bluuebunny/crossref_metadata_2025 huggingface dataset:
Market orientation and hotel performance: investigating the role of high-order marketing capabilities
Authors: Alnawas Ibrahim , Hemsley-Brown Jane
Published: March 2019

Purpose

Using the resource-based view (RBV), the purpose of this paper is to examine the potential mediation effect of customer relationship management capability, branding capability and service innovation capability on the established link between market orientation (MO) and hotel performance. It further investigates the complementarity between these capabilities in relation to hotel performance.

Design/methodology/approach

The survey data were collected from 216 UK hotels. AMOS 23 was used to analyse the research data.

Findings

The link between MO and hotel performance appears to be indirect via customer relationship capability, branding capability and service innovation capability. The three capabilities also appear to play different complementary roles when affecting hotel performance.

Practical implications

The current study offers hotel managers a ranking of the contribution of individual capabilities to hotel performance. It also helps them to make better investment decisions in developing the right capability combinations to enhance their hotel performance.

Originality/value

The research is based on integrating MO and RBV into a single framework to gain a deeper understanding of the relationship between MO and high-order marketing capabilities and how these factors shape hotel performance.
Risk factors in oil and gas construction projects in developing countries: a case study
Authors: A. Kassem Mukhtar , Khoiry Muhamad Azry , Hamzah Noraini
Published: March 2019

Purpose

This study aims to investigate the risk factors in construction projects in oil and gas processing facilities in Yemen and serves as a case study for developing countries.

Design/methodology/approach

By using a questionnaire, data were collected from 201 project managers and engineers employed in different sectors in the oil and gas industry in Yemen.

Findings

The survey analysis based on Kruskal–Wallis test method shows a high degree of agreement on the perceptions of risk factors depending on categories of companies. In other words, the tested risk factors exist in all sectors of oil companies in Yemen and are valid as a measure of risk factors in construction projects in oil and gas organizations in general. Although no evidence suggests that the risk factors differ significantly according to job title, the result of identifiable risk factors according to experience shows a statistically significant difference among participants in terms of their experience. The relative importance of the ranking of risk factors was obtained by the statistical analysis of responses on the impact and likelihood of occurrence of these risks. Findings show that internal risks are the greatest influential factors in construction projects in the oil and gas sector, followed by changes during construction project, government instability, incorrect project cost estimation, government delay in decision making, incorrect project schedule estimation, and political situation and war in the country.

Originality/value

These findings are valuable to organizations that are planning to conduct construction projects for oil and gas processing facilities in Yemen and other nations with similar environments, such as developing countries.
Exploring the nonlinear impact of critical incidents on users’ satisfaction with healthcare services
Authors: Tontini Gerson , Vaz Elaine , Neto Evelásio Vieira , de Souza Julio Cesar Lopes , da Silva Leonardo Anésio , Nowazick Mara Paz Maurício
Published: March 2019

Purpose

The purpose of this paper is to evaluate the nonlinear impact of users’ memories on their general evaluation of outpatient healthcare services by the integration of two methodologies: critical incidents technique (CIT) and penalty-reward contrast analysis (PRCA).

Design/methodology/approach

The authors carried out a survey with 356 respondents, users of seven outpatient clinics located in the city of Blumenau/SC, Brazil, during 2016. The participants were asked about their perceptions of positive and negative aspects of the service; and, using CIT, the answers were categorized according to the following dimensions: empathy, communication, facilities, access, promptness, medicines availability, complementary services, safety/confidentiality and service performance. Then, the authors evaluated the nonlinear impact of critical incidents on users’ general evaluation of the service using the identified incidents as input variables in a PRCA.

Findings

The findings show that users of healthcare services tend to remember emotion and health aspects positively, while technical and formal aspects tend to be more negatively than positively remembered. On the other hand, PRCA identifies that incidents of three dimensions positively influence the overall perception of the service (empathy, complementary services and privacy) and five negatively (empathy, facilities, speed, drugs/pharmacy and health performance), explaining 26.3 percent of the variation in clients’ general satisfaction.

