bluuebunny/crossref_metadata_2025 huggingface dataset:
Right Atrial Surgery without Caval Snaring
Authors: Dandolu Reddy , Eaton Douglas , Ali Aras , Schwann Nannette , Wechsler Andrew
Published: May 2008

Background

During tricuspid valve replacement in a patient with previous mitral valve surgery, we made an incidental observation that the right atrium can be opened without caval snaring and without air entering the venous reservoir. We tested this hypothesis on an animal model.

Methods

Two patients underwent right atrial surgery using percutaneous cannulation, and no air was entrained without caval snaring. This principle was tested in an animal model using 2 pigs weighing 80 kg each. Percutaneous cannulae were placed under epicardial echo guidance with their tips 4 cm from the right atrium. A “collapsible bag with air drainage system” was introduced into the venous return system to quantify air return from the superior vena cava (SVC) and inferior vena cava (IVC). Two types of percutaneous cannulae with (Cardiovations Quick Draw) and without (Biomedicus) proximal side holes were tested.

Results

In the animal model using Biomedicus cannulae, upon opening the right atrium, air was entrained from the SVC cannula at 60 mL/minute with no air in the IVC. There was no difference in the amount of air between the two cannulae. Pressures measured were 5 cm of water in the IVC and −20 cm water in the SVC. Epicardial ultrasound demonstrated complete collapse of both vena cavae. Partial clamping of the SVC cannula reduced the amount of air to 60 cc/min, and placing a small straight clamp at the SVC atrial junction eliminated the air. No air was noted in IVC cannula.

Conclusions

Inferior vena caval drainage by percutaneous cannula does not entrain air with either type of cannula and without snaring (both in clinical cases and animal model). This might be explained by the presence of a competent Eustachian valve. However, the SVC is not immune to air. Minimal air (approximately 60 mL/minute) could be managed by partial clamping or completely be avoided by placing a small straight clamp without snaring.
Three-Dimensional Reconstruction of Ultrafast 16-Slice Computed Tomography Images and CT Angiography versus Conventional Coronary Angiography at One Year in Multivessel Coronary Artery Bypass Surgery
Authors: Malhotra Rajneesh , Mishra Manisha , Khurana Poonam , Aggarwal Monika , Mishra Yugal , Meharwal Zile Singh , Kohli Vijay , Bapna Ramesh Kumar , Kasliwal Ravi Ratan , Mehta Yatin , Trehan Naresh
Published: May 2008

Background

The aim of this study was to evaluate and compare the postoperative graft patency assessment by multislice spiral computed tomography (MSCT) scan and conventional coronary angiography (CCA) in coronary artery bypass grafting (CABG) patients 1 year after surgery.

Methods

Sixty-nine patients who underwent isolated CABG at least 1 year before the study, were subjected to both MSCT angiography with cardiac gating and CCA. The results were evaluated and compared.

Results

There were 209 grafts in 69 patients. All grafts were evaluated by both MSCT angiography and CCA. Seventy-eight grafts were on the anterior wall, 83 on the lateral wall and 48 on the inferior wall of the heart. On MSCT angiography, all left internal mammary arteries were visualized with 3-dimensional reconstruction and found to be patent. Of 209 grafts, 11 grafts (5.26%) were blocked, 6 grafts on the lateral wall and 5 on the inferior wall. All patent grafts were correctly evaluated by MSCT angiography (specificity 100%). However, 2 grafts that were found to be patent on MSCT angiography were blocked on CCA (MSCT sensitivity 81.8%).

Conclusions

Postoperative evaluation of coronary bypass grafts is possible with very good resolution by MSCT angiography. This method allows evaluation of the bypass grafts and the quality of anastomosis with a noninvasive method that is comparable with CCA.
Dual-Beam Ultrasound versus Transit-Time Flow Meter for Intraoperative Graft Flow Measurement during Coronary Artery Bypass Grafting
Authors: Shapira Oz M. , Eskenazi Benjamin R. , Hunter Curtis T. , Korach Amit , Anter Elad , Lazar Harold L. , Shemin Richard J.
Published: May 2008

Objective

Assessment of graft flow during coronary artery bypass grafting (CABG) is increasingly practiced as a quality measure, particularly in patients undergoing minimally invasive or “off-pump” revascularization. Transit-time flow meters such as Transonic system (TS) are currently the most frequently used technology. The QuantixOR flow probe (QOR) is a novel technology comprised of dual-beam ultrasound transducer and a digital pulse-wave Doppler, allowing immediate, quantitative blood flow measurements. Excellent correlation between QOR and TS was observed in phantom and animal models. This study evaluated the QOR in patients undergoing CABG.

Methods

Graft flow was measured in 75 patients undergoing CABG (203 grafts). Intraobserver (n = 169) and interobserver (n = 33) variability was assessed and the QOR was compared with the TS (n = 155).

Results

An average of 2 probe sizes per case and “skeletonization” of a short segment of the vessel were required to measure flow in arterial conduits using TS. In contrast, measurements of flow with the QOR were achieved using a single probe without special vessel preparation for all types of conduits. Average intraobserver and interobserver variability using the QOR were 5 ± 41% and 4 ± 40%, respectively. Correlation was observed between 2 sets of measurements by the same observer (R2 = 0.746, P < 0.0001) and between 2 different observers (R2 = 0.667, P < 0.0001). Correlation was also observed between the QOR and TS (R2 = 0.542, P < 0.0001) with a variance of 12 ± 21%.

