bluuebunny/crossref_metadata_2025 huggingface dataset:
Recruitment, retention, satisfaction and stress in child and adolescent psychiatrists
Authors: Littlewood S. , Case P. , Gater R. , Lindsey C.
Published: February 2003

Aims and Method

A postal survey was sent to all consultant child and adolescent psychiatrists in the UK and Eire examining recruitment, retention, job satisfaction and job stress.

Results

A response was received from 333 (60%) child and adolescent psychiatrists. Sixty-one per cent indicated their service was inadequately resourced and 89% reported that their service failed to meet the College's minimum staffing requirements. Safe access to in-patient beds was not available to 71%. One hundred and thirty vacant posts were identified. Rates of psychological distress and burnout were high. Adequate services and the presence of a close, supportive colleague were associated with higher rates of satisfaction and lower rates of psychological distress and emotional exhaustion.

Clinical Implications

A multi-faceted approach is suggested and recommendations are described under the headings of self-management, training, recruitment and commissioning.
Consultant responsibilities in child and adolescent mental health services teams: a systems dilemma
Authors: Reder Peter
Published: February 2003

Aims and Methods

A number of relevant professional bodies were invited to state their views on the responsibilities of consultant child psychiatrists within multi-disciplinary teams in order to ascertain whether there was any consensus on the issue.

Results

Little consensus or clarity emerged, save for agreement on child psychiatrists' expertise with medical matters. Only medical organisations believed in a notion of the consultant holding ultimate responsibility, although definition of this remained elusive.

Clinical Implications

Consultants may need to seek clarity about their clinical and legal responsibilities from their employing Trust. However, there are many other dimensions to responsibility which have relevance for the training of child psychiatrists.
How writing and using Insight Poetry helped me to overcome my illness
Authors: Anonymous
Published: February 2003

In 1986 I suffered a severe mental breakdown. I have had serious mental health problems for 15 years. Over the past 15 months, my mental and physical health have improved considerably. During this time, I have been writing and using Insight Poetry to help overcome my illness.
Developing, delivering and evaluating interprofessional clinical risk training in mental health services
Authors: Doyle M. , Earnshaw P. , Galloway A.
Published: February 2003

Aims and Method

The need for training to prepare mental health professionals to assess and manage risks is now well established. This paper reports on the development, delivery and evaluation of interprofessional clinical risk training in Salford and Manchester since 1998. A training-needs analysis was carried out, followed by post-training evaluation and an impact-monitoring questionnaire.

Results

The training was very well received by participants, with over 90% of them meeting the objectives and 100% of respondents reporting that the training had a positive impact on their clinical practice more than 12 months afterwards.

Clinical Implications

The evaluation of the training demonstrates that a properly planned and delivered 2-day clinical risk assessment course can have a positive impact on the practice of clinicians in mental health services. However, this should be seen only as an introductory course, as more advanced risk training is required. This is currently being delivered and planned.
The parapineal mediates left-right asymmetry in the zebrafish diencephalon
Authors: Gamse Joshua T. , Thisse Christine , Thisse Bernard , Halpern Marnie E.
Published: February 2003

The dorsal diencephalon (or epithalamus) of larval zebrafish displays distinct left-right asymmetries. The pineal complex consists of the pineal organ anlage and an unpaired, left-sided accessory organ – the parapineal. The neighboring brain nuclei, the left and right dorsal habenulae,show consistent differences in their size, density of neuropil and gene expression. Mutational analyses demonstrate a correlation between the left-right position of the parapineal and the laterality of the habenular nuclei. We show that selective ablation of the parapineal organ results in the loss of habenular asymmetry. The left-sided parapineal therefore influences the left-right identity of adjacent brain nuclei, indicating that laterality of the dorsal diencephalon arises in a step-wise fashion.
Irx4-mediated regulation ofSlit1expression contributes to the definition of early axonal paths inside the retina
Authors: Jin Zhe , Zhang Jinhua , Klar Avihu , Chédotal Alain , Rao Yi , Cepko Constance L. , Bao Zheng-Zheng
Published: February 2003

Although multiple axon guidance cues have been discovered in recent years,little is known about the mechanism by which the spatiotemporal expression patterns of the axon guidance cues are regulated in vertebrates. We report that a homeobox gene Irx4 is expressed in a pattern similar to that of Slit1 in the chicken retina. Overexpression of Irx4 led to specific downregulation of Slit1 expression, whereas inhibition of Irx4 activity by a dominant negative mutant led to induction of Slit1expression, indicating that Irx4 is a crucial regulator of Slit1expression in the retina. In addition, by examining axonal behavior in the retinas with overexpression of Irx4 and using several in vivo assays to test the effect of Slit1, we found that Slit1 acts positively to guide the retinal axons inside the optic fiber layer (OFL). We further show that the regulation of Slit1 expression by Irx4 is important for providing intermediate targets for retinal axons during their growth within the retina.
Molecular analysis of axon repulsion by the notochord
Authors: Anderson Christopher N. G. , Ohta Kunimasa , Quick Marie M. , Fleming Angeleen , Keynes Roger , Tannahill David
Published: February 2003