Originality/value

The present paper explores the integration of two methodologies, showing how we can use open listening to healthcare service users to identify the nonlinear impact of different incidents on their general evaluation of the service. The results show that what customers remember does not necessarily influence overall customer satisfaction. The present approach allows companies to improve the process of listening to customers. There are no other papers exploring this approach, particularly in relation to healthcare services.
Graduate experiences with transnational nursing education: a qualitative enquiry
Authors: Naidoo Vasanthrie , Sibiya Maureen Nokuthula
Published: March 2019

Purpose

The purpose of this paper is to share insights, research findings and discuss key issues related to graduate experiences with transnational nursing education (TNE).

Design/methodology/approach

The authors used a qualitative approach and sampled national and international nurse graduates to identify challenges and best operating practices in cross-border nursing program facilitation.

Findings

This research paper has provided a platform for graduates to lend their voices to the promotion of effective cross-border nursing education delivery and suggests that although international collaborations endeavor to maintain high academic standards in TNE, there is still a need to re-engineer, revise and adapt curricular content, learning, teaching and assessment practices to aid the nursing student.

Research limitations/implications

Identified challenges affecting the facilitation and delivery of cross-border nursing education programs can act as levers to improving service quality of present and future cross-border programs to the nursing student. This will assist future nursing students to recognize culture shock and embrace their decision to pursue nursing.

Practical implications

The experience of being involved in TNE for nursing students may not be that much different than students of other disciplines. While not able to be generalized to the entire population, the reports by the nursing students in this sample appear to be valuable and worthwhile to continue supporting and encouraging other TNE opportunities.

Originality/value

This paper explores cross-border nursing education experiences from national and international perspectives. The authors were able to explore inherent TNE challenges from diverse population and cultural backgrounds.
Validating the Press Ganey Questionnaire (Bahasa Melayu version)
Authors: Rasudin Nur Syahmina , Ahmad Muhammad Akmal Izan , Hussain Nooraini , Che Hamah Mohd Shaharudin Shah
Published: March 2019

Purpose

The purpose of this paper is to validate the Press Ganey Questionnaire (PGQ) (Bahasa Melayu version) using Hospital Universiti Sains Malaysia (HUSM) patients.

Design/methodology/approach

This cross-sectional study comprised 252 patients visiting HUSM. Patients were selected using the convenience sampling method. The PGQ (Bahasa Melayu version) had three main factors: during your visit; your care provider and overall assessment. Data were analyzed using the structural equation modeling.

Findings

The exploratory factor analysis resulted in item reduction from 21 to 17, which contained four factors with eigenvalues greater than 1. Meanwhile, confirmatory factor analysis results showed that data fitted the model: χ2/df at 1.764, comparative fit index at 0.952, Tucker–Lewis index at 0.941 and root mean square error of approximation at 0.073. The average variance extracted value for the four factors was greater than 0.50, which indicated that PGQ convergent validity was met. Overall, PGQ produced good reliability with composite reliability score equals to 0.966. Four factors were reclassified as “during your registration,” “hospital staff attitude,” “doctor’s attitude” and “overall assessment.”

Research limitations/implications

Patient satisfaction is an important and frequently used indicator for measuring healthcare quality; hence, a validated and reliable instrument is important for measuring patient satisfaction that leads to healthcare service quality assessment.

Practical implications

Validated PGQ provides some useful information for doctors, medical assistants, nurses and staff in the emergency department to help them become more prominent and efficient in their role as healthcare providers.

Social implications

Validated PGQ will help healthcare providers to deliver the best and exceptional care toward emergency patient, and thus improve their quality of work life. The findings in this study can be used as a guide or as baseline data for further research in this area.

Originality/value

The PQG (Bahasa Melayu version) was confirmed as a reliable and valid instrument for measuring patient satisfaction. This research is the first PGQ validation study in Southeast Asia, specifically focusing on Malaysian respondents.
Conflict and conflict management in hospitals
Authors: Mosadeghrad Ali Mohammad , Mojbafan Arezoo
Published: March 2019

Purpose

Hospitals are complex and complicated organizations and are prone to the conflict. The purpose of this paper is to identify the intensity and type of conflict experienced by hospital managers and explore their conflict management strategies in hospitals affiliated with Tehran University of Medical Sciences.