Conclusions

The QOR technology provides a reliable quantitative graft flow assessment that is simpler to obtain compared with TS. Correlation between the QOR and TS is excellent.
Adjunctive Atrial Fibrillation Therapy with Off-Pump Coronary Artery Bypass Grafting: Standard of Care?
Authors: Wudel James H. , Hedderich Giles S. , Jex R. Kent
Published: May 2008

Objectives

To validate the safety and applicability of a previously unreported innovative technique: bipolar epicardial radiofrequency pulmonary vein ablation for the treatment of atrial fibrillation (AF) in conjunction with off-pump coronary artery bypass surgery.

Methods

After the completion of off-pump coronary artery bypass grafting (OPCAB) via sternotomy, patients underwent epicardial pulmonary vein ablation using a bipolar radiofrequency clamp placed on the left atrial cuff. The left atrial appendage was removed or excluded in all patients.

Results

Fifteen patients (aged 59–81 years) were treated and reviewed. An average of 2.8 ± 1 grafts were performed per patient; all patients received left internal mammary artery grafts. All sets of pulmonary veins were encircled successfully and ablated. Four patients had additional lesions placed. No patient had pulmonary vein injury. There were no reoperations for bleeding and no mortality. Preoperatively, AF was continuous in 4 patients and intermittent in 11; 10 patients were taking Coumadin preoperatively and 11 were taking antiarrhythmic drugs (AAD). At the follow-up evaluation (7.6 ± 4.4 months; range 1–16 months), 12 patients (80%) are in sinus rhythm (100% in the intermittent AF group, 25% in the continuous AF group); Coumadin has been discontinued in 5 of 10 patients (50% reduction) and AAD have been discontinued in 7 of 11 patients (74% reduction).

Conclusions

Bipolar radiofrequency epicardial pulmonary vein ablation can be safely and reproducibly used for the treatment of AF in conjunction with OPCAB. Patients with intermittent AF should be strongly considered for adjunctive treatment at the time of OPCAB.
Extraanatomic Bypass for Recurrent Aortic Coarctation Involving the Arch and Replacement of the Ascending Aorta via Sternotomy
Authors: Blasio Andrea , Benussi Stefano , Arcobasso Lorenzo , Alfieri Ottavio
Published: May 2008

A suction device, currently used to lift the heart in off-pump coronary surgery, was used to facilitate an extraanatomic bypass grafting procedure in a patient with recoarctation of the aorta, hypoplasia of the aortic arch, and dilatation of the ascending aorta.
Hemostatic Control of Coronary Arteries with Poloxamer 407 Reverse-Thermal Polymer during Off-Pump Coronary Artery Bypass Surgery in a Pig Model
Authors: Cohn William E. , Tuzun Egemen , Simonak Ryan , Baimbridge Fred
Published: May 2008

Objective

To evaluate a new material, poloxamer 407 reversethermal polymer, which may be of value in controlling bleeding during off-pump coronary anastomoses.

Methods

Poloxamer 407 reverse-thermal polymer is a clear, nontoxic compound that is a viscous liquid at room temperature but instantly changes to a firm, water-soluble gel when warmed to body temperature. Six pigs underwent off-pump coronary artery bypass with the left internal mammary artery to the left anterior descending coronary artery. Blood loss from the arteriotomy was measured over a 15-minute period before and after injection of 500 μL intracoronary polymer. After completion of the anastomosis, 10 mL of cold saline was poured along the left anterior descending artery to facilitate dissolution of the polymer. The heart was allowed to beat 2 additional hours with blood flowing through the left internal mammary to left anterior descending graft, after which a completion angiogram was obtained to evaluate graft patency and to look for gross angiographic evidence of coronary branch occlusion or intraluminal filling defects. The animals were then humanely euthanized, and myocardium from the area subtended by the left anterior descending was harvested for histologic evaluation.

Results

All animals successfully underwent the surgical procedure and survived until study termination without any complications. The amount of bleeding from coronary arteriotomy was significantly higher before intracoronary injection of the polymer (5.25 ± 1.65 mL/min versus 0.54 ± 0.53 mL/min, P = 0.0004). Angiography demonstrated that the graft was patent, and there was no evidence of intraluminal foreign bodies. Myocardial samples from the subtended bed showed no evidence of intraarterial polymer or myonecrosis.

Conclusions

Poloxamer 407 reverse-thermal polymer may be a valuable tool in performing coronary anastomoses off-pump. Completion angiograms showed total dissolution of the material with no residual intraarterial polymer visible on tissue samples.
New Instrument for Robotic-Enhanced Skeletonized Internal Thoracic Artery Harvesting: Triangular Hook
Authors: Ishikawa Norihiko , Sun You Su , Nifong L. Wiley , Watanabe Go , Chitwood W. Randolph
Published: May 2008

Objective

The introduction of robotic surgery has generated innovations in minimally invasive coronary surgery, including instrumentation. We have developed a small instrument, named by us the Triangular Hook, that expedites robotic skeletonization of the internal thoracic artery and makes the procedure safer.

