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To investigate whether there are different antecedents and consequences of different types of therapist questions as this has implications for conducting psychotherapy and for training therapists.We examined the antecedents and consequences of questions for 88 clients working with 33 doctoral student therapists in psychodynamic psychotherapy. Questions were coded into open questions for thoughts (OQT), open questions for feelings (OQF), closed questions for facts (CQF), and closed questions other (CQO). The antecedents and consequences were assessed in terms of self-referring pronouns (SRP), self-referring emotion words (SRE), and number of words.In terms of antecedents, when clients were using a high number of SRP, therapists were more likely to ask OQT and CQO than CQF. When clients were using a high number of SRE, therapists were more likely to ask OQF than CQF. In terms of consequences, clients spoke less after CQF than the other three skills, used fewer SRP after CQF than after CQO, and used more SRE after OQF than CQF.CQO were more similar in terms of antecedents and consequences to OQT and OQF than to CQF.

The Purdue Pegboard Test is a manual dexterity test that requires the manipulation of pegs, washers, and collars. Our population for this research study focused on the geriatric community owing to the lack of recent available normative data.The purpose of this study was to provide updated normative data for hand therapists to use in clinical practice to determine if seniors have dexterity deficits.This is a cohort study.This study was completed through a convenience sample which included 128 participants. Participants were stratified into three age groups (60-69, 70-79, and 80+). Participants were asked to complete the Purdue Pegboard Test. Mean scores were analyzed using an independent-sample t-test and one-way analysis of variance to compare the mean scores of each designated age group.A one-way analysis of variance reported statistically significant differences between the 3 age groups (F = 15.03, P .00). The results supported that those individuals who were younger (60-69) scored better on the assessment than those aged 80+ years. There was not a statistically significant difference between PPT mean scores of males and females.Mean scores for the PPT for community-dwelling seniors were established.The findings from this study support that dexterity may decline with age, which can affect occupational performance over time.

Glucocorticoids (GCs) have unparalleled anti-inflammatory and immunosuppressive properties, which accounts for their widespread prescription and use. Unfortunately, a limitation to GC therapy is a wide range of negative side effects including Cushing's syndrome, a disease characterized by metabolic abnormalities including muscle wasting and osteoporosis. GC-induced osteoporosis occurs in 30% to 50% of patients on GC therapy and thus, represents an important area of study. Herein, we characterize the molecular and physiologic effects of GC-induced osteoporosis using the Cushing's mouse model, the corticotropin releasing hormone (CRH) transgenic mouse (CRH-Tg). The humeri, femurs, and tibias from wild-type (WT) and CRH-Tg male mice, aged 13 to 14 weeks old were subjected to multiple bone tests including, micro-computed tomography (μCT), static and dynamic histomorphometry, strength testing, and gene expression analyses. The CRH-Tg mice had a 38% decrease in cortical bone area, a 35% decrease in cortical thickness, a 16% decrease in trabecular thickness, a sixfold increase in bone adiposity, a 27% reduction in osteoid width, a 75% increase in bone-resorbing osteoclast number/bone surface, a 34% decrease in bone formation rate, and a 40% decrease in bone strength compared to WT mice. At the gene expression level, CRH-Tg bone showed significantly increased osteoclast markers and decreased osteoblast markers, whereas CRH-Tg muscle had increased muscle atrophy gene markers compared to WT mice. Overall, the CRH-Tg mouse model aged to 14 weeks recapitulated many features of osteoporosis in Cushing's syndrome and thus, represents a useful model to study GC-induced osteoporosis and interventions that target the effects of GCs on the skeleton. © 2017 The Authors. JBMR Plus is published by Wiley Periodicals, Inc. on behalf of the American Society for Bone and Mineral Research.

