bluuebunny/crossref_metadata_2025 huggingface dataset:
Designing an interactive model of factors affecting the health technology assessment (HTA) in Iran
Authors: Bahadori Mohammadkarim , Ravangard Ramin , Nezhad Mahya Tohidi , Pourtaheri Naeimeh , Hosseini-Shokouh Sayyed Morteza
Published: October 2018

Purpose

According to the great importance of community health as well as the ever-increasing development of health technologies, the importance of designing an interactive model of factors affecting health technology assessment (HTA) can be highlighted. The purpose of designing and implementing the framework of health information system assessment is to ensure that the required accurate data which are necessary to measure the main health indicators are available. The purpose of this paper is to design an interactive model of factors affecting HTA.

Design/methodology/approach

This is a cross-sectional, descriptive-analytic study conducted in the Iran Ministry of Health and Medical Education in the second half of 2017. A sample of 60 experts and professionals working in the field of health technologies are selected using purposive and snowball sampling methods. Two researcher-made questionnaires are used to collect the required data. The collected data are analyzed using decision-making trial and evaluation laboratory (DEMATEL) and MATLAB R2013a.

Findings

The results showed that “Legal dimension,” “safety,” “Effectiveness” and “Social dimension” were the affecting factors and net causes, and “Current application,” “Knowledge of technology,” “Ethical dimension,” “Costs” and “Organizational dimension” were the affected factors and net effects in the interactive model. Furthermore, “Legal dimension” with the coordinates C: [1.88, 1.27] and “Ethical dimension” with the coordinates C: [1.75, −75] were known as the most affecting and most affected factors in the interactive model, respectively.

Originality/value

The DEMATEL model is an appropriate tool for managers and policy makers to structure and prioritize factors influencing the HTA. Policy makers and decision makers can use this model for identifying relationships among factors and prioritize them. Because health policy makers and managers have a major role in formulating the regulations and guidelines related to the HTA, they should pay more attention to the legal considerations in their decisions and use the management tools to move the available resources toward implementing and enforcing rules and guidelines related to the HTA.
The relationship between servitization and product customization strategies
Authors: Sousa Rui , da Silveira Giovani J.C.
Published: October 2018

Purpose

The purpose of this paper is to examine the relationship between product customization and servitization strategies, specifically the relationship between product customization strategy intensity and degree of servitization (offering of basic and/or advanced services) and the moderating role of product customization strategy alignment on that relationship.

Design/methodology/approach

The authors develop and test hypotheses through partial least squares path modeling to analyze data from the Sixth International Manufacturing Strategy Survey, involving 931 manufacturers in 22 countries.

Findings

The results indicate that customization strategy intensity is positively associated with the offering of basic and advanced services; these relationships are not moderated by customization strategy alignment.

Practical implications

Manufacturers pursuing product customization strategies may be especially well positioned to servitize, even those with misalignment in strategic choices. Paradoxically, while manufacturers of standard products might look at servitization as an attractive strategy to differentiate their value proposition, they appear to be less servitized than manufacturers pursuing product customization.

Originality/value

This is one of the first studies to examine how manufacturing strategy choices (intensity and alignment) influence the adoption of servitization strategies. The study introduces manufacturing strategy as a contingency factor that influences the adoption of servitization, answering calls for the study of servitization contingencies.
Representative bureaucracy in the Arab Gulf states
Authors: Kemp Linzi J. , Mathias Megan , Raji Maryam
Published: October 2018

Purpose

The purpose of this paper is to apply the lens of representative bureaucracy (RB) to women’s representation at management level in governments and government-owned companies in Arab Gulf states (AGS), and to consider the implications for government stability, legitimacy and performance.

Design/methodology/approach

Data were analysed of the numbers of men and women in management positions (8,936), of government and government-owned companies (846), for the six countries of the AGS. Analyses were conducted on the presence/absence of women in management for ten industry types.

Findings

Governments and government-owned companies in the AGS were identified as hybrid (public/private) institutions. Women were found to be underrepresented at management levels in public sector bureaucracy; women clustered in a narrow range of industries; all countries returned a high result of zero female managers in these industries.

Research limitations/implications

This research is limited by data collected from a single source, “Eikon”, which is a commercial database. The implication of these results is a benchmark for future studies on women’s representation at management level in governments and government-owned companies of Arab Gulf countries.

Practical implications

The practical implication of this study is for concerted government intervention to address gender inequality in management of governments and government-owned companies across the AGS.

Originality/value

This is the first study of RB in AGS and extends the theory of RB to a new geographical and cultural context. There is value in application of RB to government and government-owned companies as a regional form of hybrid public–private organisation.
The relationship between internal integration and manufacturing flexibility in the Egyptian industry
Authors: Khalaf Magdy A. , El Mokadem Mohamed Yehia
Published: October 2018

Purpose

This paper aims to empirically investigate the triadic relationship between internal integration, internal flexibility and external flexibility.

