Among black people, primary open-angle glaucoma is a major cause of irreversible blindness that is avoidable with early detection and treatment. This paper presents an account of a qualitative investigation, based on a phenomenological approach, into glaucoma awareness based on semi-structured interviews and focus groups with 48 African-Caribbean participants who were not receiving treatment from a hospital eye service. Data were analysed using manual and computerised methods to identify six themes: 'knowledge of glaucoma', 'glaucoma risk perception and heuristics', 'images of blindness', 'health accounts', 'glaucoma risk perception' and protection motivation theory and 'cultural context and individual differences'. Findings showed that while participants held positive attitudes to health promotion in general, these did not incorporate eye health. Factors such as family histories, where available, were very important in helping individuals to understand that glaucoma might affect them, and in what ways this might happen. Attitudes to blindness tended to reflect the notion of the blind person as a victim. The idea of taking action to prevent this happening hinged upon participants' perceptions of the credibility of both the source and the nature of the information they had received about glaucoma. It is anticipated that this study will help practitioners to understand the health beliefs of African-Caribbean patients with this condition and to assist in recruitment to further research on glaucoma pathogenesis and clinical outcomes in the African-Caribbean eye.
This article reviews some of the most influential theories relating to leadership and the management of change, and evaluates their efficacy in explaining the approach taken to leadership and the management of change in a post-1992 university. It notes that appointment practices to senior positions in such institutions appear to be based on traditional views of the function and role of senior managers. It concludes by showing that many traditional theories of leadership do little to cast light on the approach to leadership and the management of change found in such institutions, and that appointment practices based on such views may be misguided. It suggests that perspectives that include wider sets of variables, and which adopt a post-modernist approach to the understanding of management and leadership, may be more useful to our understanding of leadership and may lead to the appointment of senior managers with a more inclusive approach.
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