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Objective: Unlike excisional haemorrhoidectomy, stapled anopexy (SA), which does not involve radical excision, has theoretical advantages, thus offering potential patient benefits. We compared the clinical efficacy, safety and patient acceptability of SA, with closed haemorrhoidectomy (CH). Patients and methods: 182 patients with symptomatic haemorrhoids (grades II, III, IV) were randomly assigned to receive SA or CH and were followed for up to 1 year (6, 12, 24, 48 weeks) after operation. Postoperative pain, symptom control, complications, re-treatment rates, patient satisfaction, and quality of life were compared on an intention-to-treat basis. Results: Postoperative pain in the SA group (n = 91) was significantly lower (p = 0.004, Mann–Whitney U test). At 1 year there were no significant differences in the symptom load, symptom severity or the disease severity between the two groups. Overall complication rates were similar but faecal urgency was reported more frequently following SA (p = 0.093, Fisher’s exact test). Despite a similar rate of residual symptoms, prolapse control was better with CH (p = 0.087, Fisher’s exact test), and more patients in the SA group required re-treatment for residual prolapse at 1 year (p = 0.037, Fisher’s exact test). However, more patients rated SA as an excellent operation at 6 and 12 weeks (p = 0.008 and 0.033, binary logistic regression) and were willing to undergo a repeat procedure if required (p = 0.018, Fisher’s exact test). Conclusion: Stapled anopexy offers a significantly less painful alternative to excisional haemorrhoidectomy and achieves a higher patient acceptability. Although the overall symptom control and safety are similar in the majority of the patients, the re-treatment rate for recurrent prolapse at 1 year is higher following SA when compared to CH.

The integration of a comprehensive monitoring programme conducted in a temperate woodland through statistical analysis and simulation modelling is presented here. The Heron Wood Reserve in Peebleshire, Scotland is a 7.5-ha wood, left untended to facilitate investigation into a natural Scottish Woodland Ecosystem. Data on fungal fruiting have been collected since 1994, and since November 2000 physico-chemical and biotic experiments on soil and woodland litter have also been conducted with the aim to construct and integrate a number of simulation submodels of the various ecological systems present in an untended Scottish woodland. Important systems for modelling include patterns of fungal succession, habitat characteristics and fungal biochemical patterns. A large volume of data has been collected so computer software is used for the storage and handling of data. Microsoft Access was the database used for storage; integration of functions available in Microsoft Excel with a customised software written in Microsoft Visual Basic and Microsoft VBA allowed various statistical modelling tests (e.g. Scheffe analysis of contrast) to be carried out, and the quick display of data in a suitable manner. Model Maker software is used to construct and test simulation models formulated from the data and ultimately to facilitate the running of various simulations. Integration of the separate lines of investigation is demonstrated on the example of a case study describing differences in the dynamics of decomposers in beech- and birch-dominated habitats. Integration of the information obtained allowed us to put forward the following hypothesis. The leaf litter produced by beech trees is of lower quality compared to birch, and decomposition in beech-dominated habitats is delayed (i.e. in comparison to birch-dominated) because of the differences in the extent to which these plants create and maintain a litter and humus layer ( sensu Wardle, Communities and Ecosystems. Linking the Aboveground and Belowground Components, Princeton University Press, Princeton, 2002). Hence, the decomposition in beech-dominated habitats mainly occurs somewhat deeper in the soil profile, and may be carried out with some considerable involvement of ectomycorrhizal fungi. The correct understanding of the site-specific peculiarities of the ecological patterns is important for the improvement of biodiversity of woodland and forest ecosystems both in Scotland and worldwide.

