bluuebunny/crossref_metadata_2025 huggingface dataset:
Challenges and opportunities for the development and promotion of Ibaloy crafts as tourism products
Authors: Ona Jamaica Gayatin , Solis Leticia Susan Lagmay
Published: September 2017

Purpose

The Ibaloy is an indigenous ethnic group in the Northern Philippines. Due to modernization, changes in lifestyle, livelihood and spiritual inclination many have forgotten about their culture. Income-generating activities such as handicraft businesses and food security are among their needs and aspirations. With the potential that indigenous entrepreneurship has in improving their cultural and economic status, this study aims to identify which crafts in their material culture can be publicly shared as tourism products and to assess the landscape within which indigenous entrepreneurship can be undertaken.

Design/methodology/approach

The study utilized a qualitative methodology which involved a combination of participant observation and semi-structured interviews. An interview guide which consisted of open-ended questions that focused on themes such as identification of Ibaloy crafts, the crafts’ various categorization and significance, the challenges and opportunities and their perceptions on what they want done for their crafts and material culture in general was developed for this purpose. The primary respondents were the Ibaloys themselves and other key informants from government and other stakeholders.

Findings

Other than serving their purpose in an Ibaloy household and as objects used for special occasions, Ibaloy crafts have the potential to be developed as tourism products. While many challenges abound, availability of resources and collaborative support by the government and other institutions can bring opportunities that will lead Ibaloy crafts to become prime tourism products.

Social implications

The findings point to a compelling need for policymakers and concerned authorities to take immediate action to ensure the culture and heritage of the Ibaloys are protected.

Originality/value

The study adds to the literature about Filipino indigenous peoples, particularly the Ibaloys of Cordillera, and their aspirations for the inclusion of their material culture to the tourism industry. It can serve as a guide in addressing issues and concerns related to indigenous entrepreneurship that may be addressed through policy intervention and support from stakeholders.
The clinical governance of multidisciplinary care
Authors: Pearson Ben
Published: September 2017

Purpose

Providers of health and social care services aim to deliver personalised care that is safe, effective, caring, responsive and well led. Multidisciplinary teams often have to work together, either within or across multiple provider organisations in order to achieve this aim. It is valuable to have a framework of clinical governance for such circumstances that enables a shared assurance of quality. To achieve these aims, the purpose of this paper is to present a clinical governance matrix framework developed by the author’s experiences in clinical practice, in service change and in management and leadership.

Design/methodology/approach

There are seven pillars of clinical governance; patient and public involvement, staffing and staff management, clinical effectiveness and research, using information and IT, education and training, risk management and audit. These seven pillars of clinical governance can be mapped against the five quality domains of safe, effective, caring, responsive and well led to create a matrix that in turn describes the framework we need for quality assurance.

Findings

The matrix is populated with outcome measures and these are monitored to achieve balance across the framework. The tool can be used at the level of an individual practitioner all the way up to multiple organisations in collaboration. The detail in each cell of the matrix will change accordingly and critically should be developed and owned by the subject of the framework.

Originality/value

This clinical governance matrix is presented as a methodology to monitor quality assurance in the settings of health and social care.
Sustainability-related risk management in buying logistics services
Authors: Multaharju Sirpa , Lintukangas Katrina , Hallikas Jukka , Kähkönen Anni-Kaisa
Published: September 2017

Purpose

Sustainability-related risk management of logistics service providers (LSPs) is an essential part of sustainability performance of focal companies, as logistics services touch the entire supply chain (SC) – from raw material sources to end-customers. The purpose of this paper, draws on resource-based view and stakeholder theory in exploring how companies can manage environmental and social sustainability-related risks from logistics service suppliers. This kind of capability is essential in order to maintain reputation in the eyes of stakeholders, and to maintain long-term financial performance.

Design/methodology/approach

The data of this multiple-case study were collected from semi-structured interviews in eight case-companies in Finland. Five of the cases are primary logistics buyers, and three represent LSP companies.

Findings

The cross-case analysis showed that primary buyers of logistics services use their sustainability criteria as a prerequisite for LSP candidates, and when the level is adequate and equal, other factors, e.g. price and capacity, are decisive. Based on the analysis, large LSPs are preparing for the future competition, and act in a more sustainable manner than their customers (buyers) expect at the moment, while small LSPs strictly comply with the regulation. However, buyers’ requirements for sustainable logistics services are increasing as the stakeholder expectations for comprehensively sustainable SCs are growing.

Originality/value

Only little research has been conducted on sustainable logistics from the buyer company’s risk management perspective. This paper adds the knowledge of sustainability-related risk management in purchasing of logistics services and in the logistics industry.
Buyer and supplier perspectives on environmental initiatives
Authors: Murfield Monique Lynn , Tate Wendy L.
Published: September 2017

Purpose

The purpose of this paper is to examine managerial perspectives in both buyer and supplier firms implementing environmental initiatives in their supply chains, and explore the impact of environmental initiatives on buyer-supplier relationships.

