bluuebunny/crossref_metadata_2025 huggingface dataset:
Institutions and non‐linear change in governance
Authors: Burau Viola , Vrangbæk Karsten
Published: August 2008

Purpose

The paper aims to account for the substance of non‐linear governance change by analysing the importance of sector‐specific institutions and the pathways of governing they create.

Design/methodology/approach

The analysis uses recent reforms of the governance of medical performance in four European countries as a case, adopting an inductively oriented approach to comparison. The governance of medical performance is a good case as it is both, closely related to redistributive policies, where the influence of institutions tends to be pertinent, and is subject to considerable policy pressures.

Findings

The overall thrust of reforms is similar across countries, while there are important differences in relation to how individual forms of governance and the balance between different forms of governance are changing. More specifically, sector‐specific institutions can account for the specific ways in which reforms redefine hierarchy and professional self‐regulation and for the extent to which reforms strengthen hierarchy and affect the balance with other forms of governance.

Originality/value

The recent literature on governance mainly focuses on mapping out the substance of non‐linear change, whereas the development of explanations of the substance of governance change is less systematic. In the present paper, therefore, it is suggested coupling the notion of non‐linear change with an analysis of sector specific institutions inspired by the historical institutionalist tradition to better account for the substance of non‐linear governance change. Further, the analysis offers interesting insights into the complexity of redrawing boundaries between the public and the private in health care.
Expansive or limitative strategy? A case study of organisational responses to new public health
Authors: Juul Nielsen Annegrete , Knudsen Morten , Finke Katrine
Published: August 2008

Purpose

Since the emergence of new public health in the 1970s, health has not merely been considered the absence of disease, but physical, mental and social wellbeing. This article seeks to analyzes the implications of this broad concept of health at an organizational level.

Design/methodology/approach

The paper presents a qualitative case study of boundary drawing in a Danish municipal agency in charge of planning and conducting health promoting and disease preventing activities from 1989 to 2005. The theoretical framework draws on Niklas Luhmann's organization theory.

Findings

Two different organizational answers were found to the challenges inherent in the broad concept of new public health. First, the organization tried to increase its size and incorporate as many aspects of the environment as possible. This expansive strategy jeopardised the identity of the organization. Second, the organization tried to keep clear and tight boundaries and from this position irritate entities in the environment. This limitative strategy made the organization spend relatively more energy on organizing and controlling itself than on public health work.

Practical implications

The case study shows how a broad concept of health makes boundary management topical in organizations dealing with health promotion and disease prevention. Organizations in charge of public health activities need to reflect on how they can create intelligent compensations for the disadvantages involved in an expansive or a limitative strategy.

Originality/value

The broad concept of health inherent in new public health has been widely accepted and yet its challenges to organizational boundary drawing have attracted little attention. This paper provides an analysis of these challenges.
Doctors as managers: moving towards general management?
Authors: Opdahl Mo Tone
Published: August 2008

Purpose

The paper seeks to explore whether the development in department management in Norwegian hospitals after the unitary management reform in 2001 constitutes a development in the direction of general management

Design/methodology/approach

Interviews were conducted with ten managers from different levels in a large Norwegian university hospital in 2001‐2002, as a unitary management model was implemented.

Findings

There is an emerging change of practice among the physician managers according to this study. The manager function is more explicit and takes a more general responsibility for the department and the professions. However, the managerial function is substantiated by conditions related to the professional field of knowledge, which gives legitimacy within a medical logic. Contact with the clinic is stressed as important, but it is possible to adjust both amount and content of a clinical engagement to the demands of the new manager position. This has both a symbolic and a practical significance, as it involves both legitimacy and identity issues.

Practical implications

The paper shows that the institutionalised medical understanding of management has a bearing on managerial reforms. Managerial changes need to relate to this if they are to have consequences for the managerial roles and structures on department level in hospitals.

Originality/value

The paper suggests that the future development of this role will depend on the way the collectivist and individualist aspects of responsibility are handled, as well as on the further development of managerial knowledge of physicians.
Shared care and boundaries: lessons from an online maternity record
Authors: Ross Winthereik Brit
Published: August 2008

Purpose

The paper seeks to examine how an online maternity record involving pregnant women worked as a means to create shared maternity care.

Design/methodology/approach

Ethnographic techniques have been used. The paper adopts a theoretical/methodological framework based on science and technology studies.

Findings

The paper shows how a version of “the responsible patient” emerges from the project which is different from the version envisioned by the project organisation. The emerging one is concerned with the boundary between primary and secondary sector care, and not with the boundary between home and clinic, which the project identifies as problematic and seeks to transgress.

Research limitations/implications

The pilot project, which is used as a case, is terminated prematurely. However, this does not affect the fact that more attention should be paid to the specific redistribution of responsibilities entailed in shared care projects. Rather than seeking to connect all actors in an unbounded space, shared care might instead suggest a space for patients and professionals to experiment with new roles and responsibilities.

