, it seeks to analyse the role of individual health care professionals in developing and facilitating new systems of care that improve safety and quality.
Design/methodology/approach
The paper uses recent work in sociology that is concerned with the phenomenon of “sociological citizenship”. The authors test whether successful initiators of change in health care can be described as sociological citizens. This notion of sociological citizens is applied to a number of highly successful initiatives to improve safety and quality to extrapolate the factors associated with individual clinician leadership, which may have affected the success of such endeavours.
Findings
In each of the examples analysed the initiators of change can be characterised as sociological citizens. In reviewing the roles of these charismatic individuals it is evident that they see the relational interdependence between the individuals and organisations and that they use this information to achieve both professional and organisational objectives.
Research limitations/implications
The paper uses a case study method to investigate the usefulness of the role of sociological citizenship in interventions that aim to improve patient safety. The paper reviews the key concepts and uses of the concept of sociological citizenship to produce a framework against which the case studies were assessed.
Practical implications
The authors suggest that a goal of policy for improving patient safety should be directed to the problem of how hospitals and health care organisations can create the conditions for encouraging the individual diligence and care that is needed to support reliable, safe health care practices.
Social implications
Improving the safety and quality of health care is an important public health initiative. It has also proven to be difficult to achieve sustained reductions in the harm caused by the occurrence of adverse events in health care. The process of linking individual diligence with service outcomes may help to overcome one of the enduring struggles of health care systems around the world: the policy‐practice divide.
Originality/value
The paper directs attention towards the role of sociological citizenship in health care systems and organisations.
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The purpose of this paper is to explore women’s resistance to the religion of civilising missions abroad through empathetic feminism.
Abstract
Purpose
The purpose of this paper is to explore women’s resistance to the religion of civilising missions abroad through empathetic feminism.
Design/methodology/approach
Conceptually, this paper explores three thematic tools for transnational activism in the interwar period: empathy for silent history, intersectionality of race and class, and empowerment through advocacy within power structures. With the theoretical backdrop of Winifred Holtby’s activism inspired by the philosophy of Mary Wollstonecraft, this research compares the political involvement of Frances Emily Newton to Blanche Elizabeth Campbell Dugdale, and how their transnational activism contributed to post-colonial self-determination and the convolution of the Palestinian–Israeli conflict in the rise of the twentieth century nation-state.
Findings
These three feminists provided alternative narratives of human rights activism during the first wave of British feminism that both enabled transnational activism and planted seeds for empowering self-determination amidst colonial mandates and rising nationalism.
Practical implications
These women worked at the dovetail of colonialism and self-determination towards the twentieth century nation-state, and as the twenty-first century evolves with greater global integration and interconnectivity, imaginative insight in the transnational context evokes greater opportunities for empathy and compassion across intersectional identities, which in effect enables the mobilisation of positionality to confront structural violence perpetuating silenced voices.
Originality/value
By contextually evaluating transnational activism in a narrative of nuanced complexities, this research exudes opportunities for propagating universal human rights while maintaining the sensitivity to post-colonial sentiment for empowerment with the support of transnational networks.
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Stella Christiana Stevens, Lynn Hemmings, Claire Scott, Anthony Lawler and Craig White
– The purpose of this paper is to investigate to what extent an engaging or authentic leadership style is related to higher levels of patient safety performance.
Abstract
Purpose
The purpose of this paper is to investigate to what extent an engaging or authentic leadership style is related to higher levels of patient safety performance.
Design/methodology/approach
A survey and/or interview of 53 medical and dental staff on their perceptions of leadership style in their unit was conducted. Scores obtained from 51 responses were averaged for each question and overall performance was compared with unit specific hand hygiene (HH) compliance data. Interview material was transcribed and analysed independently by each member of the research team.
Findings
A modest negative relationship between this leadership style and hand hygiene compliance rates (r=0.37) was found. Interview data revealed that environmental factors, role modelling by the leader and education to counter false beliefs about hand hygiene and infection control may be more important determinants of patient safety performance in this regard than actual overall leadership style.
Research limitations/implications
The sample was relatively small, other attributes of leaders were not investigated.
Practical implications
Leadership development for clinicians may need to focus on situational or adaptive capacity rather than a specific style. In the case of improving patient safety through increasing HH compliance, a more directive approach with clear statements backed up by role modelling appears likely to produce better rates.
Originality/value
Little is known about patient safety and clinical leadership. Much of the current focus is on developing transformational, authentic or engaging style. This study provides some evidence that it should not be used exclusively.