Design/methodology/approach

A qualitative, grounded theory approach is used as the methodological approach to this research, including 15 in-depth interviews with managers from buyer and supplier firms implementing environmental initiatives in their supply chains to gain multiple perspectives of the buyer-supplier relationships.

Findings

The results suggest that implementing environmental initiatives within the supply chain changes the buyer-supplier relationship from transactional to collaborative, shifting from a commodity-focused purchase to a more strategic purchase as environmental initiatives are implemented.

Research limitations/implications

Although both buyer and supplier perspectives were considered, matched dyads were not used; researchers should continue to provide a holistic perspective of the phenomenon with dyadic data. Additionally, the use of a qualitative research approach suggests a lack of generalizability of results, and therefore researchers should further test the propositions.

Practical implications

Implementing environmental initiatives within the supply chain may require different approaches to supply management and development for long-term success. Suppliers should recognize that the capability to implement environmental initiatives with their customers is a differentiator. The nuances involved in managing the implementation of environmental initiatives between firms can be better managed by collaboratively developing metrics specifically related to the environment.

Originality/value

Previous research in environmental supply chain management has examined drivers and barriers of implementing environmental initiatives with suppliers, but fails to address the relationship dynamics involved when implementing environmental initiatives between organizations. This research begins to fill that gap.
Modeling and forecasting oil price risk: the role of implied volatility index
Authors: Dutta Anupam
Published: September 2017

Purpose

While numerous empirical studies have tried to model and forecast the oil price volatility over the years, such attempts using the crude oil volatility index (OVX) rarely exist. In order to conceal this void, the purpose of this paper is to investigate whether including OVX in the realized volatility (RV) models improve the accuracy of predictions.

Design/methodology/approach

At the empirical stage, the authors employ several measures to frame the RV of crude oil futures returns. In particular, the authors use three different range-based RV estimators recommended by Parkinson (1980), Rogers and Satchell (1991) and Alizadeh et al. (2002), respectively.

Findings

The findings reveal that the information content of crude OVX helps to provide more accurate volatility predictions in comparison to the base-line RV model which contains only historical oil volatilities. Besides, the forecast encompassing test further suggests that the modified RV model (when OVX is introduced in the base-line RV model) forecast encompasses the conventional RV forecast in majority of the cases.

Practical implications

Since forecasting oil price volatility plays a vital role in portfolio optimization, derivatives pricing, optimum asset allocation decisions and risk management, the findings of this study thus carry important implications for energy economists, investors and policymakers.

Originality/value

This paper adds to the existing literature, since it is one of the initial studies to explore whether OVX is informative about the realized variance of the US oil market returns. The findings recommend that the information content of oil implied volatilities should be taken into account when modeling the US oil market volatility. In addition, range-based measures should be utilized while estimating the RV.
Recovery and dementia: promoting choice and challenging controversy
Authors: Hammond Laura Louise , Debney Conrad
Published: September 2017

Purpose

The purpose of this paper is to provide a viewpoint about why people with dementia should be able to choose Recovery and how this approach might be experienced by them.

Design/methodology/approach

This paper addresses some key challenges to accepting Recovery as an approach for people with dementia by making comparisons with people with mental health difficulties. It then discusses key concepts of Recovery using the connectedness, hope, identity, meaning and empowerment framework and how each one might be experienced by the person with dementia.

Findings

The challenges which cause concerns about the applicability of Recovery to people with dementia are shared by people with mental health difficulties, therefore Recovery should be perceived as an approach suitable for anyone regardless of their diagnosis. Recovery for people with dementia could mean: connecting to the self, others and the world to promote feelings of purposefulness; having hope for the here and now; preserving one’s identity; finding meaning in retaining skills and incorporating dementia into one’s life; and, feeling empowered by keeping one’s mind working, adopting a positive attitude, having control and making decisions.

Practical implications

People with dementia can choose to access Recovery, and commonly voiced concerns can be answered and supported with evidence.

Originality/value

This is one of the only papers written to provide an understanding of how Recovery might be experienced by people living with dementia, and directly answers some concerns.
The brand personalities of brand communities: an analysis of online communication
Authors: Paschen Jeannette , Pitt Leyland , Kietzmann Jan , Dabirian Amir , Farshid Mana
Published: September 2017

Purpose

Online brand communities provide a wealth of insights about how consumers perceive and talk about a brand, rather than what the firm communicates about the brand. The purpose of this paper is to understand whether the brand personality of an online brand community, rather than of the brand itself, can be deduced from the online communication within that brand community.

Design/methodology/approach

The paper is empirical in nature. The authors use community-generated content from eight online brand communities and perform content analysis using the text analysis software Diction. The authors employ the five brand personality dictionaries (competence, excitement, ruggedness, sincerity and sophistication) from the Pitt et al. (2007) dictionary source as the basis for the authors’ analysis.

