bluuebunny/crossref_metadata_2025 huggingface dataset:
Public sector reform: an overview of recent literature and research on NPM and alternative paths
Authors: De Vries Michiel , Nemec Juraj
Published: January 2013

Purpose

– The purpose of this article is to discuss the idea that new public management (NPM) would bepassé.

Design/methodology/approach

– The article is based on a review of existing theories.

Findings

– The article argues that NPM has two dimensions, namely the minimization of the role of governmentvis-à-vissociety and the improvement of the internal performance of the public sector. Whereas the first dimension is indeed more and more disputed nowadays this does not imply this also goes for the second dimension. The conclusion of this article calls for explanatory empirical research in order to explain the increasing variance in reforms among countries, by investigating which factors are determinative for decisions by governments to turn one way or the other.

Practical implications

– It is far from certain which way the public sector is heading in the so-called post-NPM era. Some countries are still implementing NPM-kind of reforms, either by downsizing or by introducing performance management. Other countries have chosen alternative paths. All this implies an increased variance between countries in the direction public sector reforms take. It requires quite different support from administrative sciences compared to the one-size-fits-all recommendations for public sector reforms – in conformity with the maxims of NPM – as witnessed in the past decades.

Originality/value

– The article contributes to the discussion about the role of NPM today. It presents original conclusions about diverging developments based on the unique comprehensive literature review on the topic.
Reliability and validity of the “leadership competencies and engaging leadership scale”
Authors: Alban-Metcalfe Juliette , Alimo-Metcalfe Beverly
Published: January 2013

Purpose

– The aim of this paper is to present evidence of the reliability and validity of the “Local Government 360 (LG360)”, a diagnostic tool for assessing both competent and engaging leadership behaviour among managers and professionals in local government.

Design/methodology/approach

– The paper argues that the assessment of both leadership competencies (the “what”) and engaging leadership behaviours (the “how”) is essential for a valid diagnosis of individuals' strengths and developmental needs.

Findings

– Evidence is presented of the internal consistency (reliability) and the criterion and discriminant validity of the tool, among an opportunity sample comprising 288 local government staff, of whom 143 were female and 77 male; 58 were from a Black and Minority Ethnic background and 220 were White.

Practical implications

– Data on the impact of leadership behaviour on direct reports, provided by the LG360, are powerful in providing evidence to emphasise that the way in which a leader behaves can have a significant effect on staff attitudes and wellbeing at work.

Originality/value

– Although a number of 360-tools are available, only in a small number of cases are their psychometric properties, particularly empirical evidence of their criterion and discriminant validity, reported.
Data recording aids in acute admissions
Authors: Williams Dean T. , Hoare David , Shingler Guy , Fairweather Charlie , Whitaker Christopher
Published: January 2013

Purpose

Clinical data capture and transfer are becoming more important as hospital practices change. Medical record pro‐formas are widely used but their efficacy in acute settings is unclear. This paper aims to assess whether pro‐forma and aide‐memoire recording aids influence data collection in acute medical and surgical admission records completed by junior doctors.

Design/methodology/approach

During October 2007 to January 2008, 150 medical and 150 surgical admission records were randomly selected. Each was analysed using Royal College of Physicians guidelines. Surgical record deficiencies were highlighted in an aide‐memoire printed on all A4 admission sheets. One year later, the exercise was repeated for 199 admissions.

Findings

Initial assessment demonstrated similar data capture rates, 77.4 per cent and 75.9 per cent for medicine and surgery respectively (Z=‐0.74, p=0.458). Following the aide‐memoire's introduction, surgical information recording improved relatively, 70.5 per cent and 73.9 per cent respectively (Z=2.01, p=0.045). One from 11 aide‐memoire categories was associated with improvement following clinical training. There was an overall fall in admission record quality during 2008‐9 vs 2007‐8.

Research limitations/implications

The study compared performance among two groups of doctors working simultaneously in separate wards, representing four months' activity.

Practical implications

Hospital managers and clinicians should be mindful that innovations successful in elective clinical practice might not be transferable to an acute setting.

Originality/value

This audit shows that in an acute setting, over one‐quarter of clinical admission data were not captured and devices aimed at improving data capture had no demonstrable effect. The authors suggest that in current hospital practice, focussed clinical training is more likely to improve patient admission records than employing recording aids.
Quality improvement tools for chronic disease care – more effective processes are less likely to be implemented in developing countries
Authors: Jawad Hashim Muhammad , Prinsloo Adrianna , Mirza Deen M.
Published: January 2013

Purpose

Chronic disease services may be improved if care management processes (CMPs), such as disease‐specific flowsheets and chronic disease registries, are used. The newly industrialized Gulf state health service has underdeveloped primary care but higher diabetes prevalence. This paper's aim is to investigate care management processes in United Arab Emirates (UAE) primary care clinics to explore these issues.

Design/methodology/approach

A cross‐sectional survey using self‐administered questionnaires given to family physicians and nurses attending a UAE University workshop was used to collect data.

