Showing papers by "City University London published in 2011"

Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies : the Birthplace in England national prospective cohort study

Abstract: Objective: To compare perinatal outcomes, maternal outcomes, and interventions in labour by planned place of birth at the start of care in labour for women with low risk pregnancies. Design: Prospective cohort study. Setting: England: all NHS trusts providing intrapartum care at home, all freestanding midwifery units, all alongside midwifery units (midwife led units on a hospital site with an obstetric unit), and a stratified random sample of obstetric units. Participants: 64 538 eligible women with a singleton, term (≥37 weeks gestation), and "booked" pregnancy who gave birth between April 2008 and April 2010. Planned caesarean sections and caesarean sections before the onset of labour and unplanned home births were excluded. Main outcome measure: A composite primary outcome of perinatal mortality and intrapartum related neonatal morbidities (stillbirth after start of care in labour, early neonatal death, neonatal encephalopathy, meconium aspiration syndrome, brachial plexus injury, fractured humerus, or fractured clavicle) was used to compare outcomes by planned place of birth at the start of care in labour (at home, freestanding midwifery units, alongside midwifery units, and obstetric units). Results: There were 250 primary outcome events and an overall weighted incidence of 4.3 per 1000 births (95% CI 3.3 to 5.5). Overall, there were no significant differences in the adjusted odds of the primary outcome for any of the non-obstetric unit settings compared with obstetric units. For nulliparous women, the odds of the primary outcome were higher for planned home births (adjusted odds ratio 1.75, 95% CI 1.07 to 2.86) but not for either midwifery unit setting. For multiparous women, there were no significant differences in the incidence of the primary outcome by planned place of birth. Interventions during labour were substantially lower in all non-obstetric unit settings. Transfers from non-obstetric unit settings were more frequent for nulliparous women (36% to 45%) than for multiparous women (9% to 13%). Conclusions: The results support a policy of offering healthy women with low risk pregnancies a choice of birth setting. Women planning birth in a midwifery unit and multiparous women planning birth at home experience fewer interventions than those planning birth in an obstetric unit with no impact on perinatal outcomes. For nulliparous women, planned home births also have fewer interventions but have poorer perinatal outcomes.

Researchers’ Perspectives on Supply Chain Risk Management

Abstract: Supply chain risk management (SCRM) is a nascent area emerging from a growing appreciation for supply chain risk by practitioners and by researchers. However, there is diverse perception of research in supply chain risk because these researchers have approached this area from different domains. This paper presents our study of this diversity from the perspectives of operations and supply chain management scholars: First, we reviewed the researchers’ output, i.e., the recent research literature. Next, we surveyed two focused groups (members of Supply Chain Thought Leaders and International Supply Chain Risk Management groups) with open-ended questions. Finally, we surveyed operations and supply chain management researchers during the 2009 INFORMS meeting in San Diego. Our findings characterize the diversity in terms of three “gaps”: a definition gap in how researchers define SCRM, a process gap in terms of inadequate coverage of response to risk incidents, and a methodology gap in terms of inadequate use of empirical methods. We also list ways to close these gaps as suggested by the researchers.

Women's perceptions and experiences of breastfeeding support: A metasynthesis

Abstract: Background: Both peer and professional support have been identified as important to the success of breastfeeding. The aim of this metasynthesis was to examine women’s perceptions and experiences of breastfeeding support, either professional or peer, in order to illuminate the components of support that they deem ‘supportive’. Methods: The metasynthesis included studies of both formal or ‘created’ peer and professional support for breastfeeding women but excluded studies of family or informal support. Qualitative studies were included as well as large scale surveys if they reported the analysis of qualitative data gathered through open ended responses. Primiparous and multiparous women who initiated breastfeeding were included. Only studies published in English, in peer reviewed journals and undertaken between 1990 and December 2007 were included. After assessment for relevance and quality, 31 studies were included in the metasynthesis. Meta-ethnographic methods were used to identify categories and themes. Results: The metasynthesis resulted in four categories comprising a total of 20 themes. The synthesis indicates that support for breastfeeding occurs along a continuum from authentic presence at one end, perceived as effective support, to disconnected encounters at the other, perceived as ineffective or even discouraging and counterproductive. Second, the synthesis identified a facilitative approach, versus a reductionist approach as contrasting styles of support women experienced as helpful or unhelpful. Conclusions: The findings of this metasynthesis emphasise the importance of person-centred communication skills and of relationships in supporting a woman to breastfeed. Organisational systems and services that facilitate continuity of care/r, for example continuity of midwifery care or peer support models, are more likely to facilitate an authentic presence.