Practical implications

When designing coordination tools for health care, IT designers and project managers should attend to the specific ways in which boundaries are inevitably enacted and to the ways in which care is already shared. This will provide them with opportunities to use the potentials of new identities and concerns that emerge from changing the organisation of healthcare in relation to IT design.

Originality/value

The paper shows that “unshared” care does not exist; care is always shared among human and nonhuman actors. It also points to the value of studying how boundaries are enacted in projects that seek to create continuity across boundaries.
Evaluating the department of health recruitment strategy: an international perspective
Authors: Gupta Nitin , Gupta Vinesh , Singh Gurpreet
Published: August 2008

Purpose

The purpose of this paper is to assess the experiences of internationally recruited (IR) consultant psychiatrists focussing on the recruitment process and its adherence to the department of health (DH) guidance.

Design/methodology/approach

IR consultant psychiatrists (n=88) from different countries were mailed a 13‐item questionnaire assessing their experiences regarding various aspects of the recruitment process.

Findings

In total, 48 per cent IR psychiatrists responded; 97 per cent were from India. The recruitment process was generally satisfactory with perceived gaps in support from various stakeholders. Inconsistent experiences were reported regarding induction, mentorship, clinical responsibilities, and racial discrimination.

Originality/value

This is believed to be the first such questionnaire‐based study carried out on the IR consultant psychiatrists and discussing their experiences of the overall recruitment process.
Streamlining the patient journey
Authors: Hella Dahlmann‐Noor Annegret , Gupta Nitin , Hay Gordon R. , Cates Caroline A. , Galloway Gavin , Jordan Kerry , Lamb Robert J. , Ramsay Andrew S. , Vivian Anthony J.
Published: August 2008

Purpose

The patient journey from detection of an eye problem by optometrists to assessment and treatment by ophthalmologists can be streamlined by direct referral from optometrist to hospital eye service (HES). This requires locally agreed guidelines and training and feedback for optometrists to ensure high diagnostic competence. The purpose of this paper is to evaluate the quality of the West Suffolk Direct Referral Scheme, one of the first direct referral schemes in the UK to include all ophthalmic sub‐specialties.

Design/methodology/approach

Two‐cycle audit of existing practice, including all new patients referred by optometrists and seen at West Suffolk Hospital during a three‐month period in 2003 and a seven‐week period in 2006. Three interventions: direct referral clinics for urgent patients; introduced in 2003; six‐monthly training sessions for optometrists; and regular, prompt feedback via letter about individual consultation outcome. Prospective data collection via proforma in both cycles; additional retrospective data collection in the second cycle. Diagnostic accuracy, perception of urgency and request of subspecialty clinic were evaluated.

Findings

The direct referral scheme streamlines the patient journey, and patients with acute problems have fast access to HES. In total, 99 per cent of referrals are appropriate. Diagnostic competence is high (87 per cent), and has improved with tighter communication between HES and optometrists. Agreement is less for referral urgency (75 per cent) and choice of subspecialty clinic (74 per cent).

Originality/value

The West Suffolk Direct Referral Scheme provides an efficient service of high quality. Good communications and continued feedback between community‐ and hospital‐based eye care services improve standards and facilitate efficient use of resources.
Safe in their hands
Authors: Lankshear Annette , Lowson Karen , Saxby Ruth C.
Published: August 2008

Purpose

The purpose of this paper is to explore the management of the safety alert broadcast system (SABS) in England.

Design/methodology/approach

This survey was part of a multi‐method study which was undertaken over an 18‐month period. The questionnaire was sent to every trust SABS liaison officer (SLO) (n=561) in England using the DH database. In total, 343 completed questionnaires were electronically returned, a response rate of 62 per cent.

Findings

SABS is the means by which safety alerts from key agencies are electronically distributed to the NHS in England. Each organisation is required to have a named SLO who is required to acknowledge receipt on the Department of Health web site, indicate whether action is under way and finally confirm that action is complete. It offers a profile of this important segment of the workforce, over half of whom work in risk management, and 65 per cent of whom have no clinical background. Most spend very little of their working week managing the system itself, and are entirely dependent on the word of other managers to indicate that the trust has completed all action. Whilst the system is liked by the SLOs, concerns are expressed about the level of responsibility they are expected to assume.

Practical implications

Trusts may wish to consider the role in the light of the increasing number and complexity of the alerts being managed.

Originality/value

The paper offers a unique insight into the role and profile of those managing the interface between trusts and the patient safety team at the Department of Health.
Accounting in three dimensions: a case for momentum revisited
Authors: Melse Eric
Published: August 2008

Purpose

This paper aims to extend an earlier analysis of the profitability of an individual firm operating in the professional services industry from the perspective of the triple‐entry framework of the momentum accounting theory of Yuji Ijiri.

Design/methodology/approach

The paper presents a “common‐size‐format” model of balance‐sheet momentum, an approach typical of financial statements' mathematical analysis.

Findings

Common‐size‐format momentum ratios offer an alternative measurement of (the change of) business performance. They model stabilizing phenomena that might develop very differently from ratios like return on total assets or return on equity and thus provide important informational signals to the analyst of financial statements. The common‐size‐format ratio of net wealth momentum herein discussed is proposed as a supplemental measurement for business performance analysis.