Design/methodology/approach

This quantitative, descriptive and cross-sectional study was conducted in 2015. A self-administered questionnaire was used to collect data from top, middle and front line managers. In total, 563 managers from 14 hospitals responded to the questionnaires. Data were analyzed using SPSS software version 19.

Findings

Hospital managers reported average level of conflict (2.73 score out of 5). Organizational factors produced more conflict for managers than personal factors. High workload, resource shortage, bureaucracy and differences in managers’ personality, knowledge, capabilities and skills were the main causes of organizational and personal conflict. Top managers experienced more conflict than middle and front line managers. Conflict was higher in specialized hospitals compared to general hospitals. Less conflict was observed in administrative and support departments than diagnostic and therapeutic departments. Conflict was meaningfully associated with management level, education, size of hospital, number of employees and willingness to leave the hospital. The dominant conflict management style of managers was collaborating. There were significant relationships between collaborating style and management level, manager’s age, work experience and management experience.

Practical implications

The nature of hospitals requires that managers use collaborating, compromising and accommodating styles to interact better with different stakeholders. Managers by acquiring necessary training and using the right conflict resolution strategies should keep the conflict in a constructive level in hospitals.

Originality/value

This is the first study conducted in Iran examining the level of conflict, its types and identifying managers’ dominant conflict resolution strategies at front line, middle and top management levels.
Gamification and accessibility
Authors: Smith Keyonda , Abrams Sandra Schamroth
Published: March 2019

Purpose

The purpose of this paper is to explore the issue of access to digital technology by using the lens of accessibility as set forth by the Rehabilitation Act of 1973 and the American Disabilities Act (ADA) of 1990. More specifically, this paper focuses on gamification, considers the needs of all learners, including those who identify as disabled, and raises important inquiries about equity and access to technological instructional materials.

Design/methodology/approach

Juxtaposing Kapp’s (2012) nine elements of gamification with aspects of accessibility, this paper conceptualizes the challenges and possibilities associated with gamified instructional approaches.

Findings

This paper examines gamification in light of potential barriers that exist as disabled learners navigate online courses that include one or more of the following aspects of gamification – game-based, mechanics, aesthetics, game-thinking, engage, people, motivate action, promote learning, and solve problems. Notably, online courses enhanced with gamification elements present potential access barriers and challenges to learners who identify with auditory, cognitive, neurological, physical, speech, or visual disabilities.

Research limitations/implications

This paper initiates an important discussion, and as such, it incepts additional investigations into supporting differently abled learners.

Practical implications

By examining gamification through the lens of accessibility, this paper contributes yet another perspective of teaching, learning, and instructional design.

Originality/value

In addition to socio-economic factors that may preclude one from engaging in a digital play, there is a larger question of how, if at all, gamification is accessible to learners with auditory, cognitive, neurological, physical, speech, or visual disabilities or impairments. This paper raises important questions for educators, education researchers, and game and instructional designers alike to ensure ubiquitous access to gamified digital materials in general, and online, gamified materials in particular.
The viable system model as a framework to guide organisational adaptive response in times of instability and change
Authors: Cardoso Castro Pedro Pablo
Published: March 2019

Purpose

The purpose of this paper is to analyse the convenience of the Viable System Model (VSM) as a framework to guide organisational adaptive response and resilience in times of instability and change.

Design/methodology/approach

A thought experiment based on the case study of an eco-village where a project based on action research was conducted following the introduction of the VSM.

Findings

This paper provides evidence of the efficacy of the VSM and its recursive structure to facilitate resilience and organisational adaptation and provides evidence of its advantages over conventional management tools to deal with uncertainty in complex environments.

Research limitations/implications

Based on a case study, the scope of this paper is limited and context specific. The comparison of tools is also limited to the ones related to the allocation of resources aiming to provide resilience, viability and adaptive response to critical events, used by the observed community.

