bluuebunny/crossref_metadata_2025 huggingface dataset:
Cultural value, perceived value, and consumer decision‐making style in China
Authors: Sun Chuan , Su Song , Huang Jinsong
Published: September 2013

Purpose

Previous research has generally assumed that a homogeneous cultural value exists within a given country. This research aims to identify the regional differences in cultural value based on an urbanization dimension in China, which generate diversity with regard to perceived value and consumer decision‐making styles.

Design/methodology/approach

A large‐scale questionnaire was administered to freshmen from major colleges and universities across China to measure cultural value, perceived value, and consumer decision‐making style. The data were analyzed with a multi‐group structural equation model and a stepwise discrimination test.

Findings

Results demonstrated significant differences in cultural value, perceived value and consumer decision‐making style among regions with different degrees of urbanization and revealed antecedents and formation of the mechanism of decision‐making style.

Research limitations/implications

Future research should explore more antecedents that influence consumer decision‐making styles and other market dimensions other than urbanization.

Practical implications

The research might provide prominent guidelines for marketers to understand Chinese consumers. Specifically, in regions with different degrees of urbanization, marketers should develop differential strategies to exploit the market given the distinctions in cultural value, perceived value and consumer decision‐making styles.

Originality/value

This study is the first to build a theoretical relational model of cultural value, perceived value and consumer decision‐making styles. And this model revealed the antecedents and formation of the mechanism of decision‐making style.
Got the MEMO? Management education is moving on
Authors: Marques Joan
Published: September 2013

Purpose

The aim of this paper is to present the author's findings from eight conferences, organized over the course of four years by two major management education organizations in the USA, and pertaining to the trend of management education.

Design/methodology/approach

This paper offers a constructive critical review of the trend of management education, and the need for greater interaction and more hands‐on approaches, against the reality of adhering to requirements of accrediting bodies.

Findings

The trend toward more interaction and a broader variety, as well as greater inclusion of art and other areas in management education is unstoppable. The growing interest in workshop submissions and attendance at major conferences is proof of that. However, it may take a while before all stakeholders will support this reality optimally.

Practical implications

Management educators may get encouraged to explore alternative ways of engaging their students, and seek outlets to share these new findings on a larger scale. The fact that academic publishers also seem to follow the trend of deviating from strong theoretical foci could be considered hopeful.

Social implications

Management educators may get encouraged to explore alternative ways of engaging their students, and seek outlets to share these new findings on a larger scale. The fact that academic publishers also seem to follow the trend of deviating from strong theoretical foci could be considered hopeful.

Originality/value

This article presents comparative data of two major conferences, which are highly popular within the world of management education, but have never been placed alongside one another as such. Furthermore, the article reveals a trend that has thus far only been discussed as an experience‐ based or research‐based one, but was not yet brought within the scope of its implementation on globally attended forums as the ones discussed in this article.
A plea for systemic change in education
Authors: Gilbert Michael
Published: September 2013

Purpose

Columbus set out to prove the world was round. Today, Thomas Friedman posits the “world is flat.” The reversion reflects the complexity of today's world and an interdependent global economy. That complexity also relates to how we educate the citizens of tomorrow. The purpose of this commentary is to explore what is, what works, and what possibilities exist to address the complexities that surround education ‐ complexities of learning, complexities of educational systems, and complexities of determining positive outcomes of educational efforts. Related discussion includes comparing different educational systems from different countries and cultures.

Design/methodology/approach

The impetus for these perceptions arose from many years of professional practice and observation, most recently piqued by Glass's polemic, Fertilizers, Pills, and Magnetic Strips. Integral to the commentary is an overlay of the educational landscape in the USA.

Findings

The essay includes suggestions for change – adapting delivery styles, using more of what we know about learning and learners, and some jabs at holding too fast to tradition. Included are a suggestion to break away from the stale approaches that may not work anymore and an examination/re‐examination of some things that might yield salutary results – continuous progress, differentiated staffing, and matching teaching styles with learning preferences and motivational needs. (Also appended is a selected annotated bibliography of other perspectives and ideas.)

Originality/value

The urgency of examining what works and what is worth keeping must be balanced with considering the landscape of the educational environment. This essay is a gentle prodding to do just that, taken from the author's 45 years as a professional educator.
Marketing the adventure: utilizing the aspects of risk/fear/thrill to target the youth traveller segment
Authors: Schlegelmilch Fabian , Ollenburg Claudia
Published: September 2013

Purpose

This research aims to investigate the importance of emotional appeals like risk/fear/thrill as main motivation to take part in adventure activities, and their possible utilisation in viral marketing.

Design/methodology/approach

Quantitative and qualitative research methods have been applied.

Findings

The results confirm that facing fear or challenge, leading to being intrinsically rewarded, is a main motivator. However, the aspect of fun is still fundamentally important to each activity. The youth traveller market is generally extremely responsive to viral marketing, which (through wording and visuals) creates an image of a “life‐changing experience”, “thrilling adventure”, and similar.

