bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding the effect of decentralisation on health services
Authors: Regmi Krishna , Naidoo Jennie , Greer Alan , Pilkington Paul
Published: November 2014

Purpose

Despite enormous progress in health globally, primary healthcare services in many developing countries are facing different challenges. Many studies have documented that decentralisation could be useful in supporting and developing health services closer to citizens. The purpose of this paper is to assess the effect of decentralisation on health services, and to draw general lessons which might help to develop appropriate strategies to improve health services in Nepal.

Design/methodology/approach

A mixed method was used, consisting of reviews of current literatures relevant to decentralisation and health performance, engaging with health service inputs‐outputs data between 2001 and 2007, and assessing the range of choices (management, finance and governance) available to local authorities using Bossert's “decision‐space approach”.

Findings

Decentralisation in many countries, including Nepal, suggests a new form of service delivery.

Originality/value

Review of the selected studies in triangulation with health services data has revealed that decentralisation in many cases has improved access to, utilisation of, and management of health services. The effects on other performance dimensions such as policy, equity, quality and service effectiveness are poorly investigated topics in the literature. The findings suggest that the successful implementation of decentralisation requires a broader context of institutional capacity building and resource management, and underlines the need for their consideration during implementation processes, and further investigation.
Five have a leadership adventure
Authors: Naylor Jennifer Ann
Published: November 2014

Purpose

This study proposes to examine whether tales from childhood influence the psyche and self of the adult in their professional role as a leader in a large organization. It is positioned within a social constructionist and postmodernist framework.

Design/methodology/approach

The methodology development was challenging; to capture the level of abstraction within which it was positioned. Using narrative inquiry allowed for a less rigid methodology, data collection and analysis. The data were collected using a non‐structured single interview with a known subject, the data analysed using an initial thematic analysis followed by an in‐depth analysis of the themes against the background of an Enid Blyton novel.

Findings

This research project has shown how all are products of their whole life experiences to date; thus the tales from childhood must also impact on adult lives. This project identified links between the adult professional self and the characters in the tales, which were read as children. Leadership can be read as an adventure story or fairy tale, a myth born out of the narratives and language often used to describe it, reflecting tales of quest and achievement.

Originality/value

The interpretations on offer are only one version; another reader or teller would experience a different interpretation; finding her own story, while constructing herself as a researcher, was unexpected and surprising. There are at least two stories running throughout predominantly: the subjects’ story and the story of the research.
Enterprising health
Authors: Exton Rosemary
Published: November 2014

Purpose

This paper seeks to investigate conditions under which entrepreneurs emerge as agents of effective and sustainable change in UK National Health Service Trusts.

Design/methodology/approach

The research synthesises literature on changing regulatory structures (“post‐bureaucracy”) and entrepreneurial behaviour to understand how individual identity construction is informed both by context and by individual attributes. Thematic analysis of interview data involving managers from 11 NHS Trusts, including detailed analysis of six transcripts, focuses on regulatory processes, the emergence of entrepreneurial behaviour and outcome variations in workplace innovation and improvement.

Findings

This study identifies co‐existing modes of regulation, which interact with individual behaviour, generating strategies differentiated as entrepreneurial or conformist. Four ideal types are identified: organisational entrepreneurship, resisted or dissonant entrepreneurship, conformity, and symbolic entrepreneurship. Analysis reinforces those literature findings, which suggest that the interaction of regulatory structures and the identity work of individuals influence the emergence of entrepreneurial behaviour and the effectiveness of change.

Practical implications

The ability to achieve effective and sustainable outcomes varies considerably even between NHS Trusts faced with comparable challenges in implementing nationally prescribed targets. This variance is explained in terms of the organisation's ability to generate the structures, processes, individual competence and motivation which enable employees at all levels to act entrepreneurially with the ability and legitimacy to achieve strategic goals by working creatively in the spaces between formal organisational structures.

Originality/value

The study identifies specific conditions, which stimulate the emergence of entrepreneurs as agents of effective and sustainable change in the NHS, identifying factors that policymakers should consider when implementing change.
Learning practice? Exploring the links between transitions and medical performance
Authors: Kilminster Sue , Zukas Miriam , Quinton Naomi , Roberts Trudie
Published: November 2014

Purpose

The aims of this paper are to understand the links between work transitions and doctors' performance and to identify the implications for policy, regulation, practice and research.

Design/methodology/approach

The paper explains transitions in terms of the inseparability of learning, practice and performance and introduces the concept of the transition as a critically intensive learning period to draw attention to this phenomenon. It also identifies implications for practice, research and regulation

Findings

Drawing on empirical data in relation to prescribing and case management, the paper will show that, in contrast to current assumptions of, understanding about and practice in doctors' transitions, doctors can never be fully prepared in advance for aspects of their work.