Practical implications

The case study invites to revisit and discuss the fitness of conventionally used management tools to cope with complexity – from an organisational perspective.

Originality/value

This paper invites to a reflection on the nature of dominant management tools used in contemporary management to cope with complexity. This paper provides insights on the value of organisational cybernetics and its capability to guide organisations in times of instability and change while facilitating resilience and adaptation through the management of variety.
Analysis of drivers of CSR practices’ implementation among family firms in India
Authors: Singh Shubham , Mittal Shashank
Published: March 2019

Purpose

Differences in institutional environment and governance structures pave the way for heterogeneous nature of different businesses; this, in turn, shapes the way various sections of society act toward each other enacting their responsibilities. Taking into account the unique institutional environment and governance structures of firms in developing economies, this paper aims to build on the “stakeholder theory” to address the issue of the implementation of corporate social responsibilities (CSR) practices in these economies, particularly India. This paper also aims to uncover the saliency (legitimacy and power) of different stakeholder groups on different aspects of a firm’s CSR activities. Further, as most of the firms in developing economies are family-run firms, the paper examines role of organizational leadership in shaping firms’ CSR strategies.

Design/methodology/approach

Integrating literature on “stakeholder theory” and CSR, this paper examines the implementation of different CSR practices by family-run firms in India. This paper uses survey research to collect data from 80 privately held family firms operating in apparel and textiles industry in India. The data have been collected from respondents holding top leadership positions in the sample firms.

Findings

The findings indicate that pressure from primary stakeholders (i.e. customers, employees and shareholders) and CSR-oriented leadership belief significantly influence organizational implementation of CSR practices, whereas pressure from secondary stakeholder (i.e. community groups and non-governmental organizations) was found to be insignificant. Further, CSR-oriented leadership belief moderated the relationship between primary stakeholder pressure and organizational implementation of CSR practices. The findings equally highlighted lower saliency of secondary stakeholder’s legitimacy and power because of weak institutional mechanisms, while on the other hand, the primary stakeholders exert considerable power because of the direct nature of transactional legitimacy, further accentuated by the governance structure in family firms.

Originality/value

This paper is among the very few studies that address the issue of CSR among family-run businesses in developing economies. Existing frameworks on analyzing firm’s implementation of CSR practices does not recognize the inherent heterogeneity among different stakeholder groups. Recognizing that different stakeholders have different levels of influence over firms, this paper categorized the stakeholders’ groups into primary and secondary to analyze their differential impact over firms. Additionally, given the critical role of leadership belief in the implementation of CSR practices, this paper analyzed the moderated effect of CSR-oriented leadership belief toward developing a more robust model of CSR implementation.
The effectiveness of archaeological predictive maps
Authors: de Waal Maaike , Lesparre Jochem , Espersen Ryan , Stelten Ruud
Published: March 2019

Purpose

Archaeological predictive maps can be valuable tools for planning officers, spatial developers and archaeologists. In 2012, the Dutch Ministry of Education, Culture and Science asked the St Eustatius Center for Archaeological Research (SECAR) to create archaeological predictive maps for St Eustatius and Saba. The maps were supposed to contribute to more effective management and protection of archaeological sites. The maps were published in 2013 and 2015. The purpose of this paper is to address the question whether the subsequent use of these maps has indeed improved site management and protection.

Design/methodology/approach

The evaluation proceeded by identifying the users and applications of the maps through questionnaires and an internet search engine, along with follow-up interviews with heritage professionals on both islands.

Findings

The use of the predictive maps has not yet contributed to improved management and protection of archaeological sites on St Eustatius and Saba. Suggestions have been made to ameliorate this situation and to ensure the preservation of archaeological heritage for future generations.

Originality/value

The creation of archaeological predictive maps can be an important step towards improving management and protection of archaeological heritage, education and heritage awareness. This is important for St Eustatius and Saba, islands that are characterised by vulnerable archaeological heritage, rapid spