bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementing integration of ISO 9001 and ISO 14001 for construction
Authors: Zeng S.X. , Tian P. , Shi Jonathan J.
Published: May 2005

Purpose

The aim of this study is to evaluate implementation of an integrated management system (IMS) based ISO 9001 and ISO 14001 standards for construction firms.

Design/methodology/approach

Supported by a structured questionnaire survey, this paper examines several related issues in the implementation of IMS in construction firms in China. The researchers interviewed the auditors of ISO 9001 and ISO 14001 standards and senior managers of ten construction firms. The structured questionnaires were sent to 300 construction firms in China. Among them, 68 completed questionnaires were received.

Findings

The findings reveal that a majority of the firms support an integration of the ISO 9001 and ISO 14001 standards. “Similarity” and “compatibility” between the two standards are considered as the main reasons for pursuing such an integration. The benefits resulted from the integration include “avoidance duplication of procedures”, “reduced conflict of procedures”, and “reduced requirements for resources”. The research also finds that organizations need technical guidance and support from certifying bodies to complete the integration.

Practical implications

Proposes some useful suggestion for the contractors which are implementing (or will implement) both ISO 9001 and ISO 14001 standards.

Originality/value

It provides a possible solution by IMS with combining ISO 9001 and ISO 14001 for the contractors which are implementing (or will implement) both ISO 9001 and ISO 14001 standards. The IMS could help the contractors to overcome the challenges faced by them and achieve continual improvement.
E‐commerce impact: emerging technology – electronic auditing
Authors: Shaikh Junaid M.
Published: May 2005

Purpose

We expect an explosive application of these technologies to take place when they become mature and may further assist auditors in improving the quality of their work. How to use some of the computer‐assisted auditing techniques (CAATs) more effectively with the emerging information technologies.

Design/methodology/approach

Constructed an infrastructure with the support of emerging technologies. Electronic auditing (EA) framework–prepared and used with information technology, these examples are object‐oriented distributed middlewares, internet security technologies, and intelligent agents.

Findings

How a CPA may conveniently audit the loan account of a bank with EA framework. Demonstration/application.

Research limitations/implications

Auditors will have to design one specialized audit software for each auditee's electronic data processing (EDP) system if the EDP system uses proprietary file formats or different operating systems. The EA has some limitations. This approach depends on distributed middlewares standards, i.e. CORBA, DCOM, or Java RMI, to enable the interconnections of the auditor's GASI, auditee's EDP systems.

Practical implications

This system emulates EDP applications in the banking industry and is based on the Common Object Request Broker Architecture (CORBA) architecture industrial standard.

Originality/value

How auditor could effectively apply existing CAATs with the support of the modern information technologies such as object‐oriented distributed middleware, internet security technologies, and intelligent agents. Furthermore, this article proposes a new auditing approach that we call EA. Application in banking and financial institution for auditing banks loan account.
Individual learning and organization culture in learning organizations
Authors: Akin Aksu A. , Özdemir Bahattin
Published: May 2005

Purpose

To investigate nine organizational dimensions that enable individual learning in hotel establishments and to note interests of tourism professionals to the learning of organizations subject.

Design/methodology/approach

Questionnaire technique was used for the sample of 129 staff working in three different five‐star hotels in Antalya. For data evaluation, SPSS program was used.

Findings

According to the findings, the highest pure value and variance explanation rated dimension was that of behavior of superiors. This result shows the importance and role of superiors in hotel establishments. In addition to this, the majority of the sampled staff engaged in teamworking and made dialogue with colleagues, but with some considerable occurrence; sampled staff rarely had training and rewards.

Research limitations/implications

The results are limited within the sampled staff working in three different five‐star hotels, so the results cannot be generalized, but the scale in the study can be used in other researches.

Originality/value

This study can be evaluated as useful information and guidance for tourism industry professionals regarding learning of organizations.
The origins and development of quality initiatives in American business
Authors: Goldman Henry H.
Published: May 2005

Purpose

Seeks to examine the origins and development of quality initiatives in US business.

Design/methodology/approach

Reviews and discusses the literature and history pertaining to quality initiatives in US business, with particular reference to the reconstruction of Japanese industry following the Second World War.

Findings

The real beginnings of “quality initiatives” in the USA came after W. Edwards Deming, Joseph Juran, and others returned from Japan in the late 1950s. These men and their colleagues had answered a call from the US Government to assist in the reconstruction of Japanese industry following the Second World War. Their techniques and methodologies had raised the industrial output of Japan to heights not previously envisioned.

Originality/value

Examines current quality initiatives in a fresh light by reviewing their origins and history.
Using machine learning to support quality management
Authors: Tsironis Loukas , Bilalis Nikos , Moustakis Vassilis
Published: May 2005

Purpose

To demonstrate the applicability of machine‐learning tools in quality management.

Design/methodology/approach

Two popular machine‐learning approaches, decision tree induction and association rules mining, were applied on a set of 960 production case records. The accuracy of results was investigated using randomized experimentation and comprehensibility of rules was assessed by experts in the field.