During development of the amniote peripheral nervous system, the initial trajectory of primary sensory axons is determined largely by the action of axon repellents. We have shown previously that tissues flanking dorsal root ganglia, the notochord lying medially and the dermamyotomes lying laterally,are sources of secreted molecules that prevent axons from entering inappropriate territories. Although there is evidence suggesting that SEMA3A contributes to the repellent activity of the dermamyotome, the nature of the activity secreted by the notochord remains undetermined. We have employed an expression cloning strategy to search for axon repellents secreted by the notochord, and have identified SEMA3A as a candidate repellent. Moreover,using a spectrum of different axon populations to assay the notochord activity, together with neuropilin/Fc receptor reagents to block semaphorin activity in collagen gel assays, we show that SEMA3A probably contributes to notochord-mediated repulsion. Sympathetic axons that normally avoid the midline in vivo are also repelled, in part, by a semaphorin-based notochord activity. Although our results implicate semaphorin signalling in mediating repulsion by the notochord, repulsion of early dorsal root ganglion axons is only partially blocked when using neuropilin/Fc reagents. Moreover, retinal axons, which are insensitive to SEMA3A, are also repelled by the notochord. We conclude that multiple factors act in concert to guide axons in this system,and that further notochord repellents remain to be identified.
Targeted disruption of the homeobox geneNkx2.9reveals a role in development of the spinal accessory nerve
Authors: Pabst Oliver , Rummelies Janin , Winter Barbara , Arnold Hans-Henning
Published: February 2003

The homeodomain-containing transcription factor Nkx2.9 is expressed in the ventralmost neural progenitor domain of the neural tube together with the related protein Nkx2.2 during early mouse embryogenesis. Cells within this region give rise to V3 interneurons and visceral motoneurons in spinal cord and hindbrain, respectively. To investigate the role of the Nkx2.9gene, we generated a mutant mouse by targeted gene disruption. Homozygous mutant animals lacking Nkx2.9 were viable and fertile with no apparent morphological or behavioral phenotype. The distribution of neuronal progenitor cells and differentiated neurons in spinal cord was unaffected inNkx2.9-deficient animals. This finding is in contrast toNkx2.2-null mutants, which have been shown to exhibit ventral to dorsal transformation of neuronal cell fates in spinal cord. Our results suggest that specification of V3 interneurons in the posterior CNS does not require Nkx2.9, most probably because of functional redundancy with the co-expressed Nkx2.2 protein. In hindbrain, however, absence of Nkx2.9 resulted in a significantly altered morphology of the spinal accessory nerve (XIth),which appeared considerably shorter and thinner than in wild-type animals. Consistent with this phenotype, immature branchial motoneurons of the spinal accessory nerve, which normally migrate from a ventromedial to a dorsolateral position within the neural tube, were markedly reduced in Nkx2.9-deficient embryos at E10.5, while ventromedial motor column cells were increased in numbers. In addition, the vagal and glossopharyngeal nerves appeared abnormal in approximately 50% of mutant embryos, which may be related to the observed reduction of Phox2b expression in the nucleus ambiguus of adult mutant mice. From these observations, we conclude that Nkx2.9 has a specific function in the hindbrain as determinant of the branchial motoneuron precursor cells for the spinal accessory nerve and possibly other nerves of the branchial-motor column. Like other Nkx genes expressed in the CNS, Nkx2.9 seems to be involved in converting positional information into cell fate decisions.
Interdisciplinary telecommunication and expert teleconsultation in diagnostic pathology: present status and future prospects
Authors: Kayser Klaus
Published: February 2003

Telepathology can be performed in an active or a passive manner. There are two main types: interdisciplinary telepathology and expert teleconsultations. Interdisciplinary telepathology involves a pathologist and another specialist (e.g. a radiologist or endoscopist). It is mainly used in an active manner (i.e. online and in realtime) and has three purposes: to ensure correct tissue sampling, to provide additional diagnostic information to the pathologist, or to facilitate collaborative therapeutic or diagnostic decision making between the clinician and pathologist. Expert teleconsultations, typically between two pathologists, are mainly undertaken in passive mode (i.e. offline and using store-and-forward techniques). The Internet often serves as a platform for both types of telepathology application. Experience with interdisciplinary telepathology is rare at present and is usually limited to partners at a local institution. The efficiency and accuracy of expert teleconsultations in telepathology have been demonstrated in numerous studies. In future, the application of expert teleconsultation in pathology will expand, with the Internet as the communications medium. Interdisciplinary telepathology is a promising technique to improve diagnostic quality.
Validation of a telephone cognitive assessment test battery for use in chronic fatigue syndrome
Authors: McCue P , Scholey A B , Herman C , Wesnes K A
Published: February 2003

