bluuebunny/crossref_metadata_2025 huggingface dataset:
Leverage and NAV discount: evidence from Italian real estate investment funds
Authors: Morri Giacomo , Benedetto Paolo
Published: May 2009

Purpose

The closed‐end fund puzzle is one of the most famous unsolved issues in financial economics and as such, over time, it has raised the interest of many authors also in the real estate field. The aim of this paper is both to determine whether the effect of leverage on net asset value (NAV) discount is biased by an accounting effect as well as to investigate the determinants of NAV discount by means of the “rational” approach.

Design/methodology/approach

The hypotheses are tested by using both the traditional formula as well as a new, unlevered one to calculate the NAV discount. A best subset analysis is carried out to ascertain the better set of determinants.

Findings

The main result of the analysis is that the influence of leverage on the NAV discount is biased by an accounting effect while other factors are highly significant.

Research limitations/implications

This paper is a starting point for additional research on some of the identified factors as well as on similar samples for which a wider set of data is available.

Originality/value

The homogeneity of the Italian real estate investment funds sample, which is not biased by any fiscal effect, and the use of an unlevered formula to calculate NAV discount are important factors when trying to understand the determinants of NAV discount.
Invariance assumptions among the UK property professionals' decision making
Authors: Ye Xu , Dent Peter R.
Published: May 2009

Purpose

Traditional finance theory have developed on the basis of expected utility theory and assumes that investors are rational. However, recent developments in behavioural finance challenge this, and thus question the validity of the assumptions on which expected utility theory are based. However, existing studies on this matter have mainly focused on capital markets, and research in the property industry has tended to lag behind. Therefore, adopting UK property professionals as samples, this paper aims to explore the reliability of the invariance assumption of people's behaviour under expected utility theory.

Design/methodology/approach

To fulfil the aim of this paper, a questionnaire survey was undertaken among the property professionals in London during the second half of 2005. Benefited from the group administrative method 78 out of 99 questionnaires were returned, and this reflects an overall response rate of approximately 79 per cent.

Findings

The research identifies that among the tested UK samples, property professionals change their preferences according to the way the questions are presented. In other words, the invariance assumption is not valid among UK property professionals. This paper then further investigates the possible factors that might influence people's decisions. It suggests that people would change their choices anyway, regardless of their gender, age, degree subjects or their working experience in the property industry. Therefore, further research is needed to find some other factors that might influence this particular behaviour among UK property professionals.

Originality/value

This paper draws the industry attention to the use of existing investment models, and suggests that an understanding of people's behaviour could help to improve decision making.
Real estate education in Europe: some perspectives on a decade of rapid change
Authors: D'Arcy Éamonn , Taltavull Paloma
Published: May 2009

Purpose

The purpose of this paper is to provide a profile of the structure of real estate education provision in Europe, its key recent drivers and some ideas for its future development.

Design/methodology/approach

The paper provides an analysis of recent trends in provision based on the European course accreditation data provided by the Royal Institution of Chartered Surveyors (RICS). The structure of provision is examined within the context of the significant changes which have taken place in the structure of European real estate markets as a means of identifying its key drivers. The analysis goes on to consider the opportunities presented for the future development of provision by two important initiatives the “Bologna Process” and the “European Real Estate Society Education Seminar”.

Findings

There has been considerable expansion in the provision of real estate education in Europe in recent years. The postgraduate level both full‐time and part‐time has been established as the dominant mode of provision with a business school setting as an increasingly important academic context. The two initiatives examined have the potential to contribute to the development of a truly pan‐European approach to real estate education.

Originality/value

The paper provides the first systematic review of real estate education provision in Europe directly related to changes in the structure of real estate markets. It provides educators which some ideas on how to shape future provision in particular though the development of key stakeholder relationships across Europe.
European value added investing: leveraging structural and cyclical real estate opportunities
Authors: O'Roarty Brenna
Published: May 2009

Purpose

The demand for value added investment in the European real estate market emerged in the mid to late 1990s and over the past decade has grown rapidly as a preferred investment style. Recent evidence suggests that investor appetite for value added products is set to intensify further. The purpose of this paper is to consider value added investment in the context of the wider market and in particular considers the rationale underpinning the current surge in demand. The paper explores the core components of its risk return profile and puts forward a strategic investment framework for European value added investment.

Design/methodology/approach

This paper develops a three tier filter to enable the classification of investment style. First, the risk parameters of the key investment characteristics are considered; second, the degree of risk exposure experienced on any one dimension and finally, the combination of such risks taken at any one time.

Findings

The key findings of this paper are: the shift in capital towards real estate at the beginning of the decade brought a new investor audience to the sector. Alongside the existing investor base, their growing experience in the sector, together with steep pricing competition for core has increased their risk appetite within the sector.