The glucocorticoid receptor (GR) represents the crucial molecular mediator of key endocrine, glucocorticoid hormone-dependent regulatory circuits, including control of glucose, protein, and lipid homeostasis. Consequently, aberrant glucocorticoid signaling is linked to severe metabolic disorders, including insulin resistance, obesity, and hyperglycemia, all of which also appear upon chronic glucocorticoid therapy for the treatment of inflammatory conditions. Of note, long-term glucocorticoid exposure under these therapeutic conditions typically induces glucocorticoid resistance, requiring higher doses and consequently triggering more severe metabolic phenotypes. However, the molecular basis of acquired glucocorticoid resistance remains unknown. In a screen of differential microRNA expression during glucocorticoid-dependent adipogenic differentiation of human multipotent adipose stem cells, we identified microRNA 29a (miR-29a) as one of the most down-regulated transcripts. Overexpression of miR-29a impaired adipogenesis. We found that miR-29a represses GR in human adipogenesis by directly targeting its mRNA, and downstream analyses revealed that GR mediates most of miR-29a's anti-adipogenic effects. Conversely, miR-29a expression depends on GR activation, creating a novel miR-29-driven feedback loop. miR-29a and GR expression were inversely correlated both in murine adipose tissue and in adipose tissue samples obtained from human patients. In the latter, miR-29a levels were additionally strongly negatively correlated with body mass index and adipocyte size. Importantly, inhibition of miR-29 in mice partially rescued the down-regulation of GR during dexamethasone treatment. We discovered that, in addition to modulating GR function under physiologic conditions, pharmacologic glucocorticoid application in inflammatory disease also induced miR-29a expression, correlating with reduced GR levels. This effect was abolished in mice with impaired GR function. In summary, we uncovered a novel GR-miR-29a negative feedback loop conserved between mice and humans, in health and disease. For the first time, we elucidate a microRNA-related mechanism that might contribute to GR dysregulation and resistance in peripheral tissues.-Glantschnig, C., Koenen, M., Gil-Lozano, M., Karbiener, M., Pickrahn, I., Williams-Dautovich, J., Patel, R., Cummins, C. L., Giroud, M., Hartleben, G., Vogl, E., Bluher, M., Tuckermann, J., Uhlenhaut, H., Herzig, S., Scheideler, M. A miR-29a-driven negative feedback loop regulates peripheral glucocorticoid receptor signaling.

The growing importance of ethical shopping motives offers a major advantage to retailers who understand their significance in store choice decisions compared with other conventional store image influences, particularly with regard to any variations that exist between different shopper types. This study uses an exploratory two-phase integrative qualitative and quantitative research design to identify a preliminary classification of ethical shopper types. Three ethical and three store image factors emerge as relevant to the decision-making of ethical shoppers through the development of appropriate scales. Building from these factors, subsequent cluster analysis defines four distinct ethical shopper types: demanders, mavens, dissenters, and apathetics. The degree of emphasis given to ethical and other store choice factors exemplify differences among these segments. The article discusses the utility of the resultant classification in terms of research and retail strategy including opportunities for targeting through adjustment of the retail offer.

PurposeThe purpose of this paper is to identify, and explore the importance of, ethical and socially responsible (ESR) factors in Australian consumers' choices of grocery products and stores.Design/methodology/approachFollowing an earlier study in the UK, an initial qualitative investigation, then a survey of grocery shoppers in New South Wales, was conducted. Factor analysis explored the structure of the choice factors for grocery products and stores in “main” and “top‐up” shopping situations. Finally, four multiple regression equations measured the effects of these factors.FindingsThis paper finds that, when “top‐up” shopping, ESR consumers are less discriminating than when “main” shopping. The provision of ethically farmed produce has most influence on store choice when “main” shopping, while retailers' fair trading and environmentally responsible policies have the greatest influence when “topping‐up”. The ethical provenance of goods is the most important factor in product choice.Research limitations/implicationsThe constructs developed need to be validated internationally.Practical implicationsThe two large Australian retail grocers may benefit by developing roles as “choice editors” on behalf of their ESR customers; whilst smaller retailers may gain advantage by concentrating on community‐based, environmentally friendly and fair trading policies. Manufacturers of grocery products may benefit by emphasizing their products' ESR provenance and their organisations' ethical policies.Originality/valueThis is the first study of its kind in Australia. It contributes to the development of an internationally relevant set of ESR shopping choice factors.

