A Rasch analysis of the Person-Centred Climate Questionnaire – staff version

Background: Person-centred care is the bedrock of modern dementia services, yet the evidence-base to support its implementation is not firmly established. Research is hindered by a need for more robust measurement instruments. The 14-item Person-Centred Climate Questionnaire - Staff version (PCQ-S) is one of the most established scales and has promising measurement properties. However, its construction under classical test theory methods leaves question marks over its rigour and the need for evaluation under more modern testing procedures. Methods: The PCQ-S was self-completed by nurses and other care staff working across nursing homes in 35 Swedish municipalities in 2013/14. A Rasch analysis was undertaken in RUMM2030 using a partial credit model suited to the Likert-type items. Three subscales of the PCQ-S were evaluated against common thresholds for overall fit to the Rasch model; ordering of category thresholds; unidimensionality; local dependency; targeting; and Differential Item Functioning. Three subscales were evaluated separately as unidimensional models and then combined as subtests into a single measure. Due to large number of respondents (n = 4381), two random sub-samples were drawn, with a satisfactory model established in the first ('evaluation') and confirmed in the second ('validation'). Final item locations and a table converting raw scores to Rasch-transformed values were created using the full sample. Results: All three subscales had disordered thresholds for some items, which were resolved by collapsing categories. The three subscales fit the assumptions of the Rasch model after the removal of two items, except for subscale 3, where there was evidence of local dependence between two items. By forming subtests, the 3 subscales were combined into a single Rasch model which had satisfactory fit statistics. The Rasch form of the instrument (PCQ-S-R) had an adequate but modest Person Separation Index (< 0.80) and some evidence of mistargeting due to a low number of `difficult-to-endorse' items. Conclusions: The PCQ-S-R has 12 items and can be used as a unidimensional scale with interval level properties, using the nomogram presented within this paper. The scale is reliable but has some inefficiencies due to too few high-end thresholds inhibiting discrimination amongst populations who already perceive that person-centred care is very good in their environment

Productive resistance within the public sector: exploring organisational culture

The article examines how South Korean civil servants responded to the introduction of pay for performance. Drawing upon 31 in-depth interviews with career civil servants, it identifies what became known as 1/n, a form of ‘discreet resistance’ that emerged and evolved. The analytical framework allows productive resistance to be seen as ebbing and flowing during organisational change that sees institutionalisation, deinstitutionalisation and re-institutionalisation. In understanding the cultural context of organisational resistance the contribution is three-fold. First, a nuanced definition and understanding of productive resistance. Second, it argues that productive resistance must be seen as part of a process that does not simply reflect ‘offer and counter-offer’ within the change management process. Thirdly, it identifies differences within groups and sub-cultures concerning commitment towards resistance and how these fissures contribute towards change as new interpretive schemes and justifications are presented in light of policy reformulations

Recognition of the Phanerozoic “Young Granite Gneiss” in the central Yeongnam Massif

Up to now, all the high-grade gneisses of the Korean peninsula have been regarded as Precambrian basement rocks and presence of the Phanerozoic high-grade metamorphic rocks have remained unknown. However, such granite gneiss is discovered through this study from the central Yeongnam massif near Gimcheon. SHRIMP zircon U-Pb age determinations on the granite gneiss, having well-developed gneissic foliations and migmatitic textures, reveal concordant age of ca. 250 Ma indicating the Early Triassic emplacement of this pluton, which is in contradict to the previous belief that it is a Precambrian product. Even though the granite gneiss reveals well-developed gneissic foliations and some zircons show rather low Th/U ratios, the metamorphic age has not been determined successfully. However, the age of metamorphism can be constrained as middle Triassic considering the absence of any evidences of metamorphism from the nearby granitic plutons having emplacement ages of ca. 225 Ma. Early Triassic emplacement and subsequent Middle Triassic metamorphism of the granite gneiss from the Yeongnam massif bear a remarkable resemblance to the case of South China block. We suggest the possibility that Early to Middle Triassic metamorphism of the Korean peninsula might be products of the intracontinental collisional events not directly related with the Early Triassic continental collision event

Global Functional Analyses of Cellular Responses to Pore-Forming Toxins

Here we present the first global functional analysis of cellular responses to pore-forming toxins (PFTs). PFTs are uniquely important bacterial virulence factors, comprising the single largest class of bacterial protein toxins and being important for the pathogenesis in humans of many Gram positive and Gram negative bacteria. Their mode of action is deceptively simple, poking holes in the plasma membrane of cells. The scattered studies to date of PFT-host cell interactions indicate a handful of genes are involved in cellular defenses to PFTs. How many genes are involved in cellular defenses against PFTs and how cellular defenses are coordinated are unknown. To address these questions, we performed the first genome-wide RNA interference (RNAi) screen for genes that, when knocked down, result in hypersensitivity to a PFT. This screen identifies 106 genes (∼0.5% of genome) in seven functional groups that protect Caenorhabditis elegans from PFT attack. Interactome analyses of these 106 genes suggest that two previously identified mitogen-activated protein kinase (MAPK) pathways, one (p38) studied in detail and the other (JNK) not, form a core PFT defense network. Additional microarray, real-time PCR, and functional studies reveal that the JNK MAPK pathway, but not the p38 MAPK pathway, is a key central regulator of PFT-induced transcriptional and functional responses. We find C. elegans activator protein 1 (AP-1; c-jun, c-fos) is a downstream target of the JNK-mediated PFT protection pathway, protects C. elegans against both small-pore and large-pore PFTs and protects human cells against a large-pore PFT. This in vivo RNAi genomic study of PFT responses proves that cellular commitment to PFT defenses is enormous, demonstrates the JNK MAPK pathway as a key regulator of transcriptionally-induced PFT defenses, and identifies AP-1 as the first cellular component broadly important for defense against large- and small-pore PFTs