Design/methodology/approach

This research hypothesized the mediation effect of internal flexibility on the relationship between internal integration and external flexibility. Survey data were collected and analyzed using simple and mediation regression analysis to test the study hypotheses.

Findings

The research finding reveals that machine, labor and material handling flexibilities; being as internal flexibility dimensions mediate the relationship between internal integration and volume and mix flexibilities; being as external flexibility dimensions. The results provided insufficient evidence on the mediating effect of routing flexibility on the relationship between internal integration and both volume and mix flexibilities.

Research limitations/implications

This research presents a new perspective for research studies to understand the factors that affect manufacturing flexibility. However, the nature of the surveyed sample and using of a single informant might limit the generalizability of the research findings.

Practical implications

This study provides useful insights for firms wishing to enhance their competitiveness through improving their flexibility. The companies should be aware of the importance of developing a suitable platform for coordinating inter-departmental activities to enhance its internal competencies, which, in turn, improve its customer-facing capabilities and boosts its competitiveness.

Originality/value

This paper contributes to knowledge by proposing and empirically testing the mediating effect of internal flexibility on the relationship between internal integration and external flexibility.
Tribological performance of peek with green lubricant enhanced by nano hexagonal boron nitride powder
Authors: Sagbas Binnur
Published: October 2018

Purpose

The purpose of this paper is to investigate applicability of hexagonal boron nitride (h-BN) powder as a solid lubricant additive in coconut oil and to determine the tribological behavior of PEEK rubbed with DIN2080 tool steel, under prepared green lubricating condition.

Design/methodology/approach

In this study, tiribological performance of PEEK against the DIN2080 tool steel is investigated with green lubricant. Coconut oil was used as green lubricant and 4 per cent wt. h-BN powder was added as lubricant additive into the coconut oil. Reciprocal pin-plate tribological test were applied under dry, coconut oil and coconut oil+h-BN lubrication condition. Friction coefficients were recorded and wear behavior of the samples investigated by mass loss measurement and topographical inspection of wear track by optical profilometer.

Findings

Using coconut oil as lubricant provided 80 per cent reduction of friction coefficient and 33.4 per cent reduction of wear rate. Addition of h-BN into the coconut oil provide 84 per cent reduction of friction coefficient and 56 per cent reduction of wear rate. The results showed that vegetable oil is promising lubricant for sustainable manufacturing. h-BN serves to increase lubricant performance and decrease wear of the surfaces.

Practical implications

Petrochemical lubricants are one of the major sources of environmental pollution and health hazards. Development and use of environmental and health friendly lubricants support sustainability and reduce wear, friction and energy consumption. With this consciousness, recent studies have focused on green tribology and green lubricants such as vegetable oils, ionic liquid bio-lubricants and bio-based polymers.

Originality/value

In literature study coconut oil was proposed as green lubricant while h-BN powder was proposed as solid lubricant. However, applicability of h-BN powder in coconut oil has not been explored yet. Moreover, wear and friction property of PEEK material with DIN 2080 tool steel pair surface has not been studied yet with green lubricants.
Beyond budgeting: review and research agenda
Authors: Nguyen Dai Huu , Weigel Christine , Hiebl Martin R.W.
Published: October 2018

Purpose

Beyond budgeting has received an increased amount of scholarly attention in recent years. However, because most of the published research is discrete and unconnected, an overall picture of what is known about beyond budgeting has not evolved. Therefore, the purpose of this paper is to provide an overview of the available research on beyond budgeting. In particular, the authors compare conceptual papers that mostly stress the benefits of beyond budgeting with empirical evidence on beyond budgeting implementation and offer ideas for future research on beyond budgeting.

Design/methodology/approach

This paper uses systematic literature review methods. After an extensive database search and examination of references/citations, 32 papers were analysed with regard to bibliographical information, research design and findings.

Findings

Although proponents of beyond budgeting have put substantial effort into developing and promoting this concept, numerous empirical studies demonstrate that many organizations being investigated would still rather improve traditional budgeting than abandon it completely. This review also highlights the main criticisms of traditional budgeting, development of management control systems under beyond budgeting and factors hindering the implementation of beyond budgeting.

Research limitations/implication

This paper suggests that further research is needed on the scaling of beyond budgeting, organizational changes under beyond budgeting and challenges resulting from the implementation of beyond budgeting.

