bluuebunny/crossref_metadata_2025 huggingface dataset:
Theoretical and empirical analysis of the supplier induced demand in health care market in China
Authors: Li Jun-Shan , He Pei-Pei , He Rui-Bo
Published: July 2014

Purpose

– The purpose of this paper is to provide theoretical model about supplier-induced demand (SID) in health care market in China. Then, an empirical analysis will also be carried out according to the theoretical model above. At last, some advices will be provided in order to control or eliminate the SID in Chinese health care market.

Design/methodology/approach

– SID has in fact been one of the most contentious topics in the economics of health care. According to the SID theory in health economics, the theoretical model about SID in China has been provided, then, based on the co-integration theory, the empirical analysis has been brought out.

Findings

– The study tells that it is the reduction of government finance to hospital, not the increase of supply that is the long-term steady determinants of growth of health care expenditure and that the difference of marginal return to hospital among all kinds of services and medicines is the external factor.

Originality/value

– To provide theoretical model about SID in health care market in China is the main originality value.
Application of metabolic GM(1,1) model in financial repression approach to the financing difficulty of the small and medium-sized enterprises
Authors: Zhang Quanda , Chen Rongda
Published: July 2014

Purpose

– Financial repression refers to any of measures that government employs to prevent the financial intermediaries of an economy from functioning at their full capacity. On the contrary, financial deepening refers to the increased provision of financial services with a wider choice of services geared to all levels of society, which is the process of relieving financial constraint. With the theory of financial repression and financial deepening, the purpose of this paper is to focus on the performance of the financial repression in China and its influences on the financing of the small- and medium-sized enterprises (SMEs).

Design/methodology/approach

– The work procedure is as follows: first, the monetization rate and financial interrelations ratio (FIR) are defined to measure the degree of financial repression; next, the classical GM(1,1) model and the metabolic GM(1,1) model are established, respectively, comparison is given out to show which model owns better adaptability. Finally, with metabolic GM(1,1) model, this paper predicts the monetization ratio and FIR in the next few years properly.

Findings

– Unlike other theories which ascribe the financing difficulty of the SMEs to various factors, the paper argues that the financial repression in China should be responsible for the financing difficulty of the SMEs based on the theory of financial repression and financial deepening.

Originality/value

– This paper points out that measures should be taken to accelerate the progress of the reform of interest rates and promote the efficiency of the financial market system as well as establish the multi-level capital market system for the SMEs to overcome the difficulty.
Divided societies and identity boundaries: a conflict analysis framework
Authors: Kachuyevski Angela , Olesker Ronnie
Published: July 2014

Purpose

– The purpose of this paper is to develop a conflict analysis framework that better captures the complexity of conflicts in divided societies by including the differing perceptions of identity boundaries between ethnic majorities and minorities in divided societies.

Design/methodology/approach

– The analysis draws on the social boundaries and societal security literatures to develop a typology representing four dyads of perceived identity boundaries that illustrate the different dynamics of ethnic relations in divided societies.

Findings

– The exploratory cases illustrate how the perceptions of identity boundaries have implications for conflict dynamics that call for different conflict management strategies.

Research limitations/implications

– The empirical cases serve to illustrate the application of the theoretical framework. Policy makers devising conflict management strategies in these deeply divided societies are likely to err if differing perceptions of social boundaries are not taken into consideration. Thus, the authors provide explicit policy recommendations for conflict management in each of the dyads presented in the typology.

Practical implications

– Using the framework that incorporates differing perceptions of identity allows analysts to account for the impact of external actors in shaping and maintaining identity boundaries and allows for a consideration of the possible differing interpretations of the boundary held by different groups as well as the implications this has for conflict analysis and management.

Originality/value

– The authors develop a model that accounts for the perceptions of both the majority and the minority of the identity boundaries that separate divided societies. They account for the implications for conflict dynamics and thus for conflict management strategies of differing perceptions of identity boundaries, which provides a perspective that is both theoretically significant and policy relevant, as most policy makers assume that ethnic minorities and majorities see the social boundary between them in similar terms.
Human capital depreciation and education level
Authors: Weber Sylvain
Published: July 2014

Purpose

– The purpose of this paper is to investigate the link between human capital depreciation and education level, with an emphasis on potential differences between general and specific education.

Design/methodology/approach

– A nonlinear wage equation, based on Arrazola and de Hevia's (2004) model, is estimated using data from the Swiss Labor Force Survey (SLFS) over the period 1998-2008, in order to estimate a human capital depreciation rate for several education groups.

Findings

– Human capital depreciation is significantly related to education type. Academic (“concept-based”) education protects workers more effectively against depreciation than vocational (“skill-specific”) education.

Research limitations/implications

– The SLFS survey is a rotating panel of five years and no retrospective data on earnings and employment are provided. A study of lifecycle earnings like the one proposed here would clearly benefit from a longer individual observation period.