Originality/value

Adventure tourism continues to be a fast growing and popular form of tourism. Marketing the adventure, however, can present a challenge to small businesses with a limited budget. Viral marketing may present a cost‐effective opportunity to reach the youth traveller segment. This research investigates importance of emotional appeals like risk/fear/thrill as main motivation to take part in adventure activities, and their possible utilisation in viral marketing.
Slow food events as a high yield strategy for rural tourism destinations
Authors: Folorunso Adeyinka‐Ojo Samuel , Khoo‐Lattimore Catheryn
Published: September 2013

Purpose

For years, the community in Bario has chosen to organize a slow food and cultural festival annually to draw tourists to Bario. The aim of this paper is to explore the staging of slow food events as a high‐yield strategy for rural tourism destinations and how they can be used to move a destination up the value chain in responsible rural tourism practices.

Design/methodology/approach

The study adopted an interpretative approach. Participant observation and 15 in‐depth interviews with local and foreign tourists were conducted to elicit responses before, during and after the event. In addition, photography and videography were also employed.

Findings

Findings revealed that the event was seen by many as a catalyst for the provision and development of infrastructural development. More importantly, 67 percent of the foreign tourists interviewed state that the price of goods and services at the event are reasonable and affordable, given the unique cultural experience during the festival in Bario. These findings imply that such an event has potential in generating higher yield for a rural destination. However, findings also show that the event could be better marketed and managed.

Originality/value

A significant contribution of this study is its exploration of the use of slow food events in a rural destination as a strategy in generating high yield for a rural tourism destination.
Determining the wildlife value orientation (WVO): a case study of lower Kinabatangan, Sabah
Authors: King Natalie , Nair Vikneswaran
Published: September 2013

Purpose

The aim of this article is to explore wildlife value orientation (WVO) beliefs of community members involved in the Miso Walai Homestay program in Lower Kinabatangan, Sabah.

Design/methodology/approach

The researcher utilized the qualitative method of thematic analysis and the sampling technique of purposive/judgemental method which reached saturation point at 16 respondents, who were all local community employees of the Miso Walai Homestay program. A total of 13 semi‐structured questions were posed to all interviewees in their native Bahasa Melayu language or English.

Findings

Interviewees expressed preference for viewing wild species not in enclosed structures but in their natural habitat. This was also the view of tourists in the homestay program. This community recognizes that community‐based ecotourism can be a means of habitat protection and income for both wildlife protection and the local community.

Originality/value

This case study may not only contribute to an increased satisfaction level of tourists with the overall experience, but also to the attraction of new tourists, searching for a participatory role by simply choosing a homestay accommodation or physically contributing to conservation activities.
Conclusions: contemporary responsible rural tourism innovations
Authors: Nair Vikneswaran , Hussain Kashif
Published: September 2013

Purpose

The main aim of this paper is to critically review the contribution made by this theme issue to the literature by examining contemporary innovations that are emerging and enhancing responsible rural tourism practices in Malaysia.

Design/methodology/approach

Based on the theme issue, a critical content analysis of the papers selected for the issue was undertaken.

Findings

The summary paper generally highlights all emerging and innovative approaches from various case studies in rural tourism destinations in Malaysia.

Research limitations/implications

The complex and dynamic realities of rural tourism are both a challenge and an opportunity for responsible governance of rural tourism destinations.

Originality/value

The current theme issue explores emerging models from stakeholders' perspectives to enhance the concept of rural tourism sustainability in the context of the economy, social and environment.
Conceptual differences between adolescent and adult impulse buyers
Authors: Brici Natalie , Hodkinson Chris , Sullivan‐Mort Gillian
Published: September 2013

Purpose

There have been recent calls for research into the impulse shopping behaviours of adolescent consumers – an important topic because adolescents are: an increasingly important market segment; a segment which has recently been empowered by the availability of easy credit; and which is increasingly targeted by strategic marketing collateral. This paper responds to the call by aiming to focus on the impulse shopping behaviours of adolescents.

Design/methodology/approach

The research is qualitative in nature and utilises lengthy mini focus group interviews of both adolescent and adult consumer shoppers. The verbatim transcriptions are then subjected to both manual and automated textual analysis to derive conceptual and thematic maps of each group's discussions in relation to impulse shopping.

Findings

Consistent with recent neuropsychological literature on adolescents, the findings show clear differences between adolescents and adults in relation to impulse shopping. Significant differences were found in the areas of antecedent moods, shopping purpose, and the range of perceived constraints which may moderate impulse shopping behaviour. The research also shows that impulse buying among adolescents is a behaviour which is undertaken often in response to stress and/or a need for mood amelioration and further that their conceptualisation of impulse shopping is only distantly related to a deficient set of perceived constraints when compared to adult shoppers.

Practical implications

This improved understanding of the bases of adolescent impulse shopping will assist in the design of educational programs to reduce the frequency of adolescent financial problems.

Social implications

There may be a reduction in the number of adolescents facing resultant financial hardship.