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In terms of the concept of broken home as a juvenile delinquency risk factor, whilst Nigeria and Ghana are culturally different from western nations (Gyekye, 1996; Hofstede, 1980;…
Abstract
Purpose
In terms of the concept of broken home as a juvenile delinquency risk factor, whilst Nigeria and Ghana are culturally different from western nations (Gyekye, 1996; Hofstede, 1980; Smith, 2004), parental death (PDE) and parental divorce (PDI) have been previously taken-for-granted as one factor, that is ‘broken home’. This paper aims to deconstruct the singular model of ‘broken home’ and propose a binary model – the parental death and parental divorce hypotheses, with unique variables inherent in Nigerian/Ghanaian context.
Methodology/approach
It principally deploys the application of Goffman’s (1967) theory of stigma, anthropological insights on burial rites and other social facts (Gyekye, 1996; Mazzucato et al., 2006; Smith, 2004) to tease out diversity and complexity of lives across cultures, which specifically represent a binary model of broken home in Nigeria/Ghana. It slightly appraises post-colonial insights on decolonization (Agozino, 2003; Said, 1994) to interrogate both marginalized and mainstream literature.
Findings
Thus far, analyses have challenged the homogenization of the concept broken home in existing literature. Qualitatively unlike in the ‘West’, analyses have identified the varying meanings/consequences of parental divorce and parental death in Nigeria/Ghana.
Originality/value
Unlike existing data, this paper has contrasted the differential impacts of parental death and parental divorce with more refined variables (e.g. the sociocultural penalties of divorce such as stigma in terms of parental divorce and other social facts such as burial ceremonies, kinship nurturing, in relation to parental death), which helped to fill in the missing gap in comparative criminology literature.
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T.K. Hellen and W.S. Blackburn
A review is made of methods for calculating parameters characterizing crack tip behaviour in non‐linear materials. Convenient methods of calculating J‐integral type quantities are…
Abstract
A review is made of methods for calculating parameters characterizing crack tip behaviour in non‐linear materials. Convenient methods of calculating J‐integral type quantities are reviewed, classified broadly into two groups, as domain integrals and virtual crack extension techniques. In addition to considerations of how such quantities may be calculated by finite elements, assessment methods of conducting the actual incremental analyses are described.
Winnie O’Grady, Chris Akroyd and Inara Scott
Purpose: The purpose of this study is to analyze the changes organizations can adopt to move beyond budgeting. We show how these changes can be understood as modes of adaptive…
Abstract
Purpose: The purpose of this study is to analyze the changes organizations can adopt to move beyond budgeting. We show how these changes can be understood as modes of adaptive performance management that explains the ways in which organizations move beyond budgeting to become more adaptive. The proposed modes are then used to derive propositions for future research.
Methodology/approach: We follow a conceptual approach through an analysis of the beyond budgeting principles using the management and systems literatures on radical decentralization. We theorize how organizations can enhance their adaptability to environmental uncertainty through changes to their management structure and control processes.
Findings: We show that organizations can move beyond budgeting by decentralizing within or beyond their management structure and modifying or removing their budget-based control processes. We propose that beyond budgeting can be conceptualized as four modes of adaptive performance management: better budgeting, advanced budgeting, restricted budgeting, and nonbudgeting.
Research limitations/implications: The four modes of adaptive performance management can be used in future research to consider how changes to management structures and budget-based control processes can enhance the organizational adaptability needed to manage environmental uncertainty.
Practical implications: We show that while the nonbudgeting mode may be most suited to organizations facing high levels of environmental uncertainty, organizations facing low–to-moderate levels of environmental uncertainty can achieve sufficient levels of adaptability with less extensive changes to management structure and budget-based control processes.
Originality/value: The four modes of adaptive performance management reflect different approaches for dealing with environmental uncertainty. Positioning nonbudgeting as one mode and identifying alternate modes of adaptive performance management provides a basis for comparing and understanding the changes organizations make to move beyond budgeting.
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Samantha L. Jordan, Andreas Wihler, Wayne A. Hochwarter and Gerald R. Ferris
Introduced into the literature a decade ago, grit originally defined as perseverance and passion for long-term goals has stimulated considerable research on positive effects…
Abstract
Introduced into the literature a decade ago, grit originally defined as perseverance and passion for long-term goals has stimulated considerable research on positive effects primarily in the academic and military contexts, as well as attracted widespread media attention. Despite recent criticism regarding grit’s construct and criterion-related validity, research on grit has begun to spill over into the work context as well. In this chapter, the authors provide an overview of the initial theoretical foundations of grit as a motivational driver, and present newer conceptualizations on the mechanisms of grit’s positive effects rooted in goal-setting theory. Furthermore, the authors also draw attention to existing shortcomings of the current definition and measurement of grit, and their implications for its scientific and practical application. After establishing a theoretical understanding, the authors discuss the potential utility of grit for human resource management, related to staffing and recruitment, development and training, and performance management systems as well as performance evaluations. The authors conclude this chapter with a discussion of necessary and potential future research, and consider the practical implications of grit in its current state.