Originality/value

The paper discusses a new method for performance measurement and risk analysis.
Firm size and corporate financial‐leverage choice in a developing economy
Authors: Ebel Ezeoha Abel
Published: August 2008

Purpose

The purpose of this paper is to investigate, from an undeveloped market perspective, the nature and significance of firm size as a determinant of corporate financial leverage.

Design/methodology/approach

A panel data fixed‐effects regression model is used to estimate the relationship between financial leverage and firm size, while controlling also for the effects of other acclaimed determinants like asset tangibility, profitability and firm age. The dataset used covers 71 firms quoted in the Nigerian stock markets over a 17‐year period (1990‐2006).

Findings

The study reveals that as much as 91.4 percent of the total finances of Nigerian‐quoted firms is of short‐term liabilities, with just 8.6 percent constituting long‐term liabilities. It finds that firm size is negatively and significantly related to financial leverage. Controlling for some other determinants, the arising results tend to confirm an over‐bearing influence of the pecking order theory in the financing patterns of Nigerian‐quoted firms – by revealing that the relationship between profitability and financial leverage is highly significant and negative; and that firm‐age is positively and significantly related to financial leverage.

Originality/value

Using data from a country with undeveloped and inefficient financial markets, this paper provides an important insight on the international debate on the effects of size on corporate decisions.
Asymmetric rotation of risk factors in a global portfolio
Authors: Christodoulakis George A.
Published: August 2008

Purpose

The purpose of this paper is to examine the asymmetric dynamic rotation of beta coefficients to global investment style factor shocks in the Morgan Stanley Capital International (MSCI) universe of assets and its implications for investment management.

Design/methodology/approach

The paper uses an asymmetric extension of the Christodoulakis and Satchell approach of time varying beta coefficients.

Findings

Evidence suggests that positive (negative) style factor shocks tend to be associated more with increases (decreases) in beta coefficients rather than the reverse.

Research limitations/implications

There is a need to examine other forms of beta rotation and the degree of common persistence and empirical applications to investment management and portfolio performance attribution.

Practical implications

Forecast the evolution of beta. Persistent positive or negative shocks could spark rotating investment exposures, particularly relevant during turbulent periods in which asset managers may engage onto tactical asset allocation strategies.

Originality/value

The paper explores the asymmetric rotation of style factors in the MSCI universe of assets. The results can be used in applied investment management involving dynamic asset allocation strategies.
Colonial competitive algorithm
Authors: Atashpaz Gargari Esmaeil , Hashemzadeh Farzad , Rajabioun Ramin , Lucas Caro
Published: August 2008

Purpose

This paper aims to describe colonial competitive algorithm (CCA), a novel socio‐politically inspired optimization strategy, and how it is used to solve real world engineering problems by applying it to the problem of designing a multivariable proportional‐integral‐derivative (PID) controller. Unlike other evolutionary optimization algorithms, CCA is inspired from a socio‐political process – the competition among imperialists and colonies. In this paper, CCA is used to tune the parameters of a multivariable PID controller for a typical distillation column process.

Design/methodology/approach

The controller design objective was to tune the PID controller parameters so that the integral of absolute errors, overshoots and undershoots be minimized. This multi‐objective optimization problem is converted to a mono‐objective one by adding up all the objective functions in which the absolute integral of errors is emphasized to be reduced as long as the overshoots and undershoots remain acceptable.

Findings

Simulation results show that the controller tuning approach, proposed in this paper, can be easily and successfully applied to the problem of designing MIMO controller for control processes. As a result not only was the controlled process able to significantly reduce the coupling effect, but also the response speed was significantly increased. Also a genetic algorithm (GA) and an analytical method are used to design the controller parameters and are compared with CCA. The results showed that CCA had a higher convergence rate than GA, reaching to a better solution.

Originality/value

The proposed PID controller tuning approach is interesting for the design of controllers for industrial and chemical processes, e.g. MIMO evaporator plant. Also the proposed evolutionary algorithm, CCA, can be used in diverse areas of optimization problems including, industrial planning, resource allocation, scheduling, decision making, pattern recognition and machine learning.
Pedestrian tracking using single camera with new extended Kalman filter
Authors: Sadoghi Yazdi Hadi , Ebrahim Hosseini Seyyed
Published: August 2008

Purpose

The purpose of this paper is to present research in the area of the signal processing and application into pedestrian tracking in the video scene.

Design/methodology/approach

The paper describes the design of a new extended Kalman filter (EKF) in the high‐dimensional space (HDS) and studies of mean square error and variance analysis of error. A design algorithm is implemented in MATLAB software and tested. The data set includes many hours of captured films.

Findings

This paper includes a new derivation of the EKF and its implementation into the video scene.

Practical implications

The proposed algorithm can be used to track each video application.

