Union effectiveness: In Search of the Holy Grail

YesThis article revisits the concept of union effectiveness and proposes a conceptual model to inform its study and application. Previous conceptual and empirical work is examined to identify key strengths and weaknesses, and to relate the union effectiveness concept to union renewal and other key concepts. This leads to the proposal of a Goal-System framework that builds and improves on prior research

White matter microstructure correlates with mathematics but not word reading performance in 13-year-old children born very preterm and full-term

Individuals born very preterm (VPT; 1 standard deviation below FT mean) had significantly reduced neurite density compared with VPT children without an impairment. Reading performance was not significantly associated with any of the white matter microstructure parameters. Additionally, the associations between white matter microstructure and mathematics and reading performance did not differ significantly between VPT and FT groups. Our findings suggest that alterations in white matter microstructure, and more specifically lower neurite density, are associated with poorer mathematics performance in 13-year-old VPT and FT children. More research is required to understand the association between reading performance and white matter microstructure in 13- year-old children.Simonne E. Collins, Megan Spencer-Smith, Ines Mürner-Lavanchy, Claire E. Kellya, Philippa Pyman, Leona Pascoe, Jeanie Cheong, Lex W. Doyle, Deanne K. Thompson, Peter J. Anderso

Divergent mind-sets, convergent policies: Policing models against organized crime in Italy and in England within international frameworks

The fight against organized crime is a very fertile ground for policymaking at various levels. On one side, because of the perceived transnationality of the phenomenon, national states are inclined to develop harmonized responses within the European or international law frameworks. On the other side, national conceptualizations and manifestations of organized crime often make these harmonizations quite challenging. This paper shares the findings of a socio-legal investigation carried out in England and in Italy through interviews and document analysis, comparing the two national models against organized crime. The paper presents these two models ? the Italian Structure Model and the English Activity Model, which are very different in many ways ? in order to identify divergences and convergences of policies and practices. This comparative exercise not only improves our understanding of national approaches, beyond cultural, linguistic and legal boundaries, but also improves the dialogue towards concerted efforts at the international level. Nevertheless, the globalization of criminal markets and the internationalization of policies have influenced perceptions of organized crime and related policing tactics at national levels too. This paper will briefly look at international perspectives to assess to what extent divergent and convergent areas between the two models are also areas of interest and focus at the international level, in order to conclude with an enhanced understanding of both models before drawing conclusions

Voices unheard : employee voice in the new century

The concept of employee voice has attracted considerable attention in research since the 1980s primarily in the fields of Employment Relations/Human Resource Management (ER/HRM) and Organisational Behaviour (OB). Each of these disciplines focuses on different aspects of employee voice, the former examining the mechanisms for employees to have \u27a say\u27 in organisational decision-making (Freeman, Boxall, & Haynes, 2007; Gollan, Kaufman, Taras, & Wilkinson, 2015; Wilkinson & Fay, 2011) and the latter considering voice as an \u27extra-role upward communication behaviour\u27 (Morrison, 2014, p. 174) with the intent to improve organizational functioning. The purpose of voice is seen by each of these disciplines in a different way. ER/HRM perspectives are underpinned by the assumption that it is a fundamental democratic right for workers to extend a degree of control over managerial decision-making within an organisation (Kaufman, 2015; Wilkinson, Gollan, Lewin, & Marchington, 2010). Thus, everyone should have a voice and a lack of opportunities to express that voice may adversely affect workers\u27 dignity. In contrast, OB perspectives are underpinned more by a concern with organisational improvements, therefore leaving it much more to managerial discretion to reduce or change existing voice arrangements due to, for example, an economic downturn (Barry & Wilkinson, 2016)

Clinical consequences of upfront pathology review in the randomised PORTEC-3 trial for high-risk endometrial cancer