We compared a computerized version of the Cognitive Drug Research (CDR) cognitive assessment test battery and a completely automated telephone version of the same battery. These assessed aspects of attention, working memory and long-term memory. Both methods were used to assess the cognitive performance of a cohort of 30 people with confirmed chronic fatigue syndrome (CFS) and a group of 30 healthy controls matched for age and education. The CFS group had significantly slower reaction times on all four cognitive measures on both the computerized and telephone tests. The mood data followed similar patterns in the computer and telephone assessments. The results from both forms of the test battery confirmed the pattern and severity of cognitive impairment in CFS. Furthermore, the two methods of testing were similarly sensitive in detecting cognitive deficits. The incapacitating nature of CFS may cause problems for researchers if the restrictions to mobility affect the representativeness of the study group. The findings of the present study support the use of a fully automated telephone cognitive testing system for detecting deficits in CFS.
Transfer of knowledge from the specialist to the generalist by videoconferencing: effect on diabetes care
Authors: Abrahamian Heidemarie , Schueller Andrea , Mauler Harald , Prager Rudolf , Irsigler Karl
Published: February 2003

We conducted a 12-month prospective interventional study of videoconferencing between primary and secondary care. A treatment network consisting of a diabetes specialist and four general practitioners was established. The communications medium was PC-based videoconferencing via ISDN at 128 kbit/s. A total of 154 type 2 diabetic patients entered the study. The specialist was contacted 94 times via videoconferencing. Metabolic and haemodynamic parameters were significantly improved over the course of the study: the mean HbA1c level fell from 8.1% to 7.8%, systolic blood pressure from 156 to 148 mmHg and diastolic blood pressure from 88 to 83 mmHg. The study demonstrated that therapeutic counselling by videoconferencing is feasible in diabetes care and suggests that it reduces hospital admissions and improves the quality of care.
Videoconferenced continuing medical education in Nova Scotia
Authors: Allen Michael , Sargeant Joan , Macdougall Eileen
Published: February 2003

Videoconferencing has been used for continuing medical education (CME) in Nova Scotia since a pilot project to four communities in 1995. The Nova Scotia Telehealth Network was developed after the pilot project. Using the network, the videoconferenced CME programme expanded over the next few years until in, 2000 1, 66 programmes were broadcast to 38 sites. During the expansion of the programme, we improved video quality and developed efficient methods of: scheduling and planning the content of the videoconferences; training faculty presenters in videoconferencing techniques; and evaluation. We consider this programme represents a success. However, several aspects could be improved. Faculty members still need encouragement to make visual aids legible by videoconference and to provide handouts. Also, there has been little upgrading of equipment over the past four years and some reduction in the reliability of connections.
Website discussion forums: Results of an Australian project to promote telecommunication in dermatology
Authors: Chen Keng , See Adrian , Shumack Stephen
Published: February 2003

summary

Discussion forums on the Internet allow doctors to discuss issues of interest in a rapid, convenient and educational manner. In March 2002, the department of dermatology at the St George Hospital in Sydney launched a national Website with an online discussion forum for dermatologists. Features of the Website forum include the ability to moderate the discussion boards, a choice of public or private discussions and receipt of automatic email notifications. Over three months, three dermatologists posted a total of 13 messages on three different topics. The low rate of participation by dermatologists may have been due to lack of time or familiarity with the technology. Increased promotion to and education of dermatologists who are most likely to use the discussion forum may improve utilization of this means of communication.
Sustainability-the Holy Grail of telehealth?
Authors: Cradduck T D
Published: February 2003

summary

The sustainability of a telehealth programme is one measure of its success. However, the term ‘sustainable telehealth’ has almost become an oxymoron. Many telehealth programmes are initiated in good faith and are based upon well founded principles. Unfortunately, the initial funding cycle is rarely long enough to enable the programme to reach maturity and become integrated into the health-care system. Telehealth does not critically depend on technology; change management is much more important and it takes time for personnel to adopt new modes of practice. In addition, a telehealth programme needs a threshold number of installations before it can be deemed fully operational. In many cases an evaluation carried out at the conclusion of the pilot phase will fail to recognize the initial goals. As a consequence, the criteria used to justify further financial support are often at odds with the original goals and aspirations of the project initiators, and this leads to dissatisfaction by all parties concerned.
Lessons learned from the Hospital Without Walls project
Authors: Dadd Michael , Doyle Briony , Wilson Laurie , Gunaratnam Marcus
Published: February 2003

summary

The Hospital Without Walls is an ongoing ambitious project in home telecare that incorporates research into physiological monitoring, low-power radio communication, database storage of physiological data and methods of viewing clinically relevant information from large quantities of stored data. The system records vital signs from patients in their homes using a body-mounted, two-way radio system and a base station located in the home, which transmits data records to a central recording facility every day or in response to predefined emergency events. The prototype system has successfully undergone preliminary clinical trials, with a particular clinical emphasis on monitoring activity using three-axis accelerometers. Our experience with the trial suggests that there are significant differences in the technical design required for a long-term, home monitoring system and one where monitoring takes place in an environment staffed by health professionals.
Videoconferencing in facilities providing care for elderly people
Authors: Guilfoyle Clare , Wootton Richard , Hassall Stacey , Offer Jan , Warren Margo , Smith Debbie , Eddie Michelle
Published: February 2003