Originality/value

This is the first such study which reports the belief structures of adolescent impulse shoppers versus adults.
Strategic Bundling of Development Policies with Adaptation: An Examination of Delhi's Climate Change Action Plan
Authors: Aggarwal Rimjhim M.
Published: September 2013

A growing number of cities in the global South are taking proactive action on climate change. Their plans provide insights into the potential for strategically bundling long‐term development policymaking with the climate agenda. In this article I study the case of Delhi, the first city in India to adopt a climate change action plan. Drawing on the literature on urban ecological security, I examine: (1) the adaptation challenges that Delhi faces; (2) the multiple motivations that underlie early action; (3) the key actors, strategies, and associated action domains outlined in the plan; and (4) the extent to which the plan seeks to bring about systemic change. Proactive action at the city level serves multiple strategic goals. Delhi's case is significant in illustrating how it has leveraged emergent opportunities to advance its short‐term development agenda, given the tight fiscal constraints and governance challenges it faces. The plan has been strategically formulated to enhance competiveness, facilitate image‐building, garner support for pet projects and access alternative sources of funding. But the short‐term orientation of the plan and its limited mechanisms for citizen engagement have severely restrained its capacity to address underlying social vulnerabilities or bring about transformative change.
Cities and Climate Change Challenges: Institutions, Policy Style and Adaptation Capacity in Bogotá
Authors: Lampis Andrea
Published: September 2013

While a growing awareness of climate change has marked the institutional agenda at the national level in Colombia, the capital city of Bogotá has not undertaken actions to include adaptation to climate change within its policies so far. Conceptualizing the central role of city‐level institutions in the successful realization of adaptation policies is a straightforward matter. This is not the case for actions and conditions that may foster adaptation capacity according to varying institutional and social geographies. Using secondary data and a selection of interviews with key stakeholders occupying leading planning roles in important departments of the local administration, this article explores why and how a framework based on incentives and obstacles should be complemented by recent developments in the analysis of policy implementation based on the differentiation between political and programmatic success and failure on the basis of existing local policy styles.
Mobile health (mHealth) based medication adherence measurement – a pilot trial using electronic blisters in diabetes patients
Authors: Brath Helmut , Morak Jürgen , Kästenbauer Thomas , Modre‐Osprian Robert , Strohner‐Kästenbauer Hermine , Schwarz Mark , Kort Willem , Schreier Günter
Published: September 2013

Aims

The aim of the present study was to evaluate a mobile health (mHealth) based remote medication adherence measurement system (mAMS) in elderly patients with increased cardiovascular risk treated for diabetes, high cholesterol and hypertension. Cardiovascular risk was defined as the presence of at least two out of the three risk factors: type 2 diabetes, hypercholesterolaemia and hypertension.

Methods

For treatment of diabetes, hypercholesterolaemia and hypertension, four predefined routinely used drugs were selected. Drug adherence was investigated in a controlled randomized doctor blinded study with crossover design. The mAMS was used to measure and improve objectively the adherence by means of closed‐loop interactions.

Results

The mean age of the 53 patients (30 female) was 69.4 ± 4.8 years. A total of 1654 electronic blisters were handed out. A statistically significant difference (P = 0.04) between the monitoring and the control phase was observed for the diabetes medication only. In a post‐study questionnaire twenty‐nine patients appreciated that their physician knew if and when they had taken their medications and 13 asked for more or automated communication with their physicians. Only one subject withdrew from the study because of technical complexity.

Conclusions

The results indicate that mHealth based adherence management is feasible and well accepted by patients with increased cardiovascular risk. It may help to increase adherence, even in patients with high baseline adherence and, subsequently, lead to improved control of indicators including blood pressure and cholesterol concentrations. Electronic blisters can be used in a multi‐medication regimen but need to be carefully designed for day‐to‐day application.
Tree Species Effects on Soil Properties and Greenhouse Gas Fluxes in East‐central Amazonia: Comparison between Monoculture and Diverse Forest
Authors: van Haren Joost , de Oliveira Raimundo Cosme , Beldini Patrick Troy , de Camargo Plinio Barbosa , Keller Michael , Saleska Scott
Published: September 2013

Tropical plantations are considered a viable option to sequester carbon on abandoned agricultural lands, but implications of tree species selection for overall greenhouse gas budgets on plantations have been little studied. During three wet seasons, we investigated the influence of nine tree species on soil pH, temperature (ST), bulk density (BD), moisture content water filled pore space (WFPS), and greenhouse gas fluxes in diverse forest sites and monoculture plantation plots. All sites were on clay‐rich soils of the Barreiras formation, in east‐central Amazônia, Brazil. We found that ST and BD were 0.6°C and 0.2 g/cm3 higher in the plantation relative to the forest, and soil CH4, CO,2 and N2O fluxes were, respectively, 38, 12, 62, percent lower in the plantation. Tree growth rates were highly variable on the plantation, with the mean comparable to the forest sites. Tree species identity mattered (P < 0.01) for all soil properties and gas fluxes on the plantation, but only for pH, BD, WFPS, and N2O fluxes in the forest. The species rank order of pH and N2O fluxes in the forest, however, were unlike the plantation. Tree growth rates were a strong predictor for soil WFPS, and together with location, they also explained 75 percent of the mean N2O flux variation. Our study indicates that: (1) tree species influence soil processes; and (2) high tree growth and low soil gas emissions imply a reduced climate forcing effect from plantations, especially when planted with fast‐growing legume species on abandoned farmland.
Nucleoside analog inhibits microRNA‐214 through targeting heat‐shock factor 1 in human epithelial ovarian cancer
Authors: Chen Yi‐Fei , Dong Zhangli , Xia Yi , Tang Jingjie , Peng Ling , Wang Shuying , Lai Dongmei
Published: September 2013