Methods

Bilateral skeletonized internal thoracic artery harvesting was performed in four dogs (weight, 22 to 36 kg), using the da Vinci surgical system (Intuitive Surgical, Inc, Sunnyvale, CA). One internal thoracic artery was harvested with the Triangular Hook; the other was harvested without it. Harvesting time was measured for each form of harvesting, with the data being reported as mean ± SD.

Results

All eight internal thoracic arteries were harvested successfully; they were patent at the end of harvesting. Significantly less time was required for the Triangular Hook (41.5 ± 2.8 minutes) than for harvesting without it (47.5 ± 3.9 minutes; P = 0.02).

Conclusions

The Triangular Hook is practicable and safe in robotic skeletonization of the internal thoracic artery.
Video-Assisted Extended Transcervical Thymectomy
Authors: Komanapalli Christopher B. , Cohen James I. , Sukumar Mithran S.
Published: May 2008

Objective

The objective of this study was to demonstrate extended thymectomy via the transcervical route.

Methods

With the use of the Rultract retractor (Rultract, Cleveland, OH), videothoracoscopy and single-lung ventilation allowed complete thymectomy.

Results

This article demonstrates complete resection of all the thymus from the anterior and superior mediastinum.

Conclusions

In selected patients, the transcervical route can used to completely resect the thymus, avoiding the morbidity of sternotomy.
Dacron Patch Aortoplasty of Thoracic Aortic Pseudoaneurysm due to Penetrating Atherosclerotic Ulcer
Authors: Masroor Saqib , Alexander John C.
Published: May 2008

We report the case of a patient with severe diffuse peripheral vascular disease, coronary artery disease, congestive heart failure, and gastrointestinal bleeding with a pseudoaneurysm of descending thoracic aorta who underwent successful Dacron patch aortoplasty. She was not a candidate for stent-graft repair because of poor access. Using a partial occluding clamp, the pseudoaneurysm was excised and the aorta repaired with a 3.5-cm Dacron patch. She was discharged home in 7 days and has successfully undergone stenting of the left subclavian artery and right and left carotid endarterectomy.
Beating Heart Aortic Valve Replacement using Real-Time MRI Guidance
Authors: Horvath Keith A. , Guttman Michael , Li Ming , Lederman Robert J. , Mazilu Dumitru , Kocaturk Ozgur , Karmarkar Parag V. , Hunt Timothy , Kozlov Shawn , McVeigh Elliot R.
Published: May 2008

Objective

The principal limitations of percutaneous techniques to replace the aortic valve are detailed visualization and durable prostheses. We report the feasibility of using real-time magnetic resonance imaging (MRI) to provide precise anatomic detail and visual feedback to implant a proven bioprosthesis.

Methods

Twelve domestic pigs were anesthetized, and, through a minimally invasive approach using real-time MRI guidance, underwent aortic valve replacement. This was accomplished on the beating heart by using a commercially available bioprosthesis. MRI was used to precisely identify the anatomic landmarks of the aortic annulus, coronary artery ostia, and the mitral valve leaflets. Additional intraoperative perfusion, flow velocity, and functional imaging were used to confirm adequacy of placement and function of the valve.

Results

Under real-time MRI, multiple oblique planes were prescribed to delineate the anatomy of the native aortic valve and left ventricular outflow track. Enhanced by the use of an active marker wire, this imaging allowed correct placement and orientation of the valve. Through a transapical approach, a series of bioprosthetic aortic valves (21 to 25 mm) were inserted. The time to implantation after the placement of the trocar to deployment of the valve was less than 90 seconds. The average procedure duration was less than 40 minutes

Conclusions

Real-time MRI provides excellent anatomic detail and intraoperative assessment that permits placement of durable valve prostheses on the beating heart without the limitations of percutaneous approaches.
Chordal Tethering: A Unique Cause of Structural Mitral Regurgitation in Dilated Cardiomyopathy
Authors: Masroor Saqib , Berkowitz Robert , Alexander John C.
Published: May 2008

Mitral regurgitation in dilated cardiomyopathy is usually considered “functional,” and many such patients are treated medically. Surgery is often offered as a last resort in select patients who have failed medical therapy. We report a patient with dilated cardiomyopathy with ventricular tachycardia and ventricular dyssynchrony and “structural mitral regurgitation” due to chordal tethering, which was managed surgically using a minimally invasive approach.
Thoracoscopic Transmyocardial Laser Revascularization: Is Prior Coronary Artery Bypass Grafting a Contraindication?
Authors: Allen Gary S. , Budde Jason
Published: May 2008

Objective

Recently, thoracoscopic techniques have been used to perform transmyocardial laser revascularization (TMR) in patients who are not suitable candidates for coronary artery bypass graft (CABG) surgery or percutaneous coronary interventions. Whether or not prior CABG contraindicates a port access–only approach to TMR is unclear. This study compares patients with and without prior CABG who have undergone thoracoscopic TMR.

Methods

Between May 2003 and October 2005, 23 consecutive patients (6 without prior CABG, group A; and 17 with prior CABG, group B) underwent thoracoscopic TMR, using a holmium:yttriumaluminum-garnet (Ho:YAG) laser system. Either 3 or 4 port incisions (each ≤2 cm in length) were used, depending on the patient's anatomy. Procedural success was defined as the ability to create all intended channels without conversion to thoracotomy.