Originality/value

Transitions are explained in terms of the inseparability of learning, practice and performance and we introduce the concept of the transition as a critically intensive learning period to draw attention to this phenomenon. Also identified are implications for practice, research and regulation.
A new workforce in the making?
Authors: Macfarlane Fraser , Greenhalgh Trish , Humphrey Charlotte , Hughes Jane , Butler Ceri , Pawson Ray
Published: November 2014

Purpose

This paper seeks to describe the exploration of human resource issues in one large‐scale program of innovation in healthcare. It is informed by established theories of management in the workplace and a multi‐level model of diffusion of innovations.

Design/methodology/approach

A realist approach was used based on interviews, ethnographic observation and documentary analysis.

Findings

Five main approaches (“theories of change”) were adopted to develop and support the workforce: recruiting staff with skills in service transformation; redesigning roles and creating new roles; enhancing workforce planning; linking staff development to service needs; creating opportunities for shared learning and knowledge exchange. Each had differing levels of success.

Practical implications

The paper includes HR implications for the modernisation of a complex service organisation.

Originality/value

This is the first time a realist evaluation of a complex health modernisation initiative has been undertaken.
Offshoring of healthcare services: the case of US‐India trade in medical transcription services
Authors: Kshetri Nir , Dholakia Nikhilesh
Published: November 2014

Purpose

The issue of offshore outsourcing of healthcare services is a critical but little‐examined problem in healthcare research. The purpose of this study is to contribute to filling this void.

Design/methodology/approach

A library‐based study was carried out of the development of the Indian medical transcription offshoring industry.

Findings

Cost‐saving potential and the degree of outsourceability are higher for medical transcription compared with most services. Offshoring experience, typically in a low‐value BPO, helps to enhance productivity and international linkages required for the success of medical transcription.

Research limitations/implications

An important area of future research concerns comparing India's factor endowments in medical transcription outsourcing with other services. Further research is also needed to examine how India differs from its regional competitors in terms of factors endowments associated with these services. Another extension would be to investigate the drivers of offshoring of higher value services such as radiological readings.

Practical implications

ICT infrastructures needed for outsourcing require much less investment compared with leading capital‐intensive industries. The development patterns of the Indian medical and offshoring industries indicate that India may attract higher skilled medical functions in the future. The Indian offshoring industry is shifting its focus from BPO to knowledge process outsourcing (KPO). Developing countries need to shift to greater automation and greater levels of skill training to retain and reinforce their comparative advantages.

Originality/value

This paper's greatest value stems from the fact that it examines the drivers of a new but rapidly growing healthcare industry.
Financing public healthcare institutions in Ghana
Authors: Akosua Akortsu Mercy , Aseweh Abor Patience
Published: November 2014

Purpose

The financing of healthcare services has been of a major concern to all governments in the face of increasing healthcare costs. For developing countries, where good health is considered a poverty reduction strategy, it is imperative that the hospitals used in the delivery of healthcare services are well financed to accomplish their tasks. The purpose of this paper is to examine how public hospitals in Ghana are financed, and the challenges facing the financing modes adopted.

Design/methodology/approach

To achieve the objectives of the study, one major public healthcare institution in Ghana became the main focus.

Findings

The findings of the study revealed that the main sources of financing the public healthcare institution are government subvention, internally‐generated funds and donor‐pooled funds. Of these sources, the internally generated fund was regarded as the most reliable, and the least reliable was the donor‐pooled funds. Several challenges associated with the various financing sources were identified. These include delay in receipt of government subvention, delay in the reimbursement of services provided to subscribers of health insurance schemes, influence of government in setting user fees, and the specifications to which donor funds are put.

Originality/value

The findings of this study have important implications for improving the financing of public healthcare institutions in Ghana. A number of recommendations are provided in this regard.
Operational and contextual drivers of hospital costs
Authors: Stock Gregory N. , McDermott Christopher
Published: November 2014

Purpose

The purpose of this paper is to examine empirically how operational performance and contextual factors contribute to differences in overall patient care costs across different hospitals.

Design/methodology/approach

Administrative data are employed from a sample of hospitals in New York State to construct measures of contextual factors, operational performance, and cost per patient. Operational performance and cost variables are adjusted to account for case mix differences across hospitals. Hierarchical regression is used to analyze the effects of contextual and operational variables on cost performance.