Findings

Both machine‐learning approaches exhibited very good accuracy of results (average error was about 9 percent); however, association rules mining outperformed decision tree induction in comprehensibility and correctness of learned rules.

Research limitations/implications

The proposed methodology is limited with respect to case representation. Production cases are described via attribute‐value sets and the relation between attribute values cannot be determined by the selected machine‐learning methods.

Practical implications

Results demonstrate that machine‐learning techniques may be effectively used to enhance quality management procedures and modeling of cause‐effect relationships, associated with faulty products.

Originality/value

The article proposes a general methodology on how to use machine‐learning techniques to support quality management. The application of the technique in ISDN modem manufacturing demonstrates the effectiveness of the proposed general methodology.
Strategic manufacturing benchmarking
Authors: Meybodi Mohammad Z.
Published: May 2005

Purpose of this paper

The purpose of the article is to improve the effectiveness of benchmarking by detecting and reconciling possible inconsistencies in manufacturing strategy process and identifying benchmarking areas that are critical to organizational success.

Design/methodology/approach

The paper develops the following five propositions and uses survey data to test the propositions: P1, organizational goals and objectives are consistent with core competencies; P2, organizational goals and objectives are consistent with competitive priorities; P3, organizational competitive priorities are consistent with core competencies; P4, manufacturing performance objectives are consistent with organizational competitive priorities; P5, manufacturing action plans are consistent with manufacturing performance objectives.

Findings

The article shows evidence of misalignments, inconsistencies and lack of consensus at the organizational level, as well as within the specific manufacturing area.

Originality/value

Lack of proactive strategy to develop organizational core competencies, over‐emphasis on cost reduction objectives, and under‐emphasis on critical objectives such as changing manufacturing organization culture, improving inter‐functional communication, improving employee morale, and improving supplier relationship are the primary areas of misalignment. Successful resolution of these inconsistencies is essential before committing resources to external benchmarking.
Best practices of selected Greek organizations on their road to business excellence
Authors: Vouzas Fotis K. , Gotzamani Katerina D.
Published: May 2005

Purpose

To theoretically investigate and empirically test the current status of best practices in selected Greek industrial organizations on the road to business excellence through the European Quality Award (EQA). Also to examine the extent to which Greek organizations link their efforts towards business excellence with the existing quality assurance systems and particularly with the new ISO 9000:2000 series of standards.

Design/methodology/approach

Data were collected from ten selected Greek organizations that were judged as representative. They are all recipients of the European Foundation for Quality Management (EFQM) award for commitment to excellence and they are all either certified, or under certification, by the new ISO 9001:2000 quality standard. The data gathering was carried out through extensive and in‐depth interviews with multiple informants.

Findings

Besides the “good stories” of the EQA model implementation, the study also revealed a number of problematic areas such as: increased bureaucracy; lack of flexibility in the design and implementation of the model; low utilization of employees’ skills and knowledge; and low utilization of the award as a marketing tool and as a means of penetrating new markets.

Research limitations/implications

This is the first step towards an understanding of the current status of best practices in selected Greek industrial organizations on the road to business excellence through the EQA. There is a need to evaluate these organizations by measuring their business performance and the degree of EQA implementation in the future.

Practical implications

The approach used by Greek organizations to EQA poses a great challenge to the authors since, in recent years, the move towards a more strategic approach to total quality through the EFQM model has been questioned in the literature.

Originality/value

Provides a reliable and objective depiction of the current level of best practices in Greece, through examination and analysis of other relevant studies, and includes the various approaches, practices and perceptions recorded so far in the literature – some of them based on empirical data and some deriving from rhetoric and a “good stories” or “how things ought to be” perspective.
Management effects on quality‐policy implementation
Authors: London Calvin
Published: May 2005

Purpose

This paper aims to review the levels of management commitment and involvement in four small (fewer than 500 employees) pharmaceutical companies and the nature and extent of structured programs for policy implementation.

Design/methodology/approach

In each of the companies, the comparative success of policy implementation was assessed by the extent of management commitment to the process. Assessments were based on the review of 40 attributes of a four‐part implementation cycle. A lack of a structured process, lack of support and involvement of management and the degree to which management was subsequently involved in the overall implementation were commonly observed problems. The degree of management involvement was a prominent factor in the overall success of the policy implementation.

Findings

Quality policies play an important role in the understanding of a company's operational principles and practices. The most successful policy implementation in the companies studied relied on policies being drafted internally with the cooperation of not only the nominated quality management but also the supporting non‐quality management functions. The use of a structured and predetermined implementation plan that is shared across all sectors of the company and the development of supporting systems to monitor progress were also observed to benefit employee involvement and effective policies.

Originality/value

The study of these companies and their comparative abilities to follow a structured process for quality system policies provides valuable guidance for quality practitioners facing similar processes of change within their own organizations. A structured process for implementing policies is also provided.
Does soft TQM predict employees’ attitudes?
Authors: Keng Boon Ooi , Arumugam V. , Seng Hwa Teo
Published: May 2005

Purpose

This study seeks to investigate the effects of soft total quality management (TQM) on employees’ attitudes within a large Malaysian semiconductor organization. Despite extensive research on “soft” TQM practices, there has not been much research this area. Therefore, the proposed model was developed with the intention of examining this relationship.