Practical implications

– In all educational tracks, even vocational ones, a substantial time share should be devoted to the acquisition of general skills. Moreover, it is necessary to manage lifelong learning carefully in order not to waste initial investments in education.

Originality/value

– Instead of using a purely quantitative approach to separate workers by years of education, qualitative aspects of educational system are taken into account. Taking advantage of the Swiss educational system characteristics, workers are separated on the basis of their education type. Workers with vocational education (apprenticeships, professional and technical schools and universities of applied sciences) are assumed to possess a relatively specific human capital, compared to those with academic education (high schools and universities).
The impact of organisational context on the failure of key and strategic account management programmes
Authors: Wilson Kevin , Woodburn Diana
Published: July 2014

Purpose

– This paper aims to explore some of the contextual reasons for the failure of key or strategic account management (K/SAM) programmes. It will discuss how organisational context impacts the implementation and effective operation of such programmes in business-to-business markets. The paper looks at the issues affecting K/SAM programmes rather than the management of individual relationships.Organisational context shapes the work environment (Rice 2005, Porter and McGloghlin, 2006): it is comprised of those elements that drive behaviour and facilitate or impede management processes (Goodman and Haisley, 2007). The literature prescribes a wide range of contextual elements conducive to K/SAM processes, but is less expansive on the subject of elements that may cause K/SAM programmes to disappoint.

Design/methodology/approach

– This work in-progress paper takes an inductive approach to material provided by surveys of K/SAM communities and their discussions in LinkedIn special interest groups or similar forums to develop a model to give structure to the organisational context issues which may be responsible for K/SAM failure.

Findings

– From an initial reading of the literature, two broad categories of factors were identified as elements of organizational context: what might be called the formal or “hard” elements supporting K/SAM programmes and the “soft”, more informal and partly cultural elements that “moderate” or “intervene” in implementation. A model is developed to illustrate the linkages between organizational elements in K/SAM.

Research limitations/implications

– Although a pilot study, we believe that valuable insights into KAM failure are provided by the study. The next stage will include a co-operative inquiry approach based on this data, in which participants will actively validate and develop the model by exploring it within their organisations.

Practical implications

– The paper draws out a number of significant implications for managers.

Originality/value

– The existing context within which attempts are made to implement K/SAM have received little attention and often are ignored or remain “unspoken”. This paper addresses those important issues.
Work design for different generational cohorts
Authors: Hernaus Tomislav , Pološki Vokic Nina
Published: July 2014

Purpose

– The purpose of this paper is to uncover the nature of job characteristics related to different generational cohorts (Baby-boomers, Generation X and Generation Y). Significant differences between four task and four social job characteristics across generational cohorts have been revealed.

Design/methodology/approach

– The empirical research was conducted through a field study of employees from large-sized Croatian organizations. A cross-sectional and cross-occupational research design was applied. A total of 512 knowledge workers (139 managers and 373 professionals) participated in the research. Descriptive and inferential statistical methods were used to determine and compare work design across generations.

Findings

– The results indicate that job characteristics are not equally represented within different generational cohorts. While the nature of task job characteristics is mostly irrespective of generations, social job characteristics to some extent differ among generational cohorts. High task variety, reasonably high task identity, and a moderate level of both received interdependence and task significance are recognized as common job characteristics of knowledge workers across generations. However, jobs of Baby-boomers, Xers, and Yers are idiosyncratic for work autonomy, interaction with others, initiated interdependence, and teamwork. Additionally, the inclusion of the work type as a control variable revealed that interaction with others does differ but only among generations of professionals.

Originality/value

– The present study is the first research in which generational similarities and differences have been empirically examined through job characteristics. The authors focused on knowledge workers within an under-researched context (studies about knowledge workers, work design and generational differences are rare or non-existent in south-eastern European countries), making this systematic investigation unique and practically significant.
Towards a moderated mediation model of innovative work behaviour enhancement
Authors: M. Stoffers Jol , I.J.M. Van der Heijden Beatrice , L.A. Notelaers Guy
Published: July 2014

Purpose

– The purpose of this paper is to investigate a moderated mediation model of innovative work behaviour enhancement. Perceived firm (organizational and market) performance was assumed to moderate the relationships between leader-member exchange (LMX) and organizational citizenship behaviour (OCB), on the one hand, and employability, on the other hand. In a preciously validated human resources management (HRM) model, employability appeared to be a full mediator in the relationship between LMX and OCB, and innovative work behaviour, being the outcome measure.

Design/methodology/approach

– Data were collected from a sample of 487 pairs of employees and their immediate supervisors working in 151 small and medium-sized enterprises (SMEs). Structural equation modeling (SEM) was used to confirm the factor structure of the baseline model variables, including LMX, OCB, employability, and innovative work behaviour. The moderating effect of firm performance was tested using multi-group SEM.

