bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization of 17 chaperone-usher fimbriae encoded by Proteus mirabilis reveals strong conservation
Authors: Kuan Lisa , Schaffer Jessica N. , Zouzias Christos D. , Pearson Melanie M.
Published: May 2014

Proteus mirabilis is a Gram-negative enteric bacterium that causes complicated urinary tract infections, particularly in patients with indwelling catheters. Sequencing of clinical isolate P. mirabilis HI4320 revealed the presence of 17 predicted chaperone-usher fimbrial operons. We classified these fimbriae into three groups by their genetic relationship to other chaperone-usher fimbriae. Sixteen of these fimbriae are encoded by all seven currently sequenced P. mirabilis genomes. The predicted protein sequence of the major structural subunit for 14 of these fimbriae was highly conserved (≥95 % identity), whereas three other structural subunits (Fim3A, UcaA and Fim6A) were variable. Further examination of 58 clinical isolates showed that 14 of the 17 predicted major structural subunit genes of the fimbriae were present in most strains (>85 %). Transcription of the predicted major structural subunit genes for all 17 fimbriae was measured under different culture conditions designed to mimic conditions in the urinary tract. The majority of the fimbrial genes were induced during stationary phase, static culture or colony growth when compared to exponential-phase aerated culture. Major structural subunit proteins for six of these fimbriae were detected using MS of proteins sheared from the surface of broth-cultured P. mirabilis, demonstrating that this organism may produce multiple fimbriae within a single culture. The high degree of conservation of P. mirabilis fimbriae stands in contrast to uropathogenic Escherichia coli and Salmonella enterica, which exhibit greater variability in their fimbrial repertoires. These findings suggest there may be evolutionary pressure for P. mirabilis to maintain a large fimbrial arsenal.
Prevalence of hepatitis E virus infection in West Bengal, India: a hospital-based study
Authors: Chandra Nidhi S. , Ojha Durbadal , Chatterjee Sanjoy , Chattopadhyay Debprasad
Published: May 2014

India is an endemic zone for hepatitis E virus (HEV), which is associated with both epidemic and sporadic infections. In West Bengal, only two hepatitis E outbreaks have been studied to date. However, sporadic cases of HEV infection also occur during inter-epidemic periods. The aim of this hospital-based study was to detect the prevalence of HEV infection in patients with acute sporadic hepatitis in West Bengal, India. Blood samples and clinical information were collected from 285 patients of both sexes and different ages with acute viral hepatitis (AVH) at Calcutta Medical College, Kolkata, a tertiary-care centre. Samples were tested for hepatitis B virus (HBV) surface antigen, anti-hepatitis C virus antibodies, anti-hepatitis A virus IgM and anti-HEV antibodies (IgM and IgG) by ELISA. Only those patients with AVH who were in their first week of illness and negative for all hepatotropic viral antibodies were tested for HEV RNA by reverse transcriptase nested PCR. HEV was identified as the most common cause of AVH (41.8 % of patients), followed by HBV (21.4 %), hepatitis A virus (17.2 %) and hepatitis C virus (4.6 %). Co-infections with more than one virus were found in 22 patients, with HBV–HEV the most common co-infection (3.8 %). Only 14.7 % of patients had no viral marker. To the best of our knowledge, this is the first documented epidemiological study of acute sporadic hepatitis with HEV in the state of West Bengal, India, indicating that this state is an endemic zone for HEV infection.
Temporal Dynamics of Growth and Photosynthesis Suppression in Response to Jasmonate Signaling
Authors: Attaran Elham , Major Ian T. , Cruz Jeffrey A. , Rosa Bruce A. , Koo Abraham J.K. , Chen Jin , Kramer David M. , He Sheng Yang , Howe Gregg A.
Published: May 2014