summary

Two studies were conducted to test the feasibility of delivering care by videoconferencing to facilities providing care for elderly people. Both used equipment connected by ISDN lines at 384 kbit/s. During the first study, no consultations, care plans or assessments were conducted. During the second study, 120 assessments were conducted in just over two weeks, both face to face and by videoconference. Why was one project so successful and the other not? The reasons related to ownership, planning, participants and location. A comparison of the two projects highlights some of the considerations necessary to ensure the success of any telehealth project.
The evolution of a successful telemedicine mental health service
Authors: Hailey David , Bulger Tim , Stayberg Sharlene , Urness Douglas
Published: February 2003

summary

Development of telemedicine mental health services in Alberta evolved via a pilot project, the delivery of routine services to a small group of centres and subsequent expansion to a province-wide programme. Success of the service was linked to support for telehealth by the provincial government and consultation between the Alberta Mental Health Board (AMHB) and local stakeholders. Assessments by the AMHB have shown that telepsychiatry is acceptable and sustainable at a realistic cost. However, there are few measures of clinical effectiveness available and none of cost-effectiveness. A detailed economic evaluation of the telemedicine mental health network would now be a major task. The expansion of telemedicine mental health services has increased the expectations of health-care decision makers. In addition, the complexity of the network has increased and new initiatives, such as the use of telepsychology, have been introduced. Management of this successful telehealth programme continues to be time consuming and challenging.
Integrated regional services: Are working process changes desirable and achievable?
Authors: Harno Kari , Grönhagen-Riska Carola , Pohjonen Hanna , Kinnunen Jaakko , Kekomäki Martti
Published: February 2003

summary

In the hospital district of Helsinki and Uusimaa, 32 municipalities with one or more health centres provide primary care to their residents. Legal and organizational barriers between primary care and hospital care impede the continuity of patient care. Integrating primary and secondary care with the aid of information technology may facilitate a virtual electronic patient record, in which the viewing of images and other patient data is possible regardless of the organization that produced them. For example, in one trial, diabetic patients sent their home blood glucose measurements by modem to their health centre. Preliminary observations suggest that they could increase their glucose testing largely because they were able to transmit the results to the database and receive teleconsultations. Also, a picture archiving and communication system (PACS) has been in operation in two clinics of the Helsinki University Central Hospital for over two years and seven hospitals had become filmless by the end of 2001. A regional PACS is planned to be completed by the year 2004.
Using the Australian and New Zealand Telehealth Committee framework to evaluate telehealth: Identifying conceptual gaps
Authors: Hughes Emma , King Chris , Kitt Sharon
Published: February 2003

summary

Telehealth is strongly supported in policy rhetoric as being economically significant to Australia, but evaluation standards have been insufficiently developed to ensure that this is the case. The use of one such evaluation standard, the Australian and New Zealand Telehealth Committee (ANZTC) framework, for telehealth evaluation in Australia makes good sense. However, that framework emphasizes economic and technical considerations at the expense of social contexts. Furthermore, there must be questions about the utility of a framework which, it appears, has been used to evaluate only a single telehealth project in Australia. The combination of the economic rationalism of health-care policy and the technological determinism of a tool model of information and communication technologies (ICTs) can result in evaluations that fail to match the complexities of the intersection of health-care and ICTs. Using the ANZTC framework while at the same time focusing on explaining, rather than just describing, the links between interventions and outcomes seems a reasonable compromise. This involves understanding complex socio-technical networks and relationships, and requires investigators to engage with the gulf between private opinions, public statements and actual behaviour.
Telehealth for older patients: The Hong Kong experience
Authors: Hui Elsie , Woo Jean
Published: February 2003

summary

We studied the feasibility, acceptability and cost-effectiveness of using telemedicine to provide geriatric services to residents of nursing homes. A local 200-bed nursing home supported by the community geriatric assessment team (CGAT) participated in a one-year study, during which videoconferencing was used to replace conventional outreach or clinic-based geriatric care. The feasibility of telemedicine was evaluated by participating specialists in a total of 1001 consultations. Other outcome measures included productivity gains, utilization of hospital emergency and inpatient services, and user satisfaction. Telemedicine was adequate for patient care in 60 99% of cases in seven different disciplines. The CGAT was able serve more patients and see them earlier and more frequently. Telemedicine was cheaper than conventional care, and well accepted by health-care professionals as well as clients. Substantial savings were achieved in the study period through a 9% reduction in visits to the hospital emergency department and 11% fewer hospital bed-days. Telemedicine was a feasible means of care delivery to a nursing home and resulted in enhanced productivity and cost-savings. Linking more such institutions to care providers would further increase cost-effectiveness.
The cost-effectiveness of telehealth in metropolitan hospitals
Authors: Kitt Sharon M , Clayton Lexie
Published: February 2003