Originality/value

The Kalman filter in the HDS is presented for the first time. Also, the application of the proposed method is applied in pedestrian tracking and counting.
A multi‐agent approach to TS‐fuzzy modeling and predictive control of constrained nonlinear system
Authors: Nasr Hichem Ben , Faouzi M'Sahli
Published: August 2008

Purpose

The paper aims to present a new concept based on a multi‐agent approach in the area of nonlinear model predictive control (MPC) for fast systems.

Design/methodology/approach

A contribution to decentralized implementation of MPC is made. The control of the nonlinear system subject to constraints is achieved via a set of actions taken from different agents. The actions are based on an analytical solution and a neural network is used to monitor the closed system using a supervisory loop concept.

Findings

The high online computational need to solve an optimal control actions in nonlinear MPC, which results in a non‐convex optimization, is compared with the new proposed concept. Simulation results show that this approach has very remarkable performances in time computing and target arrival.

Research limitations/implications

In practice, each MPC problem of the individual agent in multi‐agent MPC can run in parallel at the same time, instead of in serial, one agent after another. A parallel processor can be useful for real time implementation. However, it is estimated that how much time can be gained by performing the computations in parallel instead of in serial.

Practical implications

The proposed concept discussed in the paper has the potential to be applied to systems with rapid dynamics.

Originality/value

The multi‐agent MPC compares favorably with respect to a numerical optimization routine and also offers a solution for non‐convex optimization problems in single‐input single‐output systems.
Constrained optimization with an improved particle swarm optimization algorithm
Authors: Muñoz Zavala Angel E. , Hernández Aguirre Arturo , Villa Diharce Enrique R. , Botello Rionda Salvador
Published: August 2008

Purpose

The purpose of this paper is to present a new constrained optimization algorithm based on a particle swarm optimization (PSO) algorithm approach.

Design/methodology/approach

This paper introduces a hybrid approach based on a modified ring neighborhood with two new perturbation operators designed to keep diversity. A constraint handling technique based on feasibility and sum of constraints violation is adopted. Also, a special technique to handle equality constraints is proposed.

Findings

The paper shows that it is possible to improve PSO and keeping the advantages of its social interaction through a simple idea: perturbing the PSO memory.

Research limitations/implications

The proposed algorithm shows a competitive performance against the state‐of‐the‐art constrained optimization algorithms.

Practical implications

The proposed algorithm can be used to solve single objective problems with linear or non‐linear functions, and subject to both equality and inequality constraints which can be linear and non‐linear. In this paper, it is applied to various engineering design problems, and for the solution of state‐of‐the‐art benchmark problems.

Originality/value

A new neighborhood structure for PSO algorithm is presented. Two perturbation operators to improve PSO algorithm are proposed. A special technique to handle equality constraints is proposed.
Swarm‐based spatial sorting
Authors: Amos Martyn , Don Oliver
Published: August 2008

Purpose

The purpose of this paper is to present an algorithm for spatially sorting objects into an annular structure.

Design/methodology/approach

A swarm‐based model that requires only stochastic agent behaviour coupled with a pheromone‐inspired “attraction‐repulsion” mechanism.

Findings

The algorithm consistently generates high‐quality annular structures, and is particularly powerful in situations where the initial configuration of objects is similar to those observed in nature.

Research limitations/implications

Experimental evidence supports previous theoretical arguments about the nature and mechanism of spatial sorting by insects.

Practical implications

The algorithm may find applications in distributed robotics.

Originality/value

The model offers a powerful minimal algorithmic framework, and also sheds further light on the nature of attraction‐repulsion algorithms and underlying natural processes.
Fragment‐HMM: A new approach to protein structure prediction
Authors: Li Shuai Cheng , Bu Dongbo , Xu Jinbo , Li Ming
Published: August 2008

We designed a simple position‐specific hidden Markov model to predict protein structure. Our new framework naturally repeats itself to converge to a final target, conglomerating fragment assembly, clustering, target selection, refinement, and consensus, all in one process. Our initial implementation of this theory converges to within 6 Å of the native structures for 100% of decoys on all six standard benchmark proteins used in ROSETTA (discussed by Simons and colleagues in a recent paper), which achieved only 14%–94% for the same data. The qualities of the best decoys and the final decoys our theory converges to are also notably better.
Male vocal behavior and phylogeny in deer
Authors: Cap Henri , Deleporte Pierre , Joachim Jean , Reby David
Published: August 2008

The phylogenetic relationships among 11 species of the Cervidae family were inferred from an analysis of male vocalizations. Eighteen characters, including call types (e.g. antipredator barks, mating loudcalls) and acoustic characteristics (call composition, fundamental frequency and formant frequencies), were used for phylogeny inference. The resulting topology and the phylogenetic consistency of behavioral characters were compared with those of current molecular phylogenies of Cervidae and with separate and simultaneous parsimony analyses of molecular and behavioral data. Our results indicate that male vocalizations constitute plausible phylogenetic characters in this taxon. Evolutionary scenarios for the vocal characters are discussed in relation with associated behaviors.
Increased death risk and altered cancer incidence pattern in patients with isolated or combined autoimmune primary adrenocortical insufficiency
Authors: Bensing Sophie , Brandt Lena , Tabaroj Farnoush , Sjöberg Olof , Nilsson Bo , Ekbom Anders , Blomqvist Paul , Kämpe Olle
Published: August 2008

Objectives  Primary adrenocortical insufficiency is mostly caused by an autoimmune destruction of the adrenal cortex. The disease may appear isolated or as a part of an autoimmune polyendocrine syndrome (APS). APS1 is a rare hereditary disorder with a broad spectrum of clinical manifestations. In APS2, primary adrenocortical insufficiency is often combined with autoimmune thyroid disease and/or type 1 diabetes. We analysed mortality and cancer incidence in primary adrenocortical insufficiency patients during 40 years. Data were compared with the general Swedish population.

