Motivation and attitudes toward changing health (MATCH): A new patient-reported measure to inform clinical conversations.

ObjectiveTo identify and assess patient motivation to initiate or maintain behavior changes.MethodsAttitudinal statements were developed from structured patient interviews and translated into 18 survey items. Items were analyzed with exploratory factor analysis (EFA).ResultsAn EFA with 340 type 2 diabetes patients identified three areas of patient attitudes toward changing health behaviors: (1) willingness to make changes (3 items; α = 0.69), (2) perceived ability to make or maintain changes (3 items; α = 0.74), and (3) and feeling changes are worthwhile (3 items; α = 0.61). Greater perceived ability and feelings of worthwhileness were associated with positive psychosocial and behavioral management indicators. All three areas were associated with confidence and attitudes toward making a specific behavioral change (e.g., improve diet).ConclusionsMATCH is an internally consistent and valid 9-item scale that provides a profile of factors influencing motivation that can be used in clinical and research settings

When is diabetes distress clinically meaningful?: establishing cut points for the Diabetes Distress Scale.

ObjectiveTo identify the pattern of relationships between the 17-item Diabetes Distress Scale (DDS17) and diabetes variables to establish scale cut points for high distress among patients with type 2 diabetes.Research design and methodsRecruited were 506 study 1 and 392 study 2 adults with type 2 diabetes from community medical groups. Multiple regression equations associated the DDS17, a 17-item scale that yields a mean-item score, with HbA(1c), diabetes self-efficacy, diet, and physical activity. Associations also were undertaken for the two-item DDS (DDS2) screener. Analyses included control variables, linear, and quadratic (curvilinear) DDS terms.ResultsSignificant quadratic effects occurred between the DDS17 and each diabetes variable, with increases in distress associated with poorer outcomes: study 1 HbA(1c) (P < 0.02), self-efficacy (P < 0.001), diet (P < 0.001), physical activity (P < 0.04); study 2 HbA(1c) (P < 0.03), self-efficacy (P < 0.004), diet (P < 0.04), physical activity (P = NS). Substantive curvilinear associations with all four variables in both studies began at unexpectedly low levels of DDS17: the slope increased linearly between scores 1 and 2, was more muted between 2 and 3, and reached a maximum between 3 and 4. This suggested three patient subgroups: little or no distress, <2.0; moderate distress, 2.0-2.9; high distress, ≥3.0. Parallel findings occurred for the DDS2.ConclusionsIn two samples of type 2 diabetic patients we found a consistent pattern of curvilinear relationships between the DDS and HbA(1c), diabetes self-efficacy, diet, and physical activity. The shape of these relationships suggests cut points for three patient groups: little or no, moderate, and high distress

Addressing the complexities of managing domestic and multinational corporate brands

Purpose – The purpose of this paper is to focus on the differences between managing domestic corporate brands (DCBs) and multinational corporate brands (MCBs), and presents a framework highlighting six types of complexity associated with managing both forms of corporate brands in an international business context. Design/methodology/approach – This paper proposes a framework addressing six types of complexity involved in managing DCBs and MCBs drawing on the literature related to corporate branding, corporate brands, and domestic and multinational corporations. The six types of complexity examined include: strategic role, organisational structure, culture, knowledge, positioning and extended responsibility. Findings – The research identifies that DCBs have a lower degree of complexity in regard to strategic role, knowledge and positioning, but have a higher level in regard to organisational structure, cultural and extended responsibility complexity. MCBs face more complexity than DCBs across all dimensions because they operate across business environments and need to coordinate activities while adapting to environmental differences. Practical implications – The findings highlight the importance of environmental complexity for firms managing brands globally. The issues of complexity identified in this paper need to be understood if firms are to effectively build and manage their corporate brands within and across markets. Originality/value – The paper highlights the concepts of DCBs and MCBs, and identifies the factors that contribute to the complexity of managing these two types of corporate brands domestically and internationally

Segmenting Australian online panellists based on volunteering motivations

Purpose– The purpose of this paper is to seek to assess whether online commercial panel volunteering can be segmented based on their motivations, using the volunteer functions inventor. The authors also investigate whether segments exist which differ in demographic characteristics.Design/methodology/approach– The authors survey 484 Australian online panel volunteers using a adapted version of the 30 item of the volunteer function inventory (VFI) scale developed by Clary et al. (1998). Data were analysed using confirmatory factor analysis (CFA) and cluster analysis, as well as ANOVA and χ2 test comparisons of demographics between clusters.Findings– CFA verifies that the VFI scale is suitable instrument to gauge online participants’ motivations. Cluster analysis produced a five-cluster solution, where respondents with low motivations overall comprised the largest grouping. Segments are interpreted by assessing the difference between the total sample average and the segment profile. The examination also identifies that the only demographic factor that varies across the five clusters is “respondents” employment status”.Research limitations/implications– Future research could explore if differences in segments result in differences in online participation. The high number or respondents with low motivations may explain the relatively high levels of churn that take place within online panels and as a result panel operators would need to continually attract new members. Further research could also investigate whether the levels of motivation change over time and if so what effect such variation would produce on respondents’ retention.Originality/value– Research on online panel respondents’ motivation is still limited and investigating online panellists’ motivation as volunteers is very important as it unveils, as in the study herein reported, that alternative types of respondents may be driven by different factors when joining an online panel (or completing a given survey). Recruitment strategies could, therefore, be shaped to suit the motivation of the different segments. By refining the matching between volunteers’ profiles and their motivation, managers could improve how volunteers are recruited, managed and retained