Findings

– Results indicated that firm performance had a substantial influence on the baseline model's relationships. More specifically, firm performance appeared to moderate partially a mediation model wherein LMX was assumed to be associated with innovative work behaviour, through employability, being the mediator. Moreover, firm performance also appeared to moderate conclusively a model with employability as a mediator in the relationship between OCB and innovative work behaviour.

Originality/value

– To the best of our knowledge, this is the very first study that investigates a mediation model of innovative work behaviour enhancement moderated by firm performance. It appears that high- vs low-performance firms present very different organizational environments for an employee to work in. Obviously, these situational factors affect workers’ employability. This study adds particular knowledge to the scholarly literature in this field since not much is known about the science and practice of HRM within SMEs.
Using mobile technologies in libraries and information centers
Authors: Singh Negi Dheeraj
Published: July 2014

Purpose

– The purpose of this paper is to describe the use of mobile technologies to develop new ways of Libraries and Information Centre. Mobile devices help to connect with patrons. Creating a library application (“app”) or mobile Web site that allows patrons to access library hours, view their library account or even search databases is easier than most people think. The resources below should help libraries begin to plan and implement their own unique mobile presence: analyzing the present usage of mobile devices; providing an overview of devices, providers and features; describing the various activities these devices support for well library use; focusing how libraries and our librarians are responding with services tailored for these devices; and what can be done by libraries in future in this respect”.

Design/methodology/approach

– Information and Communications Technology continues to expand the boundaries of higher education into the “anytime/anywhere” experiences. Mobile communication is transforming how people search, receive and interact with information on a daily basis. In just a few short years, smart phone ownership has skyrocketed, and popular use of e-readers has been steadily on the rise. These advanced mobile tools provide portable access to the world of information, across boundaries of subject, discipline and industry.

Findings

– Mobile technology holds great promise for enabling libraries to provide enhanced services in a form users increasingly are demanding. If this promise is to be fully realized, however, libraries will need to conduct analyses and make smart decisions to address the issues outlined above, support staff education and explore partnerships and new funding models, and be prepared to compromise with respect to their traditional information delivery models.

Originality/value

– The explosion of advanced mobile technology and robust digital information collection capabilities should prompt libraries to examine carefully the ramifications for user privacy. Libraries can maintain their commitment to user privacy without overcompensating by imposing burdensome security measures or annoying interruptions. For example, libraries do not have to show users a privacy statement or security warning every time they want to access information on a mobile device. A single log-in and acceptance of terms of use, similar to the procedures for other mobile applications and services, should suffice. At the same time, libraries can take the opportunity to educate users in best practices with respect to privacy issues associated with the use of mobile devices.
Managing end of life products: a review of the literature on reverse logistics in Brazil
Authors: Bouzon Marina , Augusto Cauchick Miguel Paulo , Manuel Taboada Rodriguez Carlos
Published: July 2014

Purpose

– The environmental consciousness of customers and the emergence of stricter environmental regulations has pushed industries to think about environmental management by means of reverse logistics (RL) implementation. The purpose of this paper is to provide a current panorama of RL in Brazil and a comparison to international RL body of literature as well. It also seeks to provide a systematic literature review procedure and a conceptual framework for RL literature categorization.

Design/methodology/approach

– A descriptive and content analysis approach was adopted. First, a topic delimitation phase was aimed at defining the main research areas and related keywords. Second, a material collection phase focussed on a selection of peer-reviewed Brazilian and international journals. Third, a total of 34 papers were assessed by quantitative indicators, and a conceptual RL framework was employed to classify them. Finally, papers were evaluated using content analysis.

Findings

– The RL research gaps in Brazil are in information technology, facility location, inventory control, outsourcing, and performance measurement. It is also reported that, In Brazil, RL is predominantly linked to recycling activities, and the practice of RL is driven by social conditions and economics in some specific industrial sectors.

Research limitations/implications

– The focus is restricted to RL applications in Brazil and the corresponding articles published by Brazilian researchers.

Originality/value

– Practitioners and academics might find this review useful, as it outlines gaps and limitations of existing research in the largest Latin America economy. This work is built on the recent research in RL. No systematic literature review of this kind has previously been undertaken.
Strategy for controlling agricultural land conversion of paddy by using analytical hierarchy process in Central Java
Authors: Dian Wisika Prajanti Sucihatiningsih
Published: July 2014

Purpose

–The purpose of this paper is to determine strategies in controlling over the function of paddy field in Central Java.

Design/methodology/approach

– Purposive sampling was employed by having 12 people interviewed. Analytical hierarchy process was used to determine a strategy related to policy control toward agricultural land conversion.

