University of St Andrews

About: University of St Andrews is a education organization based out in St Andrews, Fife, United Kingdom. It is known for research contribution in the topics: Population & Laser. The organization has 16260 authors who have published 43364 publications receiving 1636072 citations. The organization is also known as: St Andrews University & University of St. Andrews.

Towards systematic reviews that inform health care management and policy-making.

Abstract: Objectives: To identify ways to improve the usefulness of systematic reviews for health care managers and policy-makers that could then be evaluated prospectively. Methods: We systematically reviewed studies of decision-making by health care managers and policy-makers, conducted interviews with a purposive sample of them in Canada and the United Kingdom (n ¼ 29), and reviewed the websites of research funders, producers/purveyors of research, and journals that include them among their target audiences (n ¼ 45). Results: Our systematic review identi¢ed that factors such as interactions between researchers and health care policy-makers and timing/timeliness appear to increase the prospects for research use among policymakers. Our interviews with health care managers and policy-makers suggest that they would bene¢t from having information that is relevant for decisions highlighted for them (e.g. contextual factors that aiect a review’s local applicability and information about the bene¢ts, harms/risks and costs of interventions) and having reviews presented in a way that allows for rapid scanning for relevance and then graded entry (such as one page of take-home messages, a three-page executive summary and a 25-page report). Managers and policy-makers have mixed views about the helpfulness of recommendations. Our analysis of websites found that contextual factors were rarely highlighted, recommendations were often provided and graded entry formats were rarely used. Conclusions: Researchers could help to ensure that the future £ow of systematic reviews will better inform health care management and policy-making by involving health care managers and policy-makers in their production and better highlighting information that is relevant for decisions. Research funders could help to ensure that the global stock of systematic reviews will better inform health care management and policymaking by supporting and evaluating local adaptation processes such as developing and making available online more user-friendly ‘front ends’ for potentially relevant systematic reviews.

Timing of India‐Asia collision: Geological, biostratigraphic, and palaeomagnetic constraints

Abstract: [1] A range of ages have been proposed for the timing of India-Asia collision; the range to some extent reflects different definitions of collision and methods used to date it. In this paper we discuss three approaches that have been used to constrain the time of collision: the time of cessation of marine facies, the time of the first arrival of Asian detritus on the Indian plate, and the determination of the relative positions of India and Asia through time. In the Qumiba sedimentary section located south of the Yarlung Tsangpo suture in Tibet, a previous work has dated marine facies at middle to late Eocene, by far the youngest marine sediments recorded in the region. By contrast, our biostratigraphic data indicate the youngest marine facies preserved at this locality are 50.6–52.8 Ma, in broad agreement with the timing of cessation of marine facies elsewhere throughout the region. Double dating of detrital zircons from this formation, by U-Pb and fission track methods, indicates an Asian contribution to the rocks thus documenting the time of arrival of Asian material onto the Indian plate at this time and hence constraining the time of India-Asia collision. Our reconstruction of the positions of India and Asia by using a compilation of published palaeomagnetic data indicates initial contact between the continents in the early Eocene. We conclude the paper with a discussion on the viability of a recent assertion that collision between India and Asia could not have occurred prior to ∼35 Ma.

Haemagglutinin mutations responsible for the binding of H5N1 influenza A viruses to human-type receptors

Abstract: H5N1 influenza A viruses have spread to numerous countries in Asia, Europe and Africa, infecting not only large numbers of poultry, but also an increasing number of humans, often with lethal effects. Human and avian influenza A viruses differ in their recognition of host cell receptors: the former preferentially recognize receptors with saccharides terminating in sialic acid-alpha2,6-galactose (SAalpha2,6Gal), whereas the latter prefer those ending in SAalpha2,3Gal (refs 3-6). A conversion from SAalpha2,3Gal to SAalpha2,6Gal recognition is thought to be one of the changes that must occur before avian influenza viruses can replicate efficiently in humans and acquire the potential to cause a pandemic. By identifying mutations in the receptor-binding haemagglutinin (HA) molecule that would enable avian H5N1 viruses to recognize human-type host cell receptors, it may be possible to predict (and thus to increase preparedness for) the emergence of pandemic viruses. Here we show that some H5N1 viruses isolated from humans can bind to both human and avian receptors, in contrast to those isolated from chickens and ducks, which recognize the avian receptors exclusively. Mutations at positions 182 and 192 independently convert the HAs of H5N1 viruses known to recognize the avian receptor to ones that recognize the human receptor. Analysis of the crystal structure of the HA from an H5N1 virus used in our genetic experiments shows that the locations of these amino acids in the HA molecule are compatible with an effect on receptor binding. The amino acid changes that we identify might serve as molecular markers for assessing the pandemic potential of H5N1 field isolates.

An event-related potential study of recognition memory with and without retrieval of source

Abstract: Summary Event-related potentials (ERPs) were recorded during the test phase of a recognition memory task in two experiments. In both experiments subjects made initial old/new judgements to visually presented words, and for words judged old, indicated in which of two voices (male/female) the words had been heard at study. In the second experiment only, subjects had the option to signal that they were uncertain about the status of a test word. Two positive-going ERP effects differentiated the ERPs evoked by correctly recognized old worlds from those evoked by words correctly judged new. The two effects differed in their scalp topography and time course, and were both of greater magnitude in the ERPs evoked by recognized words for which a correct voice judgement was made. The findings are consistent with the view that multiple neural systems underlie the ability to recognize an item and to recall its study context. However, the findings offer little support for the view, articulated in certain ‘dual-process’ models of recognition memory, that recognition judgements with and without retrieval of study context depend upon qualitatively different memory processes or systems.