Findings

All 38 participants completed the questionnaire: 68 per cent were women and 81 per cent physicians. Care management processes in use included: medical records, 76 per cent; clinical guidelines, 74 per cent; chronic disease care rooms, 74 per cent; disease‐specific flowsheets, 61 per cent; medical record audits, 57 per cent; chronic disease nurse‐educators, 58 per cent; electronic medical records (EMR), 34 per cent; and incentive plans based on clinical performance, 21 per cent. Only 62 per cent and 48 per cent reported that flowsheets and problem lists, respectively, were completed by physicians. Responses to the open‐ended question included using traditional quality improvement (QI) approaches such as continuing education and staff meetings, but not proactive systems such as disease registries and self‐management.

Research limitations/implications

The study used a small, non‐random sample and the survey instrument's psychometric properties were not collected.

Practical implications

Chronic disease care CMPs are present in UAE clinics but use is limited. Quality improvement should include disease registries, reminder‐tracking systems, patient self‐management support and quality incentives.

Originality/value

This report highlights the lag regarding adopting more effective CMPs in developing countries.
Service quality in automated teller machines: an empirical investigation
Authors: Narteh Bedman
Published: January 2013

Purpose

The aim of this paper is to identify the dimensions of Automated Teller Machine (ATM) service quality and to evaluate customers’ perceptions of the relative importance of these dimensions.

Design/methods/approach

A structured questionnaire gleaned from the literature and focused group studies was used to collect data from 530 ATM customers of 15 banks in Ghana. Descriptive statistics, exploratory and confirmatory factor analysis, as well as multiple regression, were used to identify the relative importance of the dimensions of ATM service quality.

Findings

The paper identified five dimensions of the “ATMqual” model. In order of importance, these dimensions are reliability, convenience, responsiveness, ease of use and fulfillment.

Practical implications

The variables of the ATMqual scale provide practical levers for bank managers to improve customer experience with ATMs. The relative importance of the factors identified in the study also provide managers with a guide as to which issues to focus on in order to improve the efficiency and effectiveness of the ATMs.

Originality/value

The paper provides a theoretical basis for conceptualising ATM service quality. The resulting dimensions, referred to as the ATMqual, thus address the paucity of a robust research in conceptualising and testing the dimensions of ATM service quality. Apart from the improved theoretical insight, the dimensions identified also provide bank managers with better understanding of and means to better manage customers’ ATM experiences.
Bank of America Merrill Lynch taps the talent of those who have taken time out
Authors: Fullerton Michelle
Published: January 2013

Purpose

The purpose of this paper is to describe Bank of America Merrill Lynch's returning‐talent program, introduced as the company wanted to find a way to tap into the talent pool of people who have taken time out of work to care for family members.

Design/methodology/approach

The paper explains the reasons for the program, the form it takes and the results it has achieved.

Findings

The paper reveals that, as a lack of confidence can be a barrier for mothers returning to work, the bank wanted a program, which helped them to realize that their previous experience is valuable and relevant. It also wanted mothers to embrace the new skills they have likely acquired, as running a family and home combines many management, budgeting and often diplomacy skills.

Practical implications

The paper explains that the three‐day workshop helps participants to identify their strengths, motivation and newly‐developed skills; contains exercises to help to develop an action plan for returning to work; and provides practical examples on how participants can hone their CVs and prepare for interviews.

Social implications

The paper explains that Bank of America Merrill Lynch partnered Mumsnet – the online network run by mothers, for mothers – to publicize the program, which is part of the Mumsnet family‐friendly program for developing and promoting family‐friendly practices in business.

Originality/value

The paper reveals how the bank is helping to put people who have been out of employment for three years or more back in touch with the world of work.
A manufacturer moving upstream: triadic collaboration for service delivery
Authors: Finne Max , Holmström Jan
Published: January 2013

Purpose

The purpose of this paper is to explore servitization in the context of the service supply chain, particularly the effects of the relationship between the subsystem supplier and the end user on the supplier's as well as on the supply chain's ability to provide industrial services. In addition, it aims to present a solution to overcome the challenges of lack of this relationship.

Design/methodology/approach

A case study incorporating an explorative design science approach identifies a theoretically novel and practically relevant problem in the field of service supply chain management. The study combines empirical data collection; systematic conceptualization of means and ends; evaluation of proposed solutions in iterative‐ and action‐oriented cycles; and theoretical explanation of the observed phenomena and outcomes.

Findings

By establishing a triadic operational model with an integrator and end user, the subsystem supplier can servitize within a supply chain in which the end user relationship is controlled by the integrator. This enables the combining of critical service provision capabilities: supplier's maintenance‐related capabilities and integrator's end user access.

Research limitations/implications

Further research is needed to determine the importance of managing the transition to subsystem suppliers in different types of industrial service supply chains. Because these observations and proposals are based on a single case study, the authors cannot draw conclusions as to how they apply to manufacturers in different problem situations.

Practical implications

The paper presents a decision‐making procedure that describes how a subsystem supplier opting for cooperation in the service supply chain can formulate a coherent set of triadic operational models with intermediaries and end users.