Design/methodology/approach

Original research using self‐completed questionnaires, distributed to all staff within this organization, is thoroughly reported. The study sample consisted of 230 employees, resulting in a response rate of 76.6 percent. Data were analyzed by the latest version of SPSS, employing correlation and multiple regression analysis.

Findings

The results revealed that employees' perceptions of soft TQM significantly relate to employees’ attitudes with those perceiving a greater degree of awareness of soft TQM exhibiting more positive reactions towards job involvement, career satisfaction and organizational commitment. It is also found that, where teamwork was a dominant soft TQM practice, strong associations with employees’ attitudes existed. This analysis gives new insight into “soft” TQM concepts and, furthermore, the results of the multiple regression analysis confirmed that all variables were significantly related to perceptions of soft TQM practices and thus implementing TQM does pay off. The results also support the proposed model based on the empirically validated soft TQM instruments, which are reliable and valid.

Originality/value

The significance of this study would enable top management to strategize their goal alignments, which would eventually help promote mutual understanding between the management and employees and thus yielding significant results on employees’ attitudes. The conclusions, limitations and implications of the study are also extensively discussed.
Learning about learning in knowledge‐intense organizations
Authors: Dovey Ken , White Richard
Published: May 2005

Purpose

This paper describes and analyses an attempt to engage in transformational learning, oriented to the development of a culture of innovation, at a medium‐size software development organization in Australia.

Design/methodology/approach

An action research methodology was used whereby continuous cycles of strategic social learning were collectively theorized, implemented, evaluated and renewed.

Findings

The most important finding of this study is that of the influence of power relations and communication practices upon learning‐for‐innovation in organizations, and the need for the mediation of this influence through the creation of an organizational role that we have entitled an “external critic”. The case also shows the central importance of the relational dimension of social capital generation to learning and the sensitivity of this dimension to power relations.

Research limitations/implications

The research provides a rich analysis of one company's attempt to learn how to build and sustain a culture of innovation but, as with all case study research, the findings cannot be reliably generalized to other companies. Similarly, the case generates grounded theory that needs to be tested in other organizational contexts.

Practical implications

The case raises the issue of power management in organizations and its relationship to social learning practices. In particular, it argues for the establishment of a “negotiated order” in organizations (through a mission, vision and core values that are collectively and meaningfully constituted) and for the role of an “external critic” whereby the power of the executive, especially, can be mediated effectively in the interests of mission‐critical learning within the organization.

Originality/value

The paper offers an original strategy for the mediation of power in organizations in the interests of greater learning, creativity and innovation.
Enhancing learning effectiveness through connectance diagrams
Authors: Sae Lim Sirirat , Hua Tan Kim , Platts Ken
Published: May 2005

Purpose

The purpose of this paper is to provide an overview of a particular approach for increasing knowledge creation in organisation. The paper provides a discussion of related concepts, processes, and a tool.

Design/methodology/approach

This paper describes the reasons for drawing connectance diagrams, the process and the software. It also explains their application within companies, and discusses plans for further research.

Findings

The feedback from the case studies presented in this paper was positive and indicated that the tool for action plan selection (TAPS) is useful for learning and teaching.

Originality/value

This paper provides a practical tool for increasing the flow of knowledge in organisations and explains how it is used. This paper argues that one way of achieving this is through an interactive process coupled with an effective knowledge map to gather the employees' collective view of the knowledge and skills required to successfully perform each step in delivering solutions. The key is both a process and a tool that organisations use to manage their knowledge in a way that enhances employees' learning and ownership. This paper describes such an approach, and explains its application within companies, and discusses plans for further research. The process described in this paper is known as drawing connectance diagrams and the software tool to accomplish this is called TAPS.
Can universities become true learning organizations?
Authors: White Judith , Weathersby Rita
Published: May 2005

Purpose

Aims to assess whether a university can become a true learning organization.

Design/methodology/approach

Focuses on the need for, and challenges of, transforming universities into true learning organizations.

Findings

Observes that few of the underlying values that serve as the underpinnings of the learning organizations are actually honored in universities.

Originality/value

Offers some possible avenues to help transform universities toward becoming learning organizations.
Processes, relationships, settings, products and consumers: the case for qualitative diary research
Authors: Patterson Anthony
Published: May 2005

Purpose

This paper makes the case for the use of real diaries as an alternative methodology in marketing research. It is argued that Qualitative Diary Research (QDR) in marketing and consumer research is an innovative way to capture rich insights into processes, relationships, settings, products and consumers.

Design/methodology/approach

To illustrate the utility of QDR this paper explores the phenomenon of text messaging. One hundred and twenty two “texters” were recruited to maintain personal introspective diaries for 1 week; recording, not only each of their incoming and outgoing text messages, but also the personal thoughts that each communication initiated. The paper then offers a frame narrative that attempts to analyse, interpret and re‐present the embedded diary narratives.