Originality/value

The paper is the first comprehensive literature review on beyond budgeting.
Exchange rate fluctuations and firm value: impact of global financial crisis
Authors: Sikarwar Ekta
Published: October 2018

Purpose

The purpose of this paper is to examine the presence of exchange rate exposure and its relationship with currency derivatives usage in the dynamic environment of the global financial crisis of 2008.

Design/methodology/approach

Using a sample of 624 Indian firms over the period of April 2001–March 2016, this paper investigates the linear and asymmetric exposure by dividing the full sample period into different sub-periods around the crisis.

Findings

The evidence presented in the paper suggests that the firms are more exposed to the exchange rate changes since the onset of the financial crisis. However, there is a lack of evidence that the usage of currency derivatives is more effective in reducing exposure during the crisis/post-crisis period as opposed to the pre-crisis period.

Practical implications

The findings are important to investors and managers for a better understanding of firm behaviours in relation to their risk management policies during the period of external shocks like crisis.

Originality/value

There is a paucity of research to explore whether the effect of currency derivatives usage on exchange rate exposure varies during external shocks such as crisis periods. The paper provides novel evidence that the effectiveness of derivatives usage in alleviating exposure becomes less during the dynamic environment of crisis.
Production, infrastructure, bribery decisions, and corruption control
Authors: Wu Ruohan , Lan Yuexing
Published: October 2018

Purpose

The purpose of this paper is to study the reasons and decision-making processes of heterogeneous firms’ bribery behavior, and how they will affect an aggregate economy’s development and corruption status.

Design/methodology/approach

The authors build a dynamic model to study a firm’s joint decision to bribe and invest, and how the decision is determined by its production and infrastructure status. The authors simulate the firm-level decision and development paths, and then build an aggregate economy consisting of heterogeneous firms. The authors then also simulate the development and corruption growth paths of the economy, by calibrating the model according to Chinese manufacturing firms in 2012.

Findings

Following the simulation results, the authors conduct counterfactual policy analyses. By comparing between the simulation results of two different counterfactual scenarios, the authors study how a government could control bribing better – as to decrease the number of bribers, and the average amount of the bribery payments. It is found that directly raising the bribery costs works more efficiently in controlling corruption, compared with reducing the benefits received by the bribers. The finding provides insightful policy implications for the government to clear up its economy.

Originality/value

The paper makes a novel and unique contribution to the literature by filling the current theoretical gap. The authors introduce a dynamic firm-level model to interpret firms’ bribery decisions and replicate the aggregate stylized facts. The paper innovatively treats bribery as both discrete and continuous decisions. Given both types of bribery decisions, now the authors can successfully simulate and quantify a firm’s intertemporal status and growth path.
Study on relationships among terminal and instrumental values, environmental consciousness and behavioral intentions for green products
Authors: Kautish Pradeep , Sharma Rajesh
Published: October 2018

Purpose

The purpose of this study is to examine the functional relationships among terminal and instrumental values, environmental consciousness and behavioral intentions for green products in India in light of the value–attitude–behavior framework.

Design/methodology/approach

This study adopts a hypo-deductive research design. A conceptual model was developed to relate the terminal and instrumental values to environmental consciousness and behavioral intentions, which are substantiated with a comprehensive literature review. Covariance-based structural equation modeling was used along with Anderson and Gerbing’s two-step research approach to measure the dimensions of the measurement model, as well as the specifications of the structural model.

Findings

The findings of the research indicate that terminal and instrumental values significantly influence environmental consciousness, and environmental consciousness has a significant influence on behavioral intentions. Instrumental value shows a greater influence on environmental consciousness and behavioral intentions, rather than terminal value. Furthermore, this study discloses that environmental consciousness acts as a partial mediator while establishing a link between instrumental/terminal value and behavioral intentions.

Research limitations/implications

The present research is based on two distinct forms of human values, namely, terminal values and instrumental values. The study found that consumers who favored instrumental values to terminal values revealed a tendency to frame confused and incoherent judgments on environmental issues.

Practical implications

The study will help green marketing practitioners understand the important role of values, that is, both terminal and instrumental values, in promoting environmental consciousness and behavioral intentions for green products. The findings of the study will facilitate decision-making processes in relation to marketing for green product consumers in the Indian context.

Social implications

Values are the guiding forces for human behavior, both socially and individually. Moreover, values have a long-lasting impression on consumers in varied forms. This study will pave the way forward by contributing to the societal understanding of consumer values within the realms of human values for green marketing, green consumerism and sustainable businesses.