Clonal expansion under the microscope: studying lymphocyte activation and differentiation using live-cell imaging

Clonal expansion of lymphocytes is a hallmark of vertebrate adaptive immunity. A small number of precursor cells that recognize a specific antigen proliferate into expanded clones, differentiate and acquire various effector and memory phenotypes, which promote effective immune responses. Recent studies establish a large degree of heterogeneity in the level of expansion and in cell state between and within expanding clones. Studying these processes in vivo, while providing insightful information on the level of heterogeneity, is challenging due to the complex microenvironment and the inability to continuously track individual cells over extended periods of time. Live cell imaging of ex vivo cultures within micro fabricated arrays provides an attractive methodology for studying clonal expansion. These experiments facilitate continuous acquisition of a large number of parameters on cell number, proliferation, death and differentiation state, with single-cell resolution on thousands of expanding clones that grow within controlled environments. Such data can reveal stochastic and instructive mechanisms that contribute to observed heterogeneity and elucidate the sequential order of differentiation events. Intercellular interactions can also be studied within these arrays by following responses of a controlled number of interacting cells, all trapped within the same microwell. Here we describe implementations of live-cell imaging within microwell arrays for studies of lymphocyte clonal expansion, portray insights already gained from these experiments and outline directions for future research. These tools, together with in vivo experiments tracking single-cell responses, will expand our understanding of adaptive immunity and the ways by which it can be manipulated

A stakeholder approach to corporate social responsibility, reputation and business performance

Purpose - This paper aims to investigate business managers\u27 assessment of stakeholders\u27 influence on corporate social responsibility (CSR) initiatives. The key stakeholders included "employees" and "unions" as internal and "public", the "media" and the "government" as external stakeholders. The purpose was to estimate the influence of stakeholders that managers perceive as important. Moreover, the study sought to identify association between the CSR construct and corporate reputation and in turn whether this influences business performance. Design/methodology/approach - This study uses a mail survey with a random sampling of senior managers sourced from Dun & Bradstreet\u27s Australian business database, focusing on large organizations (i.e. minimum $10 million p.a. reported sales and minimum 100 employees) as the selection criteria. A conceptual model was developed and tested using structural equation modeling. Findings - The results identified that "employees" and the "public" are perceived to be the influential stakeholder groups in CSR decision-making. There was evidence of a positive relationship between the CSR construct and reputation, which in turn influenced market share, but not profitability. Research limitations/implications - This study examined a cross-section of organizations using Dun & Bradstreet\u27s database of Australian businesses and may not fully represent the Australian business mix. The effective response rate of 7.2 per cent appears to be low, even though it is comparable with other research in the CSR area. There may have been some self-selection by the respondents, although there were no statistically significant differences identified in the corporate characteristics of those invited to participate and those responding with usable questionnaires. Practical implications - Managers can adopt a stakeholder-influenced CSR strategy to generate strong corporate reputation to improve business performance. It is important to ensure that the interests of "employees" and "public" stakeholders are addressed within organizational strategy. Respondents were less concerned about government stakeholders and thus government involvement in organizational CSR may need to be revisited. Social implications - The major concern that emerges from these findings is the absence of the perceived importance of regulatory stakeholders on firms\u27 CSR activities. Regulatory controls of CSR messages could reduce or eliminate inaccurate and misleading information to the public. Originality/value - The analysis explains the perceived relative influence of stakeholders on CSR decisions. It also provides an understanding of the link between organizational CSR reputation and organization\u27s performance

The Higgs Boson Mass as a Probe of the Minimal Supersymmetric Standard Model

Recently, the LEP collaborations have reported a lower bound on a Standard Model-like Higgs boson of order 89 GeV. We discuss the implications of this bound for the minimal supersymmetric extension of the Standard Model (MSSM). In particular, we show that the lower bound on $\tan\beta$, which can be obtained from the presently allowed Higgs boson mass value, becomes stronger than the one set by the requirement of perturbative consistency of the theory up to scales of order $M_{GUT}$ (associated with the infrared fixed-point solution of the top quark Yukawa coupling) in a large fraction of the allowed parameter space. The potentiality of future LEP2 searches to further probe the MSSM parameter space is also discussed.Comment: 15 pages, 5 figures, LateX, psfi

Precision Measurements at The Higgs Resonance: A Probe of Radiative Fermion Masses

The possibility of radiative generation of fermion masses from soft supersymmetry breaking chiral flavor violation is explored. Consistent models are identified and classified. Phenomenological implications for electric dipole moments and magnetic moments, as well as collider probes -- in particular those relevant at the Higgs resonance -- are discussed. It is shown that partial widths $\Gamma_{h^{0} \to ff}$ are enhanced compared with the minimal supersymmetric standard model.Comment: 7 pages, 1 figure, aipproc.sty (included). Talk presented by N. Polonsky at the Workshop on Physics at the First Muon Collider and the Front End of a Muon Collider, Fermilab, November 6-9, 199