Journal List Fetishism and the Perversion of Scholarship: Reactivity and the ABS List

Abstract: The case for using academic journals lists is critically scrutinised. An effect of their use, it argued, is to stifle diversity and constrict scholarly innovation. A monoculture is fostered in which a preoccupation with shoehorning research into a form prized by elite, US-oriented journals overrides a concern to maintain and enrich the diversity of topics, the range of methods and the plurality of perspectives engaged in business and management research. Use of a particular journal list, such as the one prepared by the Association of Business Schools (ABS), can come to dominate the scholarly terrain of a particular discipline with consequences that can be damaging to funding as well as to research culture.

Flexible Working and Performance: A Systematic Review of the Evidence for a Business Case

Abstract: Interest in the outcomes of flexible working arrangements (FWAs) dates from the mid-1970s, when researchers attempted to assess the impact of flexitime on worker performance. This paper reviews the literature on the link between FWAs and performance-related outcomes. Taken together, the evidence fails to demonstrate a business case for the use of FWAs. This paper attempts to explain the findings by analysing the theoretical and methodological perspectives adopted, as well as the measurements and designs used. In doing so, gaps in this vast and disparate literature are identified, and a research agenda is developed.

The Determinants of Mutual Fund Performance: A Cross-Country Study

Abstract: We use a new data set to study the determinants of the performance of open-end actively managed equity mutual funds in 27 countries. We find that mutual funds underperform the market overall. The results show important differences in the determinants of fund performance in the U.S. and elsewhere in the world. The U.S. evidence of diminishing returns to scale is not an universal truth as the performance of funds located outside the U.S. and funds that invest overseas is not negatively affected by scale. Our findings suggest that the adverse scale effects in the U.S. are related to liquidity constraints faced by funds that, by virtue of their style, have to invest in small and domestic stocks. Country characteristics also explain fund performance. Funds located in countries with liquid stock markets and strong legal institutions display better performance.

The impact of stroke: are people with aphasia different to those without?

Abstract: Purpose. Stroke rehabilitation programmes aim to improve functional outcomes and quality of life. This study explored long-term outcomes in a cohort of people admitted to two acute stroke units with stroke. Comparisons were drawn between people with aphasia (PWA) and people without aphasia.Methods. People admitted to hospital with a first stroke were assessed at 2-weeks, 3-months and 6-months post-stroke. Measures included: the Barthel Index for Activities of Daily Living (ADL), the Frenchay Aphasia Screening Test, the General Health Questionnaire-12 for emotional well-being and the Stroke and Aphasia Quality of Life Scale-39g. Extended ADL and social support were also measured at 3 and 6 months, with the Frenchay Activities Index and the Social Support Survey, respectively.Results. Of 126 eligible participants, 96(76%) took part and 87(69%) were able to self-report. Self-report data are reported here. Although outcomes improved significantly across time, at 6 months people continued to experience substan...