Findings

Increased length of stay, increased patient volume, and educational mission were associated with higher cost per patient. Mortality performance was associated with lower cost per patient. However, it was not found that location, size, or ownership status had a significant relationship with cost performance.

Practical implications

This paper identifies several significant relationships between contextual and operational variables and hospital costs. From a managerial perspective, these findings highlight the fact that some drivers of cost in hospitals are under the control of managers. One of the primary cost drivers in the study is length of stay, which implies that there is significant room for improvement in healthcare performance through a focus on operational excellence.

Originality/value

For researchers, the present study highlights the relative importance of operational versus contextual factors, with respect to cost performance in hospitals. The results of this study also provide direction for additional research into the role operational performance might play in determining the overall organizational performance in a hospital.
Mind the gap
Authors: Gkeredakis Emmanouil , Swan Jacky , Powell John , Nicolini Davide , Scarbrough Harry , Roginski Claudia , Taylor‐Phillips Sian , Clarke Aileen
Published: November 2014

Purpose

The paper aims to take a reflective stance on the relationship between policy/evidence and practice, which, the authors argue, is conceptually under‐developed. The paper aims to show that current research perspectives fail to frame evidence and policy in relation to practice.

Design/methodology/approach

A qualitative study was conducted in the English NHS in four Primary Care Trusts (PCTs). Seventy‐five observations of meetings and 52 semi‐structured interviews were completed. The approach to data analysis was to explore and reconstruct narratives of PCT managers' real practices.

Findings

The exploratory findings are presented through two kinds of narratives. The first narrative vividly illustrates the significance of the active involvement, skills and creativity of health care practitioners for policy implementation. The second narrative elucidates how problems of collaboration among different experts in PCTs might emerge and affect evidence utilisation in practice.

Practical implications

The findings exemplify that policies are made workable in practice and, hence, policy makers may also need to be mindful of practical intricacies and conceive policy implementation as an iterative process.

Originality/value

The contribution of this paper lies in offering an alternative and important perspective to the debate of utilisation of policy/evidence in health care management and in advancing existing understanding of health care management practice. The paper's rich empirical examples demonstrate some important dimensions of the complexity of practice.
Organizational culture based on the example of an Estonian hospital
Authors: Saame Iisi , Reino Anne , Vadi Maaja
Published: November 2014

Purpose

The concept of organisational culture (also referred to later as OC) is one of the approaches in modern organisational analysis exploring the values, attitudes and beliefs behind human behaviour in the workplace. OC as a social phenomenon is considered to be important for the sustainability of every organisation. In the service sector, OC may affect the nature and quality of the services provided. The aim of this paper is twofold: on the one hand, to highlight the patterns of OC in a hospital; and, on the other hand, to outline relationships between OC and patient satisfaction. The study was conducted in Tartu University Hospital, one of the most influential health care organisations in Estonia. This paper has original value by presenting an insight into organisational culture in the Estonian health care sector, and the findings of the study will expand knowledge of OC in the health care sector in general.

Design/methodology/approach

The OC instrument applied in a quantitative cross‐sectional study was earlier developed according to the Competing Values Framework (CVF). Data from 456 medical and non‐medical professionals were analysed using non‐parametric tests of descriptive statistics. A factor analysis was performed to assess the instrument's compatibility for analysing the OC pattern in the health care sector.

Findings

The dominant culture type in all the groups investigated was the Internal Processes type, mainly followed by the Rational Goal type, while different cultural patterns were observed in professional groups. The factor analysis yielded a three‐subscale solution. Clinics with high patient satisfaction did not score more than clinics with low patient satisfaction in terms of the Human Relations type.

Originality/value

In future studies a random sample design and a multidisciplinary approach to OC research should be followed in order to further explore OC patterns in hospitals and their consequences for different aspects of hospital performance.
The trade‐off between efficiency and quality in hospital departments
Authors: Mennicken Roman , Kuntz Ludwig , Schwierz Christoph
Published: November 2014

Purpose

Hospital managers are confronted with decisions that have to account for multiple objectives, which may be in conflict with regard to efficiency and quality of care. In empirical studies occupancy and staffing ratios as well as in‐hospital mortality are frequently used measures for efficiency and quality‐of‐care, respectively. Efficiency and quality measures vary on a daily basis. However, most empirical studies fail to take this variation into account, especially because data of daily staffing levels are lacking. The paper seeks to exploit the notion that staffing levels are planned according to expected occupancy levels, i.e. estimated daily occupancy levels account for unobserved daily staffing levels.