Findings

This empirical analysis illustrates that ODR is particularly suited to exploring processes, relationships, settings, products, and consumers. It is shown how the arrival of a text message and its actual content can create: consumer excitement when text messages arrive, consumer pleasure when constructing and deconstructing sent and received text messages, and provides a facility to lie and attract the opposite sex. The downsides of texting were also explored, such as how consumers loath getting either too many or too few text messages.

Originality/value

ODR is a useful way of capturing genuine “thick description”. The use of real diaries presents an exciting methodological alternative for research in marketing and consumer behaviour.
Sensitive research topics: netnography revisited
Authors: Langer Roy , Beckman Suzanne C.
Published: May 2005

Purpose

This paper discusses how netnography can be applied in order to conduct covert research on sensitive research topics. An analysis of a Danish internet message board on cosmetic surgery illustrates suggestions concerning modifications of netnography guidelines.

Design/methodology/approach

Owing to the relevance of studying sensitive research topics – in particular when access to informants is difficult – netnography has been applied in an analysis of cross consumer online‐communication about cosmetic surgery on a Danish internet message board. Methodological stages and procedures including entreé, data collection, analysis and interpretation have been followed. In terms of research ethics and member checks, however, the suggested guidelines have been modified.

Findings

Empirical findings verify that consumers use internet message boards in order to exchange information and advice about cosmetic surgery. Especially the opportunity to masquerade and to cover their identities allows them to express attitudes, opinions, and experiences freely – and hence to study these in order gain deeper insights into consumption motives, concerns, and experiences.

Originality/value

The paper suggests that netnography is a suitable methodology for the study of sensitive research topics, enabling the researcher in an unobtrusive and covert way to gain deeper insights into consumers' opinions, motives, and concerns. Based on a discussion of netnography's position in between discourse analysis, content analysis and ethnography, it is argued for the legitimacy of covert research, including a revision of existing guidelines for research ethics with regard to informed consent when conducting netnography.
Moving shadows: suggestions for ethnography in globalised cultures
Authors: Canniford Robin
Published: May 2005

Purpose

Traditional notions of culture have become unicorns: assumed creatures of the past, whose authenticity seems increasingly doubtful. It is required of us to rethink the boundaries of culture and social science; to develop our understanding of interdependency and instability in cultural life. In order to incorporate possible discourses, the practice of research must also change. This paper discusses some problems associated with ethnography in global cultures.

Design/methodology/approach

I begin by presenting a brief history of ethnography as a method for investigating unconceptualised groups. Following this, through reference to my own research, I argue that the foundations of this methodology can be developed to include the broad networks of influences extant in contemporary cultures. To this end, I consider a solution that poses the researcher as a locus of investigation from which the relationships that construct a culture may be collated and interpretations built.

Findings

The research account I have presented tackles this issue, synthesising introspection, thick inscription, and thick transcription, and moving the researcher through a multi‐vocal, iterative, non‐linear process. Historical, technological and ideological influences come into play to negotiate between possible realities. Ethnography may place these realities into their broader political, social and personal contexts and continue yielding data for the theorisation of contemporary cultures.

Originality/value

The paper reassesses the experience of global culture with reference to the global surfing scene. It provides a practical solution to research in such cultures, and highlights the importance of a networked approach in the construction of adequate theory.
A retrospective analysis of medical or surgical therapy in young patients with diverticulitis
Authors: Greenberg A. S. , Gal R. , Coben R. M. , Cohen S. , Dimarino A. J.
Published: May 2005

Background : Acute diverticulitis is increasingly being recognized in younger patients, but its management remains controversial.

Aim : To compare long‐term outcomes of young patients treated with surgery vs. medical therapy for their first episode of diverticulitis.

Methods : A retrospective chart analysis at a university and an affiliated community hospital between 1991 and 2002 revealed 149 patients ≤40 years of age with confirmed diverticulitis. Forty‐nine patients (38 males, 11 females) were contacted at least 1 year after their first episode of diverticulitis. Outcomes were compared based on initial therapy – antibiotics or surgical resection. The groups were compared by outcomes, gender, age, white blood cell count, temperature and diet.

Results : Three (15%) of 20 surgical patients (mean follow‐up 6.89 years), and 16 (55%) of 29 medical patients had a recurrence of diverticulitis (mean follow‐up 5.72 years; P = 0.01). The treatment groups did not differ in age, white blood cell count, or temperature.

Conclusions : (i) Surgical treatment is effective initial therapy but disease may recur in a minority of patients; (ii) medical treatment is less effective initial therapy, with recurrence in half of the patients; (iii) initial presentation is not a strong predictor of disease recurrence.
Helicobacter pylori eradication does not cause reflux oesophagitis in functional dyspeptic patients: a randomized, investigator‐blinded, placebo‐controlled trial
Authors: Ott E. A. , Mazzoleni L. E. , Edelweiss M. I. , Sander G. B. , Wortmann A. C. , Theil A. L. , Somm G. , Cartell A. , Rivero L. F. , Uchôa D. M. , Francesconi C. F. , Prolla J. C.
Published: May 2005

Background : The protective role of Helicobacter pylori in gastro‐oesophageal reflux disease has been widely discussed.