Anxiety and depression in polycystic ovary syndrome: a systematic review and meta-analysis

Abstract: BACKGROUND - Our aim was to assess differences in anxiety and depression between women with and without (controls) polycystic ovary syndrome (PCOS). METHODS - We conducted a systematic review and meta-analysis of published literature comparing women with PCOS to control groups on anxiety and depression. Electronic databases were searched up to 17 December 2010. The inverse variance method based, as appropriate, on a random- or fixed-effects model in Review Manager, Version 5 was used to analyse the data. RESULTS - Twelve comparative studies were included; all studies assessed depression (910 women with PCOS and 1347 controls) and six also assessed anxiety (208 women with PCOS and 169 controls). Analysis revealed higher depression (Z = 17.92, P < 0.00001; Hedges’ g = 0.82; 95% CI 0.73–0.92) and anxiety (Z = 5.03, P < 0.00001; Hedges’ g = 0.54; 95% CI 0.33–0.75) scores in the participants with, than without, PCOS. Studies controlling for BMI showed a smaller difference between women with PCOS and controls on anxiety and depression scores than studies not controlling for BMI. CONCLUSIONS - Women with PCOS on average tend to experience mildly elevated anxiety and depression, significantly more than women without PCOS. Women with PCOS with lower BMI tended to have slightly lower anxiety and depression scores, suggesting that having a lower BMI reduces anxiety and depression. Future studies might consider (i) controlling for BMI, (ii) stratifying by medication use in order to control for any anti-androgenic effects of medication and (iii) excluding women with polycystic ovaries from control groups.

High Involvement Management, High Performance Work Systems and Well-being

Abstract: Studies on the impact of high-performance work systems on employees' well-being are emerging but the underlying theory remains weak. This paper attempts to develop theory of the effects on well-being of four dimensions of high-performance work systems: enriched jobs, high involvement management, employee voice, and motivational supports. Hypothesized associations are tested using multilevel models and data from Britain's Workplace Employment Relations Survey of 2004 (WERS2004). Results show that enriched jobs are positively associated with both measures of well-being: job satisfaction and anxiety–contentment. Voice is positively associated with job satisfaction, and motivational supports with neither measure. The results for high involvement management are not as predicted because it increases anxiety and is independent of job satisfaction.

Cerebral artery dilatation maintains cerebral oxygenation at extreme altitude and in acute hypoxia--an ultrasound and MRI study.

Abstract: Transcranial Doppler is a widely used noninvasive technique for assessing cerebral artery blood flow. All previous high altitude studies assessing cerebral blood flow (CBF) in the field that have used Doppler to measure arterial blood velocity have assumed vessel diameter to not alter. Here, we report two studies that demonstrate this is not the case. First, we report the highest recorded study of CBF (7,950 m on Everest) and demonstrate that above 5,300 m, middle cerebral artery (MCA) diameter increases (n=24 at 5,300 m, 14 at 6,400 m, and 5 at 7,950 m). Mean MCA diameter at sea level was 5.30 mm, at 5,300 m was 5.23 mm, at 6,400 m was 6.66 mm, and at 7,950 m was 9.34 mm (P<0.001 for change between 5,300 and 7,950 m). The dilatation at 7,950 m reversed with oxygen. Second, we confirm this dilatation by demonstrating the same effect (and correlating it with ultrasound) during hypoxia (FiO2=12% for 3 hours) in a 3-T magnetic resonance imaging study at sea level (n=7). From these results, we conclude that it cannot be assumed that cerebral artery diameter is constant, especially during alterations of inspired oxygen partial pressure, and that transcranial 2D ultrasound is a technique that can be used at the bedside or in the remote setting to assess MCA caliber.

Assessment for selection for the health care professions and specialty training: Consensus statement and recommendations from the Ottawa 2010 Conference

Abstract: Assessment for selection in medicine and the health professions should follow the same quality assurance processes as in-course assessment. The literature on selection is limited and is not strongly theoretical or conceptual. For written testing, there is evidence of the predictive validity of Medical College Admission Test (MCAT) for medical school and licensing examination performance. There is also evidence for the predictive validity of grade point average, particularly in combination with MCAT for graduate entry but little evidence about the predictive validity of school leaver scores. Interviews have not been shown to be robust selection measures. Studies of multiple mini-interviews have indicated good predictive validity and reliability. Of other measures used in selection, only the growing interest in personality testing appears to warrant future work. Widening access to medical and health professional programmes is an increasing priority and relates to the social accountability mandate of medical and health professional schools. While traditional selection measures do discriminate against various population groups, there is little evidence on the effect of non-traditional measures in widening access. Preparation and outreach programmes show most promise. In summary, the areas of consensus for assessment for selection are small in number. Recommendations for future action focus on the adoption of principles of good assessment and curriculum alignment, use of multi-method programmatic approaches, development of interdisciplinary frameworks and utilisation of sophisticated measurement models. The social accountability mandate of medical and health professional schools demands that social inclusion, workforce issues and widening of access are embedded in the principles of good assessment for selection.