Originality/value

The paper emphasizes that investment strategies focussed on delivering true risk adjusted value added returns must be capable of identifying structural change, evaluating its implications for the real estate market and analysing its impact on current and future value.
When the big “R” hits home: governance in family firms during economic recession
Authors: Braun Michael R. , Latham Scott F.
Published: May 2009

Purpose

This paper seeks to give consideration to the family imprint on governance in the context of firms experiencing economic recession. It aims to rely on agency and stewardship theories to empirically examine the relationship between CEO duality and slack resources on family firm performance during economic recession.

Design/methodology/approach

Trend analyses were used employing hierarchical linear modeling (HLM) to evaluate the influence of duality and slack resources on the performance of 75 family‐controlled public firms (FCPFs) during the 2001‐2002 US economic recession and recovery.

Findings

The results indicate that duality and slack by themselves do not influence firm performance. However, family firms with a combined CEO‐chair and ample slack resources experience enhanced performance both at the onset of recession and at its conclusion. The findings suggest that a unified leadership and access to slack provide the family with the means to weather economic hardship. The paper makes the case that the stewardship afforded by this combination provides clear benefits to outside shareholders.

Practical implications

The absolute leadership and decision‐making control afforded to a CEO‐chair who also holds the reins over firm resources helps to favorably position the business and ease its course through difficult times. The results of this paper suggest that what is good for the family may also be good for other stakeholders in the firm, in this case non‐family shareholders.

Originality/value

With this study, attention is drawn to the governance of family businesses during times of economic duress. To the authors' knowledge, this study represents the only empirical investigation into family firm governance within this unique, albeit prevalent context.
Integrating resource‐based theory in a practice‐relevant form
Authors: Knott Paul
Published: May 2009

Purpose

This paper aims to address the limited development of techniques to analyze firms' internal sources of competitive performance. It seeks to enhance the contribution of the widely diffused value‐rarity‐imitability‐organisation (VRIO) model to practical strategy making.

Design/methodology/approach

The paper draws on the resource‐based literature to assemble an integrated set of steps that evaluate a firm's resources and competence.

Findings

The paper proposes an expanded version of the VRIO model that represents resource and competence as a conditional outcome from attributes and asymmetries present in the firm. It shows how the conditions convert asymmetries between weaknesses, missed opportunities, rigidities and resources.

Research limitations/implications

By synthesising resource‐based theory in a practice‐relevant form, the paper delineates a concrete set of practices that relate to firms' dynamic capability to manage resources and competence.

Practical implications

The paper details an approach to resource and competence analysis that leads directly to decisions about how a firm can manage the resources in question. The model gives a central role to the conditions under which a firm's attributes give rise to a resource or competence, and hence suggests active management of these conditions.

Originality/value

The paper presents resource‐based theory in a form that focuses on the doing of strategy, in contrast to the traditional focus of this literature.
Determinants of strategic planning effectiveness: extension of earlier work
Authors: Elbanna Said
Published: May 2009

Purpose

This paper aims to report the results of a study which extends the research of Elbanna by testing the relationship between strategic planning practice and participation on the one hand and the effectiveness of strategic planning on the other.

Design/methodology/approach

The paper extends the work of Elbanna by conducting the study in a new setting, the United Arab Emirates (UAE) with a broader sample: private and public organizations. The study tries to control for the possible impact of the methodology on research results by adopting the same methods and measures as the initial study had adopted.

Findings

The conclusions of the combined studies show that, in Arab countries, strategic planning practice enhances strategic planning effectiveness; unexpectedly, and contrary to previous research in developed economies, management participation does not contribute here to the effectiveness of strategic planning.

Originality/value

Although previous research provides valuable knowledge concerning strategic planning, there has been a paucity of research that empirically measures the effectiveness of strategic planning. Moreover, the scarcity of replications and extensions in the strategic management literature encourages this study to try to fill this gap. The research also shows the importance of extensions in building strategic management theory.
Building a FTSE 100 company by hitting the sweet spot of strategy
Authors: O'Regan Nicholas , Ghobadian Abby
Published: May 2009

Purpose

The purpose of this paper is to present the views of Rod Aldridge OBE on building the strategy of a FTSE 100 company.

Design/methodology/approach

The paper takes the form of an interview.

Findings

The interview with Rod Aldridge brings to life a number of key strategy concepts. The first is the importance of the external environment and the ability of an organisation to create a fit with the environment. Rod also alludes to the importance of finding the “sweet spot” of strategy – a position in a product market where there is a strong customer demand, little competition, and where the organisation has distinctive capabilities. The interview also gives credence to the argument that distinctive competencies that are the source of success can equally become a potential source of the organisation's demise.

Originality/value

The paper provides valuable insights into strategy concepts from one of the most respected leaders of the business world.
Binge drinking and depressive symptoms: a 5‐year population‐based cohort study
Authors: Paljärvi Tapio , Koskenvuo Markku , Poikolainen Kari , Kauhanen Jussi , Sillanmäki Lauri , Mäkelä Pia
Published: May 2009

Background  Only few prospective population studies have been able so far to investigate depression and drinking patterns in detail. Therefore, little is known about what aspect of alcohol consumption best predicts symptoms of depression in the general population.