Development and application of statistical models for medical scientific researc

AD51B in Familial Breast Cancer

Common variation on 14q24.1, close to RAD51B, has been associated with breast cancer: rs999737 and rs2588809 with the risk of female breast cancer and rs1314913 with the risk of male breast cancer. The aim of this study was to investigate the role of RAD51B variants in breast cancer predisposition, particularly in the context of familial breast cancer in Finland. We sequenced the coding region of RAD51B in 168 Finnish breast cancer patients from the Helsinki region for identification of possible recurrent founder mutations. In addition, we studied the known rs999737, rs2588809, and rs1314913 SNPs and RAD51B haplotypes in 44,791 breast cancer cases and 43,583 controls from 40 studies participating in the Breast Cancer Association Consortium (BCAC) that were genotyped on a custom chip (iCOGS). We identified one putatively pathogenic missense mutation c.541C>T among the Finnish cancer patients and subsequently genotyped the mutation in additional breast cancer cases (n = 5259) and population controls (n = 3586) from Finland and Belarus. No significant association with breast cancer risk was seen in the meta-analysis of the Finnish datasets or in the large BCAC dataset. The association with previously identified risk variants rs999737, rs2588809, and rs1314913 was replicated among all breast cancer cases and also among familial cases in the BCAC dataset. The most significant association was observed for the haplotype carrying the risk-alleles of all the three SNPs both among all cases (odds ratio (OR): 1.15, 95% confidence interval (CI): 1.11–1.19, P = 8.88 x 10−16) and among familial cases (OR: 1.24, 95% CI: 1.16–1.32, P = 6.19 x 10−11), compared to the haplotype with the respective protective alleles. Our results suggest that loss-of-function mutations in RAD51B are rare, but common variation at the RAD51B region is significantly associated with familial breast cancer risk

Adjuvant chemoradiotherapy versus radiotherapy alone in women with high-risk endometrial cancer (PORTEC-3): patterns of recurrence and post-hoc survival analysis of a randomised phase 3 trial

