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This paper looks at the potential implications of land use and climate change for replenishment of the five aquifers which lie beneath the Upper Guadiana catchment in central Spain. The impacts of scenarios for climate and land use change on groundwater recharge are explored using a physically based hydrological model. (Research is the downward flux of water from the base of the root zone, beyond which water is no longer available for evapotranspiration and forms part of the groundwater resource.) The model is integrated for a series of climate change scenarios spanning the range of predictions from general circulation models. Aquifer replenishment through recharge from the main four cover types is examined for each scenario and the implications for groundwater resources are examined. These climate scenarios are then coupled with a scenario for change in irrigated land use in the Guadiana derived from a cellular automata model based on historical change. The implications of coupled climate and land use change are discussed. The results indicate that current climatic variability has greater impacts on groundwater recharge than a number of extreme scenarios for climatic change. Although the impact of the land use change scenario is greater than that of the climate change scenarios, it is still significantly less than current vairability and represents a relatively small change at the catchment scale. This change is too small to significantly affect groundwater resources but may impact surface flows.

The purpose of this chapter is to highlight the issue of sex trafficking – internationally, in the United States, and particularly in Florida – and the needed services for victims to promote recovery and increase the likelihood of success in redefining themselves and creating a new life. The vast majority of victims are women and children, especially those from vulnerable popu­lations. While much attention has been given to addressing the needs of minors, few programs and services focus specifically on the needs of adult women. This chapter will feature the work of Selah Freedom, a national anti-sex trafficking organization headquartered in southwest Florida dedicated to serving women 18 and over. In particular, the emphasis will be on their long-term services, which offer a comprehensive approach to the treatment of trauma and rehabilitation and have proven successful in removing women from “the life.”

This study aims to investigate the role of two structural factors – threat level depicted on fear messages and warning size – as well as two contextual factors – repeated exposure and type of packs – on pictorial and threatening tobacco warnings’ effectiveness.

A two (warning threat level: moderate vs high) × two (coverage: 40 vs 75 per cent) × two (packaging type: plain vs branded) within-subjects experiment was carried out. Subjects were exposed three times to pictorial and threatening tobacco warnings. Both self-report and psychophysiological measurements of emotion were used.

Results indicate that threat level is the most effective structural factor to influence smokers’ reactions, while warning size has very low impact. Furthermore, emotional arousal, fear and disgust, as well as attitude toward tobacco brand, decrease after the second exposure to pictorial and threatening tobacco warnings, but stay stable at the third exposure. However, there is no effect of repetition on the emotional valence component, arousal-subjective component, on intention of quitting or of reducing cigarette consumption. Finally, there is a negative effect of plain packs on attitude toward tobacco brand over repeated exposures, but there is no effect of the type of packs on smokers’ emotions and intentions.

Useful marketing social guidance, which might help government decision-makers increase the effectiveness of smoking reduction measures, is offered.

For the first time in this context, psychophysiological and self-report measurements were combined to measure smokers’ reactions toward pictorial and threatening tobacco warnings in a repeated exposure study.

This paper describes findings from recent research in the UK on one particular type of bullying, that linked to sexuality and the assumed sexual orientation of the victim ‐ namely homophobic bullying. A survey involving 307 secondary schools throughout England and Wales showed that awareness of general bullying among school staff was almost universal. Most respondents also knew of homophobic verbal bullying, and over one in four were aware of homophobic physical bullying. Existing school policies on bullying and confidentiality rarely referred to lesbian and gay issues. Respondents identified barriers to tackling homophobic bullying, but most thought schools were appropriately placed to provide information on lesbian and gay issues. Study recommendations include: modernising national policy, supporting local teachers and policy‐making in schools through training, new initiatives in citizenship education, and encouraging schools to build collaborative relationships with other local community agencies.

This study aims to explore whether and how patient voices had been taken into account within quality management systems in Hospital A in Britain and Hospital B in Taiwan.

The two hospitals were purposefully selected and the data were collected over six months, via documents, interviews, and a semi‐structured questionnaire. A mixed method strategy within an overall qualitative framework (i.e. managerial‐operational‐technical) was used to make comparisons between them.

A number of strategies were developed by both Hospital A and Hospital B to take patients' voice into account within quality systems. In an attempt to improve quality standards of services, both hospitals used patient satisfaction surveys relating to specific services to understand patients' opinions about care in outpatient services, inpatient services, or emergency services. They also set up patient suggestion boxes and managed complaints data to understand what patients needed and wanted.

