What is a Good Plan? Cultural Variations in Expert Planners’ Concepts of Plan Quality

This article presents the results of a field research study examining commonalities and differences between American and British operational planners’ mental models of planning. We conducted Cultural Network Analysis (CNA) interviews with 14 experienced operational planners in the US and UK. Our results demonstrate the existence of fundamental differences between the way American and British expert planners conceive of a high quality plan. Our results revealed that the American planners’ model focused on specification of action to achieve synchronization, providing little autonomy at the level of execution, and included the belief that increasing contingencies reduces risk. The British planners’ model stressed the internal coherence of the plan, to support shared situational awareness and thereby flexibility at the level of execution. The British model also emphasized the belief that reducing the number of assumptions decreases risk. Overall, the American ideal plan serves a controlling function, whereas the British ideal plan supports an enabling function. Interestingly, both the US and UK would view the other’s ideal plan as riskier than their own. The implications of cultural models of plans and planning are described for establishing performance measures and designing systems to support multinational planning teams

US/UK Mental Models of Planning: The Relationship Between Plan Detail and Plan Quality

This paper presents the results of a research study applying a new cultural analysis method to capture commonalities and differences between US and UK mental models of operational planning. The results demonstrate the existence of fundamental differences between the way US and UK planners think about what it means to have a high quality plan. Specifically, the present study captures differences in how US and UK planners conceptualize plan quality. Explicit models of cultural differences in conceptions of plan quality are useful for establishing performance metrics for multinational planning teams. This paper discusses the prospects of enabling automatic evaluation of multinational team performance by combining recent advances in cultural modelling with enhanced ontology languages

Exploring the role of ERβ2 at different subcellular locations in breast cancer

Two estrogen receptors exist, ERα and ERβ. ERα is often over-expressed in breast cancers, frequently coupled with ERβ downregulation. The complex function of ERβ is not fully understood. There are 5 ERβ isoforms, ERβ1-5, and three are present in breast tissue (ERβ1, -2 and -5). Knowledge surrounding the role of the ERβ2 in breast cancer is limited; however its cellular location has been demonstrated to have predictive prognostic ability; nuclear expression was associated with better prognosis and cytoplasmic with poorer prognosis. Aside from acting as a repressor of ERα in breast cancer cells, little is known about the function of ERβ2. The aim of this thesis was to improve our understanding of ERβ2 and its potential role in breast cancer. ERβ2 expression was characterised in a range of breast cancer cell lines representative of five major molecular subgroups where it was expressed in both the nucleus and cytoplasm. Nuclear ERβ2 was largely expressed in a speckled pattern while cytoplasmic ERβ2 colocalised with mitochondria in all cell lines. ERβ nuclear speckles were explored further by immunofluorescence. ERβ2 speckles did not colocalise with other known nuclear speckled proteins, including nuclear speckles, PML and cajal bodies. Speckle numbers changed in response to 4-OHT, DPN and genistein treatment but not E2, and disappeared following transcriptional or translational inhibition with actinomycin D and cyclohexamide respectively. Numbers of ERβ2 speckles decreased during G2/M phase of the cell cycle. The physiological function of ERβ2 was explored by overexpressing ERβ2 in luminal and triple negative cell lines. ERβ2 overexpression resulted in suppression of proliferation in luminal cells whereas in triple negative cells, proliferative response was cell line-dependent. Cell migration was decreased in all cell lines. ERβ2 overexpression additionally influenced gene transcription of some nuclear genes i.e. BCL-2, CDK6, S100A7 and RIP140 and also some mitochondrially transcribed genes i.e. ND1, ND2, CYB and ATP6. In summary, ERβ2 was expressed in the nucleus as speckles; dynamic structures which changed in number in response to external stimuli. Cytoplasmically expressed ERβ2 colocalised with the mitochondria may influence transcription of some mitochondrial genes

Asylum Seekers and the Labour Market: Spaces of Discomfort and Hostility

This article examines the relationship in the UK between asylum-seeking and the labour market. Since 2002, asylum-seekers have not been allowed to work unless they have waited over twelve months for an initial decision on their asylum claim. This policy change occurred as employment was considered a ‘pull factor’ encouraging unfounded asylum claims. Despite not having the right to work, asylum-seekers – and especially those whose applications for refugee status have been refused by the UK government – interact with the labour market in manifold ways. Drawing on an ESRC-funded study in the UK's Yorkshire and Humber region and related studies, this article argues that both asylum-seekers and refused asylum-seekers form a hyper-exploitable pool of ‘illegalised’ and unprotected workers. As a vital part of their survival terrain, work is largely experienced as for-cash labouring in low-paid labour market sectors where the spectre of exploitation and even ‘modern slavery’ are perpetual threats. Recent policy shifts are deepening such threats through creating increasingly ‘uncomfortable’ and ‘hostile’ environments for certain categories of migrants

The ‘Institutional Lottery’: institutional variation in the processes involved in accessing late abortion in Victoria, Australia