The Life Cycle of Family Ownership: International Evidence

Abstract: We show that in countries with strong investor protection, developed financial markets and active markets for corporate control, family firms evolve into widely held companies as they age. In countries with weak investor protection, less developed financial markets and inactive markets for corporate control, family control is very persistent over time. While family control in high investor protection countries is concentrated in industries with low investment opportunities and low M&A activity, this is not so in countries with low investor protection, where the presence of family control in an industry is unrelated to investment opportunities and M&A activity.

Patient Education to Prevent Falls Among Older Hospital Inpatients: A randomized controlled trial

Abstract: BACKGROUND: Falls are a common adverse event during hospitalization of older adults, and few interventions have been shown to prevent then. METHODS: This study was a 3-group randomized trial to evaluate the efficacy of 2 forms of multimedia patient education compared with usual care for the prevention of in-hospital falls. Older hospital patients (n = 1206) admitted to a mixture of acute (orthopedic, respiratory, and medical) and subacute (geriatric and neurorehabilitation) hospital wards at 2 Australian hospitals were recruited between January 2008 and April 2009. The interventions were a multimedia patient education program based on the health-belief model combined with trained health professional follow-up (complete program), multi-media patient education materials alone (materials only), and usual care (control). Falls data were collected by blinded research assistants by reviewing hospital incident reports, hand searching medical records, and conducting weekly patient interviews. RESULTS: Rates of falls per 1000 patient-days did not differ significantly between groups (control, 9.27; materials only, 8.61; and complete program, 7.63). However, there was a significant interaction between the intervention and presence of cognitive impairment. Falls were less frequent among cognitively intact patients in the complete program group (4.01 per 1000 patient-days) than among cognitively intact patients in the materials-only group (8.18 per 1000 patient-days) (adjusted hazard ratio, 0.51; 95% confidence interval, 0.28-0.93]) and control group (8.72 per 1000 patient-days) (adjusted hazard ratio, 0.43; 95% confidence interval, 0.24-0.78). CONCLUSION: Multimedia patient education with trained health professional follow-up reduced falls among patients with intact cognitive function admitted to a range of hospital wards. Trial Registration anzctr.org.au Identifier: ACTRN12608000015347. Language: en

Gains and Losses from the Misperception of Brand Origin: The Role of Brand Strength and Country-of-Origin Image

Abstract: Mounting empirical evidence shows that consumers often associate brands with the wrong country of origin (COO) or are unable to classify a brand to any COO. In this study, the authors investigate t...

Optical Coherence Tomography May Be Used to Predict Visual Acuity in Patients with Macular Edema

Abstract: Purpose. To determine whether the volume of retinal tissue passing between the inner and outer retina in macular edema could be used as an indicator of visual acuity. Methods. Diabetic and uveitic patients with cystoid macular edema (81 subjects, 129 eyes) were recruited. Best corrected logMAR visual acuity and spectral optical coherence tomography (OCT/SLO; OTI, Toronto, ONT, Canada) were performed in all patients. Coronal OCT scans obtained from a cross section of the retina between the plexiform layers were analyzed with a grid of five concentric radii (500, 1000, 1500, 2000, and 2500 μm centered on the fovea). The images were analyzed to determine the amount of retinal tissue present within each ring. A linear regression model was developed to determine the relationship between tissue integrity and logMAR visual acuity. Results. A linear relationship between tissue integrity and VA was demonstrated. The volume of retinal tissue between the plexiform layers in rings 1 and 2 (up to 1000 μm from the foveal center) predicted 80% of visual acuity. By contrast, central macular thickness within the central 1000 μm predicted only 14% of visual acuity. Conclusions. This study showed that the cross-sectional area of retinal tissue between the plexiform layers in cystoid macular edema, as imaged by OCT, is the best indicator of visual function at baseline. Further prospective treatment trials are needed to investigate this parameter as a predictor of visual outcome after intervention.

