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Study Highlights (study + highlight)
Selected AbstractsStakeholder perspectives on new ways of delivering unscheduled health care: the role of ownership and organizational identityJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 2 2007Gill Haddow MA PhD Abstract Rationale, aims and objectives, To explore stakeholder perspectives of the implementation of a new, national integrated nurse-led telephone advice and consultation service [National Health Service 24 (NHS 24)], comparing the views of stakeholders from different health care organizations. Methods, Semi-structured interviews with 26 stakeholders including partner organizations located in primary and secondary unscheduled care settings [general practitioner (GP) out-of-hours cooperative; accident and emergency department; national ambulance service, members of NHS 24 and national policy makers. Attendance at key meetings, documentary review and email implementation diaries provided a contextual history of events with which interview data could be compared. Results, The contextual history of events highlighted a fast-paced implementation process, with little time for reflection. Key areas of partner concern were increasing workload, the clinical safety of nurse triage and the lack of communication across the organizations. Concerns were most apparent within the GP out-of-hours cooperative, leading to calls for the dissolution of the partnership. Accident and emergency and ambulance service responses were more conciliatory, suggesting that such problems were to be expected within the developmental phase of a new organization. Further exploration of these responses highlighted the sense of ownership within the GP cooperative, with GPs having both financial and philosophical ownership of the cooperative. This was not apparent within the other two partner organizations, in particular the ambulance service, which operated on a regional model very similar to that of NHS 24. Conclusions, As the delivery of unscheduled primary health care crosses professional boundaries and locations, different organizations and professional groups must develop new ways of partnership working, developing trust and confidence in each other. The results of this study highlight, for the first time, the key importance of understanding the professional ownership and identity of individual organizations, in order to facilitate the most effective mechanisms to enable that partnership working. [source] Women's Empowerment Through Home,based Work: Evidence from IndiaDEVELOPMENT AND CHANGE, Issue 3 2003Paula Kantor This article examines the extent to which home,based production in the garment sector of Ahmedabad, India, serves to empower its female participants, defining empowerment in terms of control over enterprise income and decision,making within the household. It places this question within the literatures on resource theory and bargaining models of the household, both of which posit that improved access to resources increases women's power in the household. This study highlights why access to resources may not lead so directly to improvements in women's position in the household in the Indian context. It then discusses why home,based work may be less empowering than sources of work outside of the home. The arguments about the empowerment potential of women's access to resources through home,based work are tested by examining, first, the determinants of control over the income generated by women in home,based garment production and, second, to what extent access to and control over income from this source translates into involvement in decisions which are atypically women's and yet important to their lives. The results provide a better understanding of the potential of home,based work to offer women in urban India a source of economic activity that also can translate into increased intra,household power. [source] Nitrogen utilization by Hylocomium splendens in a boreal forest fertilization experimentFUNCTIONAL ECOLOGY, Issue 3 2006Å. FORSUM Summary 1Nitrogen uptake in the terricolous bryophyte Hylocomium splendens (Hedw.) B.S.G. was studied in a boreal forest long-term N-treatment experiment including control plots, N-addition plots (50 kg N ha,1 year,1 for 8 years) and recovery plots (50 kg N ha,1 year,1 for 5 years and thereafter no N addition for 3 years). 2A main objective was to explore whether the N treatments changed bryophyte uptake of different inorganic and organic N forms. In addition, we estimated the contribution of N from throughfall precipitation to the bryophyte N supply. 3The results demonstrated that bryophyte N uptake was similar in all the long-term N-treatment plots. Hylocomium splendens took up more 15N labelled than or glycine when these N forms were applied in situ by the spraying of solutions with N concentrations similar to those in precipitation. 4Analysis of the precipitation collected beneath the closed tree canopy from late May to early October revealed that it contributed 2·0 kg N ha,1 during the period studied, distributed between (78%), amino acid N (17%) and (5%). 5The study highlights that, in addition to analyses of and (normally included in standard environmental monitoring of precipitation), analysis of amino acid N must be performed to account fully for the precipitation N input to bryophytes in boreal forest ecosystems. [source] Effect of current reproduction on apparent survival, breeding dispersal, and future reproduction in barn swallows assessed by multistate capture,recapture modelsJOURNAL OF ANIMAL ECOLOGY, Issue 3 2009Michael Schaub Summary 1Theoretical models predict a negative effect of current reproduction on breeding dispersal, survival and future reproduction, and many studies confirm these predictions. Yet, results of most previous studies may be difficult to interpret because the fate of the affected individuals cannot always be observed. Detection is almost always imperfect and some individuals emigrate from the study area, resulting in biased estimates of both survival and dispersal. 