The extent of recent misconduct in retail financial services questions assumptions that mis-selling is perpetrated by rogue traders dealing in sub-prime markets. Yet we know little about the ...organizational dimensions of mis-selling and specifically how new employees are introduced to and subsequently enact mis-selling behaviour when not explicitly encouraged to do so. This article seeks to understand the mechanics of mis-selling through an ethnographic account of the opening of a new retail financial services call centre, and analysis of the ritual nature of the sales interaction. The study documents the training, induction and initial work of direct sales agents to better understand the complexity, social relations and organization of mis-selling, together with the way in which regulation and management regimes shape sales practice and consequent employee behaviour. The critical analysis of sales rituals allows us to explain how mis-selling becomes embedded in organizational practice and contributes to our understanding of the everydayness of mis-selling in contrast to approaches that focus either on individual decision-making or on cultural explanations.
Unhelpful thoughts and feelings of worry or despair about symptoms account for a notable amount of the variation in musculoskeletal symptom intensity. Specialists may be best positioned to diagnose ...these treatable aspects of musculoskeletal illness. Musculoskeletal specialists might be concerned that addressing mental health could offend the patient, and avoidance might delay mental health diagnosis and treatment. Evidence that conversations about mental health are not associated with diminished patient experience might increase specialist confidence in the timely diagnosis and initial motivation to treat unhelpful thoughts and feelings of worry or despair.
Using transcripts of videotaped and audiotaped specialty care visits in which at least one instance of patient language indicating an unhelpful thought about symptoms or feelings of worry or despair surfaced, we asked: (1) Is clinician discussion of mental health associated with lower patient-rated clinician empathy, accounting for other factors? (2) Are clinician discussions of mental health associated with patient demographics, patient mental health measures, or specific clinicians?
Using a database of transcripts of 212 patients that were audio or video recorded for prior studies, we identified 144 transcripts in which language reflecting either an unhelpful thought or feelings of distress (worry or despair) about symptoms was detected. These were labeled mental health opportunities. Patients were invited on days when the researcher making video or audio records was available, and people were invited based on the researcher's availability, the patient's cognitive ability, and whether the patient spoke English. Exclusions were not tracked in those original studies, but few patients declined. There were 80 women and 64 men, with a mean age of 45 ± 15 years. Participants completed measures of health anxiety, catastrophic thinking, symptoms of depression, and perceived clinician empathy. Factors associated with perceived clinician empathy and clinician discussion of mental health were sought in bivariate and multivariable analyses.
Greater patient-rated clinician empathy was not associated with clinician initiation of a mental health discussion (regression coefficient 0.98 95% confidence interval 0.89 to 1.1; p = 0.65). A clinician-initiated mental health discussion was not associated with any factors.
The observation that a clinician-initiated mental health discussion was not associated with diminished patient ratings of clinician empathy and was independent from other factors indicates that generally, discussion of mental health does not harm patient-clinician relationship. Musculoskeletal clinicians could be the first to notice disproportionate symptoms or misconceptions and distress about symptoms, and based on the evidence from this study, they can be confident about initiating a discussion about these mental health priorities to avoid delays in diagnosis and treatment. Future studies can address the impact of training clinicians to notice unhelpful thoughts and signs of distress and discuss them with compassion in a specialty care visit; other studies might evaluate the impact of timely diagnosis of opportunities for improvement in mental health on comfort, capability, and optimal stewardship of resources.
Brand scholarship traditionally resides within the marketing literature and focuses on organizations’ external relationships with customers. However, increasing critical attention in organization ...studies has focused on the brand in order to understand its impact on the internal dynamics of employment relations in contemporary organizations. Drawing on an ethnography of frontline service work in an IT consultancy call centre, we explore the brand as an internal organizational resource sustaining the process of employee meaning-making activities. Documenting the ‘work of the brand’, we outline what the brand offers both employees and employers and, in doing so, we theorize the brand at work as a connecting mechanism between processes of identity formation/re-formation and regulation. While employees are encouraged to internalize particular brand meanings (in this case prestige, success and quality), we found that they often willingly buy into these intended brand meanings as a palliative to ‘cope’ with mundane work. In this way brand meanings are central to producing a self-disciplining form of employee subjectivity.
Redox-active tetraoxolene ligands such as 1,4-dihydroxybenzoquinone provide access to a diversity of metal-organic architectures, many of which display interesting magnetic behavior and high ...electrical conductivity. Here, we take a closer look at how structure dictates physical properties in a series of 1D iron-tetraoxolene chains. Using a diphenyl-derivatized tetraoxolene ligand (H
2
Ph
2
dhbq), we show that the steric profile of the coordinating solvent controls whether linear or helical chains are exclusively formed. Despite similar ligand environments, only the helical chain displays temperature-dependent valence tautomerism, switching from (Fe
II
)(Ph
2
dhbq
2−
) to (Fe
III
)(Ph
2
dhbq
3
&z.rad;
−
) at temperatures below 203 K. The stabilization of ligand radicals leads to exceptionally strong magnetic exchange coupling (
J
= −230 ± 4 cm
−1
). Meanwhile, the linear chains are more amenable to oxidative doping, leading to Robin-Day class II/III mixed-valency and an increase in electrical conductivity by nearly three orders of magnitude. While previous studies have focused on the effects of changing metal and ligand identity, this work highlights how altering the metal-ligand connectivity can be a similarly powerful tool for tuning materials properties.