Findings

The paper offers two main contributions. First, it identifies two types of communities: those focusing on solving functional problems that consumers might encounter with a firm’s offering and those focusing on broader engagement with the brand. Second, the study serves as a blueprint that marketers can adopt to analyze online brand communities using a computerized approach. Such a blueprint is beneficial not only to analyze a firm’s own online brand community but also that of competitors, thus providing insights into how their brand stacks up against competitor brands.

Originality/value

This is the first paper examining the nature of online brand communities by means of computerized content analysis. The authors outline a number of areas that marketing scholars could explore further based on the authors analysis. The paper also highlights implications for marketers when establishing, managing, monitoring and analyzing online brand communities.
Antecedents and outcomes of online brand engagement
Authors: Loureiro Sandra Maria Correia , Gorgus Tatjana , Kaufmann Hans Ruediger
Published: September 2017

Purpose

The purpose of this paper is to investigate the antecedents and outcomes of online consumer brand engagement (OCBE). In addition, a mediator effect of satisfaction and brand love in the relationship between OCBE and positive electronic word-of-mouth (e-WOM) is analyzed.

Design/methodology/approach

Data were collected using a panel sampling with 201 participants from the millennial generation provided by the software tool Qualtrics. The online questionnaire is composed of two screening questions, the items of the constructs and a section with the socio-demographic variables.

Findings

Involvement and online brand experience (OBE) are important drivers of online brand engagement. Brand love is a significant mediator between online brand engagement and e-WOM.

Originality/value

Studies about antecedents and outcomes of online consumer engagement are rare. This paper contributes to the fledgling online consumer engagement literature by analyzing three antecedents: involvement, OBE, and self-brand image congruency. For the first time, brand love and satisfaction were considered as direct outcomes of online brand engagement. New insights are provided into the mediating role of brand love between online brand engagement and e-WOM.
Sharing co-creation experiences contributes to consumer satisfaction
Authors: Alarcón López Rocío , Ruiz de Maya Salvador , López López Inés
Published: September 2017

Purpose

The purpose of this paper is to analyze the effects of sharing co-creation experiences on consumers’ behavioral intentions. Increasingly often, companies interact with consumers and involve them in value co-creation, especially in the virtual environment, while more and more consumers tend to share their experiences and their related emotions socially. However, no research has addressed how the interplay of these two variables influences consumer behavior.

Design/methodology/approach

The authors conducted a preliminary study and a 2×2 between-subjects experiment where co-creation and sharing of emotions were orthogonally manipulated. A total of 120 participants were randomly assigned to one of the four scenarios.

Findings

The results show that not only do individuals participate in co-creation activities, but they also tend to share such experiences socially. But more important from a literature contribution perspective, the results confirm a joint effect of co-creation and sharing on satisfaction and repurchase intention. Thus, the effect of co-creation can be bolstered by encouraging participants to share the experience with other people.

Originality/value

While we can better understand the effects of co-creation in particular contexts effects such as that of sharing, the findings also contribute to the theoretical literature on social sharing of emotions as it has not been related to co-creation activities before. The results are of special relevance for those companies implementing co-creation activities, as they provide clues to increase the outcome of such initiatives in terms of consumers’ responses toward the firm.
Expectations and provocations
Authors: Kmita Maria
Published: September 2017

Purpose

The purpose of this paper is to address participants’ humorous provocations as a part of informal interactions between participants and researcher that can be treated just like the research data. By means of autoethnographic analysis, the author explores the expectations of the researcher and participants that humour research entails and discusses how different expectations are revealed in participants’ provocations.

Design/methodology/approach

This paper uses an autoethnographic approach to discuss the informal interactions between participants and the researcher gathered during research into staffroom humour. The informal interactions in general and humour specifically were recorded, analysed, coded, interpreted and theorised just like the data on humour between participants. The theoretical framework used in the study combines Goffman’s (1959) version of symbolic interactionism and Solomon et al. (2006) idea of hybrid spaces.

Findings

The study shows the need for reconsideration of expectations entangled in humour research and proposes to be prepared for unexpected. Expecting unexpected can help stay open minded in the field and in interactions with participants and apply healthy distance towards own research and own expectations. The study shows that whenever certain behaviour was expected and different behaviour was delivered, there was a chance for certain behaviour being interpreted as provocations. Participants’ provocations can result from their own expectations about the research or what they think is expected from them by the researcher and thus they remain subject to different interpretations.

Research limitations/implications

Further research could investigate and discuss the role of humour in participant-researcher interactions in different research contexts and across different methodologies. Combining and analysing experiences of use of humour from both participants and researchers could allow for creating the guidelines in the use of humour in different research situations. Ethical challenges posed by informal interactions between researcher and participants could be explored further and suggestions as to how to protect the researcher, research and participants in such interactions could be developed.