summary

We established a telehealth link between two inner-city health services about 10 km apart. The video-link between the sites was based on IP videoconferencing; ISDN connections were maintained as a form of system redundancy and to connect to sites beyond the local area network. The cost of a conventional consultation, in which the patient travelled to an outpatient appointment, was A$170. Because existing equipment and telecommunications could be used, the cost of a telehealth consultation was only A$74. During the study approximately 15 teleconsultations were completed and a number of patient transfers were cancelled because they were deemed clinically unnecessary. The preliminary results suggest that the cost-savings from telehealth can be substantial. In addition there were major benefits to continuity of patient care and clinical communication within the organization.
Experimental Analysis of the Structural Performance of Space Trusses Commonly Used in Brazil
Authors: Malite M. , Maiola C. H. , Gonçalves R. M. , Souza A. C.
Published: February 2003

Space trusses composed of tubular steel members with stamped ends connected by a single bolt ( system 1) are commonly used in Brazil. Although this is a simple solution and, therefore, interesting from an economic standpoint, it has presented structural problems, since the reduction of inertia at the member ends and the eccentricities are not foreseen in the design phase. This fact has caused some roofs to collapse partially or even totally, posing serious safety risks for their users. Another system that has been widely employed consists of members with stamped ends bolted to a node device made up of welded plates ( system 2), which eliminates eccentricities at the nodes. In this study, the structural performance of the type of stamping was initially analyzed by axial compression tests on members, followed by tests on space truss prototypes composed of system 1 and system 2. The experimental results were compared to the theoretical values obtained based on the classical models adopted in designs, allowing for the overall evaluation of structural performance of both systems, thus contributing toward the safe use of these structures.
Design Conception and Deployment Simulation for a Highly Synchronized Extendable/Retractable Space Mast
Authors: Wujun Chen , Yaozhi Luo , Gongyi Fu , Jinghai Gong , Shilin Dong
Published: February 2003

A novel design concept, together with the key components, is developed in detail for an extendable/retractable space mast. It is based on a three-dimensional linkage with triangular cross section that is deployed and stiffened by two sets of cables: passive and active cables. The active cables, whose overall length is controlled by a micro-dc motor, sequentially control the deployment. The fundamental structural dynamic performance is investigated briefly. In particular, a dynamic deployment simulation algorithm is developed in terms of the Cartesian coordinate of the idealized pinned-joint. Accordingly, a 1:2 scaled hi-tech model mast has been built to verify the design conceptions and analytical method. Finally, some suggestions to improve the design and conclusions derived from the deployment experiment results are presented.
Integrating Knowledge in Groups: How Formal Interventions Enable Flexibility
Authors: Okhuysen Gerardo A. , Eisenhardt Kathleen M.
Published: February 2003

Recent perspectives have focused on the role of the firm in the generation and use of knowledge. These perspectives suggest that, while knowledge is “owned” at the individual level, the integration of this knowledge to a collective level is necessary. This integration of knowledge typically takes place in groups. In our experimental study, we examine how individuals in groups engage in micro-level interactions to effectively integrate knowledge by examining the effects of using three formal interventions: Information Sharing, Questioning Others, and Managing Time. In particular, we observe that simple formal interventions can improve knowledge integration when they lead to “windows of opportunity” for group members to consider ways to improve their work process that go beyond the formal intervention instructions. The most effective groups used these formal interventions to focus their attention into organized clusters of activity, during which they significantly changed their work process and improved their subsequent knowledge integration. In particular, groups in the Questioning Others and Managing Time conditions exhibited greater knowledge integration than groups in the Information Sharing and Control conditions. Groups with high-knowledge integration paced their attention to both adaptive improvements to their process and task execution. Overall, this study identifies simple structures, interruptions, and time pacing as central to the emerging concept of group flexibility by which members enhance their performance on novel and/or ambiguous tasks. We note links to complexity theory and knowledge-based thinking as well.
Disentangling the Theories of Firm Boundaries: A Path Model and Empirical Test
Authors: Schilling Melissa A. , Steensma H. Kevin
Published: February 2003

Theories on the motivation underlying firm boundaries have recently sparked renewed debate. What best explains whether a firm relies on market control or hierarchical control to secure required resources? How do the characteristics of the resources come into play? In this study, we consider a comprehensive path model of the governance mode decision for sourcing technological know-how. By integrating different perspectives on firm boundaries, including transaction cost economics, a resource-based view, and an options perspective, we link characteristics of the technology (i.e., uniqueness, barriers to imitation, commercial uncertainty, technological dynamism) to the perceived threat of opportunism, the potential for sustainable advantage, and the pursuit of a licensing agreement vis-à-vis the outright acquisition of the firm that possesses the desired know-how. We use structural equation modeling to analyze 127 sourcing arrangements. Our results show that technological dynamism and barriers to imitation indirectly influence the governance mode decision by increasing the perceived threat of opportunism. Commercial uncertainty directly influences the governance mode and decreases the likelihood of an acquisition vis-à-vis a licensing agreement. Although uniqueness and barriers to imitation are also positively associated with the perceived potential for sustainable advantage, the potential for sustainable advantage had no direct effect on governance mode. Implications and suggestions for further research are offered.
Acquiring New Technologies and Capabilities: A Grounded Model of Acquisition Implementation
Authors: Ranft Annette L. , Lord Michael D.
Published: February 2003