Originality/value

The paper shows how servitization takes place on supply chain level.
E‐procurement and supply chain performance
Authors: Hsin Chang Hsin , Tsai Yao‐Chuan , Hsu Che‐Hao
Published: January 2013

Purpose

The aim of this study is to discuss the relationship between e‐procurement and supply chain performance.

Design/methodology/approach

Both interviews with practicing managers and an empirical study were conducted in the current study. Interviews with four practicing managers were conducted to gather the practical insights of the theoretical framework. Empirical data were collected from 108 Taiwanese enterprises.

Findings

The paper found that partner relationships, information sharing, and supply chain integration can represent the processes through which e‐procurement contributes to supply chain performance. Supply chain integration has the highest standardized total effect on supply chain performance.

Research limitations/implications

Future studies could more systematically analyze the relationships among e‐procurement, supply chain integration and supply chain performance. Cross‐level analysis is also worthy of investigation when considering the influence of technology‐usage characteristics.

Practical implications

Compared to partner relationships and information sharing, supply chain integration has more influences on supply chain performance. Therefore, this study suggests that a joint‐learning practice can be implemented for properly managing supply chains (e.g. know‐how collaboration, mutual competency creation).

Originality/value

This paper contributes to the literature by proposing and testing the influences of partner relationships, information sharing, and supply chain integration. This allows a strategic viewpoint when implementing e‐procurement systems intended to improve supply chain performance.
Indicators of sustainable business practices: Woolworths in South Africa
Authors: Dos Santos Maria A.O. , Svensson Göran , Padin Carmen
Published: January 2013

Purpose

The purpose of this paper is to demonstrate how Woolworths, a South African retail chain, evaluates and controls its sustainable business practices using economic, environmental and social indicators.

Design/methodology/approach

A content analysis of Woolworths' comprehensive 2008‐2011 sustainability and annual reports examined how this retail chain evaluates and implements its sustainable business practices.

Findings

The results indicate that such indicators play a significant role in evaluating and implementing various Woolworths' business practices aimed at sustainability. In addition, Woolworths' comprehensive governance system ensures that its sustainable business practices are implemented and targets achieved.

Research limitations/implications

The case study demonstrates that businesses can remain profitable, while at the same time protecting the natural environment and striving for sustainable business practices.

Practical implications

This example demonstrates how government influence, institutional mechanisms and senior management commitment to a project ultimately has gone some way to minimise barriers to the adoption of sustainable practices.

Originality/value

The example provides not only a seed of knowledge for others in retailing, but also guidance to both practice in general and theory in the field of sustainable business practices. It demonstrates how an organization has taken strategic action, extended this beyond the firm's boundaries and into the supply chain. The case study illustrates how one organization can act as the change agent in the network.
Telecommunications regulation and the institutional foundation of the Palestinian Authority
Authors: Dhaher Omar
Published: January 2013

Purpose

This paper aims to determine the most possible telecommunications regulatory system for the Palestinian Authority by investigating its institutional foundations. The paper highlights the problem of setting sophisticated institutions in fragile states that do not fully control their resources and investigates possible solution in terms of foreign investments.

Design/methodology/approach

The paper follows a qualitative research approach in two parts. The first part examines the institutional endowment framework set by Levy and Spiller and Levy and Spiller but considers critique of the framework. It also investigates institutional problems in fragile states in order to identify similar patters identified in Levy and Spiller framework. The second part focuses on the Palestinian Authority institutional foundations. Data are collected through interviews with key stakeholders of the Palestinian telecommunications sector.

Findings

The case of the Palestinian Authority shows a mix of political investment cycles and a genuine attempt of regulatory reforms. Endogenous fragility of the government magnified the effect of corruption and the maintenance of business‐politicians ties. Also, the Palestinian telecommunications sector suffers from exogenous fragility in terms of Israeli control of radio spectrum, international gateway, and importing of equipment. Inability of the Palestinian Authority to invoke GATS BTA conflict resolution mechanism and the crucial role foreign investors played to secure release of spectrum for the second mobile operator indicates the need for the Palestinian Authority to attempt attracting foreign investment. However, foreign investments require regulatory effectiveness that the Palestinian Authority lacks; thus eliminating endogenous fragility becomes a prerequisite to exogenous fragility.

Originality/value

This paper sheds light on problems regarding setting up an institution‐based regulatory system in unstable states. It contributes to the argument that “one size fit all” might not be the answer for some countries, especially fragile ones.
An Improvement Engine for empowered change in healthcare
Authors: Siverbo Kristian , Eriksson Henrik , Wijk Helle
Published: January 2013

Purpose

The purpose of this article is to describe how an Improvement Engine methodology, based on self‐assessment and everyone's involvement, can be used in order to stimulate change and what experience and results it can generate.

Design/methodology/approach

This article describes how an Improvement Engine was developed and used at Sahlgrenska University Hospital to stimulate change and what experience and results it generated. The principles behind the methodology were everyone's involvement, self‐assessment, incremental change and learning. The data were collected in interviews and analysed using a content analysis approach. The strengths, weaknesses, opportunities and threats were analysed and mapped to context, content, process and output.

Findings

The evaluation shows that the Improvement Engine methodology has advantages concerning involvement and dialogue but needs improvement in terms of information about the project.

