Customers' perspectives on the impact of the Pathways to Work Condition Management Programme on their health, wellbeing and vocational activity

Aims: Pathways to Work is a UK initiative aimed at supporting customers on incapacity benefits to return to work. This qualitative study complements previous evaluations of Pathways to Work by exploring customers’ perceptions of the impact of the Condition Management Programme (CMP) offered to claimants with long-term health conditions. Methods: 39 customers took part in focus groups held at the seven sites where Pathways was originally piloted. The main focus of the discussions was on perceptions of the ways in which participation had impacted on health, well-being and return to work. The discussions were audio-recorded and fully transcribed for analysis using a text analysis framework to enable the development and refinement of categories and overarching patterns in the data. Results: Perceived impacts on health and wellbeing included a more positive outlook, social contact, changed perceptions of conditions and improvements in health. Some customers also reported an increase in their vocational activity and others felt ready to embark on new activities. Factors associated with positive outcomes included the extent and quality of contact with CMP staff and practical advice about condition management. Factors impeding positive employment outcomes related mainly to obstacles to returning to work. Conclusions: The results indicated that CMP can assist customers to learn about and manage their health conditions and increase their vocational activity, and that CMP therefore provides a promising means of enabling people with long-term health conditions to regain a fulfilling, productive life

Transformational leadership : inspiration or domination : a critical organisational theory perspective.

Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2010.Within academic literature and contemporary organisations, it has become widely accepted that transformational leaders are required to harness the potential of their human resources in the direction of accomplishing organisational objectives and achieving organisational success. Transformational leaders are typically portrayed as charismatic, visionary individuals who are primarily concerned with the needs of their followers and who project a passionate and inspirational attitude within the organisational context. Little research however, has been directed toward a critical analysis of the power dynamics inherent in the leader-follower relationship and the discursive practices which influence and are influenced by this relationship. The current study sought to determine the extent to which a textual analysis of electronic journal articles pertaining to transformational leadership accurately reflected the presence of discursive effects. The findings revealed that both the knowledge products associated with transformational leadership as well as the practice of transformational leaders were informed by and embedded within a human resources management (HRM) discourse. As this discourse seeks to advance the interests of management and the organisation, transformational leadership functions as a mechanism through which the control and domination of workers is enacted within the workplace. Transformational leaders, through their alliance with a managerialist ideology, aspire to motivate employees to transcend their own self-interests and align their values with those of the organisation thereby engendering compliance, docility and self-domination. Discursive formations persuade employees to invest their subjectivities in the organisation, producing a hegemonic situation in which employees become instrumental in their own subordination

Extension of the composite CBS-QB3 method to singlet diradical calculations

The composite CBS-QB3 method is widely used to obtain accurate energies of molecules and radicals although its use in the case of singlet diradicals gives rise to some difficulties. The problem is related to the parameterized correction this method introduces to account for spin-contamination. We report a new term specifically designed to describe singlet diradicals separated by at least one CH2 unit. As a test case, we have computed the formation enthalpy of a series of diradicals that includes hydrocarbons as well as systems involving heteroatoms (nitrogen, oxygen). The resulting CBS-QB3 energies are very close to experiment

Further observations on mechanisms of bone destruction by squamous carcinomas of the head and neck: the role of host stroma.

Mechanisms of bone invasion by squamous carcinomas of the head and neck have been investigated using fresh tumours and established tumour cell lines in an in vitro bone resorption assay with 45Ca-labelled mouse calvaria. Fresh tumours regularly resorb bone in vitro. Activity is consistently reduced by indomethacin. The tumours release E2 prostaglandins (PGE2) in amounts sufficient to account for approximately 50% of the bone resorption observed. Small amounts of non-prostaglandin (indomethacin-resistant) osteolytic factors are also produced. Control non-neoplastic tissues show a variable capacity to resorb bone in vitro; PGE2 levels in these tissues may be related to their content of inflammatory cells. Tumour cell lines also resorb bone in vitro but, for most lines, activity is not significantly blocked by indomethacin and PGE2 levels are generally insufficient to account for the osteolysis observed. Non-prostaglandin bone resorbing factors thus predominate. It is concluded that most squamous cancers of the head and neck are osteolytic in vitro and release a mixture of prostaglandin and non-prostaglandin factors which stimulate osteoclastic bone resorption. These factors are derived from both neoplastic and stromal elements, and are "tumour-associated" rather than "tumour-specific". In vitro bone resorption and prostaglandin release does not correlate with pathological features of the tumour or with post-operative survival

Möglichkeiten der Intensivierung des Anbauus von Zwischenfruchtleguminosen mit besonderer Berücksichtigung der Fruchtfolgekrankheiten

In a two-year model crop rotation consisting of overwintering legumes as cover crops followed by maize in the first year and grain peas in the second year, the phytopathological risks and the potential of expanding the cultivation of legume cover crops in minimum tillage systems were examined

Systematic review and meta-analysis of diagnostic delay in axial spondyloarthritis

Background: . Delay to diagnosis in axial spondyloarthritis (axSpA) is longer than many other rheumatic diseases. Prolonged delay has been shown to associate with poorer outcomes including functional impairment and quality of life. Our aims were to describe 1) global variation in delay to diagnosis, 2) factors associated with delay, and 3) differences in diagnostic delay between axSpA and psoriatic arthritis (PsA). Methods: . We searched Medline, PubMed, EMBASE and Web of Science using a predefined protocol in accordance with PRISMA guidelines. Delay to diagnosis was defined as years between age at symptom onset and age at diagnosis. We pooled mean diagnostic delay using random-effects inverse variance meta-analysis. We examined variations in pooled estimates using pre-specified subgroup analyses and sources of heterogeneity using meta-regression. Results: . A total of 64 studies reported mean diagnostic delay in axSpA patients. The pooled mean delay was 6.7 years (95% confidence interval 6.2 to 7.2) with high levels of heterogeneity. Delay to diagnosis did not improve over time when stratifying results by year of publication. Studies from high-income countries (defined by the World Bank) reported longer delay than those from middle-income countries. Factors consistently reported to be associated with longer delay were: lower education levels, younger age at symptom onset and absence of extra-articular manifestations. Pooled estimate for diagnostic delay from 8 PsA studies was significantly shorter, at 2.6 years (95%CI 1.6 to 3.6). Conclusion: For axSpA patients, delay to diagnosis remains unacceptably prolonged in many parts of the world, although some countries have reported remarkable improvements. Patient factors (education) and disease presentation (age at onset and extra-articular manifestations) should inform awareness campaigns to improve delay. Targets for improvement should aim to resemble delays in other spondyloarthritis patients