Participants and design  In this prospective population‐based two‐wave cohort study, a cohort of alcohol‐drinking men and women (n = 15 926) were followed‐up after 5 years. A postal questionnaire was sent in 1998 (response proportion 40%) and again in 2003 (response proportion 80% of the baseline participants) to Finnish adults aged 20–54 years at baseline.

Measurements  Alcohol consumption was measured by average intake (g/week) and by measures of binge drinking (intoxications, hangovers and alcohol‐induced pass‐outs). Depressive symptoms were assessed with the 21‐item Beck Depression Inventory. In addition, information from hospital discharge register for depression and alcohol abuse were linked to the data.

Findings  This study found a positive association between baseline binge drinking and depressive symptoms 5 years later. Adjustment for several possible confounders attenuated the observed relationships only slightly, suggesting that binge drinking contributes independently to the occurrence of depressive symptoms. Binge drinking was related to symptoms of depression independently of average intake.

Conclusions  This study supports the hypothesis that heavy drinking, and in particular a binge pattern involving intoxications, hangovers or pass‐outs, produces depressive symptoms in the general population. The frequency of hangovers was the best predictor for depressive symptoms.
Field parasitism rates of caterpillars on Brassica oleracea plants are reliably predicted by differential attraction of Cotesia parasitoids
Authors: Poelman Erik H. , Oduor Ayub M. O. , Broekgaarden Colette , Hordijk Cornelis A. , Jansen Jeroen J. , Van Loon Joop J. A. , Van Dam Nicole M. , Vet Louise E. M. , Dicke Marcel
Published: May 2009

1. Herbivore‐induced plant volatiles (HIPVs) play an important role in host location of parasitoid wasps and may benefit the plant by top–down control of its herbivorous attackers. Although many studies have shown that accessions of plants differ in attractiveness to parasitoid wasps under controlled laboratory studies, few studies have confirmed that the most attractive accessions also sustain highest parasitism rates in the field. Here, we tested whether in‐flight preference of parasitoids for HIPVs from cultivars of Brassica oleracea in the laboratory reliably predicts the parasitism rates of herbivores feeding on these cultivars in the field.

2. In wind tunnel tests in the laboratory, we ranked cultivars of B. oleracea for the preference of two congeneric parasitoids (Cotesia glomerata and C. rubecula) for their HIPVs. The cultivars were then compared for their relative parasitism rates of caterpillars in the field. Throughout the growth season in the field, we infested the different cultivars with Pieris caterpillars on a weekly basis. The caterpillars were recollected after 3 days, dissected and scored for the rate of parasitism.

3. Cultivars of B. oleracea that we identified as most attractive to parasitoids in the laboratory also sustained highest proportions of parasitism in the field. The composition of the headspace of the B. oleracea cultivars damaged by P. rapae differs among these cultivars in the amounts of terpenoids and methyl salicylate emitted, which may be responsible for the differential attraction of parasitoids to the cultivars.

4. Our results show that intraspecific variation in HIPVs of plants is paralleled by differential parasitism of caterpillars in the field. The widely used laboratory assays on HIPV‐based preferences of parasitoids provided reliable information on relative parasitism differences of herbivores as found in the field.

5. Thereby, our work confirms that through HIPVs plants attract parasitoids that effectively parasitize herbivores even under the complex and variable abiotic and biotic conditions in (agro‐) ecosystems.
On fertilizer‐induced soil carbon sequestration in China's croplands
Authors: SCHLESINGER WILLIAM H.
Published: May 2009

Applications of fertilizer, often thought to enhance carbon sequestration in agricultural soils, are of no value to the mitigation of climate change if the carbon dioxide released during the production and distribution of nitrogen fertilizer exceeds the incremental carbon storage in soils from its use. Nitrogen fertilizer is also a source of the greenhouse gas nitrous oxide. The recent analysis of carbon sequestration in cropland soils of China does not apply these ‘discounts’ to the global warming mitigation expected from greater use of fertilizer; doing so would likely eliminate all the climate benefits of the postulated enhanced carbon sequestration.
Moisture availability influences the effect of ultraviolet‐B radiation on leaf litter decomposition
Authors: SMITH W. KOLBY , GAO WEI , STELTZER HEIDI , WALLENSTEIN MATTHEW D. , TREE ROGER
Published: May 2009