Findings

– The results indicated priorities which are recommended to include in the policy toward the function of the land conversion in Central Java. They are: first, the application of laws that regulate land conversion mechanism; second, tightening or restricting and prohibiting rules for anyone who wants to change the function of agricultural land; and finally, zoning or clustering region based on urban spatial and land use.

Research limitations/implications

– This study suggests that the government is expected to invest directly for agriculture and plantation by avoiding the use of existing rice field.

Practical implications

– It is also advisable for government to utilize the available unused land.

Originality/value

– This paper captures factual condition of the decrease of the land use for agriculture which has been very critical issues in any agrarian countries. This is essential to know the core of the problem and possible solutions for similar case in other typical nations.
Creating and establishing a recovery-oriented clinical psychology provision across an acute care mental health pathway. Ethical obligation and clinical reality
Authors: D. Mankiewicz Pawel , Truter Johan
Published: July 2014

Purpose

– The purpose of this paper is to summarise the development of a recovery-oriented and socially inclusive acute care clinical psychology service in one of the NHS Trusts based in East Anglia. It demonstrates the service's compliance with relevant national policies and guidelines, and addresses some of the criticisms directed at acute mental health care in recent years. Both achievements and difficulties are reflected on.

Design/methodology/approach

– The paper employs an organisational development case example related to applicable clinical practice model, based on national guidelines and policies, in order to demonstrate that it is possible to develop and implement a recovery-oriented clinical psychology practice in acute inpatient mental health care. This is based on the authors, experiences as a public sector clinical psychologists specialising in complex, severe, and enduring mental health needs.

Findings

– Clinical psychologists may effectively contribute to the development of psychosocially informed and recovery-based multidisciplinary attitudes towards emotional difficulties of individuals admitted to psychiatric wards.

Research limitations/implications

– Future service development project of similar nature ought to implement standardised measures (e.g. ward atmosphere scales) to increase validity of findings.

Practical implications

– Despite limited, and continuously decreasing, resources in the NHS it appears possible to develop and establish a successful and objectively replicable provision of recovery-based psychological services across an entire acute care mental health pathway.

Social implications

– Recovery-enhancing clinical psychology interventions should not be limited to those receiving care from community-based services only. Building psychologically informed understanding of mental health needs should be employed on inpatient wards too, in order to counterbalance the dominating biomedical models of mental illness.

Originality\value

– Dissemination of examples of effective psychosocial practice in acute mental health settings appears largely underrepresented.
In search of global talent: is South Asia ready?
Authors: E. Khilji Shaista , Keilson Brian
Published: July 2014

Purpose

– Using human capital theory and resource-based view (RBV), the authors argue that individuals and societies derive economic benefits from investments in people (Becker, 1992; Sweetland, 1996), thus effective management of talent is critical for economic development (Lepak and Snell, 2002; Khilji, 2012a). Next, the authors review governmental policies in three of the world's most populous countries, Bangladesh, India, and Pakistan, in order to highlight their national talent development efforts. The authors discuss how each country is meeting the challenge of making the talent they own, as well as buying diaspora talent in order to strengthen their local capabilities. The paper aims to discuss these issues.

Design/methodology/approach

– The authors adopted a comparative analysis approach in order to frame our arguments and discussion.

Findings

– The paper finds that Bangladesh, India and Pakistan have implemented a wide range of initiatives, from skill development programs to citizenship policies for its diaspora, in order to upgrade their local capabilities. In addition, these countries are simultaneously using inclusive, exclusive, and subject dimensions (Gallardo-Gallardoet al., 2013) in developing their national talent. The paper highlights prevalence of the paradox of development and retention particularly in Bangladesh and Pakistan, where youth is also being trained to emigrate.

Research limitations/implications

– Global talent management (GTM) has become an increasingly important policy initiative, in view of a global generational divide that will require youth-rich emerging economies and aging developed countries to implement policies that help them meet global talent needs.

Originality/value

– This commentary advances a macro GTM view, and argues in favor of promoting a policy perspective to better connect policy, research and practice that may lead to maximizing human potential globally and addressing global talent shortages.
An Examination of the Postmortem Redistribution of Fentanyl and Interlaboratory Variability,
Authors: Krinsky Clarissa S. , Lathrop Sarah L. , Zumwalt Ross
Published: July 2014