Aim : To assess the risk of reflux oesophagitis in patients with functional dyspepsia after treatment for H. pylori infection.

Methods : A randomized, placebo‐controlled, investigator‐blinded trial was carried out on 157 functional dyspeptic patients. Patients were randomized to receive lansoprazole, amoxicillin and clarithromycin (antibiotic group) or lansoprazole and identical antibiotic placebos (control group). Upper gastrointestinal endoscopy was performed at baseline, 3 and 12 months after randomization. The primary aim was to detect the presence of reflux oesophagitis. Analyses were performed on an intention‐to‐treat basis.

Results : A total of 147 patients (94%) and 133 (85%) completed 3 months and 12 months follow‐up, respectively. The eradication rate of H. pylori was 90% in the antibiotic group (74 of 82) and 1% (one of 75) in the control group. At 3 months, reflux oesophagitis was diagnosed in 3.7% (three of 82) in the antibiotic group and 4% (three of 75) in the control group (P > 0.2). At 12 months, diagnosis was established in five new cases within the first group and in four within the second (P > 0.2). No difference was found in heartburn symptoms.

Conclusions : H. pylori eradication does not cause reflux oesophagitis in this western population of functional dyspeptic patients.
Experience of 5‐aminosalicylate nephrotoxicity in the United Kingdom
Authors: Muller A. F. , Stevens P. E. , McIntyre A. S. , Ellison H. , Logan R. F.
Published: May 2005

Aim : To study 5‐aminosalicylate nephrotoxicity in patients with inflammatory bowel disease in the UK.

Methods : A detailed postal questionnaire was sent to all 1298 names in the British Society of Gastroenterology database and 290 consultant members of the Renal Association. The British Society of Gastroenterology reported new cases monthly, the Renal Association 6 monthly. Results were expressed as estimated glomerular filtration rate.

Results : Retrospective study: cases – British Society of Gastroenterology:Renal Association 202:87, aged 15–76 years. Median peak (range) creatinine (British Society of Gastroenterology:Renal Association) – 300:301 (78–1200) μmol/L. Prospective study – 59 cases, median age 52 years (M:F ratio: 47:12). Median pre‐treatment estimated glomerular filtration rate: 76.9 (123.9–39), at diagnosis 28.4 (80.5–3.6, creatinine range: 92–1361 μmol/L), recovery 46.8 [111.2–end stage renal failure] mL/min/1.73 m2. Recovery of renal function was significantly improved for patients treated for <12 months [n = 10, median recovery estimated glomerular filtration rate 70.5 (92–26.9) vs. >12 months 38.4 (111.2–end stage renal failure) mL/min/1.73 m2, P = 0.028].

Conclusions : Regular monitoring of renal function may allow earlier detection of nephrotoxicity, particularly during the first year of therapy. Based on an inflammatory bowel disease prevalence in the United Kingdom of 412 × 105 with about 50% on treatment, we estimate that the incidence of clinical nephrotoxicity in patients taking 5‐aminosalicylate therapy is approximately one in 4000 patients/year.
7‐day rescue therapy with ranitidine bismuth citrate after Helicobacter pylori treatment failure
Authors: Gisbert J. P. , Fuentes J. , Carpio D. , Tito L. , Guardiola J. , Tomas A. , Olivares D. , Calvet X.
Published: May 2005

Background : Quadruple rescue therapy requires a complex scheme with four drugs.

Aim : To evaluate the efficacy of ranitidine bismuth citrate‐tetracycline‐metronidazole rescue regimen, and to compare two different metronidazole dose schemes.

Methods : Prospective multicentre study including proton‐pump inhibitor + clarithromycin + amoxicillin failures. Rescue regimen included two 7‐day treatment: (i) ranitidine bismuth citrate (400 mg b.d.)‐tetracycline (500 mg q.d.s.)‐metronidazole (500 mg t.d.s.; RTM1); or (ii) the same regimen but with metronidazole 250 mg q.d.s. (RTM2). Eradication was confirmed with 13C‐urea breath test.

Results : A total of 150 patients were included (58 RTM1, 92 RTM2). All patients but two (one in each group) returned after treatment. About 86% in group RTM1 and 95% in RTM2 correctly took all the medications (P = 0.076). Per‐protocol eradication rates with RTM1 and RTM2 were 74 (95% CI: 60–84) and 69% (59–78). The intention‐to‐treat eradication rates were 64 (51–75) and 70% (59–78; P > 0.05). The type of regimen was not associated with eradication in the multivariate analysis. Adverse effects were more frequent with RTM1 (41%) than with RTM2 (30%; P > 0.05).