The important functions of heat shock factor 1 (HSF1) in certain malignant cancers have granted it to be an appealing target for developing novel strategy for cancer therapy. Here, we report that higher HSF1 expression is associated with more aggressive malignization in epithelial ovarian tumors, indicating that targeting HSF1 is also a promising strategy against ovarian cancer. We found that a nucleoside analog (Ly101‐4B) elicits efficient inhibition on HSF1 expression and potent anticancer activity on epithelial ovarian cancer both in vitro and in vivo. Moreover, by targeting HSF1, Ly101‐4B inhibits the biogenesis of microRNA‐214, which has been revealed to be overexpressed and to promote cell survival in human ovarian epithelial tumors. These findings demonstrate that Ly101‐4B is a promising candidate for ovarian cancer therapy, and expand our understanding of HSF1, by revealing that it can regulate microRNA biogenesis in addition to its canonical function of regulating protein‐coding RNAs.
Dihydropyrimidinase‐like protein 3 expression is negatively regulated by MYCN and associated with clinical outcome in neuroblastoma
Authors: Tan Fei , Wahdan‐Alaswad Reema , Yan Shuang , Thiele Carol J. , Li Zhijie
Published: September 2013

Dihydropyrimidinase‐like proteins (DPYSLs) are a family of proteins developmentally regulated during maturation of the nervous system. Recently, members of the DPYSL family have been reported to be involved in cancer with low expression of DPYSL1 correlating with poor clinical outcomes in non‐small cell lung cancer and functioning as a metastasis suppressor. Neuroblastoma (NB) is a tumor derived from precursor cells of the sympathetic nervous system and is the most common solid tumor in childhood. So far the biological functions of DPYSLs in NB remain elusive. Studying the potential roles of DPYSLs in NB may give us new insights into NB tumorigenesis. In the present study, using antibodies specific to different members of the DPYSL family, DPYSL1, DPYSL2 and DPYSL3, we investigated regulation of their expression and their subcellular distribution during retinoic acid (RA)‐induced differentiation in NB cells. The correlation between DPYSLs and MYCN, a biomarker for poor prognosis of NB, was evaluated. We found that DPYSL3 levels increased during RA‐induced cell differentiation. Downregulation of MYCN by small interfering RNA (siRNA) increased DPYSL3 levels, while upregulation of MYCN in non‐MYCN NB cells decreased DPYSL3 levels. DPYSL1 and DPYSL2 expression didn't change during RA treatment or under different expression levels of MYCN. Moreover, a high level of DPYSL3 mRNA, but not that of DPYSL1 or DPYSL2 mRNA, was detected in tumors from advanced‐stage NB that have a better survival. These data indicated that DPYSL3, not DPYSL1 or DPYSL2, is negatively regulated by MYCN and may be used as a potential biomarker for NB.
Patients' motives for consenting or refusing to participate in a clinical trial in organ transplantation
Authors: Guedj Myriam , Ballester Sandrine , Kamar Nassim , Rostaing Lionel , Donckier Vincent , Goldman Michel , Cambon‐Thomsen Anne
Published: September 2013

Background

The goal of this health‐psychology study was to investigate the range of motives that make someone consent or refuse participation in a clinical transplant trial.

Methods

The study involved (i) preparatory interviews with five transplant patients who took part in clinical trials and five persons from the general public; (ii) we created a questionnaire with scaled responses; (iii) we selected 468 patients, divided into two groups: patients waiting for a transplant and patients who already had a transplant; (iv) we obtained patient consents, sent out the questionnaire, and recorded responses; (v) data were analysed using descriptive statistics, exploratory factorial analyses, correlations and regressions.

Results

Two hundred and ten patients answered the questionnaire. Motives were classified into the following: (i) Motives to consent participating in a clinical trial (pride in participating, hope for better quality of life, sufficient and clear information, discussion with others participating in a trial, altruism); or (ii) Motives to refuse participating (no information on medical teams, lack of explanation, fear of additional expenses, being considered a “guinea pig”).

Conclusions

This study contributes to our understanding of the motivations of patients who accepted or refused participation in a clinical transplantation trial.
Publication Track Records as a Metric of Clinical Research Training Effectiveness
Authors: Knapke Jacqueline M. , Tsevat Joel , Succop Paul A. , Djawe Kpandja , Kuhnell Pierce , Haynes Erin N.
Published: September 2013

Clinical research training programs exist across the country, but no quantitative studies have been performed to evaluate the effectiveness of these programs. The goal of this study was to evaluate the success of the clinical research training program at the University of Cincinnati by comparing the publication histories of pediatric fellows who graduated from the clinical and translational research Master of Science (MS) degree programs between 1995 and 2011 with fellows who did not pursue an MS degree. Among 296 pediatric fellows, 44 of 54 graduates (81%) published at least 1 first‐authored paper, as compared with 149 of 242 (62%) fellows who did not obtain an MS degree (P < 0.01). In multivariable analysis, 3–4 years after program completion, MS graduates published more papers overall (R2 = 0.10) and more first‐authored papers than did non‐MS graduates (R2 = 0.04). These findings suggest that graduate training in clinical and translational research is related to an increase in research productivity as assessed by publication rates.
What are we looking for in the field of paediatric ‘neurodisability’?
Authors: Cans Christine
Published: September 2013