Design and patients  A population based cohort study including all patients with autoimmune primary adrenocortical insufficiency (3299) admitted to Swedish hospitals 1964–2004.

Measurements  Mortality risk was calculated as the standardized mortality ratio (SMR) and cancer incidence as the standardized incidence ratio (SIR).

Results  A more than 2‐fold increased mortality risk was observed in both women (SMR 2·9, 95% CI 2·7–3·0) and men (SMR 2·5, 95% CI 2·3–2·7). Highest risks were observed in patients diagnosed in childhood. SMR was higher in APS1 patients (SMR 4·6, 95% CI 3·5–6·0) compared with patients with APS2 (SMR 2·1, 95% CI 1·9–2·4). Cancer incidence was increased (SIR 1·3, 95% CI 1·2–1·5). When tumours observed during the first year of follow‐up were excluded, only the cancer risk among APS1 patients remained increased. Cause‐specific cancer incidence analysis revealed significantly higher incidences of oral cancer, nonmelanoma skin cancer, and male genital system cancer among patients. Breast cancer incidence was lower than in the general population.

Conclusions  Our study shows a reduced life expectancy and altered cancer incidence pattern in patients with autoimmune primary adrenocortical insufficiency.
Cultural characteristics of salmonid alphaviruses – influence of cell line and temperature
Authors: Graham D A , Wilson C , Jewhurst H , Rowley H
Published: August 2008

Laboratory studies were carried out to investigate the cultural characteristics of salmonid alphaviruses (SAV) from Atlantic salmon (AS, Salmo salar) and rainbow trout (RT, Oncorhynchus mykiss), particularly in relation to cell line and temperature. In an initial study, SAV was isolated from 12 viraemic sera and passaged in Chinook salmon embryo (CHSE‐214) cells at 15 °C. Geometric mean titres (GMT) after initial isolation were found to be significantly higher (P < 0.05) relative to those after two or four passages. Primary isolation of SAV was conducted from 12 viraemic sera (six AS and six RT) in seven different cell lines at 15 °C: CHSE‐214, rainbow trout gonad (RTG‐2), TO (derived from Atlantic salmon head kidney leucocytes), salmon head kidney (SHK‐1), blue fin‐2 (BF‐2), fat head minnow (FHM) and Epithelioma papulosum cyprini (EPC). Overall, significant differences were found between cell lines in both the numbers of strains where growth was detected and in the GMT obtained. For both AS and RT strains, GMT values were significantly (P < 0.01) higher in both TO and BF‐2 cells relative to the others, including CHSE‐214 and RTG‐2, the cell lines conventionally used for SAV. The effects of temperature of incubation (4, 10, 15 and 20 °C) on growth in TO, CHSE‐214 and RTG‐2 were investigated. In TO and RTG‐2 growth was optimal at 15 °C, whereas in CHSE‐214 results at 10 and 15 °C were more similar. Little or no growth was detected at 4 or 20 °C.
Sortase‐mediated assembly and surface topology of adhesive pneumococcal pili
Authors: Fälker Stefan , Nelson Aaron L. , Morfeldt Eva , Jonas Kristina , Hultenby Kjell , Ries Johannes , Melefors Öjar , Normark Staffan , Henriques‐Normark Birgitta
Published: August 2008

The rlrA genetic islet encodes an extracellular pilus in the Gram‐positive pathogen Streptococcus pneumoniae. Of the three genes for structural subunits, rrgB encodes the major pilin, while rrgA and rrgC encode ancillary pilin subunits decorating the pilus shaft and tip. Deletion of all three pilus‐associated sortase genes, srtB, srtC and srtD, completely prevents pilus biogenesis. Expression of srtB alone is sufficient to covalently associate RrgB subunits to one another as well as linking the RrgA adhesin and the RrgC subunit into the polymer. The active‐site cysteine residue of SrtB (Cys 177) is crucial for incorporating RrgC, even when the two other sortase genes are expressed. SrtC is redundant to SrtB in permitting RrgB polymerization, and in linking RrgA to the RrgB filament, but SrtC is insufficient to incorporate RrgC. In contrast, expression of srtD alone fails to mediate RrgB polymerization, and a srtD mutant assembles heterotrimeric pilus indistinguishable from wild type. Topological studies demonstrate that pilus antigens are localized to symmetric foci at the cell surface in the presence of all three sortases. This symmetric focal presentation is abrogated in the absence of either srtB or srtD, while deletion of srtC had no effect. In addition, strains expressing srtB alone or srtC alone also displayed disrupted antigen localization, despite polymerizing subunits. Our data suggest that both SrtB and SrtC act as pilus subunit polymerases, with SrtB processing all three pilus subunit proteins, while SrtC only RrgB and RrgA. In contrast, SrtD does not act as a pilus subunit polymerase, but instead is required for wild‐type focal presentation of the pilus at the cell surface.
Quantitative RNA expression analysis with Affymetrix Tiling 1.0R arrays identifies new E2F target genes
Authors: Naouar Naïra , Vandepoele Klaas , Lammens Tim , Casneuf Tineke , Zeller Georg , Van Hummelen Paul , Weigel Detlef , Rätsch Gunnar , Inzé Dirk , Kuiper Martin , De Veylder Lieven , Vuylsteke Marnik
Published: August 2008