Practical implications

Examples of how the Improvement Engine can be applied are discussed.

Originality/value

The intention is to shed light on what kind of issues managers must deal with when they try to stimulate change in a healthcare setting. The Improvement Engine methodology developed and used shows that the empowerment approach is a promising avenue for change in healthcare.
Patient satisfaction with nursing care and related hospital services at the National Hospital of Sri Lanka
Authors: Senarath Upul , Gunawardena Nalika S. , Sebastiampillai Benedict , Senanayake Arosha , Lekamge Sachintha , Seneviratna Anushka , Jinadasa Madushan , Wijeratne Dilshan
Published: January 2013

Purpose

This paper aims to assess patient satisfaction with nursing care and related hospital services, and association between satisfaction and patient characteristics at the National Hospital of Sri Lanka (NHSL).

Design/methodology/approach

A systematically selected sample of 380 patients warded for three to 90 days in general surgical/medical units was interviewed on discharge. Data were collected using a satisfaction instrument previously developed and validated for the same setting, that contained 36 items under five sub‐scales. Multiple logistic regression analyses were used to identify factors associated with satisfaction in each sub‐scale.

Findings

The paper finds that the majority of respondents were males (61 percent), aged 35‐64 years (70 percent), educated to GCE (O/L) and above (61 percent), and previously hospitalized (66 percent). The proportion satisfied with “interpersonal care” was 81.8 percent, “efficiency and competency”, 89.7 percent, “comfort and environment”, 59.2 percent, “cleanliness and sanitation”, 48.7 percent, and “personalized and general information”, 37.4 percent. Males reported higher satisfaction (OR varied from 2.29‐2.87, p < 0.001) than females. Patients with GCE (A/L) were less satisfied with “comfort and environment” (OR=0.45, p < 0.05) and “cleanliness and sanitation” (OR=0.45, p < 0.05) compared with those educated below grade 5. Satisfaction with “comfort and environment” was lower among patients from medical (OR=0.51, p < 0.01) rather than from surgical units.

Practical implications

Quality can be improved by assuring comfort, cleanliness, sanitary facilities in wards, and provision of general and personalized instructions. Nursing staff should understand patient characteristics and their expectations when providing care.

Originality/value

This is the first study that described patient satisfaction with nursing care and related supportive services using a validated instrument at the NHSL. The study highlighted aspects of dissatisfaction and recognized patient characteristics that predict satisfaction.
Overconfidence and endogenous information acquisition
Authors: Liang Tian
Published: January 2013

Purpose

The purpose of this paper is to examine the implications of overconfidence for information acquisition and market efficiency.

Design/methodology/approach

The paper studies a model of a competitive market with both overconfident and rational traders endogenously acquiring costly differential information.

Findings

The paper shows that overconfident traders acquire more information than do rational traders, and improve market informational efficiency by making price more informative than in a fully rational market.

Originality/value

This result is in contrast with Odean where information acquisition is exogenous, and overconfidence worsens price quality. Therefore, it may be crucial to incorporate endogenous information acquisition into models of overconfidence.
The Substantive Representation of Women—Does Issue-Salience Matter? Party Politicization and UK Westminster Elections 1945–2010
Authors: Chaney Paul
Published: January 2013

Research Highlights and Abstract

This article

Responds to recent calls for a more holistic approach to studying the substantive representation of women (SRW). Specifically, it explores the nexus between the SRW and issue-salience. A theoretically-informed review of the literature and analysis of party manifestos in UK elections 1945–2010 both confirm that this matters to contemporary understanding of the SRW. Extends existing understanding of the substantive representation of women by reviewing relevant theory and providing new, empirical research findings. Heeds earlier calls for the combination of content and critical discourse analysis in policy studies. Thus this mixed methodology responds to earlier calls for social research to ‘humanize’ quantitative data by focusing on language and meaning related to specific phenomena, notably from political actors’ perspectives. Includes a future research agenda emerging from the present study. It is one that will extend contemporary understanding of the substantive representation of women and generate debate and further research.

The following discussion responds to recent calls for a more holistic approach to studying the substantive representation of women (SRW). It uses mixed methods to explore the nexus between the SRW and issue salience in the manifesto discourse of UK state-wide elections 1945–2010. The data show that issue salience does matter to the SRW because it is part of on-going patterns and processes of party politicization linked to electoral cycles. The present findings also affirm that whilst there has been a trend of increasing issue salience over the post-war period, the SRW has also been subject to periods of set-back and reversal. Thus its status amongst competing policy priorities remains ‘fragile’; in turn, this raises issues of institutional sexism in the formative, agenda-setting phase of parties’ public policy-making.
Institutional Change and Ethics Management in the EU's College of Commissioners
Authors: Cini Michelle
Published: January 2013

Research Highlights and Abstract

This article makes the following contribution:

It identifies a gap in theoretical work on gradual institutional change by highlighting the importance of ‘reluctant agency’ that is, agents who do not oppose change outright, but are reluctant to agree to anything more than minimal reforms. It demonstrates the importance of the interplay of internal and external factors in explanations of gradual institutional change. It provides an empirical account of the evolution of the EU Commissioners' ethics regime since 1999. It identifies institutional change in the EU Commissioners' ethics regime as taking the form of a ‘layering’ process. It shows how institutional change in the EU Commissioners' ethics regime can be explained using a framework comprising political context, institutional characteristics and change agency (drawing on the work of Mahoney and Thelen).