Biotic stress constrains plant productivity in natural and agricultural ecosystems. Repression of photosynthetic genes is a conserved plant response to biotic attack, but how this transcriptional reprogramming is linked to changes in photosynthesis and the transition from growth- to defense-oriented metabolism is poorly understood. Here, we used a combination of noninvasive chlorophyll fluorescence imaging technology and RNA sequencing to determine the effect of the defense hormone jasmonate (JA) on the growth, photosynthetic efficiency, and gene expression of Arabidopsis (Arabidopsis thaliana) rosette leaves. High temporal resolution was achieved through treatment with coronatine (COR), a high-affinity agonist of the JA receptor. We show that leaf growth is rapidly arrested after COR treatment and that this effect is tightly correlated with changes in the expression of genes involved in growth, photosynthesis, and defense. Rapid COR-induced expression of defense genes occurred concomitantly with the repression of photosynthetic genes but was not associated with a reduced quantum efficiency of photosystem II. These findings support the view that photosynthetic capacity is maintained during the period in which stress-induced JA signaling redirects metabolism from growth to defense. Chlorophyll fluorescence images captured in a multiscale time series, however, revealed a transient COR-induced decrease in quantum efficiency of photosystem II at dawn of the day after treatment. Physiological studies suggest that this response results from delayed stomatal opening at the night-day transition. These collective results establish a high-resolution temporal view of how a major stress response pathway modulates plant growth and photosynthesis and highlight the utility of chlorophyll fluorescence imaging for revealing transient stress-induced perturbations in photosynthetic performance.
Plastidial Expression of Type II NAD(P)H Dehydrogenase Increases the Reducing State of Plastoquinones and Hydrogen Photoproduction Rate by the Indirect Pathway in Chlamydomonas reinhardtii
Authors: Baltz Anthony , Dang Kieu-Van , Beyly Audrey , Auroy Pascaline , Richaud Pierre , Cournac Laurent , Peltier Gilles
Published: May 2014

Biological conversion of solar energy into hydrogen is naturally realized by some microalgae species due to a coupling between the photosynthetic electron transport chain and a plastidial hydrogenase. While promising for the production of clean and sustainable hydrogen, this process requires improvement to be economically viable. Two pathways, called direct and indirect photoproduction, lead to sustained hydrogen production in sulfur-deprived Chlamydomonas reinhardtii cultures. The indirect pathway allows an efficient time-based separation of O2 and H2 production, thus overcoming the O2 sensitivity of the hydrogenase, but its activity is low. With the aim of identifying the limiting step of hydrogen production, we succeeded in overexpressing the plastidial type II NAD(P)H dehydrogenase (NDA2). We report that transplastomic strains overexpressing NDA2 show an increased activity of nonphotochemical reduction of plastoquinones (PQs). While hydrogen production by the direct pathway, involving the linear electron flow from photosystem II to photosystem I, was not affected by NDA2 overexpression, the rate of hydrogen production by the indirect pathway was increased in conditions, such as nutrient limitation, where soluble electron donors are not limiting. An increased intracellular starch was observed in response to nutrient deprivation in strains overexpressing NDA2. It is concluded that activity of the indirect pathway is limited by the nonphotochemical reduction of PQs, either by the pool size of soluble electron donors or by the PQ-reducing activity of NDA2 in nutrient-limited conditions. We discuss these data in relation to limitations and biotechnological improvement of hydrogen photoproduction in microalgae.
The Ethylene Receptors ETHYLENE RESPONSE1 and ETHYLENE RESPONSE2 Have Contrasting Roles in Seed Germination of Arabidopsis during Salt Stress
Authors: Wilson Rebecca L. , Kim Heejung , Bakshi Arkadipta , Binder Brad M.
Published: May 2014

In Arabidopsis (Arabidopsis thaliana), ethylene responses are mediated by a family of five receptors that have both overlapping and nonoverlapping roles. In this study, we used loss-of-function mutants for each receptor isoform to determine the role of individual isoforms in seed germination under salt stress. From this analysis, we found subfunctionalization of the receptors in the control of seed germination during salt stress. Specifically, loss of ETHYLENE RESPONSE1 (ETR1) or ETHYLENE INSENSITIVE4 (EIN4) leads to accelerated germination, loss of ETR2 delays germination, and loss of either ETHYLENE RESPONSE SENSOR1 (ERS1) or ERS2 has no measurable effect on germination. Epistasis analysis indicates that ETR1 and EIN4 function additively with ETR2 to control this trait. Interestingly, regulation of germination by ETR1 requires the full-length receptor. The differences in germination between etr1 and etr2 loss-of-function mutants under salt stress could not be explained by differences in the production of or sensitivity to ethylene, gibberellin, or cytokinin. Instead, etr1 loss-of-function mutants have reduced sensitivity to abscisic acid (ABA) and germinate earlier than the wild type, whereas etr2 loss-of-function mutants have increased sensitivity to ABA and germinate slower than the wild type. Additionally, the differences in seed germination on salt between the two mutants and the wild type are eliminated by the ABA biosynthetic inhibitor norflurazon. These data suggest that ETR1 and ETR2 have roles independent of ethylene signaling that affect ABA signaling and result in altered germination during salt stress.
Hard X-ray nanotomography beamline 7C XNI at PLS-II
Authors: Lim Jun , Kim Hyounggyu , Park So Yeong
Published: May 2014