In this study, we explore seven in-depth cases of high-technology acquisitions and develop an empirically grounded model of technology and capability transfer during acquisition implementation. We assess how the nature of the acquired firms' knowledge-based resources, as well as multiple dimensions of acquisition implementation, have both independent and interactive effects on the successful appropriation of technologies and capabilities by the acquirer. Our inquiry contributes to the growing body of research examining the transfer of knowledge both between and within organizations. Propositions are developed to help guide further inquiry into the dynamics of acquisition implementation processes in general and, more specifically, the process of acquiring new technologies and capabilities from other firms.
Report of the Association Internationale Pour L’étude Des Argiles (AIPEA) Nomenclature Committee for 2001: Order, Disorder and Crystallinity in Phyllosilicates and the Use of the “Crystallinity Index”
Authors: Guggenheim Stephen , Bain Derek C. , Bergaya Faíza , Brigatti Maria F. , Drits Victor A. , Eberl Dennis D. , Formoso Milton L. L. , Galán Emilio , Merriman Richard J. , Peacor Donald R. , Stanjek Helge , Watanabe Takashi
Published: February 2003

The purpose of this report is to describe the appropriate use of indices relating to crystallinity, such as the ‘crystallinity index’, the ‘Hinckley index’, the ‘Kübler index’, and the ‘Árkai index’. A ‘crystalline’ solid is defined as a solid consisting of atoms, ions or molecules packed together in a periodic arrangement. A ‘crystallinity index’ is purported to be a measure of crystallinity, although there is uncertainty about what this means (see below). This report discusses briefly the nature of order, disorder and crystallinity in phyllosilicates and discusses why the use of a ‘crystallinity index’ should be avoided. If possible, it is suggested that indices be referred to using the name of the author who originally described the parameter, e.g. ‘Hinckley index’ or ‘Kübler index’, or in honor of a researcher who investigated the importance of the parameter extensively, e.g. ‘Árkai index’.
Clay Mineralogy of Spodosols with High Clay Contents in the Subalpine Forests of Taiwan
Authors: Lin Ching-Wei , Hseu Zeng-Yei , Chen Zueng-Sang
Published: February 2003

Three Ultic Haplorthods with significant illuviation of clay and spodic materials in the subalpine forests located in the Alishan area of central Taiwan were selected to identify the clay mineral compositions by X-ray diffraction (XRD) and to explain the transformation of the clay minerals. The three pedons are dominated by vermiculite and vermiculite-illite interstratified minerals, and they have minor kaolinite, quartz and gibbsite. No hydroxy interlayered vermiculite (HIV) was found in the E horizon of the three pedons because the forest soils are very acidic and have very low Al contents. The presence of HIV in the spodic (Bhs) and argillic horizons (Bt) of the three pedons was associated with greater free Fe and Al contents (Fed and Ald), more favorable pH ranges, and coatings of organo-metallic complexes which prevented continuous weathering. The specific pedogenic process, clay illuviation and podzolization occurred sequentially in the Alishan area, and induced the unusual clay mineral distribution and transformation. The largest amounts of illite are in the C horizon and the amounts of vermiculite increased with decreasing soil depths. A reverse distribution between illite and vermiculite through the soil profile was observed. Illite was transformed to vermiculite due to the strong weathering environment associated with extremely low exchangeable K contents. The weathering sequence of clay minerals of Spodosols with fine textures in the study area is proposed as: illite → vermiculite (or interstratified vermiculite-illite minerals) → HIV and vermiculite.
A framework for a new approach to antenatal care
Authors: Gerein N , Mayhew S , Lubben M
Published: February 2003

A framework for a new approach to antenatal care (ANC) is presented to improve maternal health. Based on evaluations of ANC, safe motherhood programs, gender and social theory, it suggests that managers should draw upon existing family and community support systems, and develop partnerships beyond the health service. Policy and program changes are required in: professional mandates for ANC providers, organization of ANC services, service protocols, training programs, policy towards TBAs, referral care, and service support systems.
Postcoital contraception in Turkey
Authors: Sogukpinar N. , Turkistanli E.C. , Saydam B.K.
Published: February 2003