Results

Patient demographics were not significantly different between group A and group B (mean age, 65.8 ± 4.3 years versus 67.4 ± 2.4 years, Canadian Cardiovascular Society angina class 3.7 ± 0.2 versus 3.9 ± 0.1, and Parsonnet score 12.0 ± 3.2 versus 20.5 ± 2.4). Fourteen (82.4%) group B patients had a prior left internal mammary artery to left anterior descending artery graft, of which 12 (85.7%) were patent. One patient in group A had an airway injury at intubation that led to an extended hospital stay of 30 days. One patient in group A (16.7%) and one patient in group B (5.9%) required a blood transfusion (P = NS). Adhesion lysis time in group B ranged from 0 to 68 minutes (mean, 27 ± 5.6 minutes). Neither group had a conversion to thoracotomy or any deaths through a mean combined follow-up of 12 months.

Conclusions

A port access approach is safe and reproducible for patients who are candidates for sole therapy TMR. Prior CABG, including patent grafts, is not a contraindication to thoracoscopic TMR.
Quantitative Description of Mitral Valve Geometry Using Real-Time Three-Dimensional Echocardiography
Authors: Ryan Liam P. , Jackson Benjamin M. , Eperjesi Thomas J. , Plappert Theodore J. , John-Sutton Martin St. , Gorman Robert C. , Gorman Joseph H.
Published: May 2008

Objectives

Leaflet and annular geometry are important determinants of mitral valve (MV) stress. Repair techniques which optimize valvular geometry will reduce stress and potentially increase repair durability. The development of such procedures will require image processing methodologies that provide a quantitative description of three-dimensional valvular geometry. Using three-dimensional echocardiography in conjunction with novel geometric modeling and rendering techniques, we have developed a high-resolution, quantitative, three-dimensional methodology for imaging the human MV.

Methods

Five normal adults underwent MV imaging using real-time three-dimensional echocardiography. Using specially designed image analysis software, multiple valvular geometric parameters, including the magnitude and orientation of leaflet curvature, leaflet surface area, annular height, intercommissural width, septolateral annular diameter, and annular area were determined for each subject. Image rendering techniques that allow for the clear and concise presentation of this detailed information are also presented.

Results

Although three-dimensional annular and leaflet geometry were found to be highly conserved among normal human subjects, substantial regional variation in leaflet geometry was observed. Interestingly, leaflet geometric heterogeneity was most pronounced in the midposterior leaflet, the region most commonly involved in leaflet flail in subjects with myxomatous disease.

Conclusions

The image processing and graphical rendering techniques that we have developed can be used to provide a complete description of three-dimensional MV geometry in human subjects. Widespread application of these techniques to normal subjects and patients with MV disease will provide insight into the geometric basis of both valvular pathology and repair durability.
Transmyocardial Laser Revascularization Enhances Blood Flow within Bypass Grafts
Authors: Tran Richard , Brazio Philip S. , Kallam Seeta , Gu Junyan , Poston Robert S.
Published: May 2008

Objective

Early benefits from transmyocardial laser revascularization (TMR) may be related to acute sympathetic denervation. This study hypothesized that TMR as an adjunct to off-pump coronary artery bypass (OPCAB) would improve myocardial runoff in the TMR-treated regions and increase graft flow.

Methods

Graft blood flow was measured in 145 consecutive OPCAB patients. In patients with graft flow <40 mL/min (n = 25), the myocardial region served by the graft was treated with TMR. Blood flow was reassessed 10 minutes after TMR and compared with graft flow in the nontreated regions. Postoperative outcomes, transcardiac thrombin production, coagulation activation, myocardial, and inflammatory markers were assessed. A control group not treated with TMR (n = 14) was selected with similar graft flows and other baseline characteristics.

Results

Risk factors, comorbidities, and preoperative medications were similar in all groups. TMR led to a 48% increase in bypass graft flow in 12 patients, but no significant change in flow in the remainder (n = 13). The control group also showed no change in graft flow measured during the same time-points. Compared with those that did not respond to TMR, responders showed a greater drop in pH during warm ischemia caused by distal anastomoses during OPCAB and significantly higher transcardiac gradients of F1.2, IL-8, TNFα, and VCAM.

Conclusions

TMR acutely improves venous bypass graft flow in regions with more severe myocardial acidosis and inflammation during and after OPCAB. Acute sympathetic denervation after TMR may provide mechanistic insight into the early clinical benefits of TMR as an adjunct to OPCAB.
The relationships between the characteristics of the strategy process: evidence from Egypt
Authors: Elbanna Said , Younies Hassan
Published: May 2008

Purpose

Strategy process research has made considerable progress over the last 20 years and has produced a vast body of literature. This valuable contribution, however, has not adequately examined the relationships between the characteristics of the strategy process. This study aims to fill this gap by providing evidence on the relationships between the characteristics of the process of making strategic decisions (SDs) in a new setting.

Design/methodology/approach

The study uses quantitative and qualitative methods.

Findings

Based on quantitative and qualitative evidence from a sample of Egyptian companies, it was found that decision makers could be simultaneously rational, political and/or intuitive.

