208 research outputs found

    Shut the fridge door! HRM alignment, job redesign and energy performance

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    Anchored within the strategic HRM and alignment literature, and drawing on efficiency and legitimacy perspectives of organisational behaviour, we investigated a Human Resource Management (HRM) intervention targeted at energy reduction goals in a large multinational retailer. The HRM intervention was focused on embedding the environmental and economic performance goals of the firm within the workplace through redesigning the job so that energy tasks were aligned with training and performance management systems, as well as organisational performance goals. Using a randomised control trial design, we tracked changes in energy behaviours and energy consumption in 769 retail stores (685 in the intervention condition, 84 in the control condition). The findings provide evidence that changing the alignment of HRM practices can influence both worker behaviour and organisational outcomes, including environmental outcomes. This work contributes to debates concerning the impact of HRM alignment to both the work and organisational performance context

    Why some health and social care workers resisted compulsory COVID vaccination

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    The UK planned to make COVID vaccination compulsory for frontline NHS and social care staff, but ultimately did not. Sian Moore (University of Greenwich), Christina Clamp (Southern New Hampshire University), and Eklou R Amendah (University of Southern Maine) and colleagues look at vaccine hesitancy among this group in the UK and US, many of whom are BME, and how employers and trade unions tackled it

    An Interprofessional Clinical Placement in a Primary Healthcare Setting: A Pilot Study

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    Purpose: Internationally, and in Australia, interprofessional education (IPE) is becoming typical in primary healthcare delivery and is core to delivering patient-centred care. It is essential that primary healthcare education develop interprofessional capacity in order to produce a skilled workforce. An IPE clinical placement for undergraduate health students was developed and piloted in primary healthcare settings. The aim of this study was to evaluate the impact of the IPE clinical placement in a primary healthcare setting on students’ perceptions of interprofessional education. Method: A pre-post placement validated questionnaire (n=19) indicated overall perceptions of IPE significantly increased over the course of the IPE clinical placement. Results: There was a significant increase in competency and autonomy and understanding of roles over time. There was no significant increase in the reported perception of need for interprofessional cooperation, however there was a significant increase in actual interprofessional cooperation. Conclusion: This was a successful pilot program that warrants further development and research to include longer-term follow up of students’ perceptions towards IPE and analyze whether collaboration and teamwork skills obtained during the IPE primary healthcare experience are transferrable to future professional practice

    Antiretroviral therapy uptake and coverage in four HIV community cohort studies in sub-Saharan Africa

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    OBJECTIVE: To compare socio-demographic patterns in access to antiretroviral therapy (ART) across four community HIV cohort studies in Africa. METHODS: Data on voluntary counselling and testing and ART use among HIV-infected persons were analysed from Karonga (Malawi), Kisesa (Tanzania), Masaka (Uganda) and Manicaland (Zimbabwe), where free ART provision started between 2004 and 2007. ART coverage was compared across sites by calculating the proportion on ART among those estimated to need treatment, by age, sex and educational attainment. Logistic regression was used to identify socio-demographic characteristics associated with undergoing eligibility screening at an ART clinic within 2 years of being diagnosed with HIV, for three sites with information on diagnosis and screening dates. RESULTS: Among adults known to be HIV-infected from serological surveys, the proportion who knew their HIV status was 93% in Karonga, 37% in Kisesa, 46% in Masaka and 25% in Manicaland. Estimated ART coverage was highest in Masaka (68%) and lowest in Kisesa (2%). The proportion of HIV-diagnosed persons who were screened for ART eligibility within 2 years of diagnosis ranged from 14% in Kisesa to 84% in Masaka, with the probability of screening uptake increasing with age at diagnosis in all sites. CONCLUSIONS: Higher HIV testing rates among HIV-infected persons in the community do not necessarily correspond with higher uptake of ART, nor more equitable treatment coverage among those in need of treatment. In all sites, young adults tend to be disadvantaged in terms of accessing and initiating ART, even after accounting for their less urgent need