Objectives: The purpose of this article is to determine the knowledge status of women concerning postcoital contraception when they turn to curettage in order to terminate an undesired pregnancy. Methods: This defining study has been carried out at a maternity hospital in Izmir on pregnant women admitted for curettage. We interviewed 150 pregnant cases using an improbability sampling method. Results: We discovered that 48.7% of women had avoided pregnancy before curettage by withdrawal before ejaculation. When we investigated the method used after uncontrolled coitus, 27.3% of cases reported vaginal douche while 12.7% indicated curettage. After having an unprotected coitus or failure in contraceptive methods 99.3% of the women indicated they would report to health institutes to utilize postcoital methods if they were familiar with them. Conclusions: Postcoital contraception may be a solution for undesired pregnancies.
Connexins, gap junctional intercellular communication and kinases
Authors: Cruciani Véronique , Mikalsen Svein‐Ole
Published: February 2003

Summry— A number of kinases and signal transduction pathways are known to affect gap junctional intercellular communication and/or phosphorylation of connexins. Most of the information is available for protein kinase A, protein kinase C, mitogen‐activated protein kinase, and the tyrosine kinase Src. Much less is known for protein kinase G, Ca2+‐calmodulin dependent protein kinase, and casein kinase. However, the present lack of knowledge is not necessarily synonymous with lack of importance in the regulation of intercellular communication and phosphorylation of connexins. Kinases and the phosphorylation of connexins may be involved in the regulation of gap junctional intercellular communication at all levels ranging from the expression of connexin genes to the degradation of the gap junction channels. The exact role of the phosphorylation depends both on the kinase and the connexin involved, as well as the cellular context.
Pharmacological modulation and differential regulation of the cardiac gap junction proteins connexin 43 and connexin 40
Authors: Dhein Stefan , Polontchouk Lioudmila , Salameh Aida , Haefliger Jaques‐Antoine
Published: February 2003

Summry— Gap junction channels provide the basis for the electrical syncytial properties of the heart as a communicating electrical network. Cardiac gap junction channels are predominantly composed of connexin 40 or connexin 43. The conductance of these channels (gj) can be regulated pharmacologically: substances which activate protein kinase C, protein kinase A or protein kinase G may alter Cx43 gap junction conductance. However, for PKC, this seems to be subtype specific. Thus, antiarrhythmic peptides can enhance gj via activation of PKCε, while FGF‐2 reduces gj via PKCε. Lipophilic drugs can uncouple the channels. Besides an acute regulation of gj, the expression of the cardiac connexins can also be regulated. A decrease in Cx43 with a concomitant increase in Cx40 has been found in end‐stage failing hearts, while in renovascular hypertension, an increase in Cx43 has been described. Mediators like endothelin‐1, angiotensin‐II, TGF‐β, VEGF, and cAMP have been shown to increase Cx43. Interestingly, endothelin‐1 and angiotensin‐II increased Cx43 but did not affect Cx40 expression. In contrast, in humans suffering from atrial fibrillation (AF), the content in Cx40 can be enhanced while Cx43 was unaltered, although in several other studies, other changes of the cardiac connexins were found, which might be related to the type of AF. Regarding the role of calcium, the content in both Cx40 and Cx43 was decreased in cultured neonatal rat cardiomyocytes after 24 h administration of 100 nM verapamil. Thus, gap junctional channels can be affected pharmacologically either acutely by modulating gap junction conductance or chronically by altering gap junction protein expression. Interestingly, it appears that the expression of Cx43 and Cx40 can be differentially regulated.
Lacandonia granules are present in Ginkgo biloba cell nuclei
Authors: Jiménez‐Ramírez Jaime , Agredano‐Moreno Lourdes Teresa , Segura‐Valdez María de Lourdes , Jiménez‐García Luis Felipe
Published: February 2003

Summry— Lacandonia schismatica is a rare flowering plant with the sex organs spatially inverted. Several aspects of its cell biology are now known. Interestingly, within the cell nucleus, the chromatin is reticulated and it is associated to a novel structure named Lacandonia granules, a very abundant ribonucleoprotein particle showing similarities to perichromatin and Balbiani ring granules, which are involved in nuclear mRNA metabolism. To see whether these particles are present in other plants, we study the nucleus of Ginkgo biloba, a non‐flowering plant. Light, electron and atomic force microscopy show that the cell nuclei of G. biloba are reticulated. Ultrastructural analysis showed that in the nucleoplasm, abundant intranuclear particles 32 nm in diameter are present. The EDTA regressive staining suggested that they contain RNA. Ultrastructural in situ hybridization confirmed the presence of RNA in these particles. Therefore, we conclude that the nuclei of G. biloba are reticulated and contain Lacandonia granules. We suggest that these particles may also be present in other plants.
Connexins and secretion
Authors: Serre‐Beinier Véronique , Mas Christophe , Calabrese Alessandra , Caton David , Bauquis Juliette , Caille Dorothée , Charollais Anne , Cirulli Vincenzo , Meda Paolo
Published: February 2003