Research limitations/implications

The study recommends further research to develop new constructs of the SD making process the way in which the multi‐dimensional nature of this organic process can be considered.

Practical implications

The SD making process can be multi‐dimensional

Originality/value

The paper examines the relationships between the characteristics of the strategy process. It provides evidence on the relationships between the characteristics of the process of making strategic decisions (SDs) in a new setting.
Performance evaluation and analysis of lubricating oil using parameter profile approach
Authors: Sharma B.C. , Gandhi O.P.
Published: May 2008

Purpose

The purpose of this paper is to evaluate and analyze lube oil performance. The plant experience shows that the oil, even after completion of a number of hours of recommended operation, has some residual life. It is desirable to maximize its use to conserve this scarce resource but avoid failures. At present, continuation or change of the oil is decided, based on the manufacturer's recommendation and experience in the plant. The suggested oil change period is conservative and results in non‐efficient usage of oil. This practice needs refinement to include all possible properties/attributes of oil and use of appropriate procedure to assess its realistic performance.

Design/methodology/approach

Parameter profile approach (PPA) is applied to evaluate and analyze the lubricating oil performance parameters.

Findings

Physical and chemical properties related to degradation of the lube oil are considered as lubricating oil performance parameters. The value of these performance parameters from time to time, obtained by analyzing samples drawn from the system, are analyzed through PPA. In this approach, mean, median, performance parameter index and time performance index are defined and evaluated at different time intervals. The suggested procedure is illustrated by means of an example.

Originality/value

The suggested procedure will be helpful for the maintenance personnel in planned oil replacement, and in identifying the weak oil properties in respect of the identified lube oil performance parameters.
Tribological properties of Cyanex 301‐modified MoS2 nano‐sized hollow spheres in liquid paraffin
Authors: Zhou Xiaodong , Shi Huaqiang , Fu Xun , Wu Danmei , Hu Zhengshui
Published: May 2008

Purpose

The purpose of this paper is to investigate the tribological properties of MoS2 nano‐sized hollow spheres in liquid paraffin (LP) and the corresponding action mechanism. Morever, its feasibity of industrial application as an oil additive in the industrial lubrication field is also explored.

Design/methodology/approach

The tribological properties of MoS2 nano‐sized hollow spheres (NH‐MoS2) modified by Cyanex 301(di‐(2,4,4‐trimethylpentyl) dithiophosphinic acid) with size of 200 ∼ 300 nm in LP are studied and compared with those of the commercial colloidal MoS2 (CC‐MoS2) on a four‐ball tester and an Optimol SRV Oscillating friction and wear tester in a ball‐on disk configuration. The worn surfaces of the lower flat disc are examined with a scanning electron microscopy and an X‐ray photoelectron spectroscopy, respectively.

Findings

Results show that NH‐MoS2 is a better extreme‐pressure additive and anti‐wear (AW) and friction‐reducing additive in LP than CC‐MoS2. Under the optimum concentration of 0.5 per cent for both NH‐MoS2 and CC‐MoS2 and the load of 400 N, the friction coefficient of NH‐MoS2 + LP and CC‐MoS2 + LP decreases about 43.8 and 6.3 per cent, and the wear volume loss decreases about 60.3 and 12.0 per cent compared with the pure LP. The boundary lubrication mechanism for NH‐MoS2 + LP can be deduced as the effective chemical adsorption protective film formed by the long chain alkyls R and active elements (S and P) in the modification layer and tribochemical reaction film containing the tribochemical products of the additive. Moreover, sliding and rolling frictions co‐exist in NH‐MoS2 + LP, doing contributions to the good tribological properties as well.

Originality/value

In this paper, the Cyanex 301‐modified MoS2 nano‐sized hollow spheres with diameter of 200 ∼ 300 nm are firstly added into LP to investigate its tribological properties. The excellent AW and friction‐reducing properties indicate that this MoS2 hollow spheres product is a good oil additive, and the fundamental data presented here will be useful for its further industrial application in the future.
Relevant marketing geography: a competency‐based perspective
Authors: Nicholson John D. , Lindgreen Adam , Kitchen Philip J.
Published: May 2008

Purpose

The purpose of this paper is to apply the theory of relationship marketing to the previously unexplored context of organizations – from multiple sectors of society – that interact through no other apparent reason than geographic proximity. The paper assimilates literature from outside the discipline of marketing and synthesizes this with empirical findings in order to present a practical agenda for private sector firms in relation to their local region.

Design/methodology/approach

Qualitative, convergent depth‐interviews and interdisciplinary literature synthesis.

Findings

The paper presents a model of relevant marketing geography, which positions a resource‐based view as a new direction for relationship marketing research. An additional model conceptualizes the competencies possessed by a private sector firm that allows the firm to access local stocks of social capital.

Research limitations/implications

The paper offers the results of an exploratory, inductive investigation. Subsequent further research directions are significant and are outlined at the end of the paper.

Practical implications

Involvement by private sector firms in their local region is often a random, spontaneous activity, or a reactive activity in response to prompts by public and third sector actors. The paper presents two models that move this agenda from emergent to planned strategic activity for private sector firms.