This article comprises a theory-informed case study of the European Commissioners' ethics regime. Conceptualising the evolution of the regime since 1999 as a process of gradual institutional change, it asks how the Commissioners' ethics regime continued to evolve incrementally after its inception, and what form that evolution took. Drawing on a recent theory of gradual institutional change (Mahoney and Thelen's), the article argues that the evolution of the Commissioners' ethics regime has involved a ‘layering’ process which has resulted from the Commission's changing position within the EU system (political context) and the extent of the Commission's control over the reform process (institutional characteristics). External change agents (the European Parliament and NGOs) are crucial, but so too is the Commission itself, which engages only reluctantly, in a risk-averse manner, in the on-going reform of the regime.
Predictive value of combined cervicovaginal cytokines and gestational age at sampling for intra‐amniotic infection in preterm premature rupture of membranes
Authors: Ryu Aeli , Park Kyo Hoon , Oh Kyung Joon , Lee Sung Youn , Jeong Eun Ha , Park Jeong Woo
Published: January 2013

Objective

To determine whether interleukin (IL)‐1β, IL‐6, and IL‐8 in cervicovaginal fluid, alone or in combination with clinical risk factors, could predict intra‐amniotic infection in women with preterm premature rupture of membranes (PPROM).

Design

A prospective cohort study.

Setting

University teaching hospital.

Population

Women with singleton pregnancies presenting PPROM between 20 and 35 weeks of gestation (n = 76).

Methods

Cervicovaginal fluid samples were collected for IL‐1β, IL‐6, and IL‐8 measurements immediately before amniocentesis. Amniotic fluid obtained by amniocentesis was cultured and the white blood cell count was determined. Clinical risk factors analyzed included demographics and gestational age. Cervicovaginal concentrations of cytokines were measured using a multiplex bead array assay.

Main outcome measure

A positive amniotic fluid culture.

Results

The prevalence of a positive amniotic fluid culture was 46.1% (35/76). Stepwise multivariate regression analysis yielded a model using cervicovaginal IL‐6 and gestational age at sampling with the area under the curve (AUC) of 0.807 for predicting intra‐amniotic infection. The AUC for this model was significantly higher than either parameter retained in this model but no differences were observed between the AUC of this model based on non‐invasive variables, and amniotic fluid white blood cell count using invasive amniocentesis for the prediction of intra‐amniotic infection.

Conclusions

Among measured cytokines, the combination of cervicovaginal IL‐6 and gestational age appears to be best in predicting intra‐amniotic infection and allows for a considerably better accuracy than the use of either factor alone. Overall, this combination performed as well as amniotic fluid WBC count for predicting intra‐amniotic infection.
Important surgical measures and techniques at cesarean hysterectomy for placenta previa accreta
Authors: Matsubara Shigeki , Kuwata Tomoyuki , Usui Rie , Watanabe Takashi , Izumi Akio , Ohkuchi Akihide , Suzuki Mitsuaki , Nakata Manabu
Published: January 2013

For cesarean hysterectomy with placenta previa accreta, “universally achievable” measures are required. We propose eight measures: (i) placement of intra‐iliac arterial occlusion balloon catheters; (ii) placement of ureter stents; (iii) “holding the cervix” to identify the site to be transected; (iv) uterine fundal incision; (v) avoidance of uterotonics; (vi) “M cross double ligation” for ligating the ovarian ligament; (vii) “filling the bladder” to identify the bladder separation site and “opening the bladder” for placenta previa accreta with bladder invasion; and (viii) to continue to clamp the medial side of the parametrium or the cervix or employment of the “double edge pick‐up” to ligate it. These eight measures are simple, easy, effective, and thus “universally achievable”.
Stable purse‐string suturing using an anterior esophagotomy for reconstruction with a circular stapler during laparoscopic total gastrectomy
Authors: Kong Seong‐Ho , Suh Yunsuhk , Kwon Sebastianus , Lee Hyuk‐Joon , Kim Hyung‐Ho , Yang Han‐Kwang
Published: January 2013

Introduction

During a laparoscopic total gastrectomy, the combined process of purse‐string suture placement and anvil insertion of a circular stapler is one of the most difficult steps in the reconstruction. We have developed a stable and reliable technique in which purse‐string suture placement and anvil insertion using anterior esophagotomy precede complete transection of the esophagus.

Methods

The procedure involves tying the distal esophagus, insufflating the esophagus via a nasogastric tube, anterior wall purse‐string suture, anterior esophagotomy, posterior wall purse‐string suture, anvil insertion, fastening purse‐string suture, and transecting the esophagus. The technique has been employed in nine patients since April 2011.