Fentanyl is a synthetic opioid agonist used for pain control. Often administered as a transdermal patch, it is an interesting drug for study of postmortem redistribution. We hypothesized that fentanyl concentrations would increase over time after death, as measured in blood drawn on the day prior to autopsy and in blood drawn at the time of autopsy in ten cases where fentanyl patches were identified at the scene. Concentrations were compared, and heart blood to femoral blood ratios were calculated as markers of postmortem redistribution. Fentanyl concentrations measured in peripheral blood drawn the day of autopsy (peripheral blood 2 [PB2]) were higher than those drawn the day prior to autopsy (peripheral blood 1 [PB1]) with a mean ratio (PB2/PB1) of 1.80. The ratio of heart blood concentrations (HB) to femoral blood concentrations drawn at autopsy (PB2) had a mean ratio (HB/PB2) of 1.08. Some cases had blood from the same source analyzed at two different laboratories, and concentrations of fentanyl in those samples showed inter‐ and intralaboratory differences up to 25 ng/mL. Postmortem fentanyl concentrations may be affected by antemortem factors, postmortem redistribution, and laboratory variability. Forensic pathologists must use caution in interpreting fentanyl levels as part of death investigation.
In Vitro Effects of Household Products on Calliphoridae Larvae Development: Implication for Forensic Entomology
Authors: Aubernon Cindy , Devigne Cedric , Hedouin Valery , Gosset Didier , Charabidze Damien
Published: July 2014

Several parameters can delay the first arrival of flies on a corpse and the subsequent development of the larvae. This study focuses on the development of Lucilia sericata (Diptera: Calliphoridae) (Meigen, 1826) on household chemical‐contaminated substrates. bleach, perfume, hydrochloric acid, caustic soda, insecticide, mosquito repellent, and gasoline in quantities consistent with an amount that could possibly be spilled on a corpse were mixed with beef liver to simulate contaminated fleshes. Larvae were bred at 25°C on these media until emergence. Four developmental parameters were followed: survival rates, development times, sex ratios, and adult sizes. Hydrochloric acid, insecticide, and gasoline killed all larvae. In low quantities, caustic soda and mosquito repellent increased the development time and decreased the adult size. However, high quantities of these chemicals killed all larvae. Lastly, bleach and perfume did not affect the survival rate and barely impacted the development time or adult size. These results demonstrate common household products spilled on a corpse can strongly affect the development of Calliphoridae larvae. The effects of such products should be considered in forensic entomology cases.
Diabetes Mellitus and Atrial Remodeling: Mechanisms and Potential Upstream Therapies
Authors: Zhang Qitong , Liu Tong , Ng Chee Y. , Li Guangping
Published: July 2014

Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical practice, and its prevalence has increasing substantially over the last decades. Recent data suggest that there is an increased risk of AF among the patients with diabetes mellitus (DM). However, the potential molecular mechanisms regarding DM‐related AF and diabetic atrial remodeling are not fully understood. In this comprehensive review, we would like to summarize the potential relationship between diabetes and atrial remodeling, including structural, electrical, and autonomic remodeling. Also, some upstream therapies, such as thiazolidinediones, probucol, ACEI/ARBs, may play an important role in the prevention and treatment of AF. Therefore, large prospective randomized, controlled trials and further experimental studies should be challengingly continued.
Prophylactic tranexamic acid in parturients at low risk for post‐partum haemorrhage: systematic review and meta‐analysis
Authors: HEESEN M. , BÖHMER J. , KLÖHR S. , ROSSAINT R. , VAN DE VELDE M. , DUDENHAUSEN J. W. , STRAUBE S.
Published: July 2014

Tranexamic acid is effective in reducing blood loss during various types of surgery and after trauma. No compelling evidence has yet been presented for post‐partum haemorrhage. A systematic literature search of relevant databases was performed to identify trials that assessed blood loss and transfusion incidence after tranexamic acid administration for post‐partum haemorrhage. The random effects model was used for meta‐analysis. Risk ratios (RRs) and weighted mean differences (WMDs) were calculated with 95% confidence intervals (CIs). Seven trials with a low risk of bias comparing tranexamic acid vs. placebo with a total of 1760 parturients were included in our systematic review and meta‐analysis. Blood loss was significantly lower after tranexamic acid use (WMD −140.29 ml, 95% CI −189.64 to −90.93 ml; P < 0.00001). Tranexamic acid reduced the risk for blood transfusions (RR 0.34, 95% CI 0.20–0.60, P = 0.0001). The incidence of transfusions in the placebo group varied between 1.4% and 33%. When omitting the two trials with the highest incidence of transfusions, the RR was no longer significant. Additional uterotonics were necessary in the placebo groups; gastrointestinal adverse events were more common after tranexamic acid use. Only four cases of thrombosis were found, two each in the tranexamic acid and control groups. Tranexamic acid effectively reduced post‐partum blood loss; the effect on the incidence of blood transfusions requires further studies. Only few trials observed adverse events including thromboembolic complications and seizures.
Finding A Seat at the Table Together: Recommendations for Improving Collaboration between Social Work and Bioethics
Authors: Brazg Tracy , Dotolo Danae , Blacksher Erika
Published: July 2014