Design/methodology/approach

Using administrative data from 2004 for a sample of 62 departments in 33 German hospitals, the relation between daily occupancy levels and in‐hospital mortality count on the department level is analyzed. In an OLS‐framework the paper estimates daily occupancy level for all departments and then uses the predicted occupancy levels in a zero‐inflated Poisson (ZIP) regression framework to explain in‐hospital mortality count.

Findings

The results show a potential trade‐off relation between predicted occupancy rates and mortality. More specifically, the paper finds that the trade‐off relation is less pronounced in hospitals with a higher number of available staff per bed.

Originality/value

First, the paper shows evidence for a negative trade‐off between measures of managerial and medical performance on a day‐to‐day basis. Second, interactions between single measures of efficiency are modeled, namely predicted occupancy rate and staff per bed ratios, and policy implications are developed. Third, first empirical results in this respect using German data are presented.
Steering whilst rowing: governing and managing health services from the centre
Authors: Storey John
Published: November 2014

Purpose

The article seeks to explore the practical and theoretical implications of the ways in which senior figures in the National Health Service (NHS) interpret the role of the centre in relation to the delivery units of the health service. This is important in the light of recent plans for reorganisation of the NHS advanced by the new Conservative‐Liberal coalition government.

Design/methodology/approach

The article is based on interviews with civil servants and NHS staff at senior levels in the centre and in the strategic health authorities (SHAs).

Findings

It is found that, in practice, despite numerous attempts to separate out policy making from implementation/management, the two continue to be closely coupled and intertwined. Central staff and regional officials are found to be both steering and rowing.

Research limitations/implications

Only a small selection of senior officials at the centre and only a small proportion of SHA senior managers and directors were interviewed.

Practical implications

The implications are far‐reaching. Unless special steps are taken, it seems likely that these senior officials, despite the creation of some new institutions and the curtailment of others, will continue to behave in broadly similar ways to those described here.

Originality/value

Empirical studies of the thinking, assumptions and behaviour of very senior officials in the health service are rare. The analysis in this paper explores the organisational conditions that shape the actions of these senior players.
Molecular dynamics simulations of the shape memory effect in a chain of Lennard‐Jones crystals
Authors: Kastner Oliver , Eggeler Gunther
Published: November 2014

Purpose

Shape memory alloys are a fascinating class of materials because they combine both structural and functional properties. These properties strongly depend on temperature. One consequence of this dependency yields the characteristic shape‐memory effect: shape memory alloys can recover processed reference configurations after significant plastic deformations simply upon a change of temperature. For real materials, such processes incorporate characteristic hysteresis. This paper aims at an understanding of these materials from an atomistic point of view.

Design/methodology/approach

2D molecular‐dynamics (MD) simulations describing a chain consisting of 32 linked Lennard‐Jones crystals are presented. The crystals consist of nested lattices of two atom species. Distinct lattice structures can be identified, interpreted as austenite and (variants of) martensite. Temperature and/or load‐induced phase transitions between these configurations are observed in MD simulations. Previously, the thermal equation of state of one isolated crystal was investigated and its phase stability was discussed in detail. In the multi‐crystal chain considered in the present paper, individual crystals contribute collectively to the thermo‐mechanical behavior of the assembly.

Findings

The paper presents the results of numerical experiments with this polycrystalline chain under strain‐, load‐ and/or temperature‐control. The results show that with the assumption of simple Lennard‐Jones potentials of interaction between atoms in individual crystals and linking these crystals allows to reproduce the features associated with the fascinating behavior of shape memory alloys, including pseudo‐plasticity, pseudo‐elasticity and the shape memory effect.

Originality/value

Owing to the special setup chosen, interfaces are missing between adjacent crystals in the chain assembly. The paper shows that in this situation load‐induced austenite/martensite transitions do not exhibit hysteresis in tension/compression cycles. This observation indirectly supports mesoscopic‐level work in the literature which explicitly introduces interface energy to model such hysteresis.
Effect of rotation on plane waves in generalized thermo‐microstretch elastic solid with one relaxation time
Authors: Othman Mohamed I.A. , Lotfy Kh.
Published: November 2014

Purpose

The present paper aims to study the effect of rotation on the general model of the equations of generalized thermo‐microstretch for a homogeneous isotropic elastic half‐space solid whose surface is subjected to a thermal shock is considered. The problem is in the context of the generalized thermoelasticity Lord‐Şhulman's theory with one relaxation time, as well as the classical dynamical coupled theory.

Design/methodology/approach

The normal mode analysis is used to obtain the exact expressions.

Findings

For the displacement components, force stresses, temperature, couple stresses and microstress distribution.