Results

Eight of the nine gastrectomies were for patients with stage IA early gastric cancer and one was for a patient with medically intractable bleeding from multiple polyps. Three were men and six were women. Average BMI was 25.2 ± 5.3 (range, 16.3–33.9). Mean operation time was 276.2 ± 56.3 min (range, 215.0–395.0 min) and the mean duration for anvil insertion was 29.8 ± 7.0 min (range, 23.0–46.0 min). There were no intraoperative or postoperative anastomosis‐related complications or mortality.

Conclusion

Our method of anvil insertion of a circular stapler can be a good option for safe and reliable esophagojejunostomy during a laparoscopic total gastrectomy.
Clinical outcomes of laparoscopic surgery for transverse and descending colon cancers in a community setting
Authors: Matsuda Takeru , Fujita Hirofumi , Kunimoto Yukihiro , Kimura Taisei , Hayashi Tomomi , Maeda Toshiyuki , Yamakawa Junichi , Mizumoto Takuya , Ogino Kazunori
Published: January 2013

Introduction

The feasibility, safety and oncological outcomes of laparoscopic surgery for transverse and descending colon cancers in a community hospital setting were evaluated.

Methods

Twenty‐six patients with transverse or descending colon cancers who underwent laparoscopic surgery at our hospital were included in this retrospective analysis (group A). Their outcomes were compared with those of 71 patients who underwent laparoscopic surgery for colon cancer at other tumor sites (group B).

Results

There were no significant differences between the two groups in terms of operative time, estimated blood loss, postoperative hospital stay and morbidity rate. Extended lymphadenectomy was performed more frequently and the number of harvested lymph nodes was significantly higher in group B than in group A. However, no recurrence developed in group A, while recurrence occurred in four patients from group B. The 3‐year disease‐free survival rates were 100% for group A and 93.5% for group B. The 3‐year overall survival rates were 100% for group A and 91.6% for group B.

Conclusions

Laparoscopic surgery for transverse and descending colon cancers can be performed safely with oncological validity in a community hospital setting, provided there is careful selection of the patients and adequate lymphadenectomy considering the clinical stage of their disease.
Predicted heart rate effect of inhaled PF‐00610355, a long acting β‐adrenoceptor agonist, in volunteers and patients with chronic obstructive pulmonary disease
Authors: Diderichsen Paul Matthias , Cox Eugène , Martin Steven W. , Cleton Adriaan , Ribbing Jakob
Published: January 2013

Aim

To assess the cardiovascular effects of a new inhaled long‐acting β‐adrenoceptor agonist PF‐00610355 in COPD patients.

Methods

Thirteen thousand and sixty‐two heart rate measurements collected in 10 clinical studies from 579 healthy volunteers, asthma and COPD patients were analyzed. The relationship between heart rate profiles and predicted plasma concentration profiles, patient status, demographics and concomitant medication was evaluated using non‐linear mixed‐effects models. The median heart rate increase in COPD patients for doses of PF‐00610355 up to 280 μg once daily was simulated with the final pharmacokinetic/pharmacodynamic (PKPD) model.

Results

An Emax model accounting for delayed on‐and off‐set of the PF‐00610355‐induced change in heart rate was developed. The predicted potency in COPD patients was three‐fold lower compared with healthy volunteers, while no difference in maximum drug effect was identified. Simulations suggested a maximum placebo‐corrected increase of 2.7 (0.90–4.82) beats min−1 in COPD patients for a PF‐00610355 dose of 280 μg once daily, with 19% subjects experiencing a heart rate increase of more than 20 beats min−1 compared with 8% in the placebo group.

Conclusions

This PKPD analysis supports the clinical observation that no relevant effects of PF‐00610355 on heart rate in COPD patients should be expected for doses up to 280 μg once daily.
Dendritic cells phenotype fitting under hypoxia or lipopolysaccharide; adenosine 5′-triphosphate-binding cassette transporters far beyond an efflux pump
Authors: Lloberas N , Rama I , Llaudó I , Torras J , Cerezo G , Cassis L , Franquesa M , Merino A , Benitez-Ribas D , Cruzado J M , Herrero-Fresneda I , Bestard O , Grinyó J M
Published: January 2013