    Quantifying the core deficit in classical schizophrenia

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    In the classical descriptions of schizophrenia, Kraepelin and Bleuler recognised disorganization and impoverishment of mental activity as fundamental symptoms. Their classical descriptions also included a tendency to persisting disability. The psychopathological processes underlying persisting disability in schizophrenia remain poorly understood. The delineation of a core deficit underlying persisting disability would be of value in predicting outcome and enhancing treatment. We tested the hypothesis that mental disorganization and impoverishment are associated with persisting impairments of cognition and role-function, and together reflect a latent core deficit that is discernible in cases diagnosed by modern criteria. We used Confirmatory Factor Analysis to determine whether measures of disorganisation, mental impoverishment, impaired cognition and role functioning in 40 patients with schizophrenia represent a single latent variable. Disorganization scores were computed from the variance shared between disorganization measures from three commonly used symptom scales. Mental impoverishment scores were computed similarly. A single factor model exhibited a good fit, supporting the hypothesis that these measures reflect a core deficit.Persisting brain disorders are associated with a reduction in Post Motor Beta Rebound (PMBR), the characteristic increase in electrophysiological beta amplitude that follows a motor response. Patients had significantly reduced PMBR compared with healthy controls. PMBR was negatively correlated with core deficit score.While the symptoms constituting impoverished and disorganised mental activity are dissociable in schizophrenia, nonetheless, the variance that these two symptom domains share with impaired cognition and role function, appears to reflect a pathophysiological process that might be described as the core deficit of classical schizophrenia

    Greater access to healthy food outlets in the home and school environment is associated with better dietary quality in young children.

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    OBJECTIVE: To explore associations between dietary quality and access to different types of food outlets around both home and school in primary school-aged children. DESIGN: Cross-sectional observational study. SETTING: Hampshire, UK. SUBJECTS: Children (n 1173) in the Southampton Women's Survey underwent dietary assessment at age 6 years by FFQ and a standardised diet quality score was calculated. An activity space around each child's home and school was created using ArcGIS. Cross-sectional observational food outlet data were overlaid to derive four food environment measures: counts of supermarkets, healthy specialty stores (e.g. greengrocers), fast-food outlets and total number of outlets, and a relative measure representing healthy outlets (supermarkets and specialty stores) as a proportion of total retail and fast-food outlets. RESULTS: In univariate multilevel linear regression analyses, better diet score was associated with exposure to greater number of healthy specialty stores (ÎČ=0·025 sd/store: 95 % CI 0·007, 0·044) and greater exposure to healthy outlets relative to all outlets in children's activity spaces (ÎČ=0·068 sd/10 % increase in healthy outlets as a proportion of total outlets, 95 % CI 0·018, 0·117). After adjustment for mothers' educational qualification and level of home neighbourhood deprivation, the relationship between diet and healthy specialty stores remained robust (P=0·002) while the relationship with the relative measure weakened (P=0·095). Greater exposure to supermarkets and fast-food outlets was associated with better diet only in the adjusted models (P=0·017 and P=0·014, respectively). CONCLUSIONS: The results strengthen the argument for local authorities to increase the number of healthy food outlets to which young children are exposed

    Quantitative assessment of ultrastructure and light scatter in mouse corneal debridement wounds