Summry— Connexin channels clustered at gap junctions are obligatory attributes of all macroscopic endocrine and exocrine glands investigated so far and also connect most types of cells which produce secretory products in other tissues. Increasing evidence indicates that connexins, and the cell‐to‐cell communications that these proteins permit, contribute to control the growth of secretory cells, their expression of specific genes and their differentiated function, including their characteristic ability to biosynthetize and release secretory products in a regulated manner. Since the previous reviews which have been published on this topic, several lines of evidence have been added in support of multiple regulatory roles of gland connexins. Here, we review this novel evidence, point to the many questions which are still open and discuss some interesting perspectives of the field.
Connexins and cancer
Authors: Mesnil Marc
Published: February 2003

Summry— The hypothesis, that gap junctional intercellular communication plays a key role in carcinogenesis and more generally in growth control was formulated nearly 40 years ago. From this time, data accumulated, showing that this type of communication is frequently decreased or absent in cells treated with tumor promoting agents, among transformed cells or between transformed/tumor cells and normal cells. This observation has been made on various cell types and whatever their tissue and species origins, by using in vitro and in vivo models. It led to the general assumption that the inhibition of gap junctional intercellular communication may play a role in carcinogenesis at two levels: (1) during tumor promotion by favoring the clonal expansion of initiated cells and (2) after the phenotypic transformation of cells by preventing the diffusion of putative “normalizing” factors between tumor cells and surrounding normal cells. During the past decade, the discovery that gap junction proteins, the connexins (Cx), may act as tumour suppressors, by reverting the phenotype of transformed cells confirmed the idea that their lack of function would be actively involved in carcinogenesis. However, we still do not know precisely what are the molecular processes that gap junctional intercellular communication may regulate and still do have very few data concerning the gap junction situation in human cancers. All these aspects are presented from an historical point of view and discussed below.
Manufacturing flexibility: defining and analyzing relationships among competence, capability, and customer satisfaction
Authors: Zhang Qingyu , Vonderembse Mark A , Lim Jeen‐Su
Published: February 2003

Fast and dramatic changes in customer expectations, competition, and technology are creating an increasingly uncertain environment. To respond, manufacturers are seeking to enhance flexibility across the value chain. Manufacturing flexibility, a critical dimension of value chain flexibility, is the ability to produce a variety of products in the quantities that customers demand while maintaining high performance. It is strategically important for enhancing competitive position and winning customer orders.

This research organizes literature on manufacturing flexibility and classifies it according to competence and capability theory. It describes a framework to explore the relationships among flexible competence (machine, labor, material handling, and routing flexibilities), flexible capability (volume flexibility and mix flexibility), and customer satisfaction. It develops valid and reliable instruments to measure the sub‐dimensions of manufacturing flexibility, and it applies structural equation modeling to a large‐scale sample (n=273). The results indicate strong, positive, and direct relationships between flexible manufacturing competence and volume flexibility and between flexible manufacturing competence and mix flexibility. Volume flexibility and mix flexibility have strong, positive, and direct relationships with customer satisfaction.
Cause, consequence and control: towards a theoretical and practical model of operational risk
Authors: Lewis Michael A
Published: February 2003

Modified competitive, technological, social and political circumstances have magnified the potential impact of operations‐related failures; yet OM’s interest in operational ‘risks’ remains underdeveloped. This paper develops a provisional model of operational risk based upon the input and outcome dimensions of causal event and negative consequence. Discussion of risk control constitutes a complementary theoretical dimension. Empirical evidence from four operational failure case studies offers an opportunity to revise and extend the initial model. Specific conclusions address the structural and temporal pathology of operational failure and the subjective ‘layers’ of internal and external loss that appear to influence overall negative consequences. Additionally, effective risk control is highlighted as an integrated process with more similarities to service quality management than variation‐reduction process control. The paper concludes with reflection upon the limitations of the study and, given the preliminary nature of the work, some suggestions for future work.
Factors influencing the utilization of Internet purchasing in small organizations
Authors: Olson John R , Boyer Kenneth K
Published: February 2003

Many companies have jumped on the Internet bandwagon in an attempt to get rich quick in today’s marketplace. While there have been numerous success stories, the amount of reported failures has been extremely high. In spite of all the recent failures, a select few organizations have been able to use e‐commerce as a means to increase the overall profitability of their firm. An often‐overlooked factor in website effectiveness and development is the effect of individual user differences on the acceptance of the new technology. This exploratory study examines how individual user views and preferences affect the use of the Internet as a purchasing medium.

This research presents an exploratory study of data gathered through a survey of 416 customers of a major Internet retailer of commodity office supplies. Cluster analysis is employed to develop a model that classifies users of Internet purchasing into six distinct groups. The clusters are developed using a variety of items that measure end users’ viewpoints and preferences regarding the Internet as a purchasing medium. These factors are based on the widely supported Technology Acceptance Model (TAM). The classification system is then used to demonstrate how these groups vary on strategic items, cost issues and individual productivity measures. The findings provide important insights to companies seeking to capitalize on the Internet as a retailing channel by identifying factors that may lead to a loyal customer base rather than an opportunistic one that switches sites frequently solely to obtain lower prices.