2Most studies bypass these problems with strong assumptions. We use a multistate capture,recapture model that does not require these assumptions. States are defined based on classes of reproductive success and on observed dispersal events within the study area. By accounting for imperfect detection within the study area, the model allows estimation of the effect of reproductive success on apparent survival, dispersal probabilities within the study area and the annual transition probabilities among classes of reproductive success. Based on an assumption about the estimate of real survival, the model allows the estimation of total dispersal that is not specific to a fixed study area. 3We applied this model to capture,recapture data of 2262 adult barn swallows (Hirundo rustica) sampled from 1997,2004 in eight local populations in Switzerland. 4We found that dispersal within the study area decreased with increasing reproductive success in both sexes, that reproductive success was not affected by preceding dispersal and that apparent survival of females but not of males increased with increasing reproductive success. Apparent survival of females with high reproductive success was identical to apparent survival of males suggesting that this estimate of apparent survival (0·48) was close to true survival. Total breeding dispersal was generally higher in females and it increased with decreasing reproductive success in both sexes. Current reproductive success depended on reproductive success in the preceding year suggesting that individual differences were of importance. 5Our study highlights that reproductive success was an important factor affecting breeding dispersal and population turnover. While unsuccessful males mainly remained in the local populations, many unsuccessful females left them. Population turnover of adult swallows was mainly due to unsuccessful females. [source] Bullying among mentally-ill patients detained in a high-secure hospital: an exploratory study of the perceptions of staff and patients into how bullying is definedAGGRESSIVE BEHAVIOR, Issue 5 2006Jane L. Ireland Abstract The present study is the first to explore patient-to-patient bullying within a secure psychiatric hospital housing mentally-ill patients. Its main aim was to provide an outline of the perceptions held by both patients and staff with regards to patient-to-patient bullying as opposed to providing an objective study of bullying. The total sample comprised 104 participants, 44 patients and 60 staff. These were sampled from wards housing male patients and wards housing female patients. All participants took part in a semi-structured interview based on that developed by Ireland and Ireland [2003] and Ireland [2005, 2004]. One quarter of participants stated they had seen a patient being bullied in the previous week, with staff perceiving a higher extent of bullying than patients. Differences between wards were minimal. It was predicted that theft-related bullying would be reported most frequently, that staff would identify a wider range of bullying behaviours than patients and that direct forms of aggression would be identified more readily as bullying than indirect forms. All predictions were supported. Problems in attempting to obtain a definition of bullying were also identified, with participants operating broader definitions than those found in the school-based literature. For example, bullying was not generally considered a repeated form of aggression, the severity of the aggression or provocative behaviour of the victim were not defining features, and it was felt bullying could be accidental. In summary, the current study highlights how patient-to-patient bullying does occur in services housing mentally-ill patients and that researching the behaviour may require the adoption of broader hospital-specific definitions of bullying. Aggr. Behav. 32:1,13, 2006. © 2006 Wiley-Liss, Inc. [source] Dissecting Damages: An Empirical Exploration of Sexual Harassment AwardsJOURNAL OF EMPIRICAL LEGAL STUDIES, Issue 1 2006Catherine M. Sharkey My empirical study first replicates and then extends a prior preliminary empirical study by Cass Sunstein and Judy Shih of sexual harassment damages awards. It covers a comprehensive set of 232 cases in which plaintiffs won some positive amount of compensatory damages from state and federal, trial and appellate court decisions from 1982,2004 (published either in official reporters or solely on Westlaw). Contrary to Sunstein and Shih's finding, my analysis of these data reveals a consistent, and statistically significant, positive relationship between punitive and compensatory damages (at least in cases where punitive damages are awarded). My new empirical study then employs dependent variables that, in my view, are more theoretically and statistically sound than those employed by Sunstein and Shih and others who have focused exclusively on the relationship between punitive and compensatory damages: total combined damages (i.e., all compensatory and punitive damages), and what I term "outrage" damages, or combined noneconomic compensatory and punitive damages. My empirical results, using these new dependent variables, essentially confirm Sunstein and Shih's conclusions regarding the irrelevance of variables pertaining to the nature and severity of harassment. What my study reveals as crucial predictive factors, by contrast, are factors pertaining to damages limitations. My study highlights that these factors,including the effect of the 1991 Civil Rights Act, and whether plaintiffs append state civil rights and tort claims to their Title VII claims,are critical to a fuller understanding of damages determinations in sexual harassment cases. [source] Longitudinal analysis of inpatient care utilization among people with intellectual disabilities: 1999,2002JOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 2 2007C.