Originality/value

This paper aims to be a starting point for a discussion about the understudied relationship between expectations humour research is entangled with and participants’ provocations. The study shows innovative approach to informal interactions between participants’ and researcher which are treated as research data and are theorised using original combination of symbolic interactionism and hybrid spaces. The study contributes to the qualitative research methodology by discussing the ethics of both using humour with participants and recording and analysing informal humorous interactions between participants and the researcher.
Herd behavior in the French stock market
Authors: Litimi Houda
Published: September 2017

Purpose

This paper aims to investigate the herding behavior in the French stock market and its effect on the idiosyncratic conditional volatility at a sectoral level.

Design/methodology/approach

This sample covers all the listed companies in the French stock market, classified by sector, over four major crisis periods. The author modifies the cross-sectional absolute deviation (CSAD) model to include trading volume and investors sentiment as herding triggers. Furthermore, the author uses a modified GARCH model to investigate the effect of herding on conditional volatility.

Findings

Herding is present in the French market during crises, and it is present in only some sectors during the entire period. The main trigger for investors to embark into a collective herding movement differs from one sector to another. Furthermore, herding behavior has an inhibiting effect on market conditional volatility.

Originality/value

The author modifies the CSAD model to investigate the presence of herding in the French stock market at a sectoral level during turmoil periods. Furthermore, the particularly designed GARCH model provides new insights on the effect of herding and volume turnover on the conditional volatility.
The perception of risk by international travellers
Authors: Carballo Rita R. , León Carmelo J. , Carballo María M.
Published: September 2017

Purpose

This paper aims to investigate the perception of risk by international travellers. There are multiple risks facing tourism that contribute to the formation of perception of risk. It is necessary to identify the different types of risks that are perceived in tourist destinations. This paper suggests policies and techniques to mitigate the risk perceptions in tourism.

Design/methodology/approach

A preliminary questionnaire survey was conducted to test the types of risks that are perceived in international destinations. The data were further analysed with factor analysis to measure the dimension of risk perceptions.

Findings

The main results point to the existence of five types of risk affecting tourists during international travel: health risk, risk of suffering from crime and delinquency, accident risk, environmental risk and risk from disasters. Result shows that uncontrollable risks are perceived as more important than those which are more controllable.

Originality/value

As the existing literature on perception of risk in tourism does not contain a substantially detailed discussion relating to types of risk in international destinations and its contribution to the formation of risk perceptions, this paper may contribute to a better understanding of risk perception. The results could assist in decision-making and have implications for the management of risks.
Molecular phylogeny and taxonomic implications of Asarum (Aristolochiaceae) based on ITS and matK sequences
Authors: Takahashi Daiki , Setoguchi Hiroaki
Published: September 2017

The genus Asarum (Aristolochiaceae) encompasses approximately 120 species from five sections. Taxonomic controversies concerning the genus Asarum and/or its intrageneric classification remain unresolved. In particular, sect. Heterotropa accounts for a large percentage of the genus (80 of 120 species) and is well diverged in the Sino–Japanese Forest subkingdom. Reconstruction of Heterotropa phylogeny and estimation of its divergence times would provide significant insight into the process of species diversity in the Sino–Japanese floristic region. This study encompassed 106 operational taxonomic units (OTUs), and phylogenetic analyses were conducted based on internal transcribed spacer (ITS) and matK sequences. Although the matK sequences provided informative results solely for section Geotaenium, phylogenetic trees based on ITS regions yielded a clear result for several sections. Three sections, Asarum, Geotaenium and Asiasarum, were supported as robust monophyletic groups, whereas Heterotropa had low support. Sect. Hexastylis was revealed to be polyphyletic, suggesting taxonomic reconstruction would be needed. Sect. Heterotropa comprises two clades, which correspond to species distribution ranges: mainland China and the island arc from Taiwan to mainland Japan via the Ryukyu Islands. It is notable that the common ancestry of the latter clade in the eastern Asian islands was highly supported, suggesting that the present species diversity of Heterotropa was initially caused by allopatric range fragmentation in East Asia.
Correlating Ki67 and other prognostic markers with Oncotype DX recurrence score in early estrogen receptor‐positive breast cancer
Authors: Tan Aaron C. , Li Bob T. , Nahar Kazi , Danieletto Suzanne , Fong Eva S. , Currer Trevor , Parasyn Andrew , Middleton Philip , Wong Heidi , Smart Denis , Rutovitz Josie J. , McCloud Philip , Hughes T. Michael , Marx Gavin M.
Published: September 2017

Aim

Decisions regarding adjuvant chemotherapy for early breast cancer are complex. Ki67 is increasingly used, in conjunction with conventional prognostic markers, to help decide the use of adjuvant chemotherapy for early breast cancer. Ki67 has been proposed as an economical alternative to Oncotype DX recurrence score (RS), which is a validated prognostic marker for disease recurrence and predictive marker for benefit from chemotherapy. This study aimed to determine in patients where conventional prognostic markers did not provide a clear recommendation for adjuvant chemotherapy, whether Ki67 could be a substitute for RS.