Altered surface ultraviolet‐B (UV‐B) radiation resulting from a combination of factors that include changes in stratospheric ozone concentrations, cloud cover, and aerosol conditions may affect litter decomposition and, thus, terrestrial nutrient cycling on a global scale. Although litter decomposition rates vary across biomes, patterns of decomposition suggest that UV‐B radiation accelerates litter decay in xeric environments where precipitation is infrequent. However, under more frequent precipitation regimes where litter decay rates are characteristically high, the effect of UV‐B radiation on litter decomposition has not been fully elucidated. To evaluate this association between moisture regime and UV‐B exposure, a litter decomposition experiment was designed for aspen (Populus tremuloides) leaf litter, where conditions that influence both abiotic (photodegradation) and biotic (microbial) processes could be manipulated quantitatively. We found that experimentally increasing UV‐B exposure (0, 7.4, and 11.2 kJ m−2 day−1, respectively) did not consistently increase litter decomposition rates across simulated precipitation frequencies of 4, 12, and 24 days. Instead, a UV‐B exposure of 11.2 kJ m−2 day−1resulted in a 13% decrease in decomposition rates under the 4‐day precipitation frequency, but an increase of 80% under the 24‐day frequency. Furthermore, the same UV‐B dose increased litter decomposition rates under the 24‐day precipitation frequency by 78% even in conditions where microbial activity was suppressed. Therefore, under more xeric conditions, greater exposure to UV‐B radiation increased decomposition rates, presumably through photodegradation. In contrast, when decomposition was not moisture‐limited, greater UV‐B exposure slowed decomposition rates, most likely from the resulting inhibition of microbial activity. Ultimately, these experimental results highlight UV‐B radiation as a potential driver of decomposition, as well as indicate that both the direction and magnitude of the UV‐B effect is dependent on moisture availability, a factor that may change according to future patterns in global precipitation.
Global declines of caribou and reindeer
Authors: VORS LIV SOLVEIG , BOYCE MARK STEPHEN
Published: May 2009

Caribou and reindeer herds are declining across their circumpolar range, coincident with increasing arctic temperatures and precipitation, and anthropogenic landscape change. Here, we examine the mechanisms by which climate warming and anthropogenic landscape change influence caribou and reindeer population dynamics, namely changes in phenology, spatiotemporal changes in species overlap, and increased frequency of extreme weather events, and demonstrate that many caribou and reindeer herds show demographic signals consistent with these changes. While many caribou and reindeer populations historically fluctuated, the current, synchronous population declines emphasize the species' vulnerability to global change. Loss of caribou and reindeer will have significant, negative socioeconomic consequences for northern indigenous cultures.
CA9 level in renal cyst fluid: a possible molecular diagnosis of malignant tumours
Authors: Li Guorong , Feng Gang , Cuilleron Muriel , Zhao An , Gentil‐Perret Anne , Cottier Michèle , Genin Christian , Tostain Jacques
Published: May 2009

Aims:  The preoperative differentiation of malignant renal cystic tumours from benign lesions is critical, and it remains a common diagnostic problem. The aim was to examine if the Carbonic anhydrase 9 (CA9) level in cyst fluid can provide a molecular diagnosis of malignant cyst.

Methods and results:  Twenty‐eight patients with a cystic renal mass were included. Fine‐needle aspiration was performed to obtain the fluid. Postoperative pathology confirmed that there were 16 cystic renal cell carcinomas. Twelve benign cystic tumours were used as controls. One hundred microlitres of supernatant of cyst fluid was used to measure the CA9 protein level, which was measured by an enzyme‐linked immunosorbent assay technique. CA9 was strongly detected and considered as positive in the cyst fluid of all 16 cystic malignant tumours (>1000 pg/ml), whereas its expression was negative in 11/12 benign cystic tumours (<300 pg/ml). The difference in percentages of positive CA9 between malignant and benign renal cystic tumours was significant (P < 0.001).

Conclusion:  The fluid of malignant cystic renal tumours contains a high level of CA9 protein. The measurement of CA9 level in cyst fluid may be used as a molecular diagnosis for differentiation between malignant and benign renal cystic masses.
Exploring the relationship between skin property and absorbent pad environment
Authors: Shigeta Yoshie , Nakagami Gojiro , Sanada Hiromi , Oba Miho , Fujikawa Junko , Konya Chizuko , Sugama Junko
Published: May 2009

Aim.  The aim of this study is to identify the related factors of skin lesions found in the surrounding environment of absorbent pads by clinical investigation.

Background.  Most older patients with incontinence use absorbent products, therefore causing many patients to have skin lesion in the absorbent pad area. To prevent these skin lesions from occurring, it is necessary to examine the absorbent pad environment of clinical patients since there are many contributing factors that complicate the pathophysiology in this area.

Design.  A cross‐sectional design was used.

Methods.  One hundred older Japanese patients with faecal and/or urinary incontinence using diapers and absorbent pads participated. Excluding blanchable erythema, the presence of skin lesions in the absorbent pad area was confirmed. Skin pH, hydration level and bacterial cultures were used to assess the skin property. Absorbent pad environment and patient demographics were also investigated.

Results.  The overall prevalence of skin lesions was 36%. Forty percent of the skin lesions were contact dermatitis. Multivariate logistic regression analysis revealed that only the presence of diarrhoea independently affected contact dermatitis.