This commentary is on the original article by Morris et al. on pages 1103–1108 of this issue.
A Fetish and Fiction of Finance: Unraveling the Subprime Crisis
Authors: Pani Erica , Holman Nancy
Published: September 2013

As the moderately strengthened financial regulation ofBaselIIIcomes into effect over the next seven years, this article sets out a cautionary reminder as to why regulation needs to move beyond a focus on the mitigation and distribution of risk. To do so, the article unravels the much‐misunderstood experiences of eight Norwegian municipalities whose investments plummeted as the subprime crisis unfolded: investments that had no immediate ties to subprime mortgage lending or mortgage‐backed securities. Focusing on the processes, practices, and instruments of financialization, the article puts forward two new analytical concepts—“the fetishization of the knowledge of risk” and “fictitious distance”—to help explain how the crisis spread so quickly and extensively that it threatened not only the municipalities' investments but also the functioning of global finance as a whole. In so doing, it becomes clear that financialization has set a far more risky form of capitalism that is manifest through concrete economic geographies, from towns and cities in theUnitedStates to “distant”Norwegian municipalities. In the highly interconnected entanglement of geographies and finance that make up the global financial system, the fetishes and fictions of finance cannot be ignored.
Association between out‐of‐home trips and older adults' functional fitness
Authors: Chow Hsueh‐wen , Chen Hui‐Chen , Lin Linda L
Published: September 2013

Aim

To explore the purposes of older adults' out‐of‐home trips, and to investigate the association between the frequency of these trips and older adults' functional fitness.

Methods

A total of 412 older adults in Taiwan were recruited from 2009 to 2010. Participants were asked to fill out questionnaires on out‐of‐home trips, and trained volunteers assessed the functional fitness of respondents using objective measures. Descriptive statistics, univariate analysis, multivariate regression analysis and canonical correlation analysis were then used to analyze the resulting data.

Results

Results show that exercise is most frequently the purpose for going out at least once a day, and that parks are the most preferred places to visit. Sex and age are the significant variables explaining variance in older adults' flexibility and physical power, respectively. Canonical correlation analysis showed one significant variate pair (R2c = 8.80) between the frequency of out‐of‐home trips (engaging in exercise and participating in religious activities) and fitness measure test scores including the chair stand, arm curl, 2‐min step, and 8‐foot up‐and‐go. The relationship did not exist for the back scratch, nor chair sit‐and‐reach test scores.

Conclusion

The present study provides empirical and objective evidence on older adults' purposes for taking out‐of‐home trips, and for the positive association between the frequency of these trips, and the muscular strength and cardiovascular endurance, but not flexibility, of older adults. Geriatr Gerontol Int 2014; 14: 596–604.
Comparison of transient elastography (FibroScan), FibroTest, APRI and two algorithms combining these non‐invasive tests for liver fibrosis staging in HIV/HCV coinfected patients: ANRS CO13 HEPAVIH and FIBROSTIC collaboration
Authors: Castera L , Winnock M , Pambrun E , Paradis V , Perez P , Loko M‐A , Asselineau J , Dabis F , Degos F , Salmon D
Published: September 2013

Objectives

Combining noninvasive tests increases diagnostic accuracy for staging liver fibrosis in hepatitis C virus (HCV)‐infected patients, but this strategy remains to be validated in HIV/HCV coinfection. We compared the performances of transient elastography (TE), Fibrotest (FT), the aspartate aminotransferase‐to‐platelet ratio index (APRI) and two algorithms combining TE and FT (Castera) or APRI and FT (SAFE) in HIV/HCV coinfection.

Methods

One hundred and sixteen HIV/HCV‐coinfected patients (64% male; median age 44 years) enrolled in two French multicentre studies (the HEPAVIH cohort and FIBROSTIC) for whom TE, FT and APRI data were available were included in the study. Diagnostic accuracies for significant fibrosis (METAVIR F ≥ 2) and cirrhosis (F4) were evaluated by measuring the area under the receiver‐operating characteristic curve (AUROC) and calculating percentages of correctly classified (CC) patients, taking liver biopsy as a reference.

Results

For F ≥ 2, both TE and FT (AUROC = 0.87 and 0.85, respectively) had a better diagnostic performance than APRI (AUROC = 0.71; P < 0.005). Although the percentage of CC patients was significantly higher with Castera's algorithm than with SAFE (61.2% vs. 31.9%, respectively; P < 0.0001), this percentage was lower than that for TE (80.2%; P < 0.0001) or FT (73.3%; P < 0.0001) taken separately. For F4, TE (AUROC = 0.92) had a better performance than FT (AUROC = 0.78; P = 0.005) or APRI (AUROC = 0.73; P = 0.025). Although the percentage of CC patients was significantly higher with the SAFE algorithm than with Castera's (76.7% vs. 68.1%, respectively; P < 0.050), it was still lower than that for TE (85.3%; P < 0.033).