-H. Loh Abstract Background There has been no longitudinal study in Taiwan to identify the nature and the scale of medical care utilization of people with intellectual disabilities (IDs) up to the present. The aim of this study is to describe inpatient utilization among people under ID care in institutions in order to identify the pattern of medical care needs and the factors affecting utilization in Taiwan. Method The subject cohort was 168 individuals with ID who were cared for by a large public disability institution from 1999 to 2002 in Taipei, Taiwan. Results On the examination of the inpatient care that these persons underwent, it was found that these individuals had a heightened need (inpatient rate: 10.1,14.9%) for inpatient care compared with the general population with disabilities (9.37%) in Taiwan. The main reasons for hospitalization were pneumonia, gastrointestinal disorders, cellulites, orthopaedic problems, epilepsy and bronchitis. Using the full model of Generalized Estimating Equations for inpatient care utilization, the factors including low income family, living in an institution, being a subject with cerebral palsy and being a high outpatient user all influenced the use of inpatient care. Conclusions This study highlights that health authorities need to promote health planning more in order to ensure an excellent quality of health monitoring and health promotion among people with ID cared for by institutions. [source] Genetic analysis of SCA 2 and 3 repeat expansions in essential tremor and atypical ParkinsonismMOVEMENT DISORDERS, Issue 13 2007Eng-King Tan MD Abstract Anecdotal reports suggest that patients with spinocerebellar ataxia (SCA 2) patients can present with postural tremor with ataxia. We determined the prevalence of SCA2 and SCA3 mutations in a cohort of ET and atypical Parkinsonism patients. A total of 277 subjects comprising of 177 ET and 100 atypical Parkinsonism were examined. We identified one positive case of SCA3 among those who were diagnosed with ET, yielding a prevalence of 0.5%, but a zero prevalence among our atypical Parkinsonism patients. No study subjects carried an abnormal SCA2 repeat expansion. Our study highlights that SCA3 can present initially with ET symptoms, expanding the spectrum of genetic diseases that can be associated with ET-like phenotype. Routine screening for SCA2 and SCA3 in ET and atypical Parkinsonism patients may not be cost effective. However, in the long-term follow-up of patients who present with an ET phenotype, clinicians should be vigilant for other neurological signs, which may be point to an alternate diagnosis. © 2007 Movement Disorder Society [source] Cognitive hypothesis testing and response to intervention for children with reading problemsPSYCHOLOGY IN THE SCHOOLS, Issue 8 2006Catherine A. Fiorello Response to intervention (RTI) must be combined with comprehensive cognitive assessment to identify children with learning disabilities. This article presents the Cognitive Hypothesis Testing (CHT) model for integrating RTI and comprehensive evaluation practices in the identification of children with reading disabilities. The CHT model utilizes a scientific method approach for interpreting cognitive and neuropsychological processes together with evaluation of ecological and treatment validity data to develop targeted interventions for students who do not respond to standard academic interventions. A case study highlights how CHT practices can lead to effective interventions for a child who did not respond to a phonologically based reading intervention. In addition, discriminant analyses of 128 children with reading disabilities revealed the presence of Global, Phonemic, Fluency-Comprehension, and Orthographic subtypes. Results suggest subtypes show disparate cognitive profiles that differentially impact their reading achievement, supporting our contention that individual assessment of cognitive processing strengths and weaknesses is not only necessary for identifying children with reading disabilities but also can lead to individualized interventions designed to meet their unique learning needs. © 2006 Wiley Periodicals, Inc. Psychol Schs 43: 835,853, 2006. [source] Type II dehydroquinase: molecular replacement with many copiesACTA CRYSTALLOGRAPHICA SECTION D, Issue 1 2008Kirsty Anne Stewart Type II dehydroquinase is a small (150-amino-acid) protein which in solution packs together to form a dodecamer with 23 cubic symmetry. In crystals of this protein the symmetry of the biological unit can be coincident with the crystallographic symmetry, giving rise to cubic crystal forms with a single monomer in the asymmetric unit. In crystals where this is not the case, multiple copies of the monomer are present, giving rise to significant and often confusing noncrystallographic symmetry in low-symmetry crystal systems. These different crystal forms pose a variety of challenges for solution by molecular replacement. Three examples of structure solutions, including a highly unusual triclinic crystal form with 16 dodecamers (192 monomers) in the unit cell, are described. Four commonly used molecular-replacement packages are assessed against two of these examples, one of high symmetry and the other of low symmetry; this study highlights how program performance can vary significantly depending on the given problem. In addition, the final refined structure of the 16-dodecamer triclinic crystal form is analysed and shown not to be a superlattice structure, but rather an F -centred cubic crystal with frustrated crystallographic symmetry. [source] | ||||||||||||||||