Conclusion.  There was a significant relationship between contact dermatitis and the use of absorbent pads when the patient had diarrhoea. Although the factors related to skin lesions in the absorbent pad area are complexly intertwined, this study was the first to be able to determine diarrhoea as one specific factor in clinical setting.

Relevance to clinical practice.  This finding suggests that the presence of diarrhoea is significantly related with contact dermatitis. Therefore, when a patient has diarrhoea, health‐care professionals should immediately implement a preventative care program which includes careful skin observation and improved skin care. It is also necessary to develop a more effective absorbent pad to protect the skin of incontinent patients who suffer from the irritating effects of liquid stool.
Delivering ‘Gold Standards’ in end‐of‐life care in care homes: a question of teamwork?
Authors: Hewison Alistair , Badger Frances , Clifford Collette , Thomas Keri
Published: May 2009

Aim.  This paper reports findings from a study which investigated the introduction of the Gold Standards Framework for improving end‐of‐life care into care homes in England.

Background.  The Gold Standards Framework was developed in primary care to improve the care provided for people at the end‐of‐life. Following its successful introduction to this setting it was adapted and implemented in care homes.

Design.  A case study approach was appropriate for this study of a care programme into a ‘real life’ setting.

Method.  Fourteen managers participated in an initial telephone interview. Ten of these homes participated in the case study phase and 61 staff participated in individual or group interviews. Seven residents and three relatives participated in face to face interviews. Qualitative data were analysed in line with the template approach. Survey data were also analysed and a validated Teamworking Questionnaire was used.

Results.  It was found that teamwork is central to the successful introduction of the Gold Standards Framework in Care Homes. Good staffing levels and management support were also perceived to be key factors in homes where the Framework became established.

Conclusion.  Effective teamwork was necessary for changes in end‐of‐life care to be achieved in the care homes. If end‐of‐life care and other improvements in practice are to continue, teamwork will need to be supported and developed.

Relevance to clinical practice.  Effective teamwork appears to be a pre‐requisite for successful implementation of new programmes of care. Organisations wishing to implement such programmes should assess the quality of teamwork and may need to address this first.
Developing relationships in long term care environments: the contribution of staff
Authors: Wilson Christine Brown , Davies Sue
Published: May 2009

Aims and objectives.  The aim of this study was to consider how relationships in care homes influence the experience of older people, their families and staff. The main objective reported in this paper considers how these relationships are developed and the contribution that staff make to this process through the routines of care.

Background.  Relationships have been found to be integral to experiences of residents, families and staff in care homes but little is known about how these relationships develop. Few studies consider relationships in care homes as their main focus and there is a dearth of studies that consider relationships from the perspective of residents, families and staff within the same care home.

Design.  The study employed a constructivist design where the different perspectives held by participants were explored and shared to develop a joint construction of how relationships influenced their experiences.

Methods.  Data were collected from three care homes in England over two years between 2003–2005. Participant observation and interviews enabled a hermeneutic circle to be created between residents, families and staff. Data collection and analysis were conducted concurrently using a constant comparative method.

Results.  Staff adopted three approaches to care delivery and these influenced the type of relationships that were developed between residents, families and staff. The three approaches were described as individualised task‐centred, resident‐centred and relationship‐centred.

Conclusion.  This study progresses our understanding of the development of relationships between staff, residents and families in care homes by considering how the staff may support or constrain these relationships through their approach to care delivery.

Relevance to clinical practice.  These findings have implications for developing practice in care homes to improve the experience of older people and their families by encouraging staff to develop a relationship‐based approach to care routines.
Family experience of waiting for living donor liver transplantation: from parental donor perspective
Authors: Chou Chu‐Yi , Chen Yu‐chih , Chen Chao‐Long , Chen Jo‐Lin , Mu Pei‐Fan
Published: May 2009

Aims and objectives.  The aim of this study was to investigate from the perspectives of the donor parents of children with biliary atresia, the essence of family experiences during the period when waiting for a living donor liver transplant.

Background.  Living donor liver transplantation is a new hope for children and families when the child suffers from biliary atresia. It is obvious, during the waiting period, for a family with a child undergoing living donor liver transplantation, that the process has a serious impact and there is a need for them to be well‐prepared.

Design.  A descriptive phenomenological design was used in this study.

Methods.  Nine donor parents from a medical centre in Taiwan participated in this study. The inclusion criteria were that the parent had a child with biliary atresia, that the child had received living donor liver transplantation over the last year and a half and that the parent was the living donor for child’s liver transplantation. An open in‐depth interview technique encouraged the parents to reflect on their experiences as the process raised their feelings to a conscious level. The data were analysed using the Colaizzi’s approach.

Results.  This study explores the essence of families undergoing the waiting period for living donor liver transplantation surgery from the point of view of the donating parents. Five themes emerged: (1) surgery as hope of rebirth, (2) negotiating the decision to have surgery, (3) the selection of the donor to achieve family welfare, (4) preparing and planning for the surgery and (5) worry over the impact of the surgery.