Originality/value

The paper is the first attempt of its kind to explore the relationships among two distinct forms of values that are the foundation of human values, namely, terminal and instrumental values, and their effect on environmental consciousness and behavioral intentions for green products in the Indian market. The paper is unique in understanding factors contributing to green marketing beyond consumer values and differs from previous research in specifying the significance of human values.
An empirical exploration of the performance of alternative option pricing models
Authors: Bhat Aparna Prasad
Published: October 2018

Purpose

The purpose of this paper is to ascertain the effectiveness of major deterministic and stochastic volatility-based option pricing models in pricing and hedging exchange-traded dollar–rupee options over a five-year period since the launch of these options in India.

Design/methodology/approach

The paper examines the pricing and hedging performance of five different models, namely, the Black–Scholes–Merton model (BSM), skewness- and kurtosis-adjusted BSM, NGARCH model of Duan, Heston’s stochastic volatility model and anad hocBlack–Scholes (AHBS) model. Risk-neutral structural parameters are extracted by calibrating each model to the prices of traded dollar–rupee call options. These parameters are used to generate out-of-sample model option prices and to construct a delta-neutral hedge for a short option position. Out-of-sample pricing errors and hedging errors are compared to identify the best-performing model. Robustness is tested by comparing the performance of all models separately over turbulent and tranquil periods.

Findings

The study finds that relatively simpler models fare better than more mathematically complex models in pricing and hedging dollar–rupee options during the sample period. This superior performance is observed to persist even when comparisons are made separately over volatile periods and tranquil periods. However the more sophisticated models reveal a lower moneyness-maturity bias as compared to the BSM model.

Practical implications

The study concludes that incorporation of skewness and kurtosis in the BSM model as well as the practitioners’ approach of using a moneyness-maturity-based volatility within the BSM model (AHBS model) results in better pricing and hedging effectiveness for dollar–rupee options. This conclusion has strong practical implications for market practitioners, hedgers and regulators in the light of increased volatility in the dollar–rupee pair.

Originality/value

Existing literature on this topic has largely centered around either US equity index options or options on major liquid currencies. While many studies have solely focused on the pricing performance of option pricing models, this paper examines both the pricing and hedging performance of competing models in the context of Indian currency options. Robustness of findings is tested by comparing model performance across periods of stress and tranquility. To the best of the author’s knowledge, this paper is one of the first comprehensive studies to focus on an emerging market currency pair such as the dollar–rupee.
The performance implications of the strategy–business model fit
Authors: Chereau Philippe , Meschi Pierre-Xavier
Published: October 2018

Purpose

The purpose of this paper is to highlight different strategy–business model (BM) alignments using Miles and Snow’s strategic framework and analyze the performance implications of these different alignments.

Design/methodology/approach

The paper develops a composite conceptual model combining Miles and Snow’s strategy typology with Demil and Lecocq’s BM framework to explore the performance implications of strategy–BM fit. This model is empirically examined using a sample of 156 French small- and medium-sized enterprises (SMEs) in the manufacturing sector.

Findings

The results first highlight a limited set of BM configurations across strategic profiles, confirming that a BM reflects a firm’s strategy as a means of realizing strategic choices. Second, they reveal that deviating from ideal strategy–BM alignments negatively affects performance. Finally, they shed light on the dynamics of Miles and Snow’s typology, from intended to implemented strategy.

Research limitations/implications

The intrinsic characteristics of surveyed SMEs led to the hybridization of empirically derived profiles, which allowed to partially associate them with theoretically predicted configurations of BMs.

Practical implications

The paper suggests the patterns of predictive strategy–BM alignment that allow managers and entrepreneurs to monitor the dynamic consistency between strategic choices and their implementation.

Originality/value

Do you need a strategy if you have a BM? Adopting a fit and performance perspective, this paper addresses this question and complements other studies emphasizing the need to connect strategies and BMs.
Backpacking’s future and its drifter past
Authors: O’ Regan Michael
Published: October 2018

Purpose

The purpose of this paper is to deconstruct the backpacker label by reconstructing it using the historical antecedent of drifting. Following the deconstruction of backpacking’s near past, the author build a clearer conceptual foundation for backpacking’s future.

Design/methodology/approach

The study is framed by scenario planning, which demands a critical review of the backpacking and an appreciation of its history in order to understand its future.

Findings

Backpacking, ever evolving, remains difficult to articulate and challenges researchers to “keep up” with its complexity and heterogeneity. This paper argues that researchers must learn more about how backpacking “works” by opening a dialogue with its past, before engaging in further research. The paper finds that a poor conceptualisation of backpacking has led to a codification of backpacker criteria.

Practical implications

Backpacking remains a research topic which draws disparate researchers using criteria that produces disparate results and deviations. By understanding its past, researchers will be better placed to explore the emancipatory impulses that drive backpackers today and in the future.