The synchrotron-based hard X-ray nanotomography beamline, named 7C X-ray Nano Imaging (XNI), was recently established at Pohang Light Source II. This beamline was constructed primarily for full-field imaging of the inner structures of biological and material samples. The beamline normally provides 46 nm resolution for still images and 100 nm resolution for tomographic images, with a 40 µm field of view. Additionally, for large-scale application, it is capable of a 110 µm field of view with an intermediate resolution.
Tracking extended mucociliary transport activity of individual deposited particles: longitudinal synchrotron X-ray imaging in live mice
Authors: Donnelley Martin , Morgan Kaye S. , Siu Karen K. W. , Fouras Andreas , Farrow Nigel R. , Carnibella Richard P. , Parsons David W.
Published: May 2014

To assess potential therapies for respiratory diseases in which mucociliary transit (MCT) is impaired, such as cystic fibrosis and primary ciliary dyskinesia, a novel and non-invasive MCT quantification method has been developed in which the transit rate and behaviour of individual micrometre-sized deposited particles are measured in live mice using synchrotron phase-contrast X-ray imaging. Particle clearance by MCT is known to be a two-phase process that occurs over a period of minutes to days. Previous studies have assessed MCT in the fast-clearance phase, ∼20 min after marker particle dosing. The aim of this study was to non-invasively image changes in particle presence and MCT during the slow-clearance phase, and simultaneously determine whether repeat synchrotron X-ray imaging of mice was feasible over periods of 3, 9 and 25 h. All mice tolerated the repeat imaging procedure with no adverse effects. Quantitative image analysis revealed that the particle MCT rate and the number of particles present in the airway both decreased with time. This study successfully demonstrated for the first time that longitudinal synchrotron X-ray imaging studies are possible in live small animals, provided appropriate animal handling techniques are used and care is taken to reduce the delivered radiation dose.
Analyzing energy‐efficient configurations in hexapod robots for demining applications
Authors: Sanz‐Merodio D. , Garcia E. , Gonzalez‐de‐Santos P.
Published: May 2014

Purpose

Reducing energy consumption in walking robots is an issue of great importance in field applications such as humanitarian demining so as to increase mission time for a given power supply. The purpose of this paper is to address the problem of improving energy efficiency in statically stable walking machines by comparing two leg, insect and mammal, configurations on the hexapod robotic platform SILO6.

Design/methodology/approach

Dynamic simulation of this hexapod is used to develop a set of rules that optimize energy expenditure in both configurations. Later, through a theoretical analysis of energy consumption and experimental measurements in the real platform SILO6, a configuration is chosen.

Findings

It is widely accepted that the mammal configuration in statically stable walking machines is better for supporting high loads, while the insect configuration is considered to be better for improving mobility. However, taking into account the leg dynamics and not only the body weight, different results are obtained. In a mammal configuration, supporting body weight accounts for 5 per cent of power consumption while leg dynamics accounts for 31 per cent.

Originality/value

As this paper demonstrates, the energy expended when the robot walks along a straight and horizontal line is the same for both insect and mammal configurations, while power consumption during crab walking in an insect configuration exceeds power consumption in the mammal configuration.
Control system design for heavy duty industrial robot
Authors: You Wei , Kong Minxiu , Sun Lining , Diao Yanbin
Published: May 2014

Purpose

The purpose of this paper is to present a control system for a heavy duty industrial robot, including both the control structure and algorithm, which was designed and tested.

Design/methodology/approach

An industrial PC with TwinCAT real‐time system is chosen as the motion control unit; EtherCAT is used for command transmission. The whole system has a decoupled and centralized control structure. A novel optimal motion generation algorithm based on modified cubic spline interpolation is illustrated. The execution time and work were chosen as the objective function. The constraints are the limits of torque, velocity and jerk. The motion commands were smooth enough throughout the execution period. By using the Lagangue equation and assumed modes methods, a dynamic model of heavy duty industrial robots is built considering the elastic of both joints and links. After that a compound control algorithm based on singular perturbation theory was designed for the servo control loop.

Findings

The final experimental results showed that the control commands and algorithms could easily be calculated and transmitted in one sample unit. Both the motion generation and servo control algorithm greatly improved the control performance of the robot.

Research limitations/implications

All parts of the control algorithm can be computed on‐line except the optimal motion generation part. The motion generation part is time consuming (about 2.5 seconds), which can only be performed off‐line. Hence future work will focus on improving the efficiency of this algorithm; therefore it could be performed online, increasing the robot's overall robustness and adaptability.

Originality/value

Aiming at the internal and external causes that limit the dynamic performance of heavy duty industrial robots, this paper proposes a realizable scheme of control system and includes both the control structure and algorithms. A novel optimal motion generation algorithm is presented.
Improving the capability of a redundant robotic cell for cast parts finishing
Authors: Sabourin Laurent , Robin Vincent , Gogu Grigore , Fauconnier Jean‐Michel
Published: May 2014

Purpose

Precision aluminium moulding makes possible the production of large‐size, complex and high‐technology cast parts. However, industrial requirements linked to economic and safety reasons call into question the manual performance of finishing operations. The purpose of this paper is to enhance industrial robot applications by using vision and redundancy optimization to improve their capability.