Originality/value

The variations of the considered variables through the horizontal distance are illustrated graphically. Comparisons are made with the results in the presence and absence of rotation and in the presence and absence of microstretch constants between the two theories.
Theory and finite element implementation of orthotropic and transversely isotropic incompressible hyperelastic membrane
Authors: Abdessalem Jarraya , Kammoun Kallel Imen , Fakhreddine Dammak
Published: November 2014

Purpose

The purpose of this paper is to describe a general theoretical and finite element implementation framework for the constitutive modelling of biological soft tissues.

Design/methodology/approach

The model is based on continuum fibers reinforced composites in finite strains. As an extension of the isotropic hyperelasticity, it is assumed that the strain energy function is decomposed into a fully isotropic component and an anisotropic component. Closed form expressions of the stress tensor and elasticity tensor are first established in the general case of fully incompressible plane stress which orthotropic and transversely isotropic hyperelasticity. The incompressibility is satisfied exactly.

Findings

Numerical examples are presented to illustrate the model's performance.

Originality/value

The paper presents a constitutive model for incompressible plane stress transversely isotropic and orthotropic hyperelastic materials.
A study of the blast‐induced brain white‐matter damage and the associated diffuse axonal injury
Authors: Grujicic M. , d'Entremont B. , Pandurangan B. , Grujicic A. , LaBerge M. , Runt J. , Tarter J. , Dillon G.
Published: November 2014

Purpose

Blast‐induced traumatic brain injury (TBI) is a signature injury of the current military conflicts. Among the different types of TBI, diffuse axonal injury (DAI) plays an important role since it can lead to devastating effects in the inflicted military personnel. To better understand the potential causes associated with DAI, this paper aims to investigate a transient non‐linear dynamics finite element simulation of the response of the brain white matter to shock loading.

Design/methodology/approach

Brain white matter is considered to be a heterogeneous material consisting of fiber‐like axons and a structure‐less extracellular matrix (ECM). The brain white matter microstructure in the investigated corpus callosum region of the brain is idealized using a regular hexagonal arrangement of aligned equal‐size axons. Deviatoric stress response of the axon and the ECM is modeled using a linear isotropic viscoelastic formulation while the hydrostatic stress response is modeled using a shock‐type equation of state. To account for the stochastic character of the brain white matter microstructure and shock loading, a parametric study is carried out involving a factorial variation of the key microstructural and waveform parameters.

Findings

The results obtained show that the extent of axon undulations and the strength of axon/ECM bonding profoundly affect the spatial distribution and magnitude of the axonal axial normal and shear stresses (the stresses which can cause diffuse axonal injury).

Originality/value

The present approach enables a more accurate determination of the mechanical behavior of brain white matter when subjected to a shock.
A survey on cloud‐based sustainability governance systems
Authors: Truong Hong‐Linh , Dustdar Schahram
Published: November 2014

Purpose

The purpose of this paper is to examine how cloud‐based information systems and services can support emerging and future requirements for sustainability governance of facilities.

Design/methodology/approach

The authors present basic elements of cloud‐based sustainability governance platforms, conduct a survey of existing industrial platforms and research works, discuss distinguishable and common characteristics of cloud computing platforms for sustainability governance, and give views on future research.

Findings

Cloud computing emerges as a potential candidate for supporting sustainability governance. However, several techniques must be provided in order to support multiple stakeholders, complex analysis and compliance processes.

Research limitations/implications

The number of industrial platforms and research works in the survey is limited, as is information about industrial platforms. Furthermore, industrial platforms are continuously updated, thus some information might be outdated.

Originality/value

There exists no survey for understanding how cloud computing could be used for sustainability governance. The paper not only helps to understand state‐of‐the‐art in using cloud computing for sustainability governance but also discusses main components, stakeholders and requirements for cloud‐based sustainability governance platforms.
Public perceptions, knowledge and stigma towards people with schizophrenia
Authors: Smith Valerie , Reddy Jairus , Foster Kenneth , Asbury Edward T. , Brooks Jennifer
Published: November 2014

Purpose

The purpose of this paper is to obtain perceptions of educated non‐professionals towards people with schizophrenia.

Design/methodology/approach

A social distance scale and a schizophrenia knowledge and attitude survey were administered to 330 undergraduates. It was predicted that knowledge and personal family experience would predict tolerance attitudes and social distance comfort towards persons with schizophrenia.

Findings

Knowledge about schizophrenia and personal family experience with mental illness had similar effects on tolerance scores. Specifically, those with higher knowledge and family members with schizophrenia reported higher levels of tolerance (i.e. less stigma). Conversely, participants with a family member diagnosed with a mental illness reported less social distance comfort to persons with schizophrenia as opposed to those without mental illness in the family. Finally, gender differences indicated that women held more tolerant attitudes towards schizophrenia compared with men.