Social work and bioethics are fields deeply committed to cross‐disciplinary collaboration to do their respective work. While scholars and practitioners from both fields share a commitment to social justice and to respecting the dignity, integrity and the worth of all persons, the overlap between the fields, including shared values, has received little attention. The purpose of this article is to describe the ways in which greater collaboration between the two fields can broaden their scope, enrich their scholarship, and better ground their practice. We describe the potential for realizing such benefits in two areas – health care ethics consultation and social inequalities in health – arguing that the fields both complement and challenge one another, making them ideal partners for the interdisciplinary inquiry and problem‐solving so often called for today in health and health care.
Safety and clinical activity of 5‐aza‐2′‐deoxycytidine (decitabine) with or without Hyper‐CVAD in relapsed/refractory acute lymphocytic leukaemia
Authors: Benton Christopher B. , Thomas Deborah A. , Yang Hui , Ravandi Farhad , Rytting Michael , O'Brien Susan , Franklin Anna R. , Borthakur Gautam , Dara Samuel , Kwari Monica , Pierce Sherry R. , Jabbour Elias , Kantarjian Hagop , Garcia‐Manero Guillermo
Published: July 2014

To test the safety and activity of 5‐aza‐2′‐deoxycytidine (decitabine) in patients with relapsed/refractory acute lymphocytic leukaemia (ALL), we conducted a phase 1 study with two parts: administering decitabine alone or in combination with Hyper‐CVAD (fractionated cyclophosphamide, vincristine, doxorubicin and dexamethasone alternating with high‐dose methotrexate and cytarabine). Patients participated in either part of the study or in both parts sequentially. In the initial part, decitabine was administered intravenously at doses of 10–120 mg/m2 per d for 5 d every other week in cycles of 28 d. In the combination part, patients were treated on the first 5 d of Hyper‐CVAD with intravenous decitabine at 5–60 mg/m2 per d. A total of 39 patients received treatment in the study: 14 in the first part only, 16 sequentially in both parts and 9 in the second part only. Decitabine was tolerated at all doses administered, and grade 3 or 4 toxic effects included non‐life‐threatening hepatotoxicity and hyperglycaemia. Induction of DNA hypomethylation was observed at doses of decitabine up to 80 mg/m2. Some patients who had previously progressed on Hyper‐CVAD alone achieved a complete response when decitabine was added. Decitabine alone or given with Hyper‐CVAD is safe and has clinical activity in patients with advanced ALL.
Establishment and operation of a Good Manufacturing Practice‐compliant allogeneic Epstein‐Barr virus (EBV)‐specific cytotoxic cell bank for the treatment of EBV‐associated lymphoproliferative disease
Authors: Vickers Mark A. , Wilkie Gwen M. , Robinson Nicolas , Rivera Nadja , Haque Tanzina , Crawford Dorothy H. , Barry Jacqueline , Fraser Neil , Turner David M. , Robertson Victoria , Dyer Phil , Flanagan Peter , Newlands Helen R. , Campbell John , Turner Marc L.
Published: July 2014

Epstein‐Barr virus (EBV) is associated with several malignancies, including post‐transplant lymphoproliferative disorder (PTLD). Conventional treatments for PTLD are often successful, but risk organ rejection and cause significant side effects. EBV‐specific cytotoxic T lymphocytes (CTLs) generated in vitro from peripheral blood lymphocytes provide an alternative treatment modality with few side effects, but autologous CTLs are difficult to use in clinical practice. Here we report the establishment and operation of a bank of EBV‐specific CTLs derived from 25 blood donors with human leucocyte antigen (HLA) types found at high frequency in European populations. Since licensure, there have been enquiries about 37 patients, who shared a median of three class I and two class II HLA types with these donors. Cells have been infused into ten patients with lymphoproliferative disease, eight of whom achieved complete remission. Neither patient with refractory disease was matched for HLA class II. Both cases of EBV‐associated non‐haematopoietic sarcoma receiving cells failed to achieve complete remission. Thirteen patients died before any cells could be issued, emphasizing that the bank should be contacted before patients become pre‐terminal. Thus, this third party donor‐derived EBV‐specific CTL cell bank can supply most patients with appropriately matched cells and most recipients have good outcomes.
Diversity in Midwifery Care: Working toward Social Justice
Authors: Burton Nadya , Ariss Rachel
Published: July 2014