Design/methodology/approach

After having presented the concepts associated with machine and kinematics capability, the paper first describes the finishing constraints related to the process and the study of inaccuracy factors. Adjusting the trajectory by vision minimizes some inaccuracy factors but does not take into account the structure loading. Therefore, the authors present the optimization, kinematics and precision criteria as well as the multi‐objective method developed by integrating the loading aspect. This method has been verified by simulation and the results validated on industrial parts.

Findings

The paper presents an improvement in machine capacities based on redundancy and an optical 3D measurement system. It develops the strategies, sensors and cell architecture to perform finishing operations.

Research limitations/implications

The finishing of high‐technology structural cast parts requires the completion of the machining and polishing processes adapted to each part. The choice was made to develop a robotic cell dedicated to integrating specific features, in contrast to machine tools.

Practical implications

This study was carried out within the framework of the Eureka SANDCAST project in cooperation with the Alcan group, specialized in high‐technology moulded aluminum parts.

Originality/value

The paper presents an approach to robotic cell capability improvement. The robotic cell is dedicated to finishing operations, by machining and polishing large cast aluminum parts; the objectives are to improve machine capability and kinematics capacity with vision and redundancy management.
A multi‐phase systematic framework for performance appraisal of architectural design studio facilities
Authors: Hassanain Mohammad A. , Alhaji Mohammed Mohammed , Cetin Murat
Published: May 2014

Purpose

The objectives of this paper are to present the development of an indicative multi‐phase systematic framework for performance appraisal of architectural design studio facilities, and to present the findings of the post‐occupancy conditions of an architectural design studio facility as a case study to demonstrate the applicability of the developed framework.

Design/methodology/approach

The authors carried out a number of activities. These include reviewing the published literature to address the significance of the architectural design studio as a resource for students majoring in architectural design, and ascertaining the significance of post‐occupancy evaluation as a performance appraisal methodology in educational facilities. On the development of the proposed framework, the authors carried out a case study in one of the studios of the Architecture Department at King Fahd University of Petroleum and Minerals, Dhahran, Saudi Arabia. The authors utilized a series of data collection methods, including photographic documentation, observations through walkthrough inspection, questionnaires and interviews.

Findings

The developed framework consists of four phases. It entails identifying the performance requirements of the architectural design studio; collecting data – through conducting walkthrough inspection, questionnaire survey and interviews – to ascertain the present performance level of the architectural design studio; analyzing the data gathered from the preceding steps and subsequent reporting of findings on the degree of user satisfaction with the architectural design studio space and facilities; and developing a plan of actions in the form of recommendations to improve the conditions of the evaluated design studio. The case study served as a validation of the developed performance appraisal framework.

Originality/value

The architectural design studio is known to be the place where students majoring in architectural design generate, review and display their design projects. Previous research on the performance appraisal of educational facilities indicates that the comfort of the architectural design studio space is a significant aspect to be considered and maintained for the success of the architectural education process. The paper provides a systematic approach for evaluating the major performance requirements of an architectural design studio. It is of practical value to space planners, design professionals, facility managers and administrators involved in the planning, design, operation and management of such facilities.
Making change happen: recollections of a systems professional
Authors: Schwaninger Markus
Published: May 2014

Purpose

The purpose of this paper is to demonstrate the potential of making the systems approach fertile for the future of our world(s).

Design/methodology/approach

Underpinned by a significant case study, the idea of the paper is to show how a systems study changed the basis for deciding on an incisive interference planned for a lovely alpine valley. The study builds on a qualitative conceptual model and reverts to a quantitative, system‐dynamics simulation model, as well as standard economic evaluation methods. The decision process is explained with its outcomes and implications.

Findings

The study found, among others, the following concrete result: The optimal variant (Case B) required an additional investment for its realization. According to the calculations that were carried out, the period needed for the amortization of the pertinent amount was found to be no more than 0.9 to 1.6 years. It became clear that the most expensive variant was indeed a very good business proposition for the Austrian Republic.

Practical implications

The results of the study were integrated into the General Traffic Plan of the Austrian Ministry of Transportation, Innovation and Technology, i.e. the study's conclusions obtained legal status. This meant a shift toward a long‐term orientation. In addition, new insights for the realization of similar studies and interventions were gained.