Conclusions

In HIV/HCV‐coinfected patients, TE and FT have a similar diagnostic accuracy for significant fibrosis, whereas for cirrhosis TE has the best accuracy. The use of the SAFE and Castera algorithms does not seem to improve diagnostic performance.
The CLOQS Trial Protocol: A Cluster-Randomized Trial Evaluating a Simple, Low-Cost Intervention to Reduce Treatment Times in Acute Stroke
Authors: Swartz Richard H. , Sicard Michelle N. , Silver Frank L. , Saposnik Gustavo , Gladstone David J. , Breaton Jennifer , Ramagnano Sharon , Lee Jacques , Aviv Richard I. , Fang Jiming , Zwarenstein Merrick F. ,   and the University of Toronto Stroke Program (UTSP) Investigators
Published: September 2013

Rationale

In acute stroke, time is brain: faster tissue plasminogen activator treatment improves patient outcomes. Published guidelines for door-to-scanner time are <25 minutes, and for door-to-needle time <60 minutes. These benchmarks are rarely met. Paradoxically, the earlier a stroke patient arrives to hospital, the longer treatment takes. There is an urgent need to shift focus away from the 4·5 hour time window, towards treatment times <60 minutes.

Aims

The objective of the Countdown Lights to Optimize Quality in acute Stroke (CLOQS) trial is to determine whether a simple, low-cost organizational behavior intervention, a large, red stopwatch timer attached to the stretcher upon arrival, will decrease door-to-scanner and door-to-needle treatment times for tissue plasminogen activator-treated patients.

Design

A multicenter, time-clustered randomized control trial. The stopwatch timers will be used in Emergency Departments for all acute stroke patients across the University of Toronto Stroke Program. The order of intervention (ON) and control (OFF) blocks will be randomly assigned in a 1:1 ratio over an 18 month period. Blocks will be weighted in a 2:1 ratio of ON/OFF using a permuted block design (ON blocks last two weeks; OFF blocks last one week).

Study Outcomes

The primary end-point is percentage of patients achieving best-practice guidelines (door-to-needle treatment time <60 minutes). Secondary end-points are median time intervals for 1) door-to-scanner and 2) door-to-needle times during ON versus OFF blocks. Tertiary end-points are in-hospital mortality and time series analysis to determine change in treatment times from prior to study onset through study completion.
Impact of Unfunded Pension Obligations on Credit Quality of State Governments
Authors: MARTELL CHRISTINE R. , KIOKO SHARON N. , MOLDOGAZIEV TIMA
Published: September 2013

This study reviews the funding status of state‐administered pension plans and their impact on state credit quality. As the fund ratio (actuarial assets/actuarial accrued liability) of state‐administered pension plans decreases, states are more likely assigned a lower rating. Moreover, rating outlooks are sensitive to the fund ratio, especially for migration between stable and negative outlooks for states with lower fund ratios. These results are a timely pretest to the 2013/2014 implementation of GASB Statements No. 67 and 68, serving as a benchmark to assess whether new reporting requirements will yield information to alter the market's response to unfunded pension liabilities.
Speech‐Induced Atrial Tachycardia: An Unusual Presentation of Supraventricular Tachycardia
Authors: MEMON NADA B. , BRICENO DAVID F. , TORRES‐RUSSOTTO DIEGO , CHEN JANE , SMITH TIMOTHY W.
Published: September 2013

Speech‐Induced Atrial Tachycardia

A 63‐year‐old male radio announcer was admitted with a narrow complex, long RP tachycardia. While in the awake state, the patient spoke in his radio voice, initiating and maintaining the tachycardia. Three‐dimensional electroanatomic mapping during electrophysiology study localized the tachycardia to the ostium of the right superior pulmonary vein. After single radiofrequency energy application, no further arrhythmias were inducible with speech. At more than 1 year of follow‐up, the patient had no recurrences and continues to work as a radio announcer.
TheGerman Model and theEuropean Crisis
Authors: Bonatti Luigi , Fracasso Andrea
Published: September 2013

The large current account imbalances in the eurozone reflect persistent diverging trends between core and periphery countries, also fed by low interest rates and abundant capital flows brought about by the introduction of the euro. With the global financial crisis, the market sentiment has changed, and capital has left the periphery countries suffering from debt and growth problems due to their failure to bring price–wage dynamics into uniformity with those of the more disciplined countries.Germany is called upon to provide financial assistance and additional external demand; however, though the euro is at stake,Germans are recalcitrant. This article investigates the rationale of theGerman stance in light of the (corporatist‐etatist, neo‐mercantilist)German socio‐economic model and the widespread concern about losing the competitiveness thatGermany regained through painful reforms and changes in the last two decades.
Trade Agreements as Venues for ´Market PowerEurope´? The Case of Immigration Policy
Authors: Jurje Flavia , Lavenex Sandra
Published: September 2013