This study examines adenosine 5′-triphosphate-binding cassette (ABC) transporters as a potential therapeutic target in dendritic cell (DC) modulation under hypoxia and lipopolysaccharide (LPS). Functional capacity of dendritic cells (DCs) (mixed lymphocyte reaction: MLR) and maturation of iDCs were evaluated in the presence or absence of specific ABC-transporter inhibitors. Monocyte-derived DCs were cultured in the presence of interleukin (IL)-4/granulocyte–macrophage colony-stimulating factor (GM-CSF). Their maturation under hypoxia or LPS conditions was evaluated by assessing the expression of maturation phenotypes using flow cytometry. The effect of ABC transporters on DC maturation was determined using specific inhibitors for multi-drug resistance (MDR1) and multi-drug resistance proteins (MRPs). Depending on their maturation status to elicit T cell alloresponses, the functional capacity of DCs was studied by MLR. Mature DCs showed higher P-glycoprotein (Pgp) expression with confocal microscopy. Up-regulation of maturation markers was observed in hypoxia and LPS-DC, defining two different DC subpopulation profiles, plasmacytoid versus conventional-like, respectively, and different cytokine release T helper type 2 (Th2) versus Th1, depending on the stimuli. Furthermore, hypoxia-DCs induced more B lymphocyte proliferation than control-iDC (56% versus 9%), while LPS-DCs induced more CD8-lymphocyte proliferation (67% versus 16%). ABC transporter-inhibitors strongly abrogated DC maturation [half maximal inhibitory concentration (IC50): P-glycoprotein inhibition using valspodar (PSC833) 5 μM, CAS 115104-28-4 (MK571) 50 μM and probenecid 2·5 μM], induced significantly less lymphocyte proliferation and reduced cytokine release compared with stimulated-DCs without inhibitors. We conclude that diverse stimuli, hypoxia or LPS induce different profiles in the maturation and functionality of DC. Pgp appears to play a role in these DC events. Thus, ABC-transporters emerge as potential targets in immunosuppressive therapies interfering with DCs maturation, thereby abrogating innate immune response when it is activated after ischaemia.
Inhibition of Pref‐1 (preadipocyte factor 1) by oestradiol in adolescent girls with anorexia nervosa is associated with improvement in lumbar bone mineral density
Authors: Faje Alexander T. , Fazeli Pouneh K. , Katzman Debra , Miller Karen K. , Breggia Anne , Rosen Clifford J. , Mendes Nara , Misra Madhusmita , Klibanski Anne
Published: January 2013

Objective

Adolescents with anorexia nervosa (AN) are amenorrheic and have decreased bone mass accrual and low bone mineral density (BMD). The regulation of mesenchymal stem cell differentiation is an important factor governing bone formation. Preadipocyte factor 1 (Pref‐1), an inhibitor of adipocyte and osteoblast differentiation, is elevated in states of oestrogen deficiency. In this study, we aim to (i) investigate effects of transdermal oestradiol on Pref‐1 in adolescent girls with AN, and (ii) examine associations of changes in Pref‐1 with changes in lumbar BMD and bone turnover markers.

Design

Adolescent girls with AN and normal‐weight controls were studied cross‐sectionally. Girls with AN were examined longitudinally in a double‐blind study and received transdermal oestradiol (plus cyclic medroxyprogesterone) or placebo for 12 months.

Patients

Sixty‐nine girls (44 with AN, 25 normal‐weight controls) 13–18 years were studied at baseline; 22 AN girls were followed prospectively.

Measurements

Pref‐1 levels, bone formation and resorption markers, and BMD.

Results

Pref‐1 levels decreased in girls with AN after treatment with transdermal oestradiol compared with placebo (−0·015 ± 0·016 vs 0·060±0·026 ng/ml, P = 0·01), although at baseline, levels did not differ in AN vs controls (0·246 ± 0·015 vs 0·267 ± 0·022 ng/ml). Changes in Pref‐1 over 12 months correlated inversely with changes in lumbar BMD (r = −0·48, P = 0·02) and positively with changes in CTX (r = 0·73, P = 0·006).

Conclusions

For the first time, we show that Pref‐1 is negatively regulated by oestradiol in adolescent girls with AN. Inhibition of Pref‐1 may mediate the beneficial effects of transdermal oestradiol replacement on BMD in girls with AN.
Does differential response make a difference: examining domestic violence cases in child protection services
Authors: Alaggia Ramona , Gadalla Tahany M. , Shlonsky Aron , Jenney Angelique , Daciuk Joanne
Published: January 2013

Large numbers of domestic violence (DV) cases on child protection caseloads have necessitated the development of practices that address both DV and child safety. The first step in this process is to gain an understanding of the differences between DV‐involved cases and other forms of maltreatment. The implementation of a differential response service model in Ontario offered an opportunity to compare risk assessment ratings, service outcomes and recurrence and to identify pathways of DV cases through child protection services (CPS). A sample (n = 785) of child protection investigations over a 4‐month period was examined. Of these investigations, 26% cases were DV referred; 87% of the DV victims were mothers; perpetrating partners were mostly absent from investigations; non‐white families were more often investigated for DV than white families; and DV cases were more likely to remain open for ongoing CPS. Only one‐third of DV‐exposed children were assessed as having been harmed and most community referrals were made for the victim parent. Mothers were the primary target of investigation, remaining in CPS for extended service provision although recurrence rates were lower than found in other investigations. Results are discussed to inform investigative procedures, assessment and service response to more adequately respond to children and families when DV is present.
The use of local anaesthesia in haemorrhoidal banding: a randomized controlled trial
Authors: Kwok H. C. K. , Noblett S. E. , Murray N. E. A. , Merrie A. E. H. , Hayes J. L. , Bissett I. P.
Published: January 2013

Aim

Rubber band ligation is a common office procedure for the treatment of symptomatic haemorrhoids. It can be associated with pain and vasovagal symptoms. The effect of local anaesthetic use during banding was studied.

Method

A single‐blinded randomized controlled trial was carried out in the colorectal outpatient clinic. Patients presenting with symptomatic haemorrhoids suitable for banding were prospectively recruited and randomized to undergo the procedure with local anaesthetic or without (control). Submucosal bupivacaine was injected immediately after banding just proximal to the site. Vasovagal symptoms were assessed at the time of banding and pain scores (visual analogue scale) were recorded at the conclusion of the procedure, after 15 min, and on leaving the clinic.