Originality/value

There is little if any previous discussion of research in the above outlined context within the marketing literature. This paper offers the potential for expansion of that literature.
The effects of team reflexivity and innovativeness on new product development performance
Authors: Tien‐Shang Lee Les
Published: May 2008

Purpose

To determine the effects of project management skills, entrepreneurial proclivity, and existing knowledge on team reflexivity and performance of cross‐functional new product development (NPD) team. The moderating roles of team cohesiveness and knowledge practice are also explored.

Design/methodology/approach

This study used online questionnaire surveys by inviting 500 R&D team members of NPD from three Science Parks in Taiwan. The survey questionnaires were sent to the representative of R&D team members.

Findings

The results indicate that members' project management skills, entrepreneurial proclivity, and existing knowledge have significant impact on team reflexivity and product innovativeness of the NPD project, which then influence NPD performance. Furthermore, NPD team exercising higher levels of team cohesiveness and higher knowledge practice tend to moderate the influence of team reflexivity and product innovativeness on NPD performance.

Research limitations/implications

The use of longitudinal research is suggested to confirm the results of this study. Moreover, other research settings, either different industry or other countries, could increase the generalizability of the findings.

Practical implications

The study has high implications for managers of NPD to recruit qualified team members who have adequate knowledge and strong entrepreneurial proclivity. Moreover, managers should be aware of the moderating role of team cohesiveness and knowledge practices.

Originality/value

The paper determines the antecedents and consequences of team reflexivity and innovativeness among NPD team members. The moderating role of team cohesiveness and knowledge practices are discussed.
Environmental munificence for entrepreneurs: entrepreneurial alertness and commitment
Authors: Tang Jintong
Published: May 2008

Purpose

Existing literature suggests that the need for a conducive environment is crucial in developing entrepreneurship. Previous research on this trend has focused on what constitutes a munificent environment and how environmental conditions stimulate an entrepreneur's intentionality to start a venture. However, little is known about how entrepreneurs “switch on” their alertness to business opportunities in a benign environment. The purpose of this paper is to examine the effects of environmental munificence on entrepreneurs' alertness, as moderated by self‐efficacy, and the effects of this alertness on entrepreneurs' commitment to their new ventures.

Design/methodology/approach

Data were used from the Panel Study of Entrepreneurial Dynamics (PSED) to test the hypotheses. Exploratory Factor Analysis and Confirmatory Factor Analysis were conducted to ensure the dimensionality of entrepreneurial commitment scale. Hypotheses were tested using moderated hierarchical regression analysis.

Findings

The results of this study show a strong relationship between environmental munificence and alertness especially when the entrepreneurs have high levels of self‐efficacy in performing the roles and tasks of new venture creation. In turn, entrepreneurial alertness is related to continuance, behavioral and affective commitment of entrepreneurs.

Originality/value

The findings have important implications for the theory and practice of developing entrepreneurial firms.
A Balanced Scorecard framework for R&D
Authors: García‐Valderrama Teresa , Mulero‐Mendigorri Eva , Revuelta‐Bordoy Daniel
Published: May 2008

Purpose

The purpose of this paper is to produce a general Balanced Scorecard (BSC) model that is designed and delimited for managing research and development (R&D) activities.

Design/methodology/approach

A methodology based on the validity of content of an instrument of measurement, within the analytical framework of the validation of scales or constructs was employed.

Findings

The BSC model for R&D developed in this study has been subject to testing with recognised experts in management and in R&D. It has enabled a proposal to be put forward in respect of those indicators that best define the factors related to organisational effectiveness in the achievement of the strategic objectives set by companies, and to inter‐relate them and group them under five broad perspectives of the BSC.

Research limitations/implications

The BSC will be validated as a construct in future research.

Practical implications

The result is the design of a scale of measurement that ranks the empirical indicators under the perspectives of the BSC; for the measurement of results, this instrument will provide unique values that group all the previous indicators in a single scale of measurement.

Originality/value

No studies dealing with the content validation of a BSC have been found in the literature on innovation.
Securitising China real estate: a tale of two China‐centric REITs
Authors: Quek Michael C.H. , Eng Ong Seow
Published: May 2008

Purpose

There is currently no real estate investment trust (REIT) listed in China. As of date, only two REITs – GZI REIT of Hong Kong and CapitaRetail China Trust (CRCT) of Singapore – have securitised Chinese property assets. The purpose of this paper is to examine the driving forces and the obstacles surrounding China REITs, and evaluate REIT securitisation as an exit strategy for Chinese properties.

Design/methodology/approach

The paper analyses the performance of the two cross‐border REITs and investigates whether REITs holding Chinese assets outperform other listed REITs.

Research limitations/implications

CRCT outperforms GZI REIT as well as some of the other Singapore REITs, while GZI REIT ranked second lowest in terms of price performance when compared to other Hong Kong REITs. The limited history of CRCT suggests that when a well‐structured REIT holding Chinese assets can perform very well. We also infer that performance is closely linked to portfolio composition and diversification, growth story and originator reputation.

Originality/value

The study shows that there is indeed a strong local demand for China REITs, and that REITs can provide an alternative source of real estate financing for Chinese developers and promote a better regulated Chinese real estate market.
Some reflections on IPv6 adoption in Australia
Authors: Dell Peter , Kwong Christopher , Liu Ying
Published: May 2008

Purpose

The purpose of this paper is to put forward a case for increased research into the likely economic impact in Australia of early or late diffusion of IPv6, and to argue that Government intervention may be necessary.