In the absence of an international migration regime, the rising salience of migration issues and the limits of unilateral policies led theEuropeanUnion to seek appropriate venues for co‐operation with the sending and transit countries of migrants. Many of the newer relevant multilateral or regional venues are soft law frameworks. Conversely, trade agreements provide a formal, hard law instrument for inserting migration clauses. Based on a quantitative analysis ofEUtrade agreements and expert interviews, this article investigates how far theEUis engaging in strategic issue‐linkage when including migration clauses in its trade agreements. Testing hypotheses derived from rationalist and institutionalist approaches, it thereby provides an empirical test of its acclaimed identity as ‘trade power’ or ‘market power’.
Long‐term effects of photoperiod, temperature and their interaction on growth, gill Na+, K+‐ATPase activity, seawater tolerance and plasma growth‐hormone levels in Atlantic salmon Salmo salar
Authors: Handeland S. O. , Imsland A. K. , Björnsson B. Th. , Stefansson S. O.
Published: September 2013

This study was undertaken to examine the long‐term effects of photoperiod, temperature and their interaction on growth, gill Na+,K+‐ATPase (NKA) activity, seawater tolerance and plasma growth‐hormone levels in Atlantic salmon Salmo salar pre‐smolts and smolts. The fish (mean ± s.e. initial body mass = 15·9 ± 0·4 g) were reared on two photoperiods (continuous light, LL, and simulated natural photoperiod, LDN, 60° 25′ N) and two temperatures (8·3 and 12·7° C) from June to May of the following year. Mean body mass was affected by photoperiod, temperature and their interactions. Both temperature groups on LL developed peak levels in gill NKA activity from October to November, 4–5 months prior to the natural season for the parr–smolt transformation. Fish at 12° C showed peak levels in NKA activity 4–6 weeks before the fish at 8° C. Fish in all four experimental groups showed maximum NKA activity within a similar size range (113–162 g). The present findings further indicate that smoltification in S. salar is to some extent driven by size, and that S. salar will develop smolt characteristics, e.g. a marked increase in NKA activity, within a similar size range. Faster‐growing S. salar will, thus, reach this size threshold at a relatively younger age.
Blood lactate loads of redthroat emperor Lethrinus miniatus associated with angling stress and exhaustive exercise
Authors: Currey L. M. , Heupel M. R. , Simpfendorfer C. A. , Clark T. D.
Published: September 2013

Baseline, post‐angling and maximum attainable blood lactate concentrations were measured for the fishery species redthroat emperor Lethrinus miniatus to gain insight into the condition of fish released following c. 30 s angling and <45 s air exposure. Mean ± s.d. baseline blood lactate was 1·5 ± 0·6 mmol l−1, which increased and plateaued around 6 mmol l−1 at 15–30 min post‐angling. These values were significantly lower than those obtained from fish maximally exhausted with a prolonged chase and air exposure protocol following capture (10·9 ± 1·8 mmol l−1), suggesting that L. miniatus is not maximally exhausted during standard angling practices.
A fragile bond: adoptive parents' experiences of caring for children with a diagnosis of reactive attachment disorder
Authors: Follan Michael , McNamara Martin
Published: September 2013

Aims and objectives

To understand how adoptive parents caring for children with a diagnosis of reactive attachment disorder (RAD) make sense of their life‐worlds by establishing the meanings that underlie and structure their experiences of their everyday lives.

Background

Reactive attachment disorder is a serious psychosocial disorder of childhood that causes short‐ and long‐term relationship, health and social consequences for children. It is more likely to be observed in children being cared for by foster carers, kinship carers or adoptive parents. Exploration of adoption from parents' perspectives is not well documented, and no previous work has been undertaken to understand the challenges of caring for children with a diagnosis of reactive attachment disorder.

Design

The study was guided by Husserl's phenomenology, which aims to uncover the underlying essential meanings intrinsic to a phenomenon. Three concepts are central to this approach: essences, intuiting and eidetic reduction.

Methods

Semi‐structured interviews were conducted with eight adoptive parents. Data were analysed using an adaptation of Colaizzi's method.

Results

Four essential elements fundamental to participants' lived experiences of caring for a child with a diagnosis of RAD were uncovered: being profoundly unprepared, being insecure, being assailed by unexpected emotions and being committed.

Conclusions

The parent–child relationship is a fragile bond developed at an unexpectedly high personal cost; it is a committed relationship but vulnerable to continual destabilisation. The involvement in the preparation of adoptive parents of child and adolescent mental health (CAMH) staff with expertise in the impact of early neglect or separation on children should be considered.

Relevance to clinical practice

The development of systems to prepare, screen and identify potential challenges and problems prior to adoption might help adoptive parents. Access to a CAMH professional in the pre and postadoption phases might assist potential adoptive parents in making informed decisions around the choice of a child for adoption.
The “Designed” Israeli Interior, 1960–1977: Shaping Identity
Authors: Smith Daniella Ohad
Published: September 2013

The concept of a “home” had played an important role during the early decades of Israel's establishment as a home for all the Jewish people. This study examines the “designed” home and its material culture during the 1960s and 1970s, focusing on aesthetic choices, approaches, and practices, which came to highlight the home's role as a theater for staging, creating, and mirroring identities, or a laboratory for national boundaries. It seeks to identify the conceptualization of the domestic space during fundamental decades in the history of Israel.
How Sacrifice Impacts the Giver and the Recipient: Insights From Approach‐Avoidance Motivational Theory
Authors: Impett Emily A. , Gere Judith , Kogan Aleksandr , Gordon Amie M. , Keltner Dacher
Published: September 2013