Originality/value

This papers’ value lies in the retrospection process which explores backpacking’s near past so as to “make sense” of present research and present scenarios for it is the immediate future. The paper re-anchors backpacking by investigating the major historical, social and cultural events leading up to its emergence.
Elimination of support mechanism in additive manufacturing through substrate tilting
Authors: Kapil Sajan , Joshi Prathamesh , Kulkarni Pravin Milind , Negi Seema , Kumar Ranjeet , Karunakaran K.P.
Published: October 2018

Purpose

The support structures of sacrificial material are built in deposition-based additive manufacturing (AM), which are later removed either by breaking or dissolving. Such a sacrificial material is not feasible in metal AM. The purpose of this study is to find a suitable method for eliminating the need of support mechanism. In this work, the authors use the tilting of the substrate to alleviate the need for the support mechanism altogether.

Design/methodology/approach

As in the traditional AM, the object is grown in horizontal layers. However, wherever undercuts are encountered, the substrate is tilted appropriately to capture the droplets. Such a tilt involves two rotary axes invariably. To conform to the slice geometry, these two tilts are accompanied by the three linear movements. Thus, the object with undercuts is grown in planar layers using five-axis deposition without any support structure. Each pair of the corresponding top and bottom contours of any slice defines a ruled surface. The axis of the deposition head will be aligned with the rules of this surface.

Findings

The need for the support mechanism was eliminated using five-axis deposition. This was experimentally demonstrated by building an aluminum impeller using a metal inert gas cladding head.

Research limitations/implications

In the proposed methodology, the objects with an abrupt change in the geometry are not possible to realize.

Originality/value

This manuscript proposed a novel method of eliminating the support mechanism through continuous five-axis deposition.
Library instruction and information literacy 2017
Authors: Johnson Anna Marie , Willenborg Amber , Heckman Christopher , Whitacre Joshua , Reynolds Latisha , Sterner Elizabeth Alison , Harmon Lindsay , Lunsford Syann , Drerup Sarah
Published: October 2018

Purpose

This paper aims to present recently published resources on information literacy and library instruction through an extensive annotated bibliography of publications covering all library types.

Design/methodology/approach

This paper annotates English-language periodical articles, monographs, dissertations and other materials on library instruction and information literacy published in 2017 in over 200 journals, magazines, books and other sources.

Findings

The paper provides a brief description for all 590 sources.

Originality/value

The information may be used by librarians and interested parties as a quick reference to literature on library instruction and information literacy.
Mandated CSR and mode of implementation: the Indian context
Authors: Elembilassery Varun , Gurunathan L.
Published: October 2018

Purpose

An exploration of the global corporate social responsibility (CSR) literature unveils the inadequate focus on two aspects. First, CSR in the context of non-Anglo–Saxon countries and second the pertinent question of “How CSR”. The purpose of this study is to theoretically explore the available CSR literature and empirically assess the CSR implementation in India.

Design/methodology/approach

This study offers insights into the mode of CSR implementation in India deriving from an analysis of qualitative data, obtained through in-depth interviews using semi-structured questionnaire with functional leaders of nine Indian Firms.

Findings

Observations are made on the different mode of implementation and role of professionals in each mode. The various factors determining the objective of each implementation mode are identified and the rationale behind adopting different mode of CSR implementation is explored.

Research limitations/implications

This study makes five propositions on the rationale and the characteristics of the two predominant CSR implementation modes. Suggestions are also made for further research on corporate (CSR) foundations in India.

Practical implications

Business firms can decide on a suitable mode of CSR implementation based on the preeminence they attach to various factors discussed in the study. The need and importance of focusing on CSR competence in teams is highlighted.

Originality/value

This study attempts to fill the gap in literature pertaining to mode of CSR implementation. This study also contributes to the understanding of the Indian context of CSR.
Common and distinct components of communication partner training programmes in stroke, traumatic brain injury and dementia
Authors: O'Rourke Angela , Power Emma , O'Halloran Robyn , Rietdijk Rachael
Published: October 2018

Background

Communication partner training (CPT) programmes for health and care staff working with people with the neurologically based communication disorders associated with stroke, traumatic brain injury (TBI) and dementia are efficacious in improving communication. However, current programmes are lengthy and disorder specific, and therefore may not be suitable as staff training tools in environments with people with multiple communication disorders, and services with a variety of neurological populations.

Aims

To identify common and distinct components of CPT programmes for stroke, TBI and dementia in order to determine whether there are common delivery methods and content that can be consolidated to improve implementation of CPT in health and care services.

Methods & Procedures

A qualitative enquiry was used. Four CPT programmes targeting three disorders were identified from systematic reviews and literature searches. Programme data were recorded onto data sheets from manuals, study articles and supplementary materials, and were categorized using the Intervention Taxonomy (ITAX). Content analysis and elements of constant comparative analysis were employed to analyse the CPT programmes.