Design/methodology/approach

The paper characterises the approach to IPv6 in Australia to date as generally laissez‐faire, and compares this with diffusion and promotion efforts in countries in which IPv6 has become more widely adopted.

Findings

The paper finds that IPv6 diffusion is inevitable in the long term, but early diffusion is unlikely in the absence of government action. The likely economic impact on Australia of early versus late IPv6 diffusion is unknown, yet it is potentially of national interest.

Originality/value

This study identifies the need for research into the economic impact of IPv6 diffusion in Australia and is relevant to individuals and organisations involved in telecommunications and policy and research funding.
Operating cost analyses of long‐term care facilities
Authors: Madritsch Thomas , Steixner David , Ostermann Herwig , Staudinger Roland
Published: May 2008

Purpose

After salary and wages, facility and real estate expenditure are the largest cost items in the semi‐public sector. Especially, for long‐term care facilities, there is high‐saving potential from more efficient and effective use of property. The main purpose of this paper is an exploratory research study in order to analyse the operating costs of long‐term care facilities.

Design/methodology/approach

The survey is based on empirical data questionnaires, data generation and semi‐structured interviews at 18 long‐term care facilities in Tyrol, Austria carried out during Summer 2007. In order to determine the volume and to prioritize the cost drivers computer‐aided real‐estate benchmarking software was used, which was developed by the Institute of Real Estate Benchmarking at the University of Applied Sciences KufsteinTirol, Austria. Statistic analyses were conducted to investigate saving potential, determine the best case of the sample and submit recommendations to the decision makers.

Findings

The main findings are the investigation and visualization of saving potential of long‐term care facilities and identification of the volume and structure of the cost drivers and illuminated current best practices in effective building upkeep and operating costs of long‐term care facilities in Tyrol. Furthermore, the study reveals the immense saving potential in the costs of various services.

Research limitations/implications

This survey is based on the operating costs of long‐term care facilities. Other running costs such as costs for healthcare personnel as well as quality indicators are not considered in this survey. Further research activities will be necessary regarding the identification of these cost drivers by the application of regression models.

Practical implications

Professional property management of long‐term care facilities will be shown to decrease the cost share in the healthcare sector. The results should help to establish cost benchmarking increasingly and develop it as a strategic planning tool in order to support management in the healthcare sector in the decision‐making process.

Originality/value

The paper presents a new measuring method, which allows an holistic view of three influencing factors, namely the amount of beds, occupancy and the space consumption, to investigate weak points in cost efficiency on one chart.
Improving safety for patients with allergies: an intervention for improving allergy documentation
Authors: Ismail Ziver F. , Ismail Tevfik F. , Wilson Alan J.
Published: May 2008

Purpose

The purpose of this paper is to audit the use of three strategies for protecting hospital inpatients with allergies: red allergy wristbands for patients with allergies; white identification wristbands for all patients; and completion of an “allergy box” on drug charts. The paper also aims to assess the impact of making pharmacists responsible for ensuring allergy box completion.

Design/methodology/approach

The setting was The Whittington Hospital, London, a district general hospital. Two cross‐sectional studies were conducted 11 months apart, before and after pharmacists were made responsible for ensuring allergy box completion. The studies involved 186 (pre‐intervention) and 250 (post‐intervention) unselected adult patients.

Findings

The proportion of blank allergy boxes decreased significantly from 24.7 per cent to 5.2 per cent (p<0.001) when pharmacists were made responsible for ensuring allergy box completion. The most common reason for blank allergy boxes in both studies was that doctors sought and documented allergies in the notes but then forgot to complete the allergy box. Although the proportion of patients lacking allergy wristbands was less in the second study compared with the first (30.4 v. 44.8 per cent, respectively), the difference was not significant (p=0.206). Similarly, the second study showed a non‐significant decrease in the proportion of patients lacking identification wristbands from 12.9 per cent to 10.8 per cent (p=0.499).

Practical implications

A formal checking system is required for allergy and identification wristbands to improve use of these basic, inexpensive measures for preventing drug errors.

Originality/value

The paper shows that making pharmacists responsible for ensuring allergy status documentation on drug charts significantly increased use of this safety measure.
Costs of environmental degradation
Authors: Ahmed Hussein Muawya
Published: May 2008

Purpose

The purpose of this paper is to provide estimates of damage cost for several areas of the environment. In particular: to estimate the cost of degradation as a percentage of gross domestic product (GDP) at the national level; to enhance local capacity in environmental economics, in particular in the valuation of environmental degradation; and to provide an input to inter‐sectoral environmental priority setting.

Design/methodology/approach

To achieve the above objectives a framework was developed to estimate the cost of environmental degradation in seven countries in the region, for six categories. Estimates reflect order of magnitude and therefore represent an indication of actual damage costs. A range of estimates was provided to reflect the uncertainty of the results. Damage costs are presented in annual values (in local currencies, in US$ dollars) and as a per cent of GDP. Expressing costs as a share of GDP provides a sense of magnitude and will allow cross‐country comparison.

