Co-operative discourse : a multi-level analysis

This research investigates the discourse of co-operative management and leadership. It explores the social construction of the concept of the 'co-operative' and the philosophy that underpins co-operative ideology, culture and values. The research employs a discursive research methodology. More specifically, discourse analysis is applied to a sample of speeches (n=23) given by prominent co-operative figures between 1823 and 1997. These texts are analysed using three discursive methods, namely: content analysis, narrative analysis and intertextuality analysis. These approaches are utilised to explore different levels of discourse, i.e.: the micro-level (the interrogation of words and sentences using content analysis); the meso-level (the examination of embedded stories and plots within texts using narrative analysis) and; the macro-level (the exploration of underlying patterns and recurring themes across texts using intertextual analysis). There are two main findings of this research. First, there is an emphasis on the notion of 'heroic/ideal' leadership within the texts which runs contrary to the espoused core values of shared responsibility and democratic member-based control within co-operatives. Second, and somewhat paradoxically, the discourse of co-operatives is becoming more business like and entrepreneurial in nature while the rhetoric of profit-making organisation is generally becoming more inclusionary, participative and democratic. The research highlights that there is an inherent tension within the co-operative movement between wanting to retain traditional values and the need to incorporate contemporary business practices (e.g. hierarchical leadership) and business values (i.e. capitalistic ideals). Given that co-operatives are caught between traditional commitments and adjusting to external requirements of being profitable, there are implications for identity and there is an need to rethink some of the assumptions, concepts and values which underpin co-operative discourse. Beyond the substantive contribution, this research also offers insights into the scope for, and benefits of, applying a multi-method, multi-level approach to discursive study of organisational phenomena

Comparison of human papillomavirus (HPV) detection in urine and cervical swab samples using the HPV GenoArray Diagnostic assay

Human papillomavirus (HPV) is the leading cause of cervical cancer. Urine-based HPV testing offers a simple and non-invasive method because of its increasing acceptance. A total of 164 pairs of cervical swab and urine samples from Thai women who underwent cervical cancer screening were used for HPV testing with HPV GenoArray Diagnostic Kits. The overall concordance percentage for HPV detection in the cervical swab and urine samples was 65.2%. The HPV genotypes most commonly detected were HPV16 and HPV18. An analysis of the urine samples and a second analysis of the cervical swab samples showed that the differences in the overall HPV detection rate between women with normal and abnormal cytology were not significant (p > 0.05). Urine samples processed with the GenoArray assay is an alternative for women who decline to undergo Pap smear even though it is not ideal as the first-line screening option

Comparative accuracy of Pap smear and HPV screening in Ubon Ratchathani in Thailand

We evaluate the potential for using high-risk human papillomavirus (hr-HPV) testing-based screening for cervical intraepithelial neoplasia (CIN) in routine health services in Thailand; its accuracy in comparison to that of conventional cytology (CC); and the utility of HPV16/18 positive results and liquid-based cytology (LBC) triage for HPV-positive women in the detection of high-grade CIN. Women aged 30â60 years in Ubon Ratchathani province, Thailand were screened with CC and hr-HPV testing and those abnormal on either tests were referred for colposcopy and/or directed biopsies. The final diagnosis using COBAS was based on histology or colposcopy when histology was not available. Estimation of test accuracy parameters was done using latent class analysis using Bayesian models. Of the 5004 women were enrolled, 20 (0.4%) had abnormal CC and 174 (3.5%) women were HPV-positive. Among 185 women abnormal on CC or HPV-positive, 176 (95.1%) underwent colposcopy, of whom 101 (57.4%) had abnormal colposcopy findings. Ninety-seven women with abnormal and 69 with normal colposcopy had biopsies performed. All 21 women with histological CIN2 or worse had hr-HPV and none were abnormal on CC. The estimated sensitivity, specificity and positive predictive value were respectively 71.8%, 97.0% and 13.0% of HPV testing; 53%, 98.7% and 20.3% for triage of HPV-positive women with LBC; and 70.4%, 98.2% and 16.9% when test positivity was taken as HPV16/18 irrespective of LBC result or positive for hr-HPV non 16/18 types and LBC triage. Our study findings indicate poor performance of cytology screening and demonstrate the potential and utility of using HPV testing in public health services in Thailand as well as the utility of primary HPV testing and LBC triage in screening for cervical neoplasia. Keywords: Cervix cancer, Early detection, HPV screening, Cytology screening, Accurac