La pratique de la sage‐femme opérant dans la communauté a apporté avec elle, lorsque devenu une profession régie et financée par l’état vers la fin du vingtième siècle, les objectifs et aspirations de son mouvement social. Parmi ces objectifs, elles désiraient à faire attention à l’équité et la diversité sociale lors de la provision de soins pendant la naissance. Dans cet article, nous utilisons des interviews avec des sage‐femmes qui pratiquent en ce moment en Ontario, afin de nous concentrer sur les conceptualisations de la diversité des sage‐femmes. Nous explorons leurs efforts, dans le travail quotidien, visant à supporter et fortifier la diversité sociale des clientes et des sage‐femmes elles‐mêmes. Nous proposons que la transition de la pratique de la sage‐femme vers le système de soins santé gouvernemental ne signale pas l'abandon des projets et engagements de changement social. Les réponses à la diversité sociale en soins de santé varie des efforts à améliorer l'accès aux soins de santé jusqu'à l’étude du rôle de la justice sociale en reconnaissant les besoins des populations diverses. L'aspiration de ‘créer un monde meilleur’ continue à animer le travail des sage‐femmes nonobstant la réglementation de leur pratique. Cet article explore le patrimoine de pratique des sage‐femmes en tant que mouvement social et décrit les rapports entre la diversité, la justice sociale et la pratique actuelle des sage‐femmes.

As midwifery moved from lay practice to a regulated health‐care profession in Ontario toward the end of the twentieth century, it brought with it many of its social movement goals and aspirations. Among these was the desire to attend to diversity and equity in the provision of birthing care. Drawing on interviews with currently practicing Ontario midwives, this paper focuses on midwives’ conceptualizations of diversity and explores their everyday work to support and strengthen diversity among those using and those providing midwifery care. We argue that midwifery's recent relocation within state structured health care means neither that the social change projects of midwifery are complete nor that midwifery has abandoned its movement‐based commitment to social change. Responses to social diversity in health care range from efforts to simply improve access to care to analyses of the role of social justice in recognizing the needs of diverse populations. The social justice aspiration to “create a better world” continues to animate the work of midwives postregulation. This paper explores the legacy of midwifery as a social movement, addressing the connections between diversity, social justice and midwifery care.
Multi-centre retrospective analysis of anaphylaxis during general anaesthesia in the United Kingdom: aetiology and diagnostic performance of acute serum tryptase
Authors: Krishna M T , York M , Chin T , Gnanakumaran G , Heslegrave J , Derbridge C , Huissoon A , Diwakar L , Eren E , Crossman R J , Khan N , Williams A P
Published: July 2014

This is the first multi-centre retrospective survey from the United Kingdom to evaluate the aetiology and diagnostic performance of tryptase in anaphylaxis during general anaesthesia (GA). Data were collected retrospectively (2005–12) from 161 patients [mean ± standard deviation (s.d.), 50 ± 15 years] referred to four regional UK centres. Receiver operating characteristic curves (ROC) were constructed to assess the utility of tryptase measurements in the diagnosis of immunoglobulin (Ig)E-mediated anaphylaxis and the performance of percentage change from baseline [percentage change (PC)] and absolute tryptase (AT) quantitation. An IgE-mediated cause was identified in 103 patients (64%); neuromuscular blocking agents (NMBA) constituted the leading cause (38%) followed by antibiotics (8%), patent blue dye (6%), chlorhexidine (5%) and other agents (7%). In contrast to previous reports, latex-induced anaphylaxis was rare (0·6%). A non-IgE-mediated cause was attributed in 10 patients (6%) and no cause could be established in 48 cases (30%). Three serial tryptase measurements were available in 34% of patients and a ROC analysis of area under the curve (AUC) showed comparable performance for PC and AT. A ≥ 80% PPV for identifying an IgE-mediated anaphylaxis was achieved with a PC of >141% or an AT of >15·7 mg/l. NMBAs were the leading cause of anaphylaxis, followed by antibiotics, with latex allergy being uncommon. Chlorhexidine and patent blue dye are emerging important health-care-associated allergens that may lead to anaphylaxis. An elevated acute serum tryptase (PC >141%, AT >15·7 mg/l) is highly predictive of IgE-mediated anaphylaxis, and both methods of interpretation are comparable.
Shining theLight onSunshine: a systematic review of the influence of sun exposure on type 2 diabetes mellitus‐related outcomes
Authors: Shore‐Lorenti Catherine , Brennan Sharon L. , Sanders Kerrie M. , Neale Rachel E. , Lucas Robyn M. , Ebeling Peter R.
Published: July 2014