The Affymetrix ATH1 array provides a robust standard tool for transcriptome analysis, but unfortunately does not represent all of the transcribed genes in Arabidopsis thaliana. Recently, Affymetrix has introduced its Arabidopsis Tiling 1.0R array, which offers whole‐genome coverage of the sequenced Col‐0 reference strain. Here, we present an approach to exploit this platform for quantitative mRNA expression analysis, and compare the results with those obtained using ATH1 arrays. We also propose a method for selecting unique tiling probes for each annotated gene or transcript in the most current genome annotation, TAIR7, generating Chip Definition Files for the Tiling 1.0R array. As a test case, we compared the transcriptome of wild‐type plants with that of transgenic plants overproducing the heterodimeric E2Fa‐DPa transcription factor. We show that with the appropriate data pre‐processing, the estimated changes per gene for those with significantly different expression levels is very similar for the two array types. With the tiling arrays we could identify 368 new E2F‐regulated genes, with a large fraction including an E2F motif in the promoter. The latter groups increase the number of excellent candidates for new, direct E2F targets by almost twofold, from 181 to 334.
Strawberry Tree Blight in Spain, a New Disease Caused by various Phytophthora Species
Authors: Moralejo E. , Belbahri L. , Calmin G. , García‐Muñoz J. A. , Lefort F. , Descals E.
Published: August 2008

During surveys for Phytophthora ramorum in garden centres in Majorca, Spain, 31 isolates of Phytophthora were recovered from potted strawberry trees (Arbutus unedo) showing leaf and twig blights. Many isolates of Phytophthora syringae and Phytophthora citrophthora as well as single isolates of P. ramorum, Phytophthora tropicalis and Phytophthora nicotianae were identified on morphological features and on the sequences of the internal transcribed spacer regions from ribosomal DNA genes. Phytophthora syringae was collected most frequently in late autumn and winter, whereas P. citrophthora was dominant during late summer and autumn. In vitro pathogenicity of P. syringae and P. citrophthora was compared with that of P. ramorum by inoculating intact detached leaves of A. unedo with zoospores and twigs with mycelial plugs. In addition, in vitro sporangial production was examined on inoculated excised leaves and on agar plugs at 12, 15 and 20°C. Phytophthora citrophthora produced the largest lesions both on leaves and on twigs at all temperatures. Phytophthora ramorum formed lesions comparable in size to those of P. syringae, but it significantly produced more sporangia on excised leaves and agar plugs. In a log inoculation assay, P. syringae caused large lesions in the inner bark, whereas those of P. ramorum were moderate. Strawberry tree blight has not yet been observed in natural ecosystems in the western Mediterranean areas. Possible biological and environmental limitations hindering disease spread in the wild are discussed.
INTRAOPERATIVE METHYLENE BLUE SENTINEL LYMPH NODE MAPPING IN COLORECTAL CANCER
Authors: Chan Siew H. , Ng Colin , Looi Lai M.
Published: August 2008

Background:  Isosulfan blue is not available for clinical use in Malaysia. This study describes the use of methylene blue as an alternative to isosulfan blue in colorectal sentinel node mapping.

Methods:  Methylene blue dye was injected around colonic and rectal tumours and the first blue‐stained nodes were suture tagged and harvested after standard colorectal resection. Standard histopathological examination was then carried out to detect nodal metastasis. All negative sentinel lymph nodes (SLN) were subjected to 10 further step sectioning and immunoperoxidase staining for cytokeratin 20 to detect tumour deposits.

Results:  Thirty‐one patients were enrolled from August 2005 to July 2006. Twenty‐five attempts at identifying the SLN were successful (80.7%). Of the 18 (58.1%) who had nodal metastases (stage III), 3 had negative SLN but positive other lymph nodes (false‐negative rate of 21.4%). In one (4%), the SLN was the exclusive site of metastasis.