Methods

We reviewed all cases of luminal‐type node‐negative early breast cancer (T1‐2, N0‐1mi, M0, estrogen receptor positive, HER2 negative) referred for Oncotype DX testing by the multidisciplinary team at an Australian tertiary private hospital from 14th December 2006 to 31st December 2013, when conventional prognostic markers did not provide a clear recommendation for adjuvant chemotherapy. RS was correlated with Ki67, along with other conventional prognostic markers including tumor size, grade, mitotic rate and lymphovascular invasion. Spearman's rank order correlation coefficient and Pearson product‐moment correlation coefficient (r) were used for ordinal and continuous variables, respectively.

Results

A total of 58 patients were analyzed, median Ki67 was 15% (range 2–50%) and the median RS was 16 (range 3–65). There was no positive correlation between Ki67 and RS (r = 0.01, P = 0.93). No single conventional prognostic marker was shown to significantly correlate with RS, including tumor size (r = −0.02, P = 0.88), grade (r = 0.10, P = 0.44), mitotic rate (r = −0.07, P = 0.69) and lymphovascular invasion (r = −0.12, P = 0.39).

Conclusion

Ki67 and conventional prognostic markers do not correlate with Oncotype DX RS. In the setting where conventional prognostic markers do not show a clear indication for or against adjuvant chemotherapy as determined by consensus in a multidisciplinary team, Ki67 is not a substitute for Oncotype DX testing. RS may provide additional information to aid decision making for adjuvant chemotherapy.
Prevalence of exon 11 internal tandem duplications in the C‐KIT proto‐oncogene in Australian canine mast cell tumours
Authors: Tamlin VS , Kessell AE , Mccoy RJ , Dobson EC , Smith TS , Hebart M , Brown L , Mitrovic D , Peaston AE
Published: September 2017

Objective

To measure the prevalence of internal tandem duplications (ITDs) in exon 11 of the proto‐oncogene C‐KIT in a sample of Australian cutaneous canine mast cell tumours (MCTs) drawn from general practice and to evaluate relationships between tumour mutation status and prognostic factors including signalment, tumour histological grade, tumour anatomical location and tumour size.

Methods

C‐KIT exon 11 ITDs were detected by PCR in DNA extracted from formalin‐fixed, paraffin‐embedded canine MCTs sourced from three veterinary diagnostic laboratories in Adelaide and Melbourne. Tumours were graded according to two different systems (Patnaik and Kiupel systems) by board‐certified anatomical pathologists blinded to the PCR results. Relationships between tumour mutation status and prognostic factors were evaluated using a generalised binary logistic regression analysis.

Results

ITDs were identified in 13 of 74 cutaneous canine MCT samples, giving an overall prevalence of 17.6% (95% confidence interval: 8.9–26.2%). ITDs were detected in 10 of 18 Patnaik grade III MCTs (55.6%) and 11 of 22 Kiupel high‐grade MCTs (50%). Wald chi‐square analysis revealed that detection of tumour ITDs was significantly associated with both Patnaik’s and Kiupel’s histologic grading systems (each: P < 0.001). The presence of the ITDs in MCTs was not associated with signalment, tumour anatomical location or tumour size.

Conclusion

The prevalence of C‐KIT exon 11 ITDs in Australian canine MCTs is similar to the prevalence in overseas canine populations (overall prevalence in Australia approximately 18%). ITDs were more frequently identified in higher grade MCTs.
Phase II study of bortezomib, cyclophosphamide and dexamethasone as induction therapy in multiple myeloma: DSMM XI trial
Authors: Einsele Hermann , Engelhardt Monika , Tapprich Christoph , Müller Jürgen , Liebisch Peter , Langer Christian , Kropff Martin , Mügge Lars O. , Jung Wolfram , Wolf Hans‐Heinrich , Metzner Bernd , Hart Christina , Gramatzki Martin , Hertenstein Bernd , Pfreundschuh Michael , Rösler Wolf , Fischer Thomas , Maschmeyer Georg , Kanz Lothar , Hess Georg , Jäger Elke , Bentz Martin , Dürk Heinz A. , Salwender Hans , Hebart Holger , Straka Christian , Knop Stefan
Published: September 2017

We assessed the safety and efficacy of bortezomib, cyclophosphamide and dexamethasone (VCD) induction therapy in previously untreated multiple myeloma patients. A total of 414 patients received three 21‐day cycles of VCD prior to autologous stem‐cell transplantation (ASCT). Most common grade ≥3 adverse events were leucopenia (31·4%) and thrombocytopenia (6·8%). The overall response rate (ORR) by investigator‐based assessment was 85·4%. Most patients (74%) underwent successful central laboratory‐based molecular cytogenetic analysis. No clinically relevant differences in ORR post‐induction were seen between patients with or without high‐risk cytogenetic abnormalities (86·2% vs. 84·3%). Further follow‐up data are available for 113 patients receiving ASCT who were included in a prospective consolidation trial (median follow‐up, 55·5 months); median progression‐free survival (PFS) was 35·3 months and median overall survival (OS) was not reached. In patients with high‐risk versus standard‐risk cytogenetics, median PFS was 19·9 vs. 43·6 months (P < 0·0001), and median OS was 54·7 months versus not reached (P = 0·0022). VCD is an effective and tolerable induction regimen; results suggest that VCD induces high response rates independently of cytogenetic risk status, but after long‐term follow‐up, cytogenetic high risk is associated with markedly reduced PFS and OS post‐ASCT.
Nelarabine‐induced peripheral and central neurotoxicity: can sequential MRI brain imaging help to define its natural history?
Authors: Ewins Karl , Malone Andrea , Phelan Ethna , Webb David , McHugh J. C. , Smith Owen
Published: September 2017