Originality/value

The study described in the paper shows both rigor and relevance. It illuminates a methodology that combines the qualitative and the quantitative, as well as careful analysis and powerful synthesis. Beyond the methods and procedures used in the inquiry, its outcomes and impact on the concrete system under study are demonstrated.
“At scale” author name matching with Hadoop/MapReduce
Authors: Powell James , Collins Linn , Eberhardt Ariane , Izraelevitz David , Roman Jorge , Dufresne Thomas , Scott Mark , Blake Miriam , Grider Gary
Published: May 2014

Purpose

The purpose of this paper is to describe a process for extracting and matching author names from large collections of bibliographic metadata using the Hadoop implementation of MapReduce. It considers the challenges and risks associated with name matching on such a large‐scale and proposes simple matching heuristics for the reduce process. The resulting semantic graphs of authors link names to publications, and include additional features such as phonetic representations of author last names. The authors believe that this achieves an appropriate level of matching at scale, and enables further matching to be performed with graph analysis tools.

Design/methodology/approach

A topically‐focused collection of metadata records describing peer‐reviewed papers was generated based upon a search. The matching records were harvested and stored in the Hadoop Distributed File System (HDFS) for processing by hadoop. A MapReduce job was written to perform coarse‐grain author name matching, and multiple papers were matched with authors when the names were very similar or identical. Semantic graphs were generated so that the graphs could be analyzed to perform finer grained matching, for example by using other metadata such as subject headings.

Findings

When performing author name matching at scale using MapReduce, the heuristics that determine whether names match should be limited to the rules that yield the most reliable results for matching. Bad rules will result in lots of errors, at scale. MapReduce can also be used to generate or extract other data that might help resolve similar names when stricter rules fail to do so. The authors also found that matching is more reliable within a well‐defined topic domain.

Originality/value

Libraries have some of the same big data challenges as are found in data‐driven science. Big data tools such as hadoop can be used to explore large metadata collections, and these collections can be used as surrogates for other real world, big data problems. MapReduce activities need to be appropriately scoped so as to yield good results, while keeping an eye out for problems in code which can be magnified in the output from a MapReduce job.
Job search on the internet and its outcome
Authors: Suvankulov Farrukh , Chi Keung Lau Marco , Ho Chi Chau Frankie
Published: May 2014

Purpose

This paper aims to estimate the impact of job search on the internet on the probability of re‐employment and the duration of unemployment spells.

Design/methodology/approach

The study uses national panel datasets from Germany (SOEP 2003‐2007) and South Korea (KLIPS 1996‐2006) to estimate probit and Hausman‐Taylor IV models of the impact of job search on the internet on the probability of re‐employment. The study also explores duration analysis with the aim of estimating the impact of internet job search on the duration of unemployment.

Findings

In Germany and South Korea job seekers who used the internet had a 7.1 and 12.7 percentage point higher probability, respectively, of being re‐employed in the next 12 months. Furthermore, job seekers who used the internet had a shorter duration of unemployment in both Germany and South Korea.

Practical implications

Over the past decade, internet penetration rates and use of the internet in job search have risen sharply across the world. The internet has significantly changed the job application process and improved the channels of communication between employers and job seekers. The findings of the research indicate that the internet is beneficial and should be a part of job search efforts.

Originality/value

The contribution of this study is twofold. It is the first study to use panel datasets to analyze the link between internet use and job search outcomes. Therefore, the results are robust to unobserved heterogeneity problems. The study also addresses the issue of endogeneity of job search on the internet by using the Hausman‐Taylor IV model.
Factor analysis of partners' commitment to risk management in public‐private partnership projects
Authors: Jin Xiao‐Hua , Zhang Guomin , Yang Rebecca J.
Published: May 2014

Purpose

The purpose of this paper is to investigate and uncover key determinants that could explain partners' commitment to risk management in public‐private partnership projects so that partners' risk management commitment is taken into the consideration of optimal risk allocation strategies.

Design/methodology/approach

Based on an extensive literature review and an examination of the purchasing power parity (PPP) market, an industry‐wide questionnaire survey was conducted to collect the data for a confirmatory factor analysis. Necessary statistical tests are conducted to ensure the validity of the analysis results.

Findings

The factor analysis results show that the procedure of confirmatory factor analysis is statistically appropriate and satisfactory. As a result, partners' organizational commitment to risk management in public‐private partnerships can now be determined by a set of components, namely general attitude to a risk, perceived one's own ability to manage a risk, and the perceived reward for bearing a risk.

Practical implications

It is recommended, based on the empirical results shown in this paper, that, in addition to partners' risk management capability, decision‐makers, both from public and private sectors, should also seriously consider partners' risk management commitment. Both factors influence the formation of optimal risk allocation strategies, either by their individual or interacting effects. Future research may therefore explore how to form optimal risk allocation strategies by integrating organizational capability and commitment, the determinants and measurement of which have been established in this study.