Conclusion:  Methylene blue can be used as an alternative sentinel node marker for rectal cancer (above the peritoneal reflection) and colonic cancer.
THE QUEENSLAND TRAUMA PLAN PROJECT
Authors: FitzGerald Gerry , Tippett Vivienne , Schuetz Michael , Pollard Cliff
Published: August 2008

Background:  The aim of this paper is to outline the development of ‘A Trauma Plan for Queensland’. Injury is one of Australia’s National Health Priorities. The full impact of injury, including early death, reduction in quality of life and the social and emotional costs to individuals and the community are immeasurable. The direct health‐care costs alone amounted to A$4.13bn in 2000–2001. Queensland has one of the highest rates of injury in Australia. An estimated 1500 Queenslanders die each year as a result of major traumatic injury and it is the single most common cause of death between the ages of 1 and 35 years.

Methods:  The Queensland Trauma Plan was based on a detailed analysis of the management and outcome of trauma in Queensland and used an extensive process of stakeholder consultation to identify proposals for system improvement. Sequential workshops helped identify the issues and strategies for system improvement. These proposals were condensed into a high‐level strategic plan, which has now been endorsed by the Queensland Government.

Results:  The Trauma Plan identifies service enhancements and the improved coordination required to support ongoing policy development, research and education. The Plan outlines a future direction for the development of trauma services and the system and structures required to support that development.

Conclusion:  The Trauma Plan holds potential as a model for the development of future trauma services and injury prevention programmes. The process shows the value of engagement of clinicians and others into the policy development and planning processes. The outcome reinforces the value of taking a whole of community, coordinated and collaborative approach to injury prevention and management.
PAROTIDECTOMY: PREOPERATIVE INVESTIGATIONS AND OUTCOMES IN A SINGLE SURGEON PRACTICE
Authors: Burgess Adele N. , Serpell Jonathan W.
Published: August 2008

Background:  The aim of this study was to assess the value of fine‐needle aspiration cytology (FNAC) as a preoperative evaluation for parotid tumours.

Methods:  Prospectively collected data on 77 patients, collected on a parotid database, were retrospectively analysed. Preoperative investigations were carried out and cytology, histopathology and clinical outcomes were evaluated.

Results:  The most common histopathology was benign lesions (89.6%), including pleomorphic adenoma (55.8%) and Warthin’s tumour (11.7%). Melanoma (3.9%) and lymphoma (2.6%) were the commonest malignancies. Preoperative investigations included FNAC in 72 of the 77 patients (93.5%). FNAC had a sensitivity and specificity for benign tumours of 92.3 and 75%, respectively. FNAC for malignant tumours had a sensitivity of 75% and specificity of 93.8%. FNAC accurately diagnosed cell type in 85.9% of specimens for benign lesions, but only 50% for malignancy. Complications included wound infections (10.4%), salivary fistulas (6.5%) and temporary partial facial palsies in six patients (7.8%).

Conclusion:  We conclude FNAC assists in preoperative assessment and surgical planning for parotidectomy. This confirms the usefulness of FNAC as a preoperative assessment of parotid masses.
Doctors' attitudes towards invasive prenatal diagnosis
Authors: Pitukkijronnakorn Somsri , Manonai Jittima , Chittacharoen Apichart
Published: August 2008

Aim:  To assess the influence of a doctor's gender, age group, religion and invasive prenatal diagnosis (PND) knowledge on their attitude towards invasive PND.

Methods:  All non–obstetric and gynecologic doctors were surveyed using a structured questionnaire. The questionnaire enquired about demographic information, and doctors' knowledge, attitude and experience regarding invasive PND for themselves, and their spouses, relatives, friends, colleagues and patients.

Results:  Responses from the 289 respondents revealed that two‐thirds of respondents knew only a little about invasive PND. Most males and females were in the 31–39 and ≤30‐year‐old groups, respectively. There were no statistically significant differences in gender, age group, religion and invasive PND knowledge when recommending of invasive PND. If fetal anomalies were detected, most of the females in the Buddhist group (P < 0.05), males with quite a lot of PND knowledge group (p < 0.05) and younger doctors group (P < 0.05) would their own terminate pregnancies, or those of wives and relatives.

Conclusion:  Attitudes towards invasive PND and pregnancy termination was influenced by gender, age group, religion and PND knowledge. Females and younger doctors from both gender groups tended to recommend the termination of pregnancy if they found fetal anomalies.
A unique case of Hajdu‐Cheney syndrome and squamous cell carcinoma of the anus
Authors: Page B. R. , McDonald T. , Gagnon P. , Lu K. , Thomas C. R.
Published: August 2008

Objective  Hajdu‐Cheney syndrome (HCS), first described in 1948 by Hajdu and independently in 1965 by Cheney, is an extremely rare disorder characterized by severe and excessive bone resorption leading to osteoporosis, with a wide range of other systemic complications from connective tissue and bone dysplasia. Currently there are approximately 50 distinct cases reported in the literature. There have been several reports associating polycystic kidneys with HCS and several other connective tissue disorders, suggesting a possibility of a hyperproliferative component to the syndrome. No articles exist in the current literature describing a case of HCS with concurrent carcinoma. Here, we present a case of a 54‐year‐old nonimmune compromised woman with multiple stigmata of HCS and recently diagnosed anal squamous cell carcinoma.