Conclusion : Seven‐day triple rescue therapy with ranitidine bismuth citrate‐tetracycline‐metronidazole is effective for Helicobacter pylori eradication, and represents an encouraging alternative to quadruple therapy, with the advantage of simplicity. The administration of metronidazole every 6 h (together with tetracycline), and at a low dose (250 mg), achieves similar efficacy and is probably associated with a better compliance and a lower incidence of adverse effects.
A nationwide study of the incidence and 30‐day mortality rate of pyogenic liver abscess in Denmark, 1977–2002
Authors: Jepsen P. , Vilstrup H. , Schønheyder H. C. , Sørensen H. T.
Published: May 2005

Background : Pyogenic liver abscess is a life‐threatening disease. Accurate data on incidence and prognosis are important, but scarce.

Aim : To examine changes in the incidence and 30‐day mortality rate of patients with pyogenic liver abscess in Denmark.

Methods : Using nationwide administrative registers, we identified all patients diagnosed with pyogenic liver abscess in Denmark, 1977–2002, and their dates of death. We computed annual standardized incidence and 30‐day mortality rates, and used Poisson regression to adjust gender‐specific mortality rates for year‐by‐year differences in age at diagnosis.

Results : We identified 1448 patients with pyogenic liver abscess, of whom 54% were men. The crude incidence rate for the entire study period was 11.8 per 1 000 000 for men and 9.7 per 1 000 000 for women. Between 1977 and 2002, the incidence rate increased from 6 to 18 per 1 000 000 for men and from 8 to 12 per 1 000 000 for women. The cumulative 30‐day mortality rate was 15% for men and 23% for women. The adjusted 30‐day mortality rate decreased from 40% for men and 50% for women to around 10% for both genders.

Conclusions : In this large nationwide study spanning a 26‐year period, we found an increasing incidence rate and a decreasing mortality rate of pyogenic liver abscess. We believe that these changes are primarily explained by more sensitive diagnostic tools.
Personal view: victim blaming as management strategy for the gastroenterologist – a game theoretical approach
Authors: Sonnenberg A.
Published: May 2005

Background : A multitude of digestive diseases elude simple management strategies. Rather than admit failure of disease management, a gastroenterologist could resort to blaming patients for their own medical conditions. Blaming the patient constitutes an easy exit strategy for otherwise unsolvable disease conditions.

Aim : To shed light on the problem of patient blaming in gastroenterology and provide means for its resolution.

Methods : The interaction between physician and patient can be formulated in terms of a non‐zero‐sum game between two adversaries. The outcomes associated with two behavioural strategies available to both adversaries are arranged in a two‐by‐two game matrix.

Results : Blaming the patient is characterized by the general game pattern of the ‘prisoner's dilemma’. If the physician–patient interaction is restricted to one single event, patient blaming represents the management strategy of choice with the highest expected payoff under all foreseeable circumstances. If there is a high probability for repeated physician–patient interactions, however, a physician admitting and a patient accepting the limits of medical performance yield a dominant strategy.

Conclusion : Only for single physician–patient encounters does a non‐cooperative strategy of blaming one's adversary for a poor medical outcome yield the highest expected outcome. In the long run, the strategy of shifting blame becomes unproductive for both sides alike.
Gluten‐free diet survey: are Americans with coeliac disease consuming recommended amounts of fibre, iron, calcium and grain foods?
Authors: Thompson T. , Dennis M. , Higgins L. A. , Lee A. R. , Sharrett M. K.
Published: May 2005

Objective  This survey was conducted to assess nutrient intakes and food consumption patterns of adults with coeliac disease who adhere to a strict gluten‐free diet.

Design  Three‐day estimated self‐reported food records were used to assess daily intakes of calories, percent daily calories from carbohydrates, dietary fibre, iron, calcium and grain food servings.

Subjects  Volunteers for this survey were recruited through notices placed in coeliac disease support group newsletters, as well as a national magazine for persons with coeliac disease. Forty‐seven volunteers met all criteria for participation and returned useable food records.

Results  Group mean daily intake of nutrients by gender: Males (n = 8): 2882 calories; 55% carbohydrate; 24.3 g dietary fibre; 14.7 mg iron; 1288.8 mg calcium; 6.6 grain food servings. Females (n = 39): 1900 calories; 52% carbohydrate; 20.2 g dietary fibre; 11.0 mg iron; 884.7 mg calcium; 4.6 grain food servings. Recommended amounts of fibre, iron and calcium were consumed by 46, 44 and 31% of women and 88, 100 and 63% of men, respectively.

Conclusions  Nutrition therapy for coeliac disease has centred around food allowed/not allowed on a gluten‐free diet. Emphasis also should be placed on the nutritional quality of the gluten‐free diet, particularly as it concerns the iron, calcium and fibre consumption of women. The use of the estimated food record as the dietary survey method may have resulted in the under‐reporting of energy intake. Due to the small sample size and possible bias of survey participants, the findings of this survey may not be representative of the larger coeliac community.
The impact of a nutrition education intervention on main meal quality and fruit intake in people with financial problems
Authors: van Assema P. , Steenbakkers M. , Rademaker C. , Brug J.
Published: May 2005

Background  As part of a course teaching household budgeting, a nutrition education intervention was provided to people with financial problems. The present study aimed at assess the effects of this intervention on the nutritional quality of their main meal and fruit intake, and to collect process information on intervention participation, reactions and opinions.