Background: The PORTEC-3 trial investigated the benefit of combined adjuvant chemotherapy and radiotherapy versus pelvic radiotherapy alone for women with high-risk endometrial cancer. We updated the analysis to investigate patterns of recurrence and did a post-hoc survival analysis. // Methods: In the multicentre randomised phase 3 PORTEC-3 trial, women with high-risk endometrial cancer were eligible if they had International Federation of Gynaecology and Obstetrics (FIGO) 2009 stage I, endometrioid grade 3 cancer with deep myometrial invasion or lymphovascular space invasion, or both; stage II or III disease; or stage I–III disease with serous or clear cell histology; were aged 18 years and older; and had a WHO performance status of 0–2. Participants were randomly assigned (1:1) to receive radiotherapy alone (48·6 Gy in 1·8 Gy fractions given on 5 days per week) or chemoradiotherapy (two cycles of cisplatin 50 mg/m2 given intravenously during radiotherapy, followed by four cycles of carboplatin AUC5 and paclitaxel 175 mg/m2 given intravenously), by use of a biased coin minimisation procedure with stratification for participating centre, lymphadenectomy, stage, and histological type. The co-primary endpoints were overall survival and failure-free survival. Secondary endpoints of vaginal, pelvic, and distant recurrence were analysed according to the first site of recurrence. Survival endpoints were analysed by intention-to-treat, and adjusted for stratification factors. Competing risk methods were used for failure-free survival and recurrence. We did a post-hoc analysis to analyse patterns of recurrence with 1 additional year of follow-up. The study was closed on Dec 20, 2013; follow-up is ongoing. This study is registered with ISRCTN, number ISRCTN14387080, and ClinicalTrials.gov, number NCT00411138. // Findings: Between Nov 23, 2006, and Dec 20, 2013, 686 women were enrolled, of whom 660 were eligible and evaluable (330 in the chemoradiotherapy group, and 330 in the radiotherapy-alone group). At a median follow-up of 72·6 months (IQR 59·9–85·6), 5-year overall survival was 81·4% (95% CI 77·2–85·8) with chemoradiotherapy versus 76·1% (71·6–80·9) with radiotherapy alone (adjusted hazard ratio [HR] 0·70 [95% CI 0·51–0·97], p=0·034), and 5-year failure-free survival was 76·5% (95% CI 71·5–80·7) versus 69·1% (63·8–73·8; HR 0·70 [0·52–0·94], p=0·016). Distant metastases were the first site of recurrence in most patients with a relapse, occurring in 78 of 330 women (5-year probability 21·4%; 95% CI 17·3–26·3) in the chemoradiotherapy group versus 98 of 330 (5-year probability 29·1%; 24·4–34·3) in the radiotherapy-alone group (HR 0·74 [95% CI 0·55–0·99]; p=0·047). Isolated vaginal recurrence was the first site of recurrence in one patient (0·3%; 95% CI 0·0–2·1) in both groups (HR 0·99 [95% CI 0·06–15·90]; p=0·99), and isolated pelvic recurrence was the first site of recurrence in three women (0·9% [95% CI 0·3–2·8]) in the chemoradiotherapy group versus four (0·9% [95% CI 0·3–2·8]) in the radiotherapy-alone group (HR 0·75 [95% CI 0·17–3·33]; p=0·71). At 5 years, only one grade 4 adverse event (ileus or obstruction) was reported (in the chemoradiotherapy group). At 5 years, reported grade 3 adverse events did not differ significantly between the two groups, occurring in 16 (8%) of 201 women in the chemoradiotherapy group versus ten (5%) of 187 in the radiotherapy-alone group (p=0·24). The most common grade 3 adverse event was hypertension (in four [2%] women in both groups). At 5 years, grade 2 or worse adverse events were reported in 76 (38%) of 201 women in the chemoradiotherapy group versus 43 (23%) of 187 in the radiotherapy-alone group (p=0·002). Sensory neuropathy persisted more often after chemoradiotherapy than after radiotherapy alone, with 5-year rates of grade 2 or worse neuropathy of 6% (13 of 201 women) versus 0% (0 of 187). No treatment-related deaths were reported. // Interpretation: This updated analysis shows significantly improved overall survival and failure-free survival with chemoradiotherapy versus radiotherapy alone. This treatment schedule should be discussed and recommended, especially for women with stage III or serous cancers, or both, as part of shared decision making between doctors and patients. Follow-up is ongoing to evaluate long-term survival

Trust in management: The role of employee voice arrangements and perceived managerial opposition to unions

This study examines the relationship between employee voice arrangements and employees' trust in management using data from the 2007 Australian Worker Representation and Participation Survey of 1,022 employees. Drawing on social exchange theory and employee relations literature, we test hypotheses concerning the relationships between direct and union voice arrangements, perceived managerial opposition to unions and employees' trust in management. Consistent with our predictions, after controlling for a range of personal, job and workplace characteristics, regression analyses indicated that direct voice arrangements were positively related to employees' trust in management. Union voice arrangements and perceived managerial opposition to unions were negatively related to trust in management. The article concludes by highlighting the study's implications for management practice and avenues for further research

Factors affecting staff morale on inpatient mental health wards in England : a qualitative investigation

Background: Good morale among staff on inpatient psychiatric wards is an important requirement for the maintenance of strong therapeutic alliances and positive patient experiences, and for the successful implementation of initiatives to improve care. More understanding is needed of mechanisms underlying good and poor morale. Method: We conducted individual and group interviews with staff of a full range of disciplines and levels of seniority on seven NHS in-patient wards of varying types in England. Results: Inpatient staff feel sustained in their potentially stressful roles by mutual loyalty and trust within cohesive ward teams. Clear roles, supportive ward managers and well designed organisational procedures and structures maintain good morale. Perceived threats to good morale include staffing levels that are insufficient for staff to feel safe and able to spend time with patients, the high risk of violence, and lack of voice in the wider organisation. Conclusions: Increasing employee voice, designing jobs so as to maximise autonomy within clear and wellstructured operational protocols, promoting greater staff-patient contact and improving responses to violence may contribute more to inpatient staff morale than formal support mechanisms