Originality/value

Few studies have focused on educated non‐professional perceptions and attitudes towards the mentally ill.
Homelessness and mental health: adding clinical mental health interventions to existing social ones can greatly enhance positive outcomes
Authors: Cockersell Peter
Published: November 2014

Purpose

This paper seeks to discuss the association between homelessness and poor health, both physical and mental. A pilot project run by St Mungo's suggests that adding clinical mental health interventions, notably psychotherapy, makes existing social care interventions several times more effective, enables deeper recovery, and frees people to move on across all the domains of their lives.

Design/methodology/approach

St Mungo's was awarded a grant by the Cabinet Office as one of the national pilots working with “adults facing chronic exclusion” (jointly funded by the Department of Work & Pensions, Ministry of Justice, Department of Health, Department of Communities, and Department of Families and Children – because these clients impact on the remits of all these departments). The aim of the project was essentially simple: to test the hypothesis that, if chronically excluded adults were excluded because of their psychological disorders, then could a psychotherapeutic intervention reduce their exclusion?

Findings

Recently, 274 people have attended for therapy; 30 per cent of these are women, 70 per cent men, with 68 per cent white and 32 per cent black. In total, 30 per cent did not come to the initial assessment session, and there are many reasons for this, for example, people abandoning or being evicted from their accommodation, death, imprisonment and resettlement. Some were also referred without proper consultation, so that when they were contacted it turned out they did not want psychotherapy or, in a few cases were already accessing it elsewhere. Of those who did attend assessment, 80 per cent went on to attend four or more sessions; most clients attended either two to four sessions, or more than 12. Attendance overall was 76 per cent, and non‐attendances were noted on 11 per cent of occasions.

Originality/value

Many homeless people become caught in the “revolving door” of hostels, prison, hospitals and the streets, often for many years. This paper argues that this form of homelessness affects people because of their mental health, and that social solutions alone are not sufficient, which is why the door continues to revolve. Offering appropriate clinical interventions alongside existing social ones could begin to transform this situation.
It's all about the money – randomised controlled trial of public opinion towards prescribing injectable heroin in drug treatment
Authors: Mushtaq Salman , Maucoli Easow Joby , Mendes Vania , Luty Jason
Published: November 2014

Purpose

Injectable opioid therapy (prescribing heroin for heroin addicts to inject) remains a highly controversial and expensive option. Recent research has shown significant benefits for this therapy in otherwise refractory patients. The aim of this paper is to assess the public opinion regarding heroin prescribing to addicts and to determine what effect the cost of this might have on their opinions.

Design/methodology/approach

Participants were asked to complete a questionnaire after reading a vignette which described current opioid maintenance therapy. Two vignettes were generated and the experimental group was randomised to receive the additional information that the cost of heroin prescribing was £15,000 per addict, per year.

Findings

Questionnaires were received from 187 subjects (response rate 74 percent). For the control group, 23 percent agreed and 58 percent disagreed with prescribing heroin to addicts (23 vs 62). For the experimental group, where the additional cost of £15,000 per addict was introduced into the vignette, 10 percent agreed and 75 percent disagreed (10 vs 71). The difference was statistically significant (p<0.05; χ2). In total, 58 percent of people were opposed to the idea that heroin should be prescribed to heroin addicts on the National Health Service but this rises to 75 percent when the annual cost of prescribed heroin (£15,000) is included.

Originality/value

This study supports an earlier survey that showed over 80 percent of the general public opposed the prescription of diamorphine to addicts even to reduce crime. Heroin prescribing remains controversial and lacks public support.
Child poverty and child well‐being in Europe
Authors: Bradshaw Jonathan , Richardson Dominic , Ritakallio Veli‐Matti
Published: November 2014

European Union (EU) indicators on poverty and social exclusion employ only two child breakdowns: the proportion of children living in households with incomes below 60% of the national median using the modified OECD equivalence scale and the proportion of children living in workless households. The UK also uses these indicators in the Opportunities for All series. This article first develops a new indicator of child poverty based on income, subjective and deprivation indicators which may be more reliable than income alone. It then explores the extent to which income poverty and worklessness represent international variation in child well‐being using an index that we have developed. The conclusions are that: (1) relative income poverty and worklessness are poor indicators of child well‐being, especially for some of the new EU countries; (2) deprivation has a stronger association with overall well‐being than relative income poverty or worklessness; (3) there are a number of other single indicators of child well‐being that could be used as proxies for overall child well‐being; and (4) The EU (and the UK) could easily develop its own index of child well‐being.
Consumer perceptions of online consumer product and service reviews
Authors: Lee Hyun‐Hwa , Jin Ma Yoon
Published: November 2014

Purpose

Online consumer reviews play an important role in influencing consumers' purchasing decisions by providing a wealth of information about products and services. Framed by uncertainty reduction theory, the purpose of this paper is to examine consumer perceptions of online consumer reviews and effects on consumer attitudes and usage behaviors in relation to individual characteristics.