Method  This is a case report of HCS and stage T3N0 squamous cell carcinoma of the anus.

Results  This is the first report of a patient with HCS with malignancy.

Conclusions  We present a patient with HCS who developed anal squamous cell carcinoma. The mechanism of HCS, which is still unknown, may either make patients more susceptible to carcinoma or may just be a reflection of the normal incidence of anal squamous cell carcinoma given attributable risk factors.
Systematic review of laparoscopic vs open colonic surgery within an enhanced recovery programme
Authors: Vlug M. S. , Wind J. , Zaag E. van der , Ubbink D. T. , Cense H. A. , Bemelman W. A.
Published: August 2008

Background  Fast track surgery accelerates recovery, reduces morbidity and shortens hospital stay. It is unclear what the effects are of laparoscopic or open surgery within a fast track programme. The aim of this systematic review was to review the existing evidence.

Method  A systematic review was performed of all randomized (RCTs) and controlled clinical trials (CCTs) on laparoscopic and open surgery within a fast track setting. Primary endpoints were primary and overall hospital stay, readmission rate, morbidity and mortality. Study selection, quality assessment and data extraction were performed independently by two observers.

Results  Only two RCTs and three CCTs were eligible for final analysis, which reported on 400 patients. Data could not be pooled because of clinical heterogeneity. One RCT and one CCT stated a shorter primary hospital stay in the laparoscopic group of 3 and 2 days, respectively. In one RCT, the readmission rate was lower in the laparoscopic group; absolute risk reduction (ARR) 21.4% [95% confidence interval (CI): 6–42.3%] resulting in a number needed to treat (NNT) of 4.7 patients (95% CI: 2.4–176). Another study showed a 23% difference in favour of the laparoscopic group with regard to morbidity (95% CI: 6.3–39.1%), i.e. an NNT of 4.4 patients (95% CI: 2.6–15.9). There were no significant differences in mortality rates.

Conclusion  Due to the present lack of data, no robust conclusions can be made. A large randomized controlled trial is required to compare laparoscopic with open surgery within a fast track setting.
Evaluating depression in a sample of children and adolescents with cancer in Greece
Authors: Matziou V. , Perdikaris P. , Galanis P. , Dousis E. , Tzoumakas K.
Published: August 2008

Background:  Several studies have found that serious illness increases the risk of depression. One of the most common psychiatric disorders related to the diagnosis and treatment of cancer is depression.

Aim:  The aim of the present study was to investigate the rate of depression in children with cancer compared with that in healthy children.

Patients and methods:  The present study is an ongoing prospective study. The research group consisted of 80 children with cancer followed up by an oncology inpatient clinic of a Greek Children's hospital. The control group consisted of 84 healthy children. After parental consent was obtained, data were collected using the Children's Depression Inventory (CDI) and a socio‐demographic data form.

Results:  At the time that this study was carried out, neither the research group nor the control group suffered from depression. In particular, there was no statistically significant difference between the two groups with respect to symptoms of depression (X̄ = 5.88 for children with cancer vs. X̄ = 7.23 for healthy children, U = 3013, P = 0.25).

Conclusions:  Our findings suggest that the children in this study with malignancies did not have higher depression scores than their healthy peers, although many previous surveys confirm that children with cancer are at high risk for depression.
Practising mental rotation using interactive Desktop Mental Rotation Trainer (iDeMRT)
Authors: Rafi Ahmad , Samsudin Khairulanuar
Published: August 2008

An experimental study involving 30 undergraduates (mean age = 20.5 years) in mental rotation (MR) training was conducted in an interactive Desktop Mental Rotation Trainer (iDeMRT). Stratified random sampling assigned students into one experimental group and one control group. The former trained in iDeMRT and the latter trained in conventional condition. A multifactorial pretest posttest design procedure was used and data were analysed using two‐way analysis of covariance. Overall, there was substantial improvement in MR accuracy. Main effects of training and gender were observed, indicating that iDeMRT group and boys outperformed the control group and girls respectively. In addition, an interaction between training method and gender was present, indicating that boys were more accurate when trained in iDeMRT and performed moderately in conventional method. Female participants achieved equivalent improvement gain in MR accuracy regardless of the training conditions used. For the speed measure of MR, no appreciable improvement was observed after training.
Understanding Business Process Management: Implications for Theory and Practice
Authors: Smart P. A. , Maddern H. , Maull R. S.
Published: August 2008

This paper presents an empirically validated framework of business process management (BPM) to enable the pursuit of BPM theory. Phase 1 of the research focused on the development of an initial framework of BPM, derived from a synthesis of current literature. This comprised five key themes, subsequently categorized as ‘application components’ of BPM. The empirical validation of the framework was approached through case‐based research, utilizing semi‐structured interviews with managers of a large financial services organization, to explore the dimensions of the framework. The results suggest that, in addition to confirming the five ‘application components’ of the initial framework, three additional ‘conceptual components’ are important. These concepts differentiate BPM from other process management activities, and suggest that developing a prerequisite ‘process mindset’ is a fundamental component of a BPM approach.