Conclusions.  The results demonstrate that the parents’ experiences included a variety of domains: hope of rebirth, mental negotiation while deciding on surgery and choice of donor, coping with the preparation for surgery and the possible impact on the family of the surgery.

Relevance to clinical practice.  The findings indicated that nursing professionals should provide family‐centred care to assist the family with the steps needed to move toward surgery.
Identifying trajectories of birth‐related fatigue of expectant fathers
Authors: Tzeng Ya‐Ling , Teng Yu‐Kuei , Chou Fan‐Hao , Tu Hsiu‐Chin
Published: May 2009

Aims and objectives.  The objectives of this prospective study were to identify birth‐related fatigue trajectories in expectant fathers with the progress of labour and the physiological, psychological and situational factors related to specific trajectory patterns.

Background.  An increasing number of fathers participate in their partner’s labour; however, their fatigue experience remains unclear. Previous studies have focused on overall groups without considering the possibility of between‐subject heterogeneity. With an advanced data‐analytic strategy, it is feasible to identify subgroup variation within the population over time.

Design.  A prospective, repeated measures design was used.

Method.  A convenience sample of 108 Taiwanese expectant fathers was followed throughout the labour process. Data were collected by visual analogue scales and self‐administered questionnaires. The repeated measures of fatigue were analysed by using semi‐parametric, group‐based modelling.

Results.  Two distinct groups of individual trajectories among the expectant fathers were identified; the persistent low‐fatigue group (49·2%) and the persistent high‐fatigue group (50·8%). After birth, a moderate level of fatigue persisted in the high‐fatigue group. The fastest period of increasing level in the persistent high‐fatigue group was in the latent phase. The persistent high‐fatigue group also experienced significantly more sleep difficulties prior to labour and more anxiety than the persistent low‐fatigue group.

Conclusions.  Identifying and characterising meaningful clusters of trajectories could provide a better understanding of the birth‐related fatigue experience of fathers and contributes to recognising the target client and timing for early intervention.

Relevance to clinical practice.  There are points in time at which professional caregiver actions may have an effect on the birth‐related fatigue of fathers. Caregivers should prevent high levels of fatigue, which could accumulate as fathers accompany the women entering the labour phase. Fathers who present with high fatigue at onset of labour should receive early intervention, especially in the rapid‐increasing fatigue period.
Assessing predictive validity of the modified Braden scale for prediction of pressure ulcer risk of orthopaedic patients in an acute care setting
Authors: Chan Wai Shan , Pang Samantha Mei Che , Kwong Enid Wai Yung
Published: May 2009

Aims and objectives.  To assess and compare the predictive validity of the modified Braden and Braden scales and to identify which of the modified Braden subscales are predictive in assessing pressure ulcer risk among orthopaedic patients in an acute care setting.

Background.  Although the Braden scale has better predictive validity, literature has suggested that it can be used in conjunction with other pressure ulcer risk calculators or that some other subscales be added. To increase the predictive power of the Braden scale, a modified Braden scale by adding body build for height and skin type and excluding nutrition was developed.

Design.  A prospective cohort study.

Method.  A total of 197 subjects in a 106‐bed orthopaedic department of an acute care hospital in Hong Kong were assessed for their risk for pressure ulcer development by the modified Braden and Braden scales. Subsequently, daily skin assessment was performed to detect pressure ulcers. Cases were closed when pressure ulcers were detected.

Results.  Out of 197 subjects, 18 patients (9·1%) developed pressure ulcers. The area under the receiver operating characteristic curve for the modified Braden scale was 0·736 and for the Braden scale was 0·648. The modified Braden cut‐off score of 19 showed the best balance of sensitivity (89%) and specificity (62%). Sensory perception (Beta = −1·544, OR=0·214, p = 0·016), body build for height (Beta = −0·755, OR = 0·470, p = 0·030) and skin type (Beta = −1·527, OR = 0·217, p = 0·002) were significantly predictive of pressure ulcer development.

Conclusion.  The modified Braden scale is more predictive of pressure ulcer development than the Braden scale.

Relevance to clinical practice.  The modified Braden scale can be adopted for predicting pressure ulcer development among orthopaedic patients in an acute care setting. Specific nursing interventions should be provided, with special attention paid to orthopaedic patients with impaired sensory perception, poor skin type and abnormal body build for height.
Identification of ‘hot spots’ of obesity and being underweight in early pregnancy in Liverpool
Authors: Abayomi J. C. , Watkinson H. , Boothby J. , Topping J. , Hackett A. F.
Published: May 2009

Background:  Obesity and being underweight in pregnancy are related to an increased risk of maternal and foetal morbidity, yet their prevalence is often unknown. The present study aimed to identify neighbourhoods with a higher than average prevalence or ‘hot spots’ of obesity and/or being underweight among first trimester pregnant women.