Enacting engagement online: framing social media use for the museum

Abstract: Purpose – The purpose of this paper is to highlight and reflect on the increased use of social media in the museums sector in the UK and beyond. It seeks to explore the challenges of utilising such media for institutions steeped in discourses of authority, authenticity and materiality. Design/methodology/approach – Arguments are illustrated using examples of practice and policy from across the museums sector, and are informed by critical theory. In particular, Erving Goffman's frame analysis is used as a means for understanding and articulating the current use of social media by museums. Findings – There is currently a gulf between the possibilities presented by social media, and their use by many museums. This leads to forms of frame misalignment, which can be intensely problematic. It is crucial that museums increase their understanding of the frames within which such activity is being encouraged and experienced. Research limitations/implications – The paper does not offer a comprehensive mapping of social media use by museums at the current time. Rather, it uses notable examples to foreground a number of concerns for exploration through further research. Originality/value – The paper calls into question the naturalised discourse surrounding social media use in the museums sector. It calls for a re-appraisal and re-framing of such activity so that it might more genuinely and satisfactorily match the claims that are being made for and about it.

Developing European indicators of trust in justice

Abstract: A social indicators approach to trust in justice recognizes that the police and criminal courts need public support and institutional legitimacy if they are to operate effectively and fairly. In order to generate public cooperation and compliance, these institutions must demonstrate to citizens that they are trustworthy and that they possess the authority to govern. In this paper we first outline the conceptual roadmap for a current comparative analysis of trust in justice. We then describe the methodological development process of a 45-item module in Round 5 of the European Social Survey, which fields the core survey indicators. After presenting the findings from a quantitative pilot of the indicators, we consider the policy implications of a procedural justice model of criminal justice.

A comparative study of parametric mortality projection models

Abstract: The relative merits of different parametric models for making life expectancy and annuity value predictions at both pensioner and adult ages are investigated. This study builds on current published research and considers recent model enhancements and the extent to which these enhancements address the deficiencies that have been identified of some of the models. The England & Wales male mortality experience is used to conduct detailed comparisons at pensioner ages, having first established a common basis for comparison across all models. The model comparison is then extended to include the England & Wales female experience and both the male and female USA mortality experiences over a wider age range, encompassing also the working ages.

The Validity and Incremental Validity of Knowledge Tests, Low-Fidelity Simulations, and High-Fidelity Simulations for Predicting Job Performance in Advanced-Level High-Stakes Selection

Abstract: In high-stakes selection among candidates with considerable domain-specific knowledge and experience, investigations of whether high-fidelity simulations (assessment centers; ACs) have incremental validity over low-fidelity simulations (situational judgment tests; SJTs) are lacking. Therefore, this article integrates research on the validity of knowledge tests, low-fidelity simulations, and high-fidelity simulations in advanced-level high-stakes settings. A model and hypotheses of how these 3 predictors work in combination to predict job performance were developed. In a sample of 196 applicants, all 3 predictors were significantly related to job performance. Both the SJT and the AC had incremental validity over the knowledge test. Moreover, the AC had incremental validity over the SJT. Model tests showed that the SJT fully mediated the effects of declarative knowledge on job performance, whereas the AC partially mediated the effects of the SJT.