Design/methodology/approach

Data were randomly collected from 1,930 US online consumer review users using an online survey.

Findings

The researchers found that consumers perceived both benefits and costs from online consumer reviews and that both benefits and costs influenced consumer attitudes toward, and usage behaviors of, online consumer reviews. Individual characteristics – confidence in the information process and consumer susceptibility to interpersonal influence – were shown to determine how online consumer reviews were perceived.

Originality/value

The results provide insight to retailers and marketers as to how they can use consumer reviews for their products or services to improve business performance.
Failing to plan is planning to fail: out‐of‐area placements for people with learning disabilities
Authors: Allen David
Published: November 2014

Being placed in out‐of‐area services can be one of the most significant forms of transition experienced by people with learning disabilities. The paper reviews the extent of such provision, identifies who is most at risk of being placed out of area, briefly explores the effects of such placement and concludes with a discussion of possible strategic solutions.
An adolescent with Rasmussen's encephalitis and psychosis: transition to adult services
Authors: Kannabiran Muthukumar , Bernard Sarah
Published: November 2014

This case study highlights issues surrounding the transition of a 19‐year‐old man with moderate learning disabilities and a psychotic illness from child and adolescent mental health services to adult services. He had undergone hemispherectomy following Rasmussen's encephalitis at a young age. Important issues in transition of care are discussed.
A new input system for disabled users involving eye gaze tracker and scanning interface
Authors: Biswas Pradipta , Langdon Pat
Published: November 2014

Purpose

This paper aims to present a new input interaction system for people with severe disabilities. The new system works based on eye gaze tracking and single switch scanning interaction techniques. It combines eye gaze tracking and scanning in a unique way which is faster than only scanning‐based systems while more comfortable to use than only eye gaze tracking‐based systems, which is also supported by a user study.

Design/methodology/approach

The aim was to design a new interaction technique combining eye tracking and scanning technique for severely disabled people. A comparative study with eight users involving only an eye tracking system and the system combining eye tracking and scanning was conducted.

Findings

The participants rated the new system easier and less strenuous to use than the eye gaze tracking‐based system, while the new system did not slow the speed of interaction.

Originality/value

This new method based on eye gaze tracking and single switch scanning interaction techniques has potential to be a new interaction technique combining free source eye tracker and scanning switches. It is hoped users who can move a limb to use a single switch‐based scanning system will be hugely benefitted by this new system.
Do the victims of school bullies tend to become depressed later in life? A systematic review and meta‐analysis of longitudinal studies
Authors: Ttofi Maria M. , Farrington David P. , Lösel Friedrich , Loeber Rolf
Published: November 2014

Purpose

The purpose of this paper is to investigate the extent to which bullying victimization in school predicts depression in later life and whether this relation holds after controlling for other major childhood risk factors.

Design/methodology/approach

As no previous systematic review has been conducted on this topic, effect sizes are based on both published and unpublished studies: longitudinal investigators of 28 studies have conducted specific analyses for the authors' review.

Findings

The probability of being depressed up to 36 years later (mean follow‐up period of 6.9 years) was much higher for children who were bullied at school than for non‐involved students (odds ratio (OR)=1.99; 95 per cent CI: 1.71‐2.32). Bullying victimization was a significant risk factor for later depression even after controlling for up to 20 (mean number of six covariates) major childhood risk factors (OR=1.74; 95 per cent CI: 1.54‐1.97). Effect sizes were smaller when the follow‐up period was longer and larger the younger the child was when exposed to bullying. Finally, the summary effect size was not significantly related to the number of risk factors controlled for.

Originality/value

Although causal inferences are tentative, the overall results presented in this paper indicate that bullying victimization is a major childhood risk factor that uniquely contributes to later depression. High quality effective anti‐bullying programmes could be viewed as an early form of public health promotion.
Bullies, victims, and bully‐victims: a longitudinal examination of the effects of bullying‐victimization experiences on youth well‐being
Authors: Özdemir Metin , Stattin Håkan
Published: November 2014

Purpose

The purpose of this paper is to investigate how children's involvement in bullying (as bullies, victims and bully‐victims) is related to longer term levels of various internalizing problems such as depression and self‐harm.