Methods:  A database was compiled consisting of postcode, height and weight for 7981 women who had booked‐in for antenatal care between July 2004 and June 2005 at Liverpool Women’s Hospital. Body mass index (BMI) was calculated and women were categorised accordingly. Postcodes for 6865 cases across Merseyside were converted to geolocations (pin‐points on a map) using conversion software (http://www.census.ac.uk/cdu/).

Results:  There was a very high prevalence of being overweight (27%) and obesity (17%); 3.8% of women were underweight and probably malnourished (BMI < 18.5 kg m−2); and a further 10.7% of women were possibly malnourished (BMI < 20.0 kg m−2. Deriving case density from the geolocations allowed visualisation and identification of six neighbourhoods with above average levels of obesity and three neighbourhoods had marked concentrations of both being underweight and obesity.

Conclusions:  These neighbourhoods, particularly those identified as ‘hot spots’ for both being underweight and obesity, include some of the most deprived wards in the UK. As dietetic intervention may help to promote optimal weight gain during pregnancy and improve dietary intake for pregnant women and their families, primary health care providers should target these localities with a high prevalence of low and high BMI as a priority.
Stigma, negative attitudes and discrimination towards mental illness within the nursing profession: a review of the literature
Authors: ROSS C. A. , GOLDNER E. M.
Published: May 2009

The aim of this paper was to review the existing literature pertaining to stigma, negative attitudes and discrimination towards mental illness, specifically as viewed through the lens of the nursing profession. The results of the literature review were synthesized and analysed, and the major themes drawn from this were found to correspond with Schulze's model identifying three positions that healthcare workers may assume in relation to stigma of mental illness: ‘stigmatizers’, ‘stigmatized’ and ‘de‐stigmatizers’. In this paper, the nursing profession is examined from the perspectives of the first two major themes: the ‘stigmatizers’ and ‘stigmatized’. Their primary sub‐themes are identified and discussed: (1) Nurses as ‘the stigmatizers’: (a) nurses' attitudes in general medical settings towards patients with psychiatric illness and (b) psychiatric nurses; (2) Nurses as ‘the stigmatized’: (a) nurses who have mental illness and (b) stigma within the profession against psychiatric nurses and/or psychiatry in general. The secondary and tertiary sub‐themes are also identified and reviewed.
Moving beyond policy rhetoric: building a moral community for early psychosis intervention
Authors: WILSON J. HAMILTON
Published: May 2009

Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. Margaret Mead

It has been my privilege to work in partnership with hundreds of patients experiencing emergent psychosis, in Hamilton, Ontario during the course of my lengthy nursing career. Indeed, the knowledge I have gleaned from both the courageous individuals who have experienced serious mental illness and their resilient families has been monumental. When I first began my career, I was utterly naïve and most certainly held the misguided assumption that to be a mental health nurse required an adherence to a strict set of nursing principles and that the nurse–patient relationship was approached from an objective and ‘safe’ distance. Reflecting on this now, many years later I understand that the therapeutic relationship between nurses and those they serve is foundational to the delivery of safe and ethical mental health care. Although increasingly clinical practice guidelines and evidence‐based interventions serve to inform nursing practice, in my mind it is the embodied experience of relationship that is the real instrument of healing and transformation. Recognizing that early intervention provides an unprecedented opportunity to begin anew with young patients who have no prior experiences with the mental health care system, the purpose of this paper is to serve as a vehicle for discussion and potentially inspire a group of thoughtful, committed nurses to change the world of mental health services by creating a respectful moral community. I propose that relational ethics form the values and ideals of a fully humane early psychosis intervention community in Ontario. Using the foundational tenets of the nurse–patient relationship illustrated through the use of a clinical narrative, I will suggest ways that nurses can proactively take up the early intervention challenge and contribute to an overall culture of optimism and hope. Intervening early is simply not enough. We must first commit to developing comprehensive recovery‐oriented treatments in a coordinated and thoughtful way.
MzrA: a novel modulator of the EnvZ/OmpR two‐component regulon
Authors: Gerken Henri , Charlson Emily S. , Cicirelli Elisha M. , Kenney Linda J. , Misra Rajeev
Published: May 2009

Analysis of suppressors that alleviate the acute envelope stress phenotype of a ΔbamBΔdegP strain of Escherichia coli identified a novel protein MzrA and pleiotropic envZ mutations. Genetic evidence shows that overexpression of MzrA – formerly known as YqjB and EcfM – modulates the activity of EnvZ/OmpR similarly to pleiotropic EnvZ mutants and alter porin expression. However, porin expression in strains devoid of MzrA or overexpressing it is still sensitive to medium osmolarity, pH and procaine, all of which modulate EnvZ/OmpR activities. Thus, MzrA appears to alter the output of the EnvZ/OmpR system but not its ability to receive and respond to various environmental signals. Localization and topology experiments indicate that MzrA is a type II membrane protein, with its N‐terminus exposed in the cytoplasm and C‐terminus in the periplasm. Bacterial two‐hybrid experiments determined that MzrA specifically interacts with EnvZ but not with OmpR or the related membrane sensor kinase, CpxA. This and additional genetic and biochemical evidence suggest that the interaction of MzrA with EnvZ would either enhance EnvZ's kinase activity or reduce its phosphatase activity, thus elevating the steady state levels of OmpR∼P. Furthermore, our data show that MzrA links the two‐component envelope stress response regulators, CpxA/CpxR and EnvZ/OmpR.
Evaluation of essential and variable residues of nukacin ISK‐1 by NNK scanning
Authors: Islam Mohammad R. , Shioya K. , Nagao J. , Nishie M. , Jikuya H. , Zendo T. , Nakayama J. , Sonomoto K.
Published: May 2009