Outcomes & Results

Delivery characteristics were similar across all four programmes. All were delivered face to face in either group or individual contexts. However, duration varied from 1 to 35 h. Six of the 12 categories of information provided were common across all programmes, including ‘strategy’ ‘background to disorder’, ‘information about communication’, ‘information about program’, ‘negative behaviours to avoid’ and ‘purpose of program’. Programmes differed in the types of skill‐building techniques used, with the most common being videos (3/4 programmes), discussions (2/4 programmes) and trainer demonstrations (2/4 programmes). While strategies provided to trained partners targeted similar domains of communication, only 3/96 individual strategies were common to all programmes.

Conclusions & Implications

There are both common and distinct components in content and delivery methods across CPT programmes. Further research is needed to evaluate the distinct components of the programmes, to determine which individual strategies are efficacious, and which approach to skill‐building techniques is most effective. The present study has contributed a comprehensive list of programme components, which can form a basis for describing and refining CPT programmes in future.
Money and relationships online: communication and norm formation in women’s discussions of couple resource allocation
Authors: Moor Liz , Kanji Shireen
Published: October 2018

Research on intra‐household resource allocation practices has largely ignored the role of communication within but especially beyond the household. This article shows that discussions engaged in outside of the household shed light on intra‐household deliberation and also contribute to an understanding of how norms are formed and used in discussions and negotiations. Using data from the website Mumsnet, and grounding our analysis in a framework that combines the literature on gender norms in allocation practices with insights from the study of online communication, we contribute to the sociological literature on household distribution in three ways: first, we show that women use discussion sites like Mumsnet to clarify and sometimes contest social norms regarding money and relationships; second, we show that users conceive the ability to communicate with partners as a source of ‘relationship power’ and use online discussion with other women to develop that skill; third, we argue that sites like Mumsnet provide fresh insights into household resource allocation processes. The article concludes with a broader discussion of the role of communication in household distribution and the value of online data for understanding such processes.
The effect of political control on financial performance, structure, and outcomes of US nursing homes
Authors: Blankart Carl Rudolf , Foster Andrew D. , Mor Vincent
Published: October 2018

Objective

To evaluate the effect of partisan political control on financial performance, structure, and outcomes of for‐profit and not‐for‐profitUSnursing homes.

Data Sources/Study Setting

Nineteen‐year panel (1996‐2014) of state election outcomes, financial performance data from nursing home cost reports, operational and aggregate resident characteristics fromOSCARof 13 737 nursing homes.

Study Design

A linear panel model was estimated to identify the effect of Democratic and Republican political control on next year's outcomes. Nursing home outcomes were defined as yearly facility revenues, expenses, and profits; the number of Medicaid, Medicare, and private‐pay residents; staffing levels; and selected resident outcomes.

Principal Findings

Democratic political control leads to an increase in financial flows to for‐profit nursing homes, boosting profits without producing observable improvements in resident outcomes. Republican political control leads to lower revenues and profits of for‐profit nursing homes. A shift from Medicaid to more profitable private‐pay residents following Republican political control is observed for all nursing homes. Financial performance of not‐for‐profit nursing homes is not significantly affected by changes in political control.

Conclusion

Political control of the two legislative chambers—but not of the governorship—shapes the structure of the nursing home industry as seen in provider behavior.
Dynamic Changes in Health‐Promoting Properties and Eating Quality During Off‐Vine Ripening of Tomatoes
Authors: Siddiqui Mohammed Wasim , Lara Isabel , Ilahy Riadh , Tlili Imen , Ali Asgar , Homa Fozia , Prasad Kamlesh , Deshi Vinayak , Lenucci Marcello Salvatore , Hdider Chafik
Published: October 2018

Tomato (Solanum lycopersiconL.) fruit is rich in various nutrients, vitamins and health‐promoting molecules. Fresh tomatoes are an important part of the Mediterranean gastronomy, and their consumption is thought to contribute substantially to the reduced incidence of some chronic diseases in the Mediterranean populations in comparison with those of other world areas. Unfortunately, tomato fruit is highly perishable, resulting in important economic losses and posing a challenge to storage, logistic and supply management. This review summarizes the current knowledge on some important health‐promoting and eating quality traits of tomato fruits after harvest and highlights the existence of substantial cultivar‐to‐cultivar variation in the postharvest evolution of the considered traits according to maturity stage at harvest and in response to postharvest manipulations. It also suggests the need for adapting postharvest procedures to the characteristics of each particular genotype to preserve the optimal quality of the fresh product.
Randomized and controlled study comparing patient controlled and radiologist controlled intra‐procedural conscious sedation, using midazolam and fentanyl, for patients undergoing insertion of a central venous line
Authors: Clements Warren , Sneddon David , Kavnoudias Helen , Joseph Tim , Goh Gerard S , Koukounaras Jim , Snow Thomas
Published: October 2018

Introduction

Interventional Radiology procedures can provoke anxiety and may be painful. Current practice, Radiologist Controlled Sedation (RCS), involves titrating aliquots of midazolam and fentanyl to patient response but underdosing and overdosing may occur. This study tests a new method of titrating sedation/analgesia during the procedure, Patient Controlled Sedation (PCS), in which a combination of fentanyl and midazolam are administered using a patient‐controlled analgesia pump. This allows the patient to self‐control their sedation/analgesia during the procedure.