Objective: This research aimed to evaluate the effectiveness of the Rural Student Recruitment (RSR) program. This program was an initiative to address the low number of rural students enrolled in medicine at the University of Western Australia. RSR identifies students throughout rural and remote areas of Australia interested in pursuing a career in medicine. The program provides support to these students through the various stages of the selection process and subsequently through the course. Setting: Medical School, the University of Western Australia. Participants: Rural students enrolled in medicine at the University of Western Australia. Results: Of the 1591 participants in the RSR program, 11.6% have been successful in being offered a place. Participation was consistently higher for women, although men were proportionately more successful at gaining entry (14.5% versus 10.4%). It was found that the distribution of successful students in the RSR program generally reflects population density across rural Western Australia, with the majority of students coming from the South West, and the minority from the Pilbara and Kimberley. However, over the last three years (2006–2008) an increase in access from very remote regions was noted. This has been associated with a modification to the entry process that now includes a remoteness weighting for the secondary school attended. Conclusions: The conclusion from this analysis was that the RSR program in concert with refinements in entry criteria has been effective in increasing the number of medical students from a rural background.

Given the growing importance of ethical and socially responsible (ESR) issues in retailing, this research uses empirical evidence from the UK grocery sector to investigate the significance of these factors on shoppers' store and product choice decisions. A number of different ESR shopping motivations are identified including global and local issues in store decisions, together with product heritage, animal and human rights, and advertising and communications issues in product decisions. Results suggest that both ESR and other influences are important in explaining shopping intentions, and that these vary according to shopping occasion, particularly whether the shopper is undertaking a main or top-up shop. Whilst in some circumstances ESR motives remain paramount to the decision, in others shoppers are prepared to forgo some element of this to overcome situational imperatives. Customer service, product quality and promotions are important motivators of shoppers even when they are looking for ethical and so...

PurposeTo draw together the diverse and diffuse elements of previous research into the determinants of success in export marketing by SMEs.Design/methodology/approachGroups of export marketing activities derived from the literature and preliminary qualitative fieldwork were incorporated in a questionnaire‐based survey of a purposive sample of small exporters in one region of the UK, measuring the frequency of their use against levels of export commitment, involvement, and experience.FindingsResults contradict the traditional view that the longer a company has been exporting, the more likely it is to do well. The study provides evidence to encourage ambitious exporting SMEs to develop active and on‐going marketing and information‐gathering activities, and to dedicate specific financial and human resources to exporting.Research limitations/implicationsThe highly focused approach to measuring the relationships between export marketing activities and company characteristics should ideally be further extended, in the context of a wide range of studies relating other organizational, managerial and environmental variables to export success.Practical implicationsThe findings and conclusions alert marketing intelligence‐gatherers to the dangers of conventional assumptions about marketing practice, provide practical guidelines for planners of export marketing strategy, and could form the basis of an easily administered diagnostic tool, all in the SME context.Originality/valueFocusing on behaviour rather than attitudes, the research provides a practical set of criteria against which SME activities can be measured.