Prospective observational studies uniformly link vitaminDdeficiency with the incidence of type 2 diabetes mellitus (T2DM), yet trials supplementing participants at risk ofT2DMwith vitaminDto reduce progression toT2DMhave yielded inconsistent results. Inconsistencies between supplementation trials may be due to insufficient dosing or small sample sizes. Observational studies may also have reported spurious associations due to uncontrolled confounding by lifestyle or genetic factors. Alternatively, observational and intervention studies may not be entirely comparable. Observational studies show an association between higher vitaminDstatus, which is predominantly derived from sun exposure, and decreased incidence ofT2DM. Trials intervene with vitaminDsupplementation, and therefore may be missing alternate causes of the effect of sun exposure, as seen in observational studies. We propose that sun exposure may be the driving force behind the associations seen in observational studies; sun exposure may have additional benefits beyond increasing serum 25‐hydroxyvitaminD(25OHD) levels. We performed an electronic literature search to identify articles that examined associations between sun exposure andT2DMand/or glucose metabolism. A best evidence synthesis was then conducted using outcomes from analyses deemed to have high methodological quality. Ten eligible full‐text articles were identified, yielding 19T2DM‐related outcomes. The best evidence analysis considered 11 outcomes which were grouped into six outcome types:T2DM, fasting glucose, glucose tolerance, fasting insulin, insulin secretion and insulin sensitivity. There was moderate evidence to support a role of recreational sun exposure in reducing odds ofT2DMincidence. High‐level evidence was lacking; evidence presented for other outcomes was of low or insufficient level. This review highlights significant gaps in research pertaining to sun exposure andT2DM‐related outcomes. Further research is encouraged as we aim to identify novel preventative strategies for T2DM.
Positive and Negative Effects of a Threatened Parrotfish on Reef Ecosystems
Authors: MCCAULEY DOUGLAS J. , YOUNG HILLARY S. , GUEVARA ROGER , WILLIAMS GARETH J. , POWER ELEANOR A. , DUNBAR ROBERT B. , BIRD DOUGLAS W. , DURHAM WILLIAM H. , MICHELI FIORENZA
Published: July 2014

Species that are strong interactors play disproportionately important roles in the dynamics of natural ecosystems. It has been proposed that their presence is necessary for positively shaping the structure and functioning of ecosystems. We evaluated this hypothesis using the case of the world's largest parrotfish (Bolbometopon muricatum), a globally imperiled species. We used direct observation, animal tracking, and computer simulations to examine the diverse routes through which B. muricatum affects the diversity, dispersal, relative abundance, and survival of the corals that comprise the foundation of reef ecosystems. Our results suggest that this species can influence reef building corals in both positive and negative ways. Field observation and simulation outputs indicated that B. muricatum reduced the abundance of macroalgae that can outcompete corals, but they also feed directly on corals, decreasing coral abundance, diversity, and colony size. B. muricatum appeared to facilitate coral advancement by mechanically dispersing coral fragments and opening up bare space for coral settlement, but they also damaged adult corals and remobilized a large volume of potentially stressful carbonate sediment. The impacts this species has on reefs appears to be regulated in part by its abundance—the effects of B. muricatum were more intense in simulation scenarios populated with high densities of these fish. Observations conducted in regions with high and low predator (e.g., sharks) abundance generated results that are consistent with the hypothesis that these predators of B. muricatum may play a role in governing their abundance; thus, predation may modulate the intensity of the effects they have on reef dynamics. Overall our results illustrate that functionally unique and threatened species may not have universally positive impacts on ecosystems and that it may be necessary for environmental managers to consider the diverse effects of such species and the forces that mediate the strength of their influence.

Efectos Positivos y Negativos de un Pez Loro Amenazado Sobre Ecosistemas Arrecifales
Effects of Invasive Plants on Arthropods
Authors: LITT ANDREA R. , CORD ERIN E. , FULBRIGHT TIMOTHY E. , SCHUSTER GRETA L.
Published: July 2014

Non‐native plants have invaded nearly all ecosystems and represent a major component of global ecological change. Plant invasions frequently change the composition and structure of vegetation communities, which can alter animal communities and ecosystem processes. We reviewed 87 articles published in the peer‐reviewed literature to evaluate responses of arthropod communities and functional groups to non‐native invasive plants. Total abundance of arthropods decreased in 62% of studies and increased in 15%. Taxonomic richness decreased in 48% of studies and increased in 13%. Herbivorous arthropods decreased in response to plant invasions in 48% of studies and increased in 17%, likely due to direct effects of decreased plant diversity. Predaceous arthropods decreased in response to invasive plants in 44% of studies, which may reflect indirect effects due to reductions in prey. Twenty‐two percent of studies documented increases in predators, which may reflect changes in vegetation structure that improved mobility, survival, or web‐building for these species. Detritivores increased in 67% of studies, likely in response to increased litter and decaying vegetation; no studies documented decreased abundance in this functional group. Although many researchers have examined effects of plant invasions on arthropods, sizeable information gaps remain, specifically regarding how invasive plants influence habitat and dietary requirements. Beyond this, the ability to predict changes in arthropod populations and communities associated with plant invasions could be improved by adopting a more functional and mechanistic approach. Understanding responses of arthropods to invasive plants will critically inform conservation of virtually all biodiversity and ecological processes because so many organisms depend on arthropods as prey or for their functional roles, including pollination, seed dispersal, and decomposition. Given their short generation times and ability to respond rapidly to ecological change, arthropods may be ideal targets for restoration and conservation activities.

Efectos de las Plantas Invasoras sobre los Artrópodos