A 14‐year‐old boy with relapsed T cell acute lymphoblastic leukaemia received reinduction chemotherapy that included nelarabine, a purine nucleoside analogue known to cause dose‐dependent neurotoxicity. Although he achieved aminimal residual disease negative remission after two cycles of chemotherapy he also developed severe, progressive peripheral and central neurotoxicities. Loss of grey‐white differentiation was seen on a T2‐weighted magnetic resonance imaging brain scan. This unusual clinical picture and previously unreported radiological findings are thought to be due to nelarabine toxicity. He was bridged with 6‐mercaptopurine while transplant was deferred pending sustainable neurological improvement. This case posed clinical and ethical dilemmas while demonstrating previously unreported radiological features.
Negotiating deficiency: Exploring ethnic minority parents' narratives about encountering child welfare services in Norway
Authors: Fylkesnes Marte Knag , Iversen Anette Christine , Nygren Lennart
Published: September 2017

Evaluating the participatory opportunities for service users within social welfare institutions is a pressing issue. In this article, we explore a group of ethnic minority parents' experiences with child welfare services (CWS) in Norway. A strong narrative theme was deficiency positioning—how lacking a Norwegian normative set of knowledge and skills challenged the parents' opportunities to participate. We analysed how deficiency positioning was perceived, negotiated, and contested in the parents' accounts, and 4 themes emerged: (a) learning to parent, (b) contesting expert knowledge, (c) learning to be a client, and (d) constructing CWS deficiency. Nancy Fraser's concept of “participatory parity” was applied to explore how current institutional structures may enable and limit parents' participation. The analysis provides insight into agencies and informants' sense‐making processes as well as the diverse resources and strategies that parents draw upon in the CWS encounter. Furthermore, we argue that an interplay between a strong focus on “parenting skills” and bureaucratic and economic structures positions ethnic minority parents as deficient, thus providing powerful mechanisms for marginalization. Implications for case work and institutional levels are discussed.
Self‐testing for contact allergy to hair dyes – a 5‐year follow‐up multicentre study
Authors: Friis Ulrik F. , Goosens An , Giménez‐Arnau Ana M. , Lidén Carola , Giménez‐Arnau Elena , White Ian R. , Alfonso Jose H. , Uter Wolfgang , Johansen Jeanne D.
Published: September 2017

Background

In 2011, a multicentre study was conducted in order to determine how hair dye manufacturers instructed consumers to perform a self‐test prior to dyeing their hair, in order to identify individuals who are likely to react upon subsequent hair dyeing. A number of concerns were raised concerning the variability in instructions between products and producers, and the safety and validity of this tool.

Objectives

To perform a 5‐year follow‐up study in order to determine whether manufacturers still recommend a self‐test, and if so, whether the procedures have been changed.

Methods

During March 2016, a total of 40 oxidative hair dye products from 21 different manufacturers were bought in retail stores in 8 European countries.

Results

The consumers were instructed to perform a self‐test prior to hair dyeing for 39 of the products; however, the procedures varied greatly regarding the method of application, the amount of hair dye applied, the location and size of the application area, the number of applications, whether or not rinsing was performed after application, the reading times, and how a positive reaction was defined.

Conclusions

Self‐testing is still recommended by almost all manufacturers of permanent hair dyes. There are major variations in the instructions, even in products from the same manufacturer. The previously raised concerns regarding safety and validity still remain.
Surgery for constipation: systematic review and practice recommendations
Authors: Grossi U. , Knowles C. H. , Mason J. , Lacy‐Colson J. , Brown S. R. ,   the NIHR CapaCiTY working group,   Pelvic floor Society
Published: September 2017

Aim

To assess the outcomes of rectal suspension procedures (forms of rectopexy) in adults with chronic constipation.

Method

Standardised methods and reporting of benefits and harms were used for all CapaCiTY reviews that closely adhered to PRISMA 2016 guidance. Main conclusions were presented as summary evidence statements with a summative Oxford Centre for Evidence‐Based Medicine (2009) level.