The quantitative measurement of organizational culture in health care: A review of the available instruments

Abstract: Health system reforms have until recently tended to focus primarily on structural change. The introduction of managed care in the United States (Miller and Luft 1997), the establishment of standard-setting bodies such as the National Institute for Clinical Excellence (Department of Health 1998) in the United Kingdom, the development of medical error reporting systems in Australia (Wilson et al. 1995), and the restructuring of primary care in the United Kingdom and Canada (Hutchison, Abelson, and Lavis 2001) are examples of this approach. However, recent studies show that structural changes alone do not deliver anticipated improvements in quality and performance in health care (Le Grand, May, and Mulligan 1998; Shortell, Bennett, and Byck 1998). As a result, we hear calls for “cultural transformation” to be wrought alongside structural change in order to deliver improvements in quality and performance. This call has been prominent in the United States (Institute of Medicine 2001) and also as a central component of the recent reforms of the National Health Service (NHS) in the United Kingdom (Department of Health 2000; 2002). A theory of organizational culture emerges from a combination of organizational psychology, social psychology, and social anthropology. The development of organizational culture as a subject of study can be seen as an elaboration of the human relations (Roethlisberger and Dickson 1939) and social systems approaches (Parsons 1977); which in turn developed as correctives to the scientific management techniques of Frederick Winslow (“Speedy”) Taylor, and his successor Frank B. Gilbreth. The study of organizations has been conducted from within various different theories or paradigms (Burrell and Morgan 1979). The term “organizational culture” first appeared in the academic literature in an article in Administrative Science Quarterly by Pettigrew (Pettigrew 1979; Hofstede et al. 1990)—though Jacques refers to the culture of a factory as early 1952 (Jacques 1952). Its constituent themes can be traced to earlier literature on organizational analysis. Pettigrew's own empirical study of a private British boarding school appears strongly influenced by Burton Clarke (Clarke 1970). Both trace the influence of the strong, idiosyncratic individuals who founded the organizations. This concern with the role of leaders and leadership in turn underlines the influence of Selznick's Leadership in Administration (Selznick 1957). Selznick distinguishes between two ideal types of enterprise: on the one hand, a rational instrumental organization and, on the other hand, the value-infused institution. According to Selznick, the term “organisation” suggests a technical instrument to harness human energies and direct them towards set aims, while the term “institution” suggests an organic social entity, or culture. Organizational culture has been variously defined (Ott 1989; Schein 1990; Davies, Nutley, and Mannion 2000). It denotes a wide range of social phenomena, including an organization's customary dress, language, behavior, beliefs, values, assumptions, symbols of status and authority, myths, ceremonies and rituals, and modes of deference and subversion; all of which help to define an organization's character and norms. Unsurprisingly in view of this diverse array of phenomena, little agreement exists over a precise definition of organizational culture, how it should be observed or measured, or how different methodologies can be used to inform routine administration or organizational change. While some commentators see the task in terms of specific and measurable variables, traits or processes, others see it as a global challenge to capture culture as an intrinsic property of the social milieu that forms whenever people are brought together in common enterprise. A third approach sees organizational culture as an anthropological metaphor or a paradigm (Burrell and Morgan 1979; Burrell 1996) to analyze organizations as microsocieties (Morgan, Frost, and Pondy 1983; Smircich 1983; Morgan 1986). According to Edgar Schein, Organizational culture is the pattern of shared basic assumptions—invented, discovered, or developed by a given group as it learns to cope with its problems of external adaptation and internal integration—that has worked well enough to be considered valid and, therefore, to be taught to new members as the correct way to perceive, think, and feel in relation to those problems (Schein 1985a). This definition captures one of the basic challenges faced by any culture to reconcile the often divergent aims and actions of its members. It also points to the difficulty of addressing that challenge. Its emphasis on the role of shared basic assumptions influencing beliefs and behavior suggests that organizational culture denotes much more than just “the way things are done around here” (Davies, Nutley, and Mannion 2000). Changing the way things are done appears, on the functional level of systems redesign, relatively easy. Attempting to understand why things are done in their distinctive ways, the factors underlying resistance to change attempts, and the extent to which new practices are sustained is far more challenging. To successfully engender change in organizational behavior we need to understand the collective thought processes informing that behavior at both conscious and unconscious levels. This is where a deeper analysis and understanding of organizational culture may be productive. Advocates of strategic cultural change typically make a number of implicit assumptions. First, health organizations possess discernible cultures, which affect quality and performance. Second, although cultures may be resistant to change, they are to some extent malleable and manageable. Third, it is possible to identify particular cultural attributes that facilitate or inhibit good performance and it should therefore be feasible for managers to design strategies for cultural change. Finally, it is assumed that any benefits accruing from the change will outweigh any dysfunctional consequences. Although there is as yet little empirical evidence to support these assumptions, some academics and many policymakers are showing renewed interest in the quantitative measurement of organizational culture in order to determine its relationship with performance and quality of care (Davies, Nutley, and Mannion 2000; Shortell et al. 2000; Shortell et al. 2001). A range of tools designed to measure organizational culture have been developed and applied in industrial, educational, and health care settings over the last two decades. In this paper we describe the results of an extensive review of these instruments and examine their usefulness for health service researchers. The review forms part of a larger study into the relationship between organizational culture and the performance of health organizations (Scott et al. 2001, In press).