Originality/value

This paper makes an original contribution to the general body of knowledge on risk allocation in large‐scale infrastructure projects in Australia adopting the procurement method of public‐private partnership. In particular, this paper has innovatively established a measurement model of organisational commitment to risk management, which is crucial to determining optimal risk allocation strategies and in turn achieving project success. The score coefficients of all obtained components can be used to construct components by linear combination so that commitment to risk management can be measured. Previous research has barely focused on this topic.
Fending knights or masked kings: toward a theoretical framework of interim CEO succession
Authors: Liang Xin , Liu Yanxin , Wu Sibin , Zhang Shujuan
Published: May 2014

Purpose

There is no previous systematic and theoretical investigation of the interim CEO succession practice. This research attempts to fill the gap by studying this phenomenon and hence advance executive succession research/practice.

Design/methodology/approach

Based on agency theory, the authors propose a model and several propositions to predict what determines the origin of interim CEOs, the length of the interim tenure, and the career prospects for the interim CEO after the interim tenure.

Findings

Both firm performance and environmental uncertainty play an important role in the dynamic interim CEO succession process.

Research limitations/implications

The paper provides the foundations for future empirical research on interim CEO succession.

Practical implications

Board members at companies experiencing sudden CEO departures should choose a loyal non‐aggressive veteran to be the interim CEO so as to minimize disruption and to smooth the transition. They should use caution when choosing an internal candidate because if such a candidate is not chosen to be the permanent CEO later, a talent may be lost.

Originality/value

The research is the first to systematically examine the phenomenon of interim CEOs. The authors make a unique contribution to the literature on CEO succession.
A systems perspective on nursing productivity
Authors: North Nicola , Hughes Frances
Published: May 2014

Purpose

Recent New Zealand reports have identified the nursing workforce for its potential to make a significant contribution to increased productivity in health services. The purpose of this paper is to review critically the recent and current labour approaches to improve nursing productivity in New Zealand, in a context of international research and experience.

Design/methodology/approach

An examination of government documents regarding productivity, and a review of New Zealand and international literature and research on nursing productivity and its measurement form the basis of the paper.

Findings

It is found that productivity improvement strategies are influenced by theories of labour economics and scientific management that conceptualise a nurse as a labour unit and a cost to the organisation. Nursing productivity rose significantly with the health reforms of the 1990s that reduced nursing input costs but impacts on patient safety and nurses were negative. Current approaches to increasing nursing productivity, including the “productive ward” and reconfiguration of nursing teams, also draw on manufacturing innovations. Emerging thinking considers productivity in the context of the work environment and changing professional roles, and proposes reconceptualising the nurse as an intellectual asset to knowledge‐intensive health organisations.

Practical implications

Strategies that take a systems approach to nursing productivity, that view nursing as a capital asset, that focus on the interface between nurse and working environment and measure patient and nurse outcomes are advocated.

Originality/value

The paper shows that reframing nursing productivity brings into focus management strategies to raise productivity while protecting nursing and patient outcomes.
Implementing organisation and management innovations in Swedish healthcare
Authors: Øvretveit John , Andreen‐Sachs Magna , Carlsson Jan , Gustafsson Helena , Hansson Johan , Keller Christina , Lofgren Susana , Mazzocato Pamela , Tolf Sara , Brommels Mats
Published: May 2014

Purpose

The purpose of this paper is to compare the implementation of 12 different organisation and management innovations (OMIs) in Swedish healthcare, to discover the generic and specific factors important for successful healthcare improvement change in a public health system.

Design/methodology/approach

Longitudinal cross‐case comparison of 12 case studies was employed, where each case study used a common framework for collecting data about the process of change, the content of the change, the context, and the intermediate and final outcomes.

Findings

Clinical leaders played a more important part in the development of these successful service innovations than managers. Strategies for and patterns of change implementation were found to differ according to the type of innovation. Internal organisational context factors played a significant role in the development of nearly all, but external factors did not. “Developmental evolution” better described the change process than “implementation”.

Research limitations/implications

The 12 cases were all of relatively successful change processes: some unsuccessful examples would have provided additional testing of the hypotheses about what would predict successful innovation which were used in the case comparison. The cross‐case comparative hypothesis testing method allows systematic comparison if the case data are collected using similar frameworks, but this approach to management research requires considerable resources and coordination.

Practical implications

Management innovations that improve patient care can be carried out successfully by senior clinicians, under certain circumstances. A systematic approach is important both for developing and adapting an innovation to a changing situation. A significant amount of time was required for all involved, which could be reduced by “fast‐tracking” approval for some types of change.