Here we show how a simple change in the geometry of 1D iron-tetraoxolene chains dramatically alters the observed physical properties, including the presence of valence tautomerism, strong magnetic coupling, and electrical conductivity.
Summary
Background
Airway hyperresponsiveness (AHR) to stimuli that cause bronchial smooth muscle (BSM) contraction indirectly through the release of endogenous mediators is thought to reflect airway ...inflammation more closely compared with AHR measured by stimuli that act directly on BSM.
Methods
Fifty‐three adult non‐smoking asthmatics (28 females, 18–56 years) who were not taking inhaled steroids were challenged with mannitol (up to 635 mg) and methacholine (up to 8 μmol). Induced sputum eosinophils, exhaled nitric oxide (eNO), peak flow variation and clinical severity of asthma according to the Global Initiative for Asthma guidelines were measured in addition to the health‐related quality‐of‐life score using the Juniper asthma quality‐of‐life questionnaire.
Findings
Both AHR to mannitol as well as to methacholine was associated with elevated markers of airway inflammation: in 83% of asthma patients with AHR to mannitol, and in 88% of asthma patients with AHR to methacholine, the eNO level was >20 p.p.b. Sputum% eosinophils >1% was measured in 70% of asthma patients with AHR to mannitol and in 77% of asthma patients with AHR to methacholine. In asthma patients without AHR, 15% had an eNO level >20 p.p.b., but none had sputum% eosinophils >1%. AHR to mannitol was more closely associated with the percentage of sputum eosinophils (PD15 to mannitol vs. sputum% eosinophils: r: −0.52, P<0.05), compared with AHR to methacholine (PD20 to methacholine vs. sputum% eosinophils: r: −0.28, NS). Furthermore, there was a stronger correlation between AHR to mannitol and the level of eNO PD15 to mannitol vs. eNO (p.p.b.): r: −0.63, P<0.001, compared with AHR to methacholine PD20 to methacholine vs. eNO (p.p.b.): r: −0.43, P<0.05.
Interpretation
In asthma patients not being treated with steroids, AHR to mannitol and to methacholine indicated the presence of airway inflammation. AHR to mannitol reflected the degree of airway inflammation more closely when compared with methacholine.
EGF-like domain 7 (EGFL7) is a secreted protein and recently has been shown to play an important role in acute myeloid leukemia (AML); however, the underlying mechanism by which EGFL7 promotes ...leukemogenesis is largely unknown.
Using an antibody interaction array, we measured the ability of EGFL7 to bind directly approximately 400 proteins expressed by primary AML blasts. Primary patient samples were stimulated
with recombinant EGFL7 (rEGFL7) or anti-EGFL7 blocking antibody to assess alterations in downstream signaling and the ability to effect blast differentiation and survival. We treated three independent AML models with anti-EGFL7 or IgG1 control to determine whether anti-EGFL7 could prolong survival
.
We found EGFL7 significantly binds several signaling proteins important for normal and malignant hematopoiesis including NOTCH. Stimulation of AML blasts with rEGFL7 reduced NOTCH intracellular domain and NOTCH target gene expression while treatment with an anti-EGFL7 blocking antibody resulted in reactivation of NOTCH signaling, increased differentiation, and apoptosis. Competitive ligand-binding assays showed rEGFL7 inhibits DELTA-like (DLL) 4-mediated NOTCH activation while anti-EGFL7 combined with DLL4 significantly increased NOTCH activation and induced apoptosis. Using three different AML mouse models, we demonstrated that
treatment with anti-EGFL7 alone results in increased survival.
Our data demonstrate that EGFL7 contributes to NOTCH silencing in AML by antagonizing canonical NOTCH ligand binding. Reactivation of NOTCH signaling
using anti-EGFL7 results in prolonged survival of leukemic mice, supporting the use of EGFL7 as a novel therapeutic target in AML.
Summary
Asthma is a chronic inflammatory disease of the airways characterized by physiological abnormalities of variable airflow obstruction and airway hyperresponsiveness (AHR) to a wide variety of ...physical and inhaled chemical stimuli and the presence of symptoms. AHR is measured by challenging the airways with a variety of agonists and naturally occurring stimuli, which results in constriction of the airway smooth muscle, leading to airway narrowing and airflow limitation. There are two distinct mechanisms by which the airways can narrow to a constrictor stimulus and these are defined by the pathways they take to induce AHR. Direct stimuli are pharmacological agents administered exogenously (such as histamine or methacholine) that act ‘directly’ on specific receptors on the bronchial smooth muscle to cause constriction. The other mechanism by which the airway can narrow is via the inhalation of indirect stimuli, which include natural stimuli, such as allergen or exercise, and pharmacological agents such as adenosine monophosphate and hyper‐osmotic agents (e.g. hypertonic saline or dry powder mannitol). These stimuli induce airway narrowing ‘indirectly’ by causing the endogenous release of mediators of bronchoconstriction from airway inflammatory cells. Provoked models of asthma have been extremely valuable in understanding the pathobiology of asthma, in aiding diagnosis, in helping to clarify the mechanisms of actions of effective drugs and in the development of new entities to treat asthma. Some provoked models are valuable clinically, particularly those that measure direct AHR, while others, particularly allergen challenge, have been used in animal models and in humans to study the mechanisms of allergen‐induced airway inflammation and the associated physiological changes, as well in the development of new drugs for asthma. An emerging role for measurements of AHR is in the evaluation of the optimal treatment for patients with asthma.