There is very limited literature related to the comparison of quality systems. In particular, this study explores the mechanisms to take patients' voices into account within quality systems. The most important distinction between the two hospitals is that in Hospital A, complaints are managed by a quality manager, while in Hospital B the Social Work Department (SWD) is responsible for dealing with patient complaints. In practice, it is more effective for quality officers to take care of complaints management than social workers, in terms of using complaints to improve quality.

The purpose of this paper is to examine gender inequality in Saudi Arabia by using a relational perspective that takes into account the interrelated nature of the multilevel factors that influence this phenomenon.

A total of 21 in-depth interviews with female employees in Saudi Arabia were conducted and analysed using a thematic analysis.

The findings show how the interplay of factors on macro, meso and micro levels influences equal opportunities for women in Saudi Arabia, such as religio-cultural factors, the social power of wasta, the notions of female modesty and family honour and issues related to gender segregation, discrimination and harassment at work. Moreover, Saudi women’s experiences are varied on the basis of social class, family status and other dimensions of individual identity, adding to a growing body of intersectional research. The paper highlights the role of male guardianship system as well as the intersection of gender and class in pushing gender equality forward.

This study stresses the interrelated nature of the multilevel factors that affect gender equality and highlights the important role of individual agency and resilience.

The influence of electronic word-of-mouth (eWOM) information, such as online reviews, on consumers’ decision making is well documented, but it is unclear if online reviews still matter in post-purchase evaluation and behaviours. The purpose of this paper is to examine the extent to which online reviews (aggregate rating (AR) and individual reviews (IR)) influence consumers’ evaluation and post-purchase behaviour by considering the valence congruence of online reviews and consumption experience (CE).

Following social comparison theory and relevant literature, the authors conduct an online experiment (pre-test: n=180; main study: n=347). The authors rely on a 2 (CE valence) ×2 (AR valence) ×2 (IR valence) between-subjects design.

Congruence/incongruence between the valences of CE, AR and IR affects consumers’ post-purchase evaluation at the emotional, brand and media levels and review-writing behaviour. In comparison to aggregated rating, IR are more important in the post-purchase stage. Similarly, consumers have a higher eWOM-writing intention when there is congruence between the valences of CE, AR and IR.

The authors demonstrate the importance of service providers continually monitoring their business profiles on review sites to ensure consistency of review information, as these influence consumers’ post-purchase evaluation and behaviours. For this reason, the authors illustrate the utility of why media owners of review sites should support the monitoring process to facilitate the engagement of both businesses and customers.

The authors break new ground by empirically testing the impact of online review information post-purchase seen through the theoretical lens of social comparison. The approach is novel in breaking down and testing the dimensions of post-purchase evaluation and behavioural intentions in understanding the social comparison elicited by online reviews in the post-purchase phase.

This study aims to construct an instrument for identifying certain attributes or capabilities that might enable healthcare staff to use complaints to improve service quality.

PubMed and ProQuest were searched, which in turn expanded access to other literature. Three paramount dimensions emerged for healthcare quality management systems: managerial, operational, and technical (MOT).

The paper reveals that the managerial dimension relates to quality improvement program infrastructure. It contains strategy, structure, leadership, people and culture. The operational dimension relates to implementation processes: organizational changes and barriers when using complaints to enhance quality. The technical dimension emphasizes the skills, techniques or information systems required to achieve successfully continuous quality improvement.

The MOT model was developed by drawing from the relevant literature. However, individuals have different training, interests and experiences and, therefore, there will be variance between researchers when generating the MOT model.

The MOT components can be the guidelines for examining whether patient complaints are used to improve service quality. However, the model needs testing and validating by conducting further research before becoming a theory.

Empirical studies on patient complaints did not identify any analytical tool that could be used to explore how complaints can drive quality improvement. This study developed an instrument for identifying certain attributes or capabilities that might enable healthcare professionals to use complaints and improve service quality.

The purpose of this paper is to examine the influence of the symmetrical disposition of information items displayed on the front of product packaging on perceived complexity, perceptual fluency, aesthetic evaluation and product purchase intention.

A sample of 104 participants was exposed to fast-moving consumer goods packaging. A within-subject design experiment was carried out to assess the influence of the symmetrical disposition of information items displayed on the front of the packaging. ANOVA and a PROCESS procedure to assess mediation (Hayes, 2013) examined the relationships among the factors influenced by symmetry.

This study found that the symmetrical disposition of information items around the vertical axis (mirror symmetry) decreased visual complexity and highlighted an “indirect-only mediation” of visual complexity on the aesthetic evaluation of the packaging through processing fluency. This research also highlighted the fact that packaging aesthetic evaluation had a positive influence on purchase intention.

This study extends knowledge on package design by showing that the elements on which the producer can act (in this case, symmetry on the front of packaging) have an influence on the consumer’s evaluation of the product and intention to purchase.