Design/methodology/approach

A prospective longitudinal design was used based on data from the Swedish Seven Schools Longitudinal Study. The authors also examined whether bullying/victimization experiences predict changes in internalizing problems.

Findings

Results vary depending on children's participation in bullying behavior as bullies, victims or bully‐victims.

Originality/value

Overall, the paper's findings highlight the importance of uniqueness of different bullying/victimization experiences. This study showed that the bully‐victims, followed by the victimized group, were more at risk for displaying internalizing problems. Bullies showed neither higher internalizing problems nor increases over time in symptom levels compared to the youths who were neither bullies nor victims.
Women tourism entrepreneurs: doing gender on farms in Sweden
Authors: Pettersson Katarina , Heldt Cassel Susanna
Published: November 2014

Purpose

– This paper aims to explore how gender is “done” on farms in Sweden in the context of increased tourism and hospitality activities. The authors seek to investigate how gender is done vis-à-vis women’s farm tourism entrepreneurship. They seek to answer the questions: What has motivated the farm women to become tourism entrepreneurs? How are the gendered divisions of labor changed through women starting businesses? How does the gendered associated symbolism, as well as the identities, change?

Design/methodology/approach

– Research has indicated that introducing tourism entrepreneurship at farms may challenge established gender relations, as many of these entrepreneurs are women. The empirical material consists of in-depth interviews with 15 women farm tourism entrepreneurs in central Sweden.

Findings

– The analysis suggests that the gendered divisions of labor are not changed through the interviewed women starting tourism businesses. The authors conclude that the women build their entrepreneurship and develop some of their products on an image of rural domesticity, including a representation of themselves as traditional farm women. At the same time they are changing how gender is done through identifying as entrepreneurs and changing the use of the farms.

Originality/value

– The authors seek to fill the research gap concerning women’s farm tourism entrepreneurship and the potential associated gendered changes. Their theoretical contribution is applying the perspective of “doing gender” and entrepreneurship, for delineating potential changes in gendered relations.
Suzhi: an indigenous criterion for human resource management in China
Authors: Xu Liguo , Fu Pinging , Xi Youmin
Published: November 2014

Purpose

– The purpose of this paper is to conceptualize the indigenous concept of suzhi at individual and organizational levels, and identify its dimensions for human resource management (HRM) research and practice in China.

Design/methodology/approach

– Based on a comprehensive review of suzhi literature, Chinese cultural and historical literature, as well as Western mainstream HRM research, a multidimensional suzhi framework is conceptualized.

Findings

– As an indigenous expression, suzhi can be and has been adopted for Chinese HRM research and practice. As a multidimensional construct, one’s cognitive suzhi is jointly determined by corresponding moral suzhi, wenhua (knowledge-based) suzhi and zhuanye (professional) suzhi. Cognitive suzhi, in turn, determines one’s behavioral suzhi that drives employees to enhance organizational performance, and this relationship is moderated by psychological suzhi.

Research limitations/implications

– The proposed framework provides new insight for Chinese indigenous management research, particularly in developing suzhi measurement for different dimensions. It also informs HRM practices in recruiting, selection, performance analysis and employee career development.

Originality/value

– The complexity of suzhi dimensions from an organizational HRM perspective is analyzed. The resulting suzhi framework offers new insight for HRM research and practices in China.
Back to the future: 900 years of securitization
Authors: Buchanan Bonnie
Published: November 2014

Purpose

– Before the 2007 financial crisis, securitized products accounted for half the credit market. Once regarded as one of the biggest financial innovations of the last century, securitization is now viewed as a contributory factor to the crisis. Until recently research has focused on the post-1970s mortgage securitization market. In this paper, I trace the earlier origins of securitization, from the 12th century Genoese compera through to early 20th century efforts. The historical examples highlight unifying themes on risk allocation and complexity. As the future securitization market remains uncertain, it is important to consider lessons to be learned from these historical episodes.

Design/methodology/approach

– This is primarily a survey article that utilizes historical documents to compare/contrast features of securitization with the recent crisis.

Findings

– Improved disclosure is the key element to address recent securitization flaws, but disclosure does not really matter if the entire process is not understood. An examination of historical episodes can be instructive. Forging ahead, any securitization reform needs to address why securitization markets formed, why they failed and how the securitization market can be improved.

Practical implications

– As the future securitization market remains uncertain, it is important to consider lessons to be learned from these historical episodes.

Originality/value

– To the best of my knowledge, this is one of the first research papers that surveys the history of securitization as far back as the twelfth century.