This study investigated how sacrificing for approach versus avoidance goals shapes the giver's and the recipient's emotions and relationship quality. A sample of 80 dating couples participated in a three‐part study in which they discussed sacrifice in the laboratory (Part 1), reported on their daily sacrifices for 14 days (Part 2), and completed a follow‐up survey 3 months later (Part 3). When partners discussed a sacrifice they had made for approach goals, they experienced greater relationship quality, whereas when they discussed a sacrifice they had made for avoidance goals, they experienced poorer relationship quality. These effects were replicated with outside observer reports. On days when partners sacrificed for approach goals, both partners experienced increased relationship quality, but on days when people sacrificed for avoidance goals, the giver experienced decreased relationship quality. These effects were mediated by positive and negative emotions, respectively. Approach sacrifice goals predicted increases in relationship quality and avoidance sacrifice goals predicted decreases in relationship quality, as reported by both partners 3 months later. Sacrifice per se does not help or harm relationships, but the goals that people pursue when they give up their own interests can critically shape the quality of intimate bonds.
Effects of a Sustained‐Release Form of Isosorbide Dinitrate on Left Atrial Pressure in Dogs with Experimentally Induced Mitral Valve Regurgitation
Authors: Yamamoto Y. , Suzuki S. , Hamabe L. , Aytemiz D. , Huai‐Che H. , Kim S. , Yoshiyuki R. , Fukayama T. , Fukushima R. , Tanaka R.
Published: September 2013

Background

The effects of isosorbide dinitrate (ISDN) have not been sufficiently investigated in conscious dogs with mitral valve regurgitation (MR).

Objective

The objective was to investigate the effects of a sustained‐release form of ISDN (sr‐ISDN) on hemodynamics and the autonomic nervous system in dogs with MR.

Animals

Six healthy Beagles weighing 11.2 ± 2.2 kg (2 years of age; 2 males and 4 females) were used.

Methods

Experimental, crossover, and interventional study. Dogs with experimentally induced MR were administered placebo, 2, 5, and 10 mg/kg sr‐ISDN PO on separate days with a 7‐day washout period between randomized dosings. Left atrial pressure (LAP) had been recorded continuously from 30 minutes before administration of sr‐ISDN to 12 hours after administration.

Results

LAP was significantly decreased after administration in the 5 and 10 mg/kg groups. Significant decrease was observed at 3 and 4 hours after administration in the 5 mg/kg group. In the 10 mg/kg group, significant decrease was observed at 2, 3, 4, 5, 6, 7, 10, and 11 hours after administration. The lowest value was observed at 4 hours after administration in the 5 and 10 mg/kg groups (20.9 ± 4.2 to 15.9 ± 3.9 mmHg, P < .01, and 21.3 ± 4.0 to 13.6 ± 4.2 mmHg, P < .001).

Conclusions and Clinical Importance

Sustained‐release form of ISDN showed significant decrease of LAP in the 5 mg/kg and 10 mg/kg groups, and duration of effect was dose related.
The Effect of Feeding a Renal Diet on Plasma Fibroblast Growth Factor 23 Concentrations in Cats with Stable Azotemic Chronic Kidney Disease
Authors: Geddes R.F. , Elliott J. , Syme H.M.
Published: September 2013

Background

Fibroblast growth factor 23 (FGF‐23) is a phosphatonin, which is increased in cats with azotemic CKD. Dietary phosphate restriction decreases FGF‐23 concentrations in humans and rodents, but this relationship has not previously been examined in the cat.

Objectives

To investigate the effect of feeding renal diet on plasma FGF‐23 concentrations in cats with stable azotemic CKD.

Animals

Azotemic, client‐owned cats (≥9 years); 33 cats ate renal diet (RD group) and 11 cats did not eat renal diet (comparator group) over 28–56 days.

Methods

Retrospective longitudinal study: Plasma FGF‐23, PTH, and phosphate concentrations were measured at baseline and after 28–56 days. Cats in the RD group were classified as hyperphosphatemic (HP) or normophosphatemic (NP) based on the International Renal Interest Society targets for plasma phosphate concentration. Nonparametric tests were performed.

Results

In the HP group (n = 15), feeding renal diet was associated with a significant decrease in plasma phosphate (P = .001), PTH (P = .007), and FGF‐23 (P = .008), but not creatinine concentrations (P = .91). In the NP group (n = 18), feeding renal diet was associated with a significant decrease in plasma FGF‐23 (P = .006), but not phosphate (P = .48), PTH (P = .35), or creatinine concentrations (P = .10). No significant changes were seen in any parameters in the comparator group during the study period.

Conclusions and Clinical Importance

Feeding renal diet is associated with reductions in plasma FGF‐23 concentrations in hyper‐ and normophosphatemic cats with stable azotemic CKD, suggesting that dietary phosphate restriction may enable cats with CKD to maintain normal plasma phosphate concentrations in association with lower plasma FGF‐23 concentrations.