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    Purpose. The mouse has become an important wound healing model with which to study corneal fibrosis, a frequent complication of refractive surgery. The aim of the current study was to quantify changes in stromal ultrastructure and light scatter that characterize fibrosis in mouse corneal debridement wounds. Methods. Epithelial debridement wounds, with and without removal of basement membrane, were produced in C57BL/6 mice. Corneal opacity was measured using optical coherence tomography, and collagen diameter and matrix order were quantified by x-ray scattering. Electron microscopy was used to visualize proteoglycans. Quantitative PCR (Q-PCR) measured mRNA transcript levels for several quiescent and fibrotic markers. Results. Epithelial debridement without basement membrane disruption produced a significant increase in matrix disorder at 8 weeks, but minimal corneal opacity. In contrast, basement membrane penetration led to increases in light scatter, matrix disorder, and collagen diameter, accompanied by the appearance of abnormally large proteoglycans in the subepithelial stroma. This group also demonstrated upregulation of several quiescent and fibrotic markers 2 to 4 weeks after wounding. Conclusions. Fibrotic corneal wound healing in mice involves extensive changes to collagen and proteoglycan ultrastructure, consistent with deposition of opaque scar tissue. Epithelial basement membrane penetration is a deciding factor determining the degree of ultrastructural changes and resulting opacity

    A socio-technical approach to improving retail energy efficiency behaviours

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    In recent years, the UK retail sector has made a significant contribution to societal responses on carbon reduction. We provide a novel and timely examination of environmental sustainability from a systems perspective, exploring how energy-related technologies and strategies are incorporated into organisational life. We use a longitudinal case study approach, looking at behavioural energy efficiency from within one of the UK's leading retailers. Our data covers a two-year period, with qualitative data from a total of 131 participants gathered using phased interviews and focus groups. We introduce an adapted socio-technical framework approach in order to describe an existing organisational behavioural strategy to support retail energy efficiency. Our findings point to crucial socio-technical and goal-setting factors which both impede and/or enable energy efficient behaviours, these include: tensions linked to store level perception of energy management goals; an emphasis on the importance of technology for underpinning change processes; and, the need for feedback and incentives to support the completion of energy-related tasks. We also describe the evolution of a practical operational intervention designed to address issues raised in our findings. Our study provides fresh insights into how sustainable workplace behaviours can be achieved and sustained over time. Secondly, we discuss in detail a set of issues arising from goal conflict in the workplace; these include the development of a practical energy management strategy to facilitate secondary organisational goals through job redesign

    Neurodevelopmental and Epilepsy Phenotypes in Individuals With Missense Variants in the Voltage-Sensing and Pore Domains of KCNH5

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    Background and Objectives KCNH5 encodes the voltage-gated potassium channel EAG2/Kv10.2. We aimed to delineate the neurodevelopmental and epilepsy phenotypic spectrum associated with de novo KCNH5 variants.Methods We screened 893 individuals with developmental and epileptic encephalopathies for KCNH5 variants using targeted or exome sequencing. Additional individuals with KCNH5 variants were identified through an international collaboration. Clinical history, EEG, and imaging data were analyzed; seizure types and epilepsy syndromes were classified. We included 3 previously published individuals including additional phenotypic details.Results We report a cohort of 17 patients, including 9 with a recurrent de novo missense variant p.Arg327His, 4 with a recurrent missense variant p.Arg333His, and 4 additional novel missense variants. All variants were located in or near the functionally critical voltage-sensing or pore domains, absent in the general population, and classified as pathogenic or likely pathogenic using the American College of Medical Genetics and Genomics criteria. All individuals presented with epilepsy with a median seizure onset at 6 months. They had a wide range of seizure types, including focal and generalized seizures. Cognitive outcomes ranged from normal intellect to profound impairment. Individuals with the recurrent p.Arg333His variant had a self-limited drug-responsive focal or generalized epilepsy and normal intellect, whereas the recurrent p.Arg327His variant was associated with infantile-onset DEE. Two individuals with variants in the pore domain were more severely affected, with a neonatal-onset movement disorder, early-infantile DEE, profound disability, and childhood death.Discussion We describe a cohort of 17 individuals with pathogenic or likely pathogenic missense variants in the voltage-sensing and pore domains of Kv10.2, including 14 previously unreported individuals. We present evidence for a putative emerging genotype-phenotype correlation with a spectrum of epilepsy and cognitive outcomes. Overall, we expand the role of EAG proteins in human disease and establish KCNH5 as implicated in a spectrum of neurodevelopmental disorders and epilepsy.</p
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