Originality/value

This is the first empirical report comparing longitudinal and contextualised findings from a number of case studies of different organisational and management healthcare innovations. The findings made possible explanations for success factors and useful practical recommendations for conditions needed to nurture such innovation in public healthcare.
Managing in the context of healthcare's escalating technology and evolving culture
Authors: Bowden Dawn E. , Smits Stanley J.
Published: May 2014

Purpose

As healthcare has become more scientifically based and far more sophisticated in terms of technology, it has become more fragmented in terms of care‐giving, and less personal. The purpose of this paper is to discuss the challenging task of leading and managing in the gap between the existing and emerging cultures of healthcare.

Design/methodology/approach

This paper considers the literature on culture, how it exists at many levels and in multiple forms, and the impacts it has on the US healthcare system. Further, the paper explores foundations of the current healthcare culture and attempts to forecast features of the emerging culture, incorporating examples of advances in scientific knowledge and technology.

Findings

System change will continue to be problematic until leaders and change agents find ways to operate effectively in the gap between the existing cultural tenets and those emerging as the result of scientific and technological advancements.

Originality/value

Punctuated equilibrium theory serves as a main tenet for describing how changes will continue to push the USA towards a cultural tipping point. This paper contends that leaders and managers can succeed only by understanding and respecting both cultures and calls for improved theory development and research to help find creative ways to advance the new culture without trampling the old.
Social values and health priority setting in Germany
Authors: Kieslich Katharina
Published: May 2014

Purpose

The purpose of this paper is to provide an overview of health priority setting structures in Germany. It reflects on how and which social values may influence decision making, and in particular investigates the role of the Institute for Quality and Efficiency in Health Care (IQWiG) in integrating evidence‐based decision making into the German system.

Design/methodology/approach

The paper applies Clark and Weale's framework of analysis for Social Values and Health Priority Setting to the German context. Placing German health care decision making into Clark and Weale's framework allows for an analysis of the role and content of social values in different dimensions of decision making.

Findings

Germany has witnessed significant changes in its health care decision‐making procedures in recent decades. The establishment of the Institute of Quality and Efficiency in Health Care (IQWiG) represents an effort to introduce health technology assessment (HTA) as a formal element of decision making in health care. In doing so, Germany has made unique methodological and structural choices that reflect the social values and institutional traditions that underpin its self‐governing statutory health insurance (SHI) system. The empirical evidence suggests that the principle of solidarity is upheld as a core value in health priority setting in Germany.

Originality/value

The German case of health priority setting highlights some of the challenges involved when introducing centralised HTA structures to a self‐governing SHI system. As such, this paper contributes to an understanding of the different forms that HTA can take, what social values they embody and how they can affect health priority setting in different ways.
The Value of Model Programmes in Mental Health Promotion and Mental Disorder Prevention
Authors: Hosman Clemens , Claire M. , Engels L.
Published: May 2014

This article discusses the state of the art concerning the meaning and value of model programmes in mental health promotion and mental disorder prevention. Model programmes are considered an important instrument for improving the quality, social impact and cost‐effectiveness of promotion and prevention. However, there is a lack of conceptual clarity and insight in the processes and mechanisms for successful use of model programmes in this field. This article offers a further clarification of the concept of model programmes and discusses its pros and cons and current views on the process of programme development and programme use. The discussion will be based particularly on recent experiences with model programmes in Europe. Until recently, prevention research was directed mainly at the design and testing of new model programmes. However, successful use of the ‘model programme strategy’ requires more attention to the pre‐conditions for effective dissemination, adoption and implementation of model programmes. Only when this multi‐phased process is taken into account and the required pre‐conditions and quality criteria are specified can one expect that model programmes will be more effective at a community level. The consequences of this view for prevention science and prevention research policies are discussed. To implement such a multi‐phased process successfully, not only are conceptual clarity and a scientific underpinning crucial, but also collaborative organisational structures are needed at national and international level if the range of complementary tasks is to be executed effectively and efficiently.
An outcomes study of eTherapy for dual diagnosis using Breaking Free Online
Authors: Elison Sarah , Ward Jonathan , Davies Glyn , Lidbetter Nicky , Hulme Daniel , Dagley Mike
Published: May 2014

Purpose

– In recent years there has been a proliferation of computer-based psychotherapeutic interventions for common mental health difficulties. Building on this, a small number of such interventions have now been developed to address substance dependence, one of which is Breaking Free Online (BFO). A new “eTherapy” self-help service, which was set up by the UK mental health charity Self-Help Services, has provided access to BFO to service users presenting with comorbid mental health and substance misuse difficulties. The purpose of this paper is to evaluate a range of clinical outcomes in the first cohort of service users accessing this dual diagnosis service.