Integrability, spin-chains and the AdS(3)/CFT(2) correspondence

Abstract: Building on arXiv:0912.1723 [1], in this paper we investigate the AdS3/CFT2 correspondence using integrability techniques. We present an all-loop Bethe Ansatz (BA) for strings on AdS 3 × S 3 × S 3 × S 1, with symmetry d(2, 1; α)2, valid for all values of α. This construction requires an α-dependent scaling of the Zhukovsky map. We investigate the weakly-coupled limit of this BA and of the all-loop BA for strings on AdS 3 × S 3 × T 4. We construct integrable short-range spin-chains and Hamiltonians that correspond to these weakly-coupled BAs. The spin-chains are alternating and homogenous, respectively. The alternating spin-chain can be regarded as giving some of the first hints about the unknown CFT2 dual to string theory on AdS 3 × S 3 × S 3 × S 1. We show that, in the α → 1 limit, the integrable structure of the d(2, 1; α)2 model is non-singular and keeps track of not just massive but also massless modes. This provides a way of incorporating massless modes into the integrability machinery of the AdS3/CFT2 correspondence.

Why do people lose their friends after a stroke

Abstract: Background: It is well-known that people lose friends after a stroke; what is less well understood is why this occurs. Aims: This study explored why people lose contact with their friends, and whether there are any protective factors. It also examined how friendship loss and change is perceived by the individual. Methods and Procedures: Participants with a first stroke were recruited from one acute stroke unit in the UK. In-depth qualitative interviews took place between 8 and 15 months post stroke. Outcomes and Results: 29 participants were recruited of whom 10 had aphasia. The main reasons given for losing friends were: loss of shared activities, reduced energy levels, physical disability, aphasia, unhelpful responses of others, environmental barriers, and changing social desires. The subset of participants who experienced the most extensive loss of friends were those who described a sense that they were ‘closing in’ on themselves leading to a withdrawal from social contact and a new preference for meeting only close friends and family. Those with aphasia experienced the most hurtful negative responses from others and found it more difficult to retain their friends unless they had strong supportive friendship patterns prior to the stroke. The factors which helped to protect friendships included: having a shared history, friends who showed concern, who lived locally, where the friendship was not activity-based, and where the participant had a ‘friends-based’ social network prior to the stroke. Conclusions and Implications: Given the link between depression and loss of friends post stroke, supporting an individual in maintaining a social network is likely to be beneficial. For intervention to be effective, however, it may need to take into account not only the impact of new physical and language disabilities, but also changing social desires.

Making ‘The Daily Me’: Technology, economics and habit in the mainstream assimilation of personalized news

Abstract: The mechanisms of personalization deployed by news websites are resulting in an increasing number of editorial decisions being taken by computer algorithms — many of which are under the control of external companies — and by end users. Despite its prevalence, personalization has yet to be addressed fully by the journalism studies literature. This study defines personalization as a distinct form of interactivity and classifies its explicit and implicit forms. Using this taxonomy, it surveys the use of personalization at 11 national news websites in the UK and USA. Research interviews bring a qualitative dimension to the analysis, acknowledging the influence that institutional contexts and journalists’ attitudes have on the adoption of technology. The study shows how: personalization informs debates on news consumption, content diversity, and the economic context for journalism; and how it challenges the continuing relevance of established theories of journalistic gate-keeping.

A comprehensive evaluation of the impact of telemonitoring in patients with long-term conditions and social care needs: protocol for the whole systems demonstrator cluster randomised trial.

Abstract: It is expected that increased demands on services will result from expanding numbers of older people with long-term conditions and social care needs. There is significant interest in the potential for technology to reduce utilisation of health services in these patient populations, including telecare (the remote, automatic and passive monitoring of changes in an individual's condition or lifestyle) and telehealth (the remote exchange of data between a patient and health care professional). The potential of telehealth and telecare technology to improve care and reduce costs is limited by a lack of rigorous evidence of actual impact. We are conducting a large scale, multi-site study of the implementation, impact and acceptability of these new technologies. A major part of the evaluation is a cluster-randomised controlled trial of telehealth and telecare versus usual care in patients with long-term conditions or social care needs. The trial involves a number of outcomes, including health care utilisation and quality of life. We describe the broad evaluation and the methods of the cluster randomised trial If telehealth and telecare technology proves effective, it will provide additional options for health services worldwide to deliver care for populations with high levels of need. Current Controlled Trials ISRCTN43002091