Results

Eighteen articles were identified, providing data on outcomes in 1238 patients. All studies reported only on laparoscopic approaches. Length of procedures ranged between 1.5 to 3.5 h, and length of stay between 4 to 5 days. Data on harms were inconsistently reported and heterogeneous, making estimates of harm tentative and imprecise. Morbidity rates ranged between 5–15%, with mesh complications accounting for 0.5% of patients overall. No mortality was reported after any procedures in a total of 1044 patients. Although inconsistently reported, good or satisfactory outcome occurred in 83% (74–91%) of patients; 86% (20–97%) of patients reported improvements in constipation after laparoscopic ventral mesh rectopexy (LVMR). About 2–7% of patients developed anatomical recurrence. Patient selection was inconsistently documented. As most common indication, high grade rectal intussusception was corrected in 80–100% of cases after robotic or LVMR. Healing of prolapse‐associated solitary rectal ulcer syndrome occurred in around 80% of patients after LVMR.

Conclusion

Evidence supporting rectal suspension procedures is currently derived from poor quality studies. Methodologically robust trials are needed to inform future clinical decision making.
Avoided Deforestation Linked to Environmental Registration of Properties in the Brazilian Amazon
Authors: Alix‐Garcia Jennifer , Rausch Lisa L. , L'Roe Jessica , Gibbs Holly K. , Munger Jacob
Published: September 2017

We quantified the avoided deforestation impacts of environmental land registration in Brazil's Amazonian states of Mato Grosso and Pará between 2005 and 2014. We find that the program reduced deforestation on registered lands. The magnitude of the effect implies that deforestation in the two states would have been 10% higher in the absence of the program. The impacts of registration varied over time, likely due to changing suites of policies linking environmental registration to land use incentives. Our results also reveal that agriculturally suitable lands and those located in regions undergoing the most land‐use change were more likely to be registered than those in less suitable, less dynamic regions. We conclude that environmental registration is an important first step in implementing avoided deforestation policies targeting private landholders.
The midwife–woman relationship in a South Wales community: Experiences of midwives and migrant Pakistani women in early pregnancy
Authors: Goodwin Laura , Hunter Billie , Jones Aled
Published: September 2017

Background

In 2015, 27.5% of births in England and Wales were to mothers born outside of the UK. Compared to their White British peers, minority ethnic and migrant women are at a significantly higher risk of maternal and perinatal mortality, along with lower maternity care satisfaction. Existing literature highlights the importance of midwife–woman relationships in care satisfaction and pregnancy outcomes; however, little research has explored midwife–woman relationships for migrant and minority ethnic women in the UK.

Methods

A focused ethnography was conducted in South Wales, UK, including semi‐structured interviews with 9 migrant Pakistani participants and 11 practising midwives, fieldwork in the local migrant Pakistani community and local maternity services, observations of antenatal appointments, and reviews of relevant media. Thematic data analysis was undertaken concurrently with data collection.

Findings

The midwife–woman relationship was important for participants' experiences of care. Numerous social and ecological factors influenced this relationship, including family relationships, culture and religion, differing health‐care systems, authoritative knowledge and communication of information. Marked differences were seen between midwives and women in the perceived importance of these factors.

Conclusions

Findings provide new theoretical insights into the complex factors contributing to the health‐care expectations of pregnant migrant Pakistani women in the UK. These findings may be used to create meaningful dialogue between women and midwives, encourage women's involvement in decisions about their health care and facilitate future midwifery education and research. Conclusions are relevant to a broad international audience, as achieving better outcomes for migrant and ethnic minority communities is of global concern.
Recovery‐focussed care: How it can be utilized to reduce aggression in the acute mental health setting
Authors: Lim Eric , Wynaden Dianne , Heslop Karen
Published: September 2017

Consumer aggression is common in the acute mental health inpatient setting. Mental health nurses can utilize a range of interventions to prevent aggression or reduce its impact on the person and others who have witnessed the event. Incorporating recovery‐focussed care into clinical practice is one intervention, as it fosters collaborative partnerships with consumers. It promotes their engagement in decisions about their care and encourages self‐management of their presenting behaviours. It also allows the consumer to engage in their personal recovery as their mental health improve. Yet there is a paucity of literature on how nurses can utilize recovery‐focussed care with consumers who are hospitalized and in the acute phase of their illness. In the present study, we report the findings of a scoping review of the literature to identify how recovery‐focussed care can be utilized by nurses to reduce the risk of consumer aggression. Thirty‐five papers met the inclusion criteria for review. Four components were identified as central to the use of recovery‐focussed care with consumers at risk of becoming aggressive: (i) seeing the person and not just their presenting behaviour; (ii) interact, don't react; (iii) coproduction to achieve identified goals; and (iv) equipping the consumer as an active manager of their recovery. The components equip nurses with strategies to decrease the risk of aggression, while encouraging consumers to self‐manage their challenging behaviours and embark on their personal recovery journey. Further research is required to evaluate the translation of these components clinically in the acute care setting.
Documentation of pharmaceutical care: Validation of an intervention oriented classification system
Authors: Maes Karen A. , Studer Helene , Berger Jérôme , Hersberger Kurt E. , Lampert Markus L.
Published: September 2017

Rationale, aims, and objectives

During the dispensing process, pharmacists may come across technical and clinical issues requiring a pharmaceutical intervention (PI). An intervention‐oriented classification system is a helpful tool to document these PIs in a structured manner. Therefore, we developed the PharmDISC classification system (Pharmacists' Documentation of Interventions in Seamless Care). The aim of this study was to evaluate the PharmDISC system in the daily practice environment (in terms of interrater reliability, appropriateness, interpretability, acceptability, feasibility, and validity); to assess its user satisfaction, the descriptive manual, and the online training; and to explore first implementation aspects.