Design/methodology/approach

– A number of standardised psychometric assessments were conducted with service users at baseline and post-treatment at discharge from the service. Outcome data were available for 47 service users out of an original cohort of 74.

Findings

– Statistically significant improvements were found in terms of measures of social functioning, depression, anxiety, alcohol and drug use and social anxiety. Clinically relevant gains were also identified, with fewer service users reaching threshold scores for depression and anxiety at post-treatment compared to baseline. Effect sizes also indicated that the identified improvements across the psychometric measures were robust and significant.

Research limitations/implications

– These findings provide further support for the clinical effectiveness of BFO, and also provide evidence that an eTherapy self-help service may be appropriate for some individuals presenting with dual diagnosis. Further research is underway with larger and alternative clinical populations to examine the effectiveness of BFO and also this novel eTherapy self-help approach.

Originality/value

– This paper has provided initial data to support effectiveness of a novel eTherapy service for dual diagnosis.
Developing indicators to improve educational governance in hospitals
Authors: Sadegh Tabrizi Jafar , Saadati Mohammad , Sadeghi-Bazargani Homayoun , Ebadi Ali , E.J. Golzari Samad
Published: May 2014

Purpose

– Clinical governance should be based on cultural elements that value lifelong learning, skill development and research. The purpose of this paper is to introduce a set of indicators to improve educational governance in hospitals.

Design/methodology/approach

– Key indicators were identified from the international and national literatures. Later, the indicators were rated and prioritized by a multidisciplinary panel of medical professionals using two rounds of Delphi technique. Subsequently at two consensus meetings, the panel evaluated the indicators.

Findings

– A set of 51 draft indicators were identified. The expert panel members rated 28 indicators as high priority indicators for measuring educational performance of the hospitals.

Practical implications

– This set of indicators can be used to measure the educational performance of the hospitals in identifying the gaps and take steps to resolve them.

Originality/value

– Education and training is the basic component of clinical governance. Hospital staff education and training is a fundamental step towards organizational and individual development. To improve the educational performance at hospital level it is necessary to reliably measure such performance. This can be done through developing and using relevant indicators. There are limited systematic studies, especially in middle and low income countries, to introduce appropriate indicators. This study has investigated developing a set of indicators to measure and improve the educational performance in hospitals.
Nurse led discharge: improving efficiency, safely
Authors: Bowen Alex , Kumar Rohit , Howard John , E. Camilleri Andrew
Published: May 2014

Purpose

– The purpose of this paper is to demonstrate that nurse led discharge (NLD) could improve the efficiency of simple discharges from a short stay surgical ward without compromising patient safety.

Design/methodology/approach

– A protocol for NLD was designed and implemented. Introduction of the protocol was audited and re-audited prospectively.

Findings

– Introduction of the nurse led discharge protocol significantly reduced the rate of delayed discharge (p>0.001). The protocol successfully identified all patients for whom a NLD would be inappropriate and no patients discharged by the nursing team were re-admitted.

Research limitations/implications

– No formal measure of staff and patient satisfaction with the new protocol was performed.

Practical implications

– The nursing team are now able to more effectively manage patient flow through the short stay surgical ward. Mismatch between demand for beds and capacity has reduced.

Social implications

– Patient experience has been improved by the release of time to care for our nurses and the elimination of unnecessary delay in discharge.

Originality/value

– Formal protocol driven NLD can be a safe way of improving efficiency in patient flow. This pattern of discharge could be applied in many hospital systems.
Law as a tool to promote healthcare safety
Authors: Ramanathan Tara
Published: May 2014

Purpose

– The purpose of this paper is to inform healthcare providers and healthcare facility leadership about the statutory, administrative, criminal, and tort law implications related to preventable harms from unsafe injection practices.

Design/methodology/approach

– Review of legal theory and precedents.

Findings

– The law can address disputes over unsafe injection practices in a variety of ways. Administrative agencies may hold a provider or facility responsible for preventable harms according to specific statutory and regulatory provisions governing licensure. State courts can compensate victims of certain actions or inactions based on tort law, where a breach of a legal duty caused damages. Prosecutors and the public can turn to criminal law to punish defendants and deter future actions that result in disability or death.

Research limitations/implications

– The state law findings in this review are limited to legal provisions and court cases that are available on searchable databases. Due to the nature of this topic, many cases are settled out of court, and those records are sealed from the public and not available for review.

Practical implications

– Preventable harm continues to occur from unsafe injection practices. These practices pose a significant risk of disease or even death for patients and could result in legal repercussions for healthcare providers and facility leadership.

Originality/value

– This article reviews emerging law and potential legal implications for health care and public health related to unsafe medical practices related to needle, syringe, and vial use.