Findings

The damage cost of environmental degradation in Middle East and North Africa (MENA) in 2000 is estimated at US$ 9 billion per year, or 2.1‐7.4 per cent of GDP, with a mean estimate of 5.7 per cent of GDP. In addition, the damage cost to the global environment is estimated at 0.5‐1.6 of GDP, with a mean estimate of 0.9 per cent of GDP.

Research limitations/implications

Owing to data constraints, no cost estimates are provided for some impact such as: degradation associated with industrial, hazardous and hospital waste, biodiversity loss, and impact of inadequately treated wastewater, thus calculations often represent lower bound estimates.

Originality/value

This paper is a contribution in a process towards the use of environmental damage cost assessments for priority setting and as an instrument for integrating environmental consideration into economic and social development.
The Development of TIME STUDY
Authors: Anson C.J.
Published: May 2008

THE ideal to which all payment for work is striving is to reward “a fair day's work” by “a fair day's pay”. The two most usual methods of payment used in the attempt to achieve this ideal are:
The Contribution of Management and Man to Higher Productivity in Great Britain
Authors: Noel‐Brown S.J.
Published: May 2008

In Great Britain today National Productivity Year is drawing to a close; launched in November 1962 by Prince Philip, Duke of Edinburgh, its purpose was well advertised in public vehicles, press, and on postage stamps. In November next, there is to be held in Eastbourne a conference ‘to compare notes, to discuss future action and to provide a guide for firms and organisations in every section of our working life’. In these words Prince Philip expresses the aims of the conference and it is significant that he stresses the wide field of responsibility for increasing productivity. It does not rest only with manufacturing industry, and the interest of more than thirty national bodies, typical of management and man, represented at the conference, brings home more than anything else can do that the ordinary citizen is just as valuable a statistic as the mine worker, the farmer, and the foundryman. Regrettably there is a widespread attitude of mind—‘My job is different’ is a typical example—which has countered, and continues to counter, many attempts by individuals and organisations to persuade small firms and businesses that the techniques which have made enlightened concerns efficient are equally available—and workable.
Preparing for the worst: Flexibility is the Key
Authors: Gallinule G.P.
Published: May 2008

Whilst leaving work the other day I noticed the headlines on a piece of newspaper trampled into the wet concrete: ‘HOLIDAYS CRISIS’. During the next ten minutes several hundred people walked over the newspaper; everyone noticed it ‐ they could not fail because it rested on the threshold of the door. Not one was sufficiently interested to read the sub‐headings, or to pass a remark about it to a friend of colleague.
Choice Of Export Markets By Small‐And Mid‐Sized Firms
Authors: Mahone Charlie E.
Published: May 2008

U.S. exports, which recently have been increasing, are still dominated by large firms. According to one study, only 10 percent of the total U.S. export business is conducted by small companies, in spite of the vast export opportunities that exist. That same study further reports that of those small firms that do export, only 6 to 7 percent of their sales are derived from overseas, as compared to 10 to 15 percent for their counterparts from Japan and Germany. This situation is especially disappointing because small‐ and mid‐sized businesses possess the very attributes that: (1) substantially contribute to the U.S. economy by generating the largest number of new jobs; and (2) portend success in the global markets because these firms produce a wide variety of goods and services, often of exceptional quality. Additionally, small‐ and mid‐sized firms have a high degree of flexibility that allow them to profitably penetrate small markets and small niches in large markets, using strategies that are difficult for large companies to implement.
Can We Sell Our Way Out Of This Problem?
Authors: Enen Jack
Published: May 2008

It looks as if the recession is here. We had plenty of warning over the past several months. Remember those job layoff announcements in “other” areas. It was creeping up on all of us. We American's don't respond well to attrition. Although we have just experienced the longest peace time economic growth in our nation's history, economists are mixed in their growth predictions as we enter this new decade. It is estimated that in 1990 alone that 650,000 manufacturing jobs were lost in the United States. Many of our small‐to‐medium‐sized companies, the backbone of our nation's economy, have been reluctant to recognize the urgent need to get involved in overseas partnerships for new market expansion opportunities in todays' borderless, global economy. It is imperative that we, as a nation, employ our Yankee Trader spirit and ingenuity to participate in this growing market to preserve and create new quality jobs in America. The three most frequent reasons given by small business for this reluctance to enter foreign markets are: (1) we're not selling in California yet, why should we look at export; (2) it's just too complicated to learn at this stage of our corporate development; and (3) if we export, how will we get paid? Let's examine each of these briefly. Firstly, you probably have more competitors in domestic markets than you would have in overseas trade. Domestic market penetration in new areas can be tough. In international, you may more easily find a “niche” and a willing partner to assist you in market share development. Secondly, learning about global trade isn't an option anymore. Years ago, domestic business was thought of as the meal and exports, if any, were considered the gravy. In today's real world of global competition, exports are essential to a company's sustained growth making understanding a must! Thirdly, you can get paid. There are numerous resources for assistance with financial questions such as international departments in major banks, trade merchant or finance banks, government loan guarantee programs, factoring groups, private consultants, and freight forwarders. The key with getting paid is to do it right the first time. This means getting help (in writing) before a problem exists. For example, if you are doing business with letters of credit, get your paying bank to assist you with its' preparation in their own comfortable language.