Methods

We performed a randomised control trial comparing the effects of pain, sedation, amnesia and overall patient satisfaction between PCS and RCS, by enrolling forty patients undergoing insertion of a tunnelled central line.

Results

Our results showed that PCS was safe, with no adverse events. PCS was effective in providing sedation, amnesia and overall pain relief comparable to RCS. There was no significant difference in dose given to patients using PCS or RCS. There was a tendency for patients in the PCS group to begin sedation later than those in the RCS group, but both were equally sedated during the procedure. We show that patients in the PCS group were very satisfied with the procedure.

Conclusions

We show that PCS is non‐inferior to RCS in terms of dosage given and degree of sedation. To the authors’ knowledge, this is the first study to show intra‐procedural PCS in an Interventional Radiology setting using midazolam and fentanyl as a randomised comparative trial. It has wide applicability in a procedural setting for very low cost and with minimal additional training required.
Androgen deprivation therapy use with post‐prostatectomy radiotherapy in the Prostate Cancer Outcomes Registry Victoria
Authors: Ong Wee Loon , Foroudi Farshad , Evans Sue , Millar Jeremy
Published: October 2018

Introduction

The aim of this study is to evaluate the use of androgen deprivation therapy (ADT) with post‐prostatectomy radiotherapy (PPRT) in a population‐based cohort of Australian men.

Methods

This is a prospective cohort of men with localised prostate cancer captured in the Prostate Cancer Outcomes Registry Victoria (PCOR‐Vic), who received PPRT between January 2010 and December 2015. The primary outcome was ADT use with PPRT. Multivariate logistic regressions were used to identify patient, tumour and institutional factors influencing ADT use.

Results

485 men were included in this study – 115 (24%) had pT2 disease, 231 (48%) pT3a, 134 (28%) pT3b and 5 (1%) pT4. Eighteen (4%) men had ISUP grade 1 disease, 139 (29%) ISUP grade 2, 170 (35%) ISUP grade 3 and 158 (33%) ISUP grade 4/5, while 267 (64%) men had positive surgical margins. Median time from prostatectomy to PPRT was 8.1 months (IQR = 5.3–13.9). Sixty‐six (14%) patients had ADT with PPRT. In multivariate analyses, men who had increased age (OR = 1.06; 95% CI = 1.01–1.11), seminal vesicle involvement (OR = 3.81; 95% CI = 1.63–8.91) and underwent treatment in regional centres (OR = 2.17; 95% CI = 1.08–4.33) were more likely to have ADT with PPRT.

Conclusion

We reported that 14% of men treated with PPRT received ADT in a population‐based cohort of Australian men, which was less than half of the proportion of ADT use with PPRT in the US. It will be of interest to evaluate the uptake of ADT with PPRT in the coming years following recent publications of level 1 evidence confirming overall survival benefits of ADT with PPRT.
Circadian disruption favors alcohol consumption and differential ΔFosB accumulation in Corticolimbic structures
Authors: Reséndiz‐Flores Maricruz , Escobar Carolina
Published: October 2018

Shift‐work and exposure to light at night lead to circadian disruption, which favors the use of alcohol and may be a risk factor for development of addictive behavior. This study evaluated in two experimental models of circadian disruption behavioral indicators of elevated alcohol intake and looked for ΔFosB, which is a transcription factor for neuronal plasticity in corticolimbic structures. Male Wistar rats were exposed to experimental shift‐work (AR) or to constant light (LL) and were compared with a control group (LD). After 4 weeks in their corresponding conditions, control LD rats remained rhythmic, AR rats exhibited a loss of day–night patterns in the brain and the LL rats showed arrhythmicity in general activity and day–night PER1 patterns in corticolimbic structures. During 12 days of exposure to 10 percent alcohol solution, the AR group showed daily increased alcohol intake while LD and LL rats ingested similar amounts. After 72 h of alcohol deprivation, AR and LL rats increased alcohol intake in a binge‐like test; this could be due not only to circadian disruption but also to stress and/or anxiety developed from the AR and LL manipulations. Associated to the increased alcohol intake, the AR and LL rats had significant accumulation of ΔFosB in the nucleus accumbens shell and decreased ΔFosB in the infralimbic cortex. Data here reported confirm that the disruption of temporal patterns favors the increased alcohol consumption and that this is associated with a differential accumulation of ΔFosB which may favor the development of addictive behavior.
Effect of ibuprofen on the efficacy of inferior alveolar nerve block in patients with irreversible pulpitis: A meta‐analysis
Authors: de Geus Juliana L. , Wambier Leticia M. , Boing Thaynara F. , Loguercio Alessandro D. , Reis Alessandra
Published: October 2018