Nukacin ISK‐1, a type‐A(II) lantibiotic, comprises 27 amino acids with a distinct linear N‐terminal and a globular C‐terminal region. To identify the positional importance or redundancy of individual residues responsible for nukacin ISK‐1 antimicrobial activity, we replaced the native codons of the parent peptide with NNK triplet oligonucleotides in order to generate a bank of nukacin ISK‐1 variants. The bioactivity of each peptide variant was evaluated by colony overlay assay, and hence we identified three Lys residues (Lys1, Lys2 and Lys3) that provided electrostatic interactions with the target membrane and were significantly variable. The ring structure of nukacin ISK‐1 was found to be crucially important as replacing the ring‐forming residues caused a complete loss of bioactivity. In addition to the ring‐forming residues, Gly5, His12, Asp13, Met16, Asn17 and Gln20 residues were found to be essential for antimicrobial activity; Val6, Ile7, Val10, Phe19, Phe21, Val22, Phe23 and Thr24 were relatively variable; and Ser4, Pro8, His15 and Ser27 were extensively variable relative to their positions. We obtained two variants, Asp13Glu and Val22Ile, which exhibited a twofold higher specific activity compared with the wild‐type and are the first reported type‐A(II) lantibiotic mutant peptides with increased potency.
Population of Follicles and Luteal Structures during the Oestrous Cycle of Mares Detected by Three‐Dimensional Internal Structure Microscopy
Authors: Hirano Y. , Kimura J. , Nambo Y. , Yokota H. , Nakamura S. , Takemoto S. , Himeno R. , Mishima T. , Matsui M. , Miyake Y.‐I.
Published: May 2009

The structure of the equine ovary is different from that of other mammals in its extremely large size, the presence of ovarian fossa and the inverted location of its cortex and medulla. A three‐dimensional internal structure microscopy (3D‐ISM), which consists of a computer‐controlled slicer, a CCD camera, a laser disc recorder and a PC, is very useful for the observation of the internal structures in equine ovaries. In addition, the three‐dimensional images of follicles and corpus luteum (CL) reconstructed by the segmentation technique can clarify the spatial arrangement in the equine ovary. In this study, to understand the changes in the ovarian internal structures of the mare during the oestrous cycle, the size and numbers of follicles and luteal structures were analysed by 3D‐ISM in addition to the concentrations of progesterone (P4) and oestradiol‐17β. As a result, many small follicles (<10 mm in diameter) were detected. It was recognized that the luteal structures were distinguished into three types, such as the corpus haemorragicum (CH), which is formed by blood elements at the cavity after ovulation, CL and corpus albican (CA). There were some CHs and CL in the group, which had the concentration of P4 > 1 ng/ml. CHs were also observed in the group, which had low level of P4 (P4 < 1 ng/ml). CAs were found regardless of the P4 level. In conclusion, 3D‐ISM enabled the internal observation of the ovarian structures in detail, and estimation of the stage of the ovarian cycle with complementary physiological information. The findings by 3D‐ISM provide basic information for clinical applications.
Normal Development of the Muscular Region of the Interventricular Septum. II. The Importance of Myocardial Proliferation
Authors: Contreras‐Ramos A. , Sánchez‐Gómez C. , Fierro‐Pastrana R. , González‐Márquez H. , Acosta‐Vazquez F. , Arellano‐Galindo J.
Published: May 2009

In a first paper, we concluded that the muscular region of the interventricular septum is developed by the trabecular branches and showed evidence that the developing interventricular septum elongates in a direction opposite to that of atria. Nevertheless, to date the literature is lacking precise information on the importance of myocardial proliferation not only in this process but also in the morphogenesis of the ventricular cavities. The aim of this study was to determine the spatial and temporal distribution of high‐intensity foci of cycling myocytes in the ventricular region of the heart of chicken embryos during cardiac septation. Histological studies, detection of the proliferating cell nuclear antigen by light and confocal microscopy and flow cytometric analysis were carried out. The results corroborate that the developing interventricular septum grows in a direction opposite to that of atria. A remoulding mechanism that results in fenestrated trabecular sheets and trabecular branching is discussed. Our findings allowed us to summarize the normal morphogenesis of the muscular region of the interventricular septum in a way that is different from that suggested by other researchers.