PurposeDespite growing awareness of ethical and social responsibility (E&SR) issues in academia and industry, investigation of their influence on consumers' buying decisions has been limited. To help fill this gap, this paper reports the findings of a preliminary investigation to establish the key E&SR factors affecting grocery shopping behaviour.Design/methodology/approachThe study drew upon existing literature in the areas of ethics, social responsibility, shopping and store image to identify the individual elements of E&SR. An exploratory qualitative study of E&SR consumers (E&SRC) was then conducted, using seven focus groups, and a typology of key factors of concern to these consumers was derived from analysis.FindingsThe findings identify seven core categories, containing seventy‐one sub‐categories. These interlink to form three main clusters: food quality and safety, human rights and ethical trading, and environmental (green) issues. Shoppers trade off these E&SR factors against standard retail purchasing factors, in particular convenience, price and merchandise range when deciding which shops to use and what products to buy.Research limitations/implicationsThe typology derived from this exploratory research may be used alongside conventional store image factors in future research, to help predict those factors that influence purchasing behaviour. Similarly, it may assist brand and retail managers in profiling, and meeting the needs of, E&SRC.Originality/valueThe research distinguishes differences in how shopper types vary in their behaviour, and proposes a set of implications for managers of the research and areas for further investigation.

Within the academic literature there is general acceptance that customer knowledge competence can have a critical influence over whether a firm can successfully achieve a market advantage over competition. There is, however, only limited empirical evidence to support this perspective. This study utilises a previously developed customer knowledge survey tool to compare knowledge management practices within small relationship orientated accountancy practices and small, transactionally orientated firms. The survey was undertaken across a sample of small UK accountancy practices. Results suggest that compared to their transactional counterparts, small relationship orientated firms perceive that customer knowledge is an important aspect of the marketing process. Small, relationship orientated practices also appear to recognise the importance of operating a structured knowledge management system within their organisations.

This article presents the results of qualitative and quantitative investigations into the international background and language skills of export managers in small and medium-sized enterprises (SMEs), and their export marketing intelligence behaviour. In doing so, it attempts to shed light on the relationship between these two sets of factors, both of which have been identified as affecting export performance. At the quantitative stage, non-parametric statistical analyses were used to identify profiles of export managers’ information gathering, information use and decision-making activities, based on their linguistic ability, their experience of working or living overseas and their exporting experience. The research provides guidelines for SME employers who wish to match export managers’ market intelligence styles with their firms’ overseas market objectives.

This study focuses on the use of export marketing information in small and medium‐sized enterprises (SMEs), an area that has previously attracted little academic research attention. It reports on the application of scales measuring instrumental/conceptual and symbolic export information use, using a random sample of UK exporters, to SME exporters of engineering and IT products. The results show that the scales are applicable within the specific context of the industrial SMEs surveyed and that levels of symbolic export information use are higher in these SMEs than in UK exporting companies as a whole. The latter is explained as a function of a shortfall in two areas: first, in available export marketing information, leading to greater dependence on “guesswork” and intuition; and second, in specialist marketing information‐processing skills on the part of SME export decision makers. The article concludes by appealing for an extension of export support for SMEs, to include the use of export information as well as simply its acquisition. It suggests that the scales tested here could be used both to diagnose the need for such SME support and to measure its effectiveness.

The glucocorticoid receptor (GR) was one of the first nuclear hormone receptors cloned and represents one of the most effective drug targets available today for the treatment of severe inflammation. The physiologic consequences of endogenous or exogenous glucocorticoid excess are well established and include hyperglycemia, insulin resistance, fatty liver, obesity, and muscle wasting. However, at the molecular and tissue-specific level, there are still many unknown protein mediators of glucocorticoid response and thus, much remains to be uncovered that will help determine whether activation of the GR can be tailored to improve therapeutic efficacy while minimizing unwanted side effects. This review summarizes recent discoveries of tissue-selective modulators of glucocorticoid signaling that are important in mediating the unwanted side effects of therapeutic glucocorticoid use, emphasizing the downstream molecular effects of GR activation in the liver, adipose tissue, muscle, and pancreas.

Madam Justice Elaine Adair of the BC Supreme Court has begun hearing a class-action lawsuit involving 7000 doctors, including the province’s former health minister, who are trying to recover fees they claim British Columbia owes them. Dr. James Halvorson, the lead plaintiff in the lawsuit, is