Methods  For the effect study, a quasi‐experimental multiple pre and post‐test control group design was used. Telephone dietary recalls were conducted with 35 people in the intervention group and 39 people in the control group. Observations, personal interviews and written questionnaires were used to collect the process data.

Results  A significant reduction in saturated fat intake during the mail meal was found. Also, an intervention effect was found for fruit juice consumption, but not for daily fruit intake or vegetable intake during main meal occasions.

Conclusions  The process data revealed some improvements that should be made to the intervention, such as providing more individualized information and tailored recipes.
Aspergillus nidulans HOG pathway is activated only by two‐component signalling pathway in response to osmotic stress
Authors: Furukawa Kentaro , Hoshi Yukiko , Maeda Tatsuya , Nakajima Tasuku , Abe Keietsu
Published: May 2005

Genome sequencing analyses revealed that Aspergillus nidulans has orthologous genes to all those of the high‐osmolarity glycerol (HOG) response mitogen‐activated protein kinase (MAPK) pathway of Saccharomyces cerevisiae. A. nidulans mutant strains lacking sskA, sskB, pbsB, or hogA, encoding proteins orthologous to the yeast Ssk1p response regulator, Ssk2p/Ssk22p MAPKKKs, Pbs2p MAPKK and Hog1p MAPK, respectively, showed growth inhibition under high osmolarity, and HogA MAPK in these mutants was not phosphorylated under osmotic or oxidative stress. Thus, activation of the A. nidulans HOG (AnHOG) pathway depends solely on the two‐component signalling system, and MAPKK activation mechanisms in the AnHOG pathway differ from those in the yeast HOG pathway, where Pbs2p is activated by two branches, Sln1p and Sho1p. Expression of pbsB complemented the high‐osmolarity sensitivity of yeast pbs2Δ, and the complementation depended on Ssk2p/Ssk22p, but not on Sho1p. Pbs2p requires its Pro‐rich motif for binding to the Src‐homology3 (SH3) domain of Sho1p, but PbsB lacks a typical Pro‐rich motif. However, a PbsB mutant (PbsB(Pro)) with the yeast Pro‐rich motif was activated by the Sho1p branch in yeast. In contrast, HogA in sskAΔ expressing PbsB(Pro) was not phosphorylated under osmotic stress, suggesting that A. nidulans ShoA, orthologous to yeast Sho1p, is not involved in osmoresponsive activation of the AnHOG pathway. We also found that besides HogA, PbsB can activate another Hog1p MAPK orthologue, MpkC, in A. nidulans, although mpkC is dispensable in osmoadaptation. In this study, we discuss the differences between the AnHOG and the yeast HOG pathways.
The Bacillus subtilis ydcDE operon encodes an endoribonuclease of the MazF/PemK family and its inhibitor
Authors: Pellegrini Olivier , Mathy Nathalie , Gogos Arhonda , Shapiro Lawrence , Condon Ciarán
Published: May 2005

Operons encoding stable toxins and their labile antidote are widespread in prokaryotes and play important roles in plasmid partitioning and cellular responses to stress. One such family of toxins MazF/ChpAK/PemK encodes an endoribonuclease that inactivates cellular mRNAs by cleaving them at specific, but frequently occurring sites. Here we show that the Bacillus subtilis ydcE gene encodes a member of this family of RNases, which we have called EndoA. Overexpression of EndoA is toxic for bacterial cell growth and this toxicity is reversed by coexpression of the gene immediately upstream, ydcD. Furthermore, YdcD inhibits EndoA activity directly in vitro. EndoA has similar cleavage specificity to MazF and PemK and yields cleavage products with 3′‐phosphate and 5′‐hydroxyl groups, typical of EDTA‐resistant degradative RNases. This is the first example of an antitoxin–toxin system in B. subtilis.
Mycobacterium avium 104 deleted of the methyltransferase D gene by allelic replacement lacks serotype‐specific glycopeptidolipids and shows attenuated virulence in mice
Authors: Krzywinska Elzbieta , Bhatnagar Sanchita , Sweet Lindsay , Chatterjee Delphi , Schorey Jeffrey S.
Published: May 2005