A previous qualitative study [Nurse Education Today 20 (2000) 499] investigated perceptions of nurse teachers, student nurses and preceptors of the theory-practice gap said to exist within nursing. One theme was views of how the theory-practice gap could be closed. A subsequent quantitative study is reported here, in which this theme was translated into three factors. A full factorial experimental design was used to study the effect of these factors on theoretical knowledge and practical skill acquisition in a sample of first year undergraduate student nurses from one institution of higher education (n=19). The effect of whether a nurse teacher or preceptor taught students theoretical elements relating to a clinical specialty, whether the nurse teacher and preceptor collaborated on the content of what was taught to students and whether students went straight to, or delayed the clinical specialty following theoretical input, was examined. The results demonstrated preceptors were more effective than nurse teachers in promoting theoretical knowledge relating to their clinical specialty. Collaboration between the preceptors and nurse teachers on teaching content was ineffective at increasing theoretical knowledge. Delay between theoretical input and clinical experience was not detrimental for medical placements and for rehabilitation placements, resulted in an improved theoretical knowledge.

Although international retailing has received increased research attention in recent years, there have been few contributions to the academic literature on the supply chain implications of the internationalization process or the variations in logistics networks in different geographical markets. This paper seeks to explore such variations by providing a taxonomy of European grocery distribution networks through the use of cluster analysis on 18 logistics-related variables applied to 10 country markets. The results show that the grocery retail market in Europe continues to exhibit significant differences at the country level. Similarities exist on several variables but there is a high degree of variability between country clusters on the three sub-sets of market structure, trading format and physical/socio-economic infrastructure.

The article sets out a process describing the links between the breach of psychological contracts and the resistance to strategic and organizational change. When organizations fail to respect employee interests, the low-trust relationships and levels of cynicism that invariably result severely constrain the potential for effective strategic change. Employee perceptions of breach of their psychological contracts over issues such as pay, communications and development were associated with lower levels of job satisfaction and organizational commitment. Lack of job security was a major influence on the quality of trust relations in the organizations and also became an important factor in influencing employee cynicism. The case study draws on data from a study of a Scottish industrial textiles firm. For practitioners, the principal lesson to be learned is that the frequent introduction of programmes of change, far from signalling to employees an image of an innovative management team, can produce the opposite reaction where managers are viewed as incompetent and disrespectful of employees' talents and intellects. Copyright © 2000 John Wiley & Sons, Ltd.

A stochastic cellular automaton for modelling the dynamics of a two-species fungal microcosm is presented. The state of each cell in the automaton depends on the state of a predefined neighbourhood via a set of conditional probabilities derived from experiments conducted on pairwise combinations of species. The model is tested by detailed comparison with larger-scale experimental microcosms. By employing different hypotheses which relate the pairwise data to the conditional probabilities in the model, the nature of the local and non-local interactions in the community is explored. The hypothesis that the large-scale dynamics are a consequence of independent interactions between species in a local neighbourhood can be excluded at the 5% significance level. The form of the interdependencies is determined and it is shown that the outcome of the interactions at the local neighbourhood-scale depends on the community-scale patterning of individuals. The dynamics of the microcosm are therefore an emergent property of the system of interacting mycelia that cannot be deduced from a study of the components in isolation.

This study of a sample of firms based in a region of Scotland, examines the characteristics of organizations that are early adopters of management development methods. The survey results show that organizations that are early adopters of one or more of four fashionable management development techniques—open learning, computer‐assisted learning, action learning and outdoor management training—are also characterized by a sophisticated approach to human resource development and the use of other ‘high performance’ HRM practices. Such findings are consistent with the literature on innovation that points to rational‐technical factors influencing the decision‐making process of early adopter organizations in contrast to institutional factors such as social conformity that are more important in influencing late adopter organizations. However, the data also point to the limitations of using an early‐late stage adoption framework for the diffusion of techniques such as those used in management development.

The failure rate of small firms in the UK is high, but there is little reliable evidence as to what factors account for success or failure in small businesses. Lending organizations have adopted a set of criteria that they use to evaluate new business proposals. One lending organization sponsored a research project with the object of identifying whether a general set of competences could be found which were associated with effective performance in the region. Describes the setting up and findings of the research, and identifies the competences that were found.