This paper examines how employer branding is used and embedded through the organizational HR practices; specifically recruitment, selection and integration. The paper adds to the growing literature ...on employer branding by specifically focussing upon concrete HR practices, which are often left unexplored in contemporary accounts of branding practices. Our research question is to explore the specific role that these practices play in the enactment of employer branding and assess their implications. Moreover, in order to better understand the wider significance of employer branding, scholarship needs to explore these processes in contexts where brand recognition is less prevalent. Drawing on a large multi-national organization (CollinaTrade) involved in the provision of products and services in the construction industry, the organization's minimalist focus on consumer brands makes them a useful case study for evaluating the work of employer branding outside consumer facing industries. This paper points to the significance of viewing employer branding as a management tool in terms of cultural reinforcement and symbolic representations at work and the way in which this work through HR practices. Our data shows that the logic of employer branding in contexts where the brand is less significant, is essentially contradictory, requiring both individualism and uniformity which may have a greater impact on workplace identities than previously thought.
The aim of this study was to investigate if mannitol inhalation, as a model of exercise-induced bronchoconstriction (EIB), causes mast cell activation and release of mediators of bronchoconstriction. ...Urinary excretion of previously identified mediators of EIB was investigated in association with mannitol-induced bronchoconstriction. Twelve asthmatic and nine nonasthmatic subjects inhaled mannitol and urine was collected 60 min before and for 90 min after challenge. The urinary concentrations of leukotriene (LT)E4, the prostaglandin (PG)D2 metabolite and the mast cell marker 9alpha,11beta-PGF2 were measured by enzyme immunoassay. N(tau)-methylhistamine was measured by radioimmunoassay. In asthmatic subjects, inhalation of a mean+/-SEM dose of 272+/-56 mg mannitol induced a reduction in forced expiratory volume in one second (FEV1) of 34.5+/-2.1%. This was associated with increases in urinary 9alpha,11beta-PGF2 (91.9+/-8.2 versus 66.9+/-6.6 ng x mmol creatinine(-1), peak versus baseline) and LTE4 (51.3+/-7.5 versus 32.9+/-4.7). In nonasthmatic subjects, the reduction in FEV1 was 1.0+/-0.5% after inhaling 635 mg of mannitol. Although smaller than in the asthmatics, significant increases of urinary 9alpha,11beta-PGF2 (68.4+/-6.9 versus 56.0+/-5.8 ng x mmol creatinine(-1)) and LTE4 (58.5+/-5.3 versus 43.0+/-3.3 ng x mmol creatinine(-1)) were observed in the nonasthmatic subjects. There was also a small increase in urinary excretion of N(tau)-methylhistamine in the nonasthmatics, but not in the asthmatics. The increased urinary levels of 9alpha,11beta-prostaglandin F2 support mast cell activation with release of mediators following inhalation of mannitol. Increased bronchial responsiveness to the released mediators could explain the exclusive bronchoconstriction in asthmatic subjects.
This paper is a study of fluctuations in the U.S. gross domestic product (GDP) around locally defined balanced growth paths. In an uncertain environment, we extend the Solow model of economic growth ...to allow for capital dependent saving, and time delay between output and planned capital investment. Modeling saving rate as a sigmoid function of capital in effect inserts a positive feedback loop into the dynamics. As a consequence, time periods of positive and negative fluctuations about balanced growth paths are prolonged compared to corresponding fluctuations that would occur in the absence of the feedback loop. We first formulate and analyze the model in continuous time and then follow up with a discrete time approximation. Using data derived from the GDP, we estimate parameters by minimizing one-step-ahead prediction error while simultaneously matching second order statistics of the approximation to second order statistics of the data. In the model’s dynamic stationary state, business cycles occur naturally as excursions of bounded random walks from balanced growth paths where the random walks themselves consist of sums of correlated random variables. Linearization of the model about a balanced growth path yields a method for representing fluctuations in growth data as a superposition of three processes that evolve on different time scales—slow, intermediate, and fast. The resulting frequency based decomposition reveals a natural, slow time ebb and flow in output that can be used to predict future growth trends in the economy.
•A modified Solow model that reveals structure in GDP fluctuations.•Gives a mathematical explanation for business cycles.•Time scales are identified in a discrete approximation.•Gives a time scale based method for forecasting economic growth.
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