Method

Twenty‐one pharmacists from different community pharmacies each classified 30 prescriptions requiring a PI with the PharmDISC system on 5 selected days within 5 weeks. Interrater reliability was determined using model PIs and Fleiss's kappa coefficients (κ) were calculated. User satisfaction was assessed by questionnaire with a 4‐point Likert scale. The main outcome measures were interrater reliability (κ); appropriateness, interpretability, validity (ratio of completely classified PIs/all PIs); feasibility, and acceptability (user satisfaction and suggestions).

Results

The PharmDISC system reached an average substantial agreement (κ = 0.66). Of documented 519 PIs, 430 (82.9%) were completely classified. Most users found the system comprehensive (median user agreement 3 [2/3.25 quartiles]) and practical (3[2.75/3]). The PharmDISC system raised the awareness regarding drug‐related problems for most users (n = 16). To facilitate its implementation, an electronic version that automatically connects to the prescription together with a task manager for PIs needing follow‐up was suggested. Barriers could be time expenditure and lack of understanding the benefits.

Conclusion

Substantial interrater reliability and acceptable user satisfaction indicate that the PharmDISC system is a valid system to document PIs in daily community pharmacy practice.
Creating falseness—How to establish statistical evidence of the untrue
Authors: Lytsy Per
Published: September 2017

Null hypothesis significance testing is the typical statistical approach in search of the truthfulness of hypotheses. This method does not formally consider the prior credence in the hypothesis, which affects the chances of reaching correct conclusions. When scientifically implausible or empirically weakly supported hypotheses are tested, there is an increased risk that a positive finding in a test in fact is false positive. This article argues that when scientifically weakly supported hypotheses are tested repeatedly—such as when studying the clinical effects of homeopathy—the accumulation of false positive study findings will risk providing false evidence also in systematic reviews and meta‐analyses. False positive findings are detrimental to science and society, as once published, they accumulate persistent untrue evidence, which risks giving rise to nonpurposive research programmes, policy changes, and promotion of ineffective treatments. The problems with false positive findings are discussed, and advice is given on how to minimize the problem. The standard of evidence of a hypothesis should depend not only on the results of statistical analyses but also on its a priori support. Positive findings from studies investigating hypotheses with poor theoretical and empirical foundations should be viewed as tentative until the results are replicated and/or the hypothesis gains more empirical evidence supporting it as likely to be true.
Concentration of phenolic compounds from apple pomace extracts by nanofiltration at lab and pilot scale with a techno‐economic assessment
Authors: Uyttebroek Maarten , Vandezande Pieter , Van Dael Miet , Vloemans Sam , Noten Bart , Bongers Bas , Porto‐Carrero Wim , Muñiz Unamunzaga Maria , Bulut Metin , Lemmens Bert
Published: September 2017

Apple pomace can be used as resource for the extraction of phenolic compounds with antioxidant properties. Pressing of apple in juice and pomace at lab scale in open air (aerobic) and under N2 atmosphere (anaerobic) showed a recovery of phenolic compounds of 85% in juice and pomace after anaerobic pressing, compared to 43% after aerobic pressing, indicating loss of phenolic compounds by oxidation and the advantage of anaerobic over aerobic pressing. After a membrane screening and concentration test at lab scale, the commercial nanofiltration membrane NFX was selected to concentrate phenolic compounds in an ethanol : water extract of apple pomace. At pilot scale, the concencentration of 10 selected phenolic compounds and quinic acid increased from 59.5 mg/L in the ethanol : water extract to 1256.1 mg/L in the final retentate, that is, by a factor 21.1. The volume of the crude extract was reduced by a factor of 28.5 during the filtration, indicating some loss of phenolic compounds during pilot testing due to membrane fouling or oxidation of polyphenols. The pilot concentration test using a spiral‐wound membrane module showed good flux and concentration of phenolic compounds, indicating the technical feasibility of membrane technology for efficient concentration of polyphenols in an ethanol : water extraction solvent. Unfortunately, the extraction and concentration process was not economically feasible under the assumptions made.

Practical applications

The valorization of food waste for the production of high‐added value products is an increasingly hot topic. Phytochemicals are present in relatively low concentration in the fruit matrix, and concentration in the extraction solvent is necessary to develop an industrially relevant process. In this study, membrane filtration was selected for concentration due to its low energy consumption and mild processing conditions compared to other technologies. Membrane screening and testing at lab and pilot scale with techno‐economic assessment can be used by food and nutraceutical industries to evaluate membrane technology for concentration of phytochemicals extracted from agroindustrial by‐products.