Despite abortion being decriminalised in Victoria, Australia, access remains difficult, especially at later gestations. Institutions (i.e. health services) place restrictions on the availability of late abortions and/or require additional requirements to be satisfied (e.g. Hospital Termination Review Committee approval), as a consequence of local regulation (i.e. policies and processes determined at the institutional level). This paper reports on the results of 27 interviews with Victorian health professionals about late abortion processes and the operation of Termination Review Committees in Victorian health services, which were analysed thematically. The results reveal the operation of an ‘institutional lottery’ whereby patients' experiences in seeking late abortion services were variable and largely shaped by the institution(s) they found themselves in

Psychosocial impact of alternative management policies for low-grade cervical abnormalities : results from the TOMBOLA randomised controlled trial

Background: Large numbers of women who participate in cervical screening require follow-up for minor cytological abnormalities. Little is known about the psychological consequences of alternative management policies for these women. We compared, over 30-months, psychosocial outcomes of two policies: cytological surveillance (repeat cervical cytology tests in primary care) and a hospital-based colposcopy examination. Methods: Women attending for a routine cytology test within the UK NHS Cervical Screening Programmes were eligible to participate. 3399 women, aged 20–59 years, with low-grade abnormal cytology, were randomised to cytological surveillance (six-monthly tests; n = 1703) or initial colposcopy with biopsies and/or subsequent treatment based on colposcopic and histological findings (n = 1696). At 12, 18, 24 and 30-months post-recruitment, women completed the Hospital Anxiety and Depression Scale (HADS). A subgroup (n = 2354) completed the Impact of Event Scale (IES) six weeks after the colposcopy episode or first surveillance cytology test. Primary outcomes were percentages over the entire follow-up period of significant depression (≥8) and significant anxiety (≥11; “30-month percentages”). Secondary outcomes were point prevalences of significant depression, significant anxiety and procedure-related distress (≥9). Outcomes were compared between arms by calculating fully-adjusted odds ratios (ORs) for initial colposcopy versus cytological surveillance. Results: There was no significant difference in 30-month percentages of significant depression (OR = 0.99, 95% CI 0.80–1.21) or anxiety (OR = 0.97, 95% CI 0.81–1.16) between arms. At the six-week assessment, anxiety and distress, but not depression, were significantly less common in the initial colposcopy arm (anxiety: 7.9% vs 13.4%; OR = 0.55, 95% CI 0.38–0.81; distress: 30.6% vs 39.3%, OR = 0.67 95% CI 0.54–0.84). Neither anxiety nor depression differed between arms at subsequent time-points. Conclusions: There was no difference in the longer-term psychosocial impact of management policies based on cytological surveillance or initial colposcopy. Policy-makers, clinicians, and women themselves can be reassured that neither management policy has a significantly greater psychosocial cost

Parenting influences on adolescent alcohol use

Report prepared by the Australian Institute of Family Studies for the Australian Government Department of Health and Ageing Australian Institute

Biopsy and selective recall compared with immediate large loop excision in management of women with low grade abnormal cervical cytology referred for colposcopy : multicentre randomised controlled trial

Peer reviewedPublisher PD

The use of art work in art psychotherapy with people who are prone to psychotic states: an evidence-based clinical practice guideline

This Clinical Guideline addresses the evidence base for the theory and practice of Art Psychotherapy for clients who have severe and complex problems. It draws on different types of evidence – from users, experienced practitioners, local custom and practice, research and other related literature. It addresses both in-patient and community care, and situates the profession and its practices in the context of National Service Frameworks. The document begins with description of Art Psychotherapists’ long-standing history of work with this client population and, in so doing, outlines something of the development of the discipline’s theory and clinical practice. It describes the Guideline’s development, the aims and objectives of the project and the overall scope of the guideline. The processes of generating evidence through consultation with two expert panels – one comprising Art Psychotherapists experienced in this area of work and another comprising service users – are also described. The identification and critical appraisal of research and other texts relevant to the Guideline’s topic, and the development of evidence weightings appropriate to the discipline, are also explained. The Guideline then moves on to an extensive Evidence Review. This narrative describes the evidence the Guideline Development Group gleaned from all possible sources - textual, oral and practical. This includes research-based literature, other academically rigorous and descriptive literature and the opinions of expert practitioners, local practitioners and local expert users. The findings from the review process are described in the narrative and each is assigned to an evidence level. The evidence is reviewed thematically, for example regarding the contexts and settings of Art Psychotherapy practice, the referral process, assessment and clinical approaches. The theory that underpins clinical work is described first, followed by practice itself; the former (theory) derives almost entirely from the literature, but the latter (practice) is significantly informed by the opinions of our two expert panels and by the custom and practice of Art psychotherapists at Oxleas NHS Foundation Trust. In so doing, the Guideline addresses some of the gaps in the current Art Psychotherapy literature. The Evidence Review is followed by Recommendations. These distil the findings of the Review into General Principles and specific Recommendations for Art Psychotherapy practice with users who are prone to psychotic states. Each Principle and Recommendation is accompanied by a brief statement that refers to the evidence it has been derived from; like the evidence in the review, it too is assigned to a level. The highest level (1a and 1b) should be afforded the most significance. The document concludes with discussion of the implementation of the guideline and audit criteria