Results

Seventy‐two patients (40 local anaesthetic injection, group 1; 32 no injection, group 2) were recruited. The mean ages were 50 and 54 years respectively, the median duration of symptoms was 12 months in each group and the median number of haemorrhoids banded was three in each group. The mean pain score on leaving the clinic was 2.6 (95% CI 2.1, 3.1) in group 1 and 4.1 (95% CI 3.3, 5.0) (P = 0.04) in group 2. There were no complications related to local anaesthetic use. No significant difference in vasovagal symptoms was found (P = 0.832).

Conclusion

Local anaesthetic injection at the time of banding is simple and safe. It may reduce patient discomfort following banding of haemorrhoids.
Conformational changes of recombinant Ca2+–ATPase studied by reaction‐induced infrared difference spectroscopy
Authors: Kumar Saroj , Li Chenge , Montigny Cédric , le Maire Marc , Barth Andreas
Published: January 2013

Recombinant Ca2+–ATPase was expressed in Saccharomyces cerevisiae with a biotin‐acceptor domain linked to its C–terminus by a thrombin cleavage site. We obtained 200 μg of ~ 70% pure recombinant sarcoendoplasmic reticulum Ca2+–ATPase isoform 1a (SERCA1a) from a 6–L yeast culture. The catalytic cycle of SERCA1a was followed in real time using rapid scan FTIR spectroscopy. Different intermediate states (Ca2E1P and Ca2E2P) of the recombinant protein were accumulated using different buffer compositions. The difference spectra of their formation from Ca2E1 had the same spectral features as those from the native rabbit SERCA1a. The enzyme‐specific activity for the active enzyme fraction in both samples was also similar. The results show that the recombinant protein obtained from the yeast‐based expression system has similar structural and dynamic properties as native rabbit SERCA1a. It is now possible to apply this expression system together with IR spectroscopy to the investigation of the role of individual amino acids.
Synergistic effects of antibodies against high‐mobility group box 1 and tumor necrosis factor‐α antibodies on d‐(+)‐galactosamine hydrochloride/lipopolysaccharide‐induced acute liver failure
Authors: Wang Wei , Sun Li , Deng Yonghao , Tang Jie
Published: January 2013

High‐mobility group box 1 (HMGB1) protein is released into the serum after tissue damage, and serves as a warning signal to enhance the inflammatory response. Acute liver injury is one of the diseases that starts with tissue damage and ends with systemic inflammation. We used d‐(+)‐galactosamine hydrochloride (d‐GalN)/lipopolysaccharide (LPS)‐treated mice as an acute liver injury model to explore the functions of HMGB1 in more detail. HMGB1 is released into the serum at a very early stage of d‐GalN/LPS‐induced acute liver injury. It upregulates the expression of tumor necrosis factor‐α (TNF‐α), interleukin‐6, inducible nitric oxide synthase, and tissue factor. TNF‐α and HMGB1 form a positive feedback loop to amplify the downstream signals. mAbs against HMGB1 and TNF‐α have synergistic effects in protecting mice from d‐GalN/LPS‐induced acute liver failure. The results suggest that HMGB1 is a key mediator in d‐GalN/LPS‐induced acute liver injury. Tissue damage and cell necrosis shortly after administration of d‐GalN and LPS lead to early HMGB1 release, and HMGB1 acts synergistically with TNF‐α to promote pathological processes in acute liver failure.
Identification of a highly reactive substrate peptide for transglutaminase 6 and its use in detecting transglutaminase activity in the skin epidermis
Authors: Fukui Mina , Kuramoto Katsuma , Yamasaki Risa , Shimizu Yoshitaka , Itoh Miho , Kawamoto Tadafumi , Hitomi Kiyotaka
Published: January 2013

Mammalian transglutaminases (TGs) are a family of enzymes that catalyze the formation of covalent crosslinks between glutamine and lysine residues in proteins. These catalytic reactions play roles in several essential biological processes, including blood coagulation, skin formation, and stabilization of the extracellular matrix. Among the members of this family, factor XIII and TGs 1–5 have been characterized well, but very little is known about the novel members TG6 and TG7. Recently, however, autoantibodies against TG6 were found in a patient with gluten ataxia, a disease caused by enzymatically modified gluten‐derived peptides in neuronal cells. To characterize the possible physiological functions of TG6, in this study we screened a phage‐displayed random peptide library to find highly reactive glutamine donor substrate peptides. From several candidate peptides, one sequence, designated Y25, appeared to have the highest reactivity. The Y25 sequence also has apparent isozyme specificity when evaluated by incorporation of the labeled glutamine acceptor substrate as a fusion protein with glutathione‐S‐transferase. Also, the sequence retained high reactivity as well as the isozyme specificity in the peptide form. Analyses with the biotin‐labeled and fluorescence‐labeled peptides showed TG6 to be an active enzyme and react to specific substrates in the skin, which is consistent with the results of the expression pattern of its transcripts.