Mycobacterium avium is a major opportunistic pathogen of AIDS patients in the United States. The understanding of M. avium pathogenesis has been hampered by the inability to create gene knockouts by homologous recombination, an important mechanism for defining and characterizing virulence factors. In this study a functional methyltransferase D (mtfD) gene was deleted by allelic replacement in the M. avium strain 104. Methyltransferase D is involved in the methylation of glycopeptidolipids (GPLs); highly antigenic glycolipids found in copious amounts on the M. avium cell surface. Interestingly, the loss of mtfD resulted in M. avium 104 containing only the non‐serotype specific GPL. Results also suggest that the mtfD encodes for a 3‐O‐methyltransferase. The absence of significant amounts of any serotype‐specific GPLs as a consequence of mtfD deletion indicates that the synthesis of the core 3,4‐di‐O‐methyl rhamnose is a prerequisite for synthesis of the serotype‐specific GPLs. Macrophages infected with the mtfD mutant show elevated production of tumour necrosis factor‐α (TNF‐α) and RANTES compared to control infections. In addition, the M. avium 104 mtfD mutant exhibits decreased ability to survive/proliferate in mouse liver and lung compared to wild‐type 104, as assessed by bacterial counts. Importantly, the mtfD mutant complemented with a wild‐type mtfD gene maintained an infection level similar to wild‐type. These experiments demonstrate that the loss of mtfD results in a M. avium 104 strain, which preferentially activates macrophages in vitro and shows attenuated virulence in mice. Together our data support a role for GPLs in M. avium pathogenesis.
A member of the cAMP receptor protein family of transcription regulators in Mycobacterium tuberculosis is required for virulence in mice and controls transcription of the rpfA gene coding for a resuscitation promoting factor
Authors: Rickman Lisa , Scott Colin , Hunt Debbie M. , Hutchinson Thomas , Menéndez M. Carmen , Whalan Rachael , Hinds Jason , Colston M. Joseph , Green Jeffrey , Buxton Roger S.
Published: May 2005

Deletion of gene Rv3676 in Mycobacterium tuberculosis coding for a transcription factor belonging to the cAMP receptor protein (CRP) family caused growth defects in laboratory medium, in bone marrow‐derived macrophages and in a mouse model of tuberculosis. Transcript profiling of M. tuberculosis grown in vitro identified 16 genes with significantly altered expression in the mutant compared with the wild type. Analysis of the DNA sequences upstream of the corresponding open reading frames revealed that 12 possessed sequences related to a consensus CRP binding site that could represent the sites of action of Rv3676. These included rpfA, lprQ, whiB1 and ahpC among genes with enhanced expression in the wild type, and Rv3616c‐Rv3613c, Rv0188 and lipQ among genes exhibiting enhanced expression in the mutant. The activity of an rpfA::lacZ promoter fusion was lowered in the Rv3676 mutant and by mutation of the predicted Rv3676 binding site. Moreover, the product of Rv3676 (isolated as a TrxA fusion protein) interacted specifically with the rpfA promoter, and binding was inhibited by mutation of the Rv3676 site. Although Rv3676 retains four of the six amino acid residues that bind cAMP in Escherichia coli CRP addition of cAMP did not enhance Rv3676 binding at the rpfA promoter in vitro. In summary, it has been shown that Rv3676 is a direct regulator of rpfA expression, and because rpfA codes for a resuscitation promoting factor this may implicate Rv3676 in reactivation of dormant M. tuberculosis infections.
Switching aconitase B between catalytic and regulatory modes involves iron‐dependent dimer formation
Authors: Tang Yue , Guest John R. , Artymiuk Peter J. , Green Jeffrey
Published: May 2005

In addition to being the major citric acid cycle aconitase in Escherichia coli the aconitase B protein (AcnB) is also a post‐transcriptional regulator of gene expression. The AcnB proteins represent a distinct branch of the aconitase superfamily that possess a HEAT‐like domain (domain 5). The HEAT domains of other proteins are implicated in protein:protein interactions. Gel filtration analysis has now shown that cell‐free extracts contain high‐molecular‐weight species of AcnB. Furthermore, in vitro and in vivo protein interaction experiments have shown that AcnB forms homodimers. Addition of the iron chelator bipyridyl to cultures inhibited the dimer‐dependent readout from an AcnB bacterial two‐hybrid system. A similar response was observed with a catalytically inactive AcnB variant, AcnB(C769S), suggesting that the monomer–dimer transition is not mediated by the state of the AcnB iron–sulphur cluster. The iron‐responsive interacting unit was accordingly traced to the N‐terminal region (domains 4 and 5) of the AcnB protein, and not to domain 3 that houses the iron–sulphur cluster. Thus, it was shown that a polypeptide containing AcnB N‐terminal domains 5 and 4 (AcnB5‐4) interacts with a second AcnB5‐4 to form a homodimer. AcnB has recently been shown to initiate a regulatory cascade controlling flagella biosynthesis in Salmonella enterica by binding to the ftsH transcript and inhibiting the synthesis of the FtsH protease. A plasmid encoding AcnB5‐4 complemented the flagella‐deficient phenotype of a S. enterica acnB mutant, and the isolated AcnB5‐4 polypeptide specifically recognized and bound to the ftsH transcript. Thus, the N‐terminal region of AcnB is necessary and sufficient for promoting the formation of AcnB dimers and also for AcnB binding to target mRNA. Furthermore, the relative effects of iron on these processes provide a simple iron‐mediated dimerization mechanism for switching the AcnB protein between catalytic and regulatory roles.