The aim of this study was to compare preventive ibuprofen administration to placebo on the efficacy of inferior alveolar nerve block in patients with irreversible pulpitis. A search was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, SIGLE, and grey literature. The risk of bias was evaluated through the Cochrane Collaboration's tool. The quality of evidence was assessed using the GRADE approach. Only seven studies remained for the meta‐analysis. Administering ibuprofen before anaesthesia increased the success rate of injectable anaesthesia (RR = 1.79; 95% confidence interval (CI) 1.32–2.42; P = 0.0002) even in cases of symptomatic irreversible pulpitis (RR = 1.55; 95% CI 1.05–2.29; P = 0.03). The intensity of pain was lower for ibuprofen (standardised difference means (SMD) = −3.73; 95% CI −6.43 to −1.04; P = 0.007). Ibuprofen as premedication is beneficial for the success of inferior alveolar nerve block.
Local‐ and landscape‐level effects of land use change on bird diversity in Abiata‐Shalla Lakes National Park, Ethiopia
Authors: Asefa Addisu , Mengesha Girma , Sori Tolera , Mamo Yosef
Published: October 2018

Understanding the effects of anthropogenic disturbances on biodiversity is important for conservation prioritization. This study examined the effects of vegetation degradation on bird diversity in Abiata‐Shalla Lakes National Park, Ethiopia. We surveyed birds and vegetation structure between January and March 2015 in disturbed (impacted by settlement and agriculture) and undisturbed (not impacted) transects of two vegetation types (savannah woodland and gallery forest). We compared between disturbed and undisturbed transects at local (within vegetation types) and landscape (across vegetation types) levels: (a) avian species richness of the entire assemblage and feeding guilds and (b) species assemblage composition. We found significantly greater mean and total bird species richness of the entire assemblage and insectivore and granivore feeding guilds in the undisturbed transects, while the nectarivore guild was totally absent in the disturbed transects. We also found significant differences in bird species assemblage composition between the disturbed and undisturbed transects both within and across the vegetation types, and bird species assemblage composition at the landscape level was positively correlated with tree abundance and understorey vegetation height. In conclusion, our results demonstrate and add to the increasing body of evidence concerning the adverse effects of human‐induced vegetation change on bird diversity.
Benzoyl peroxide + chlorhexidine versus chlorhexidine alone skin preparation to reduce Propionibacterium acnes: a randomized controlled trial
Authors: Hancock Douglas S. , Rupasinghe Shavantha L. , Elkinson Ilia , Bloomfield Max G. , Larsen Peter D.
Published: October 2018

Background

Traditional skin preparation for shoulder surgery is not specific for Propionibacterium acnes. Topical benzoyl peroxide for 48 h preoperatively has been shown to reduce the bacterial load of P. acnes on the skin. Our aim was to investigate whether skin preparation with a single application of benzoyl peroxide combined with 2% chlorhexidine/alcohol immediately prior to surgery was superior to 2% chlorhexidine/alcohol alone at inhibiting P. acnes.

Methods

We conducted a single‐blinded interventional study. Each shoulder of the participant was assigned a different preparation through a randomization process. Two sites were assessed per shoulder. The intervention was the application of benzoyl peroxide followed by chlorhexidine/alcohol to the shoulder. The control was two applications of 2% chlorhexidine/alcohol. Superficial skin swabs for semi‐quantitative culture were taken pre‐ and post‐skin preparation.

Results

A total of 22 male participants were randomized. All participants were colonized with P. acnes on baseline swabs. We found complete inhibition of P. acnes at 14 days at 80% of sites prepared with benzoyl peroxide + chlorhexidine/alcohol compared with 86% inhibition at shoulder sites prepared with chlorhexidine alone.

Conclusion

There was no reduction in the growth of P. acnes over 14 days with chlorhexidine/alcohol and benzoyl peroxide compared with chlorhexidine alone. On the basis of these results, the addition of benzoyl peroxide at the time of surgery does not appear to increase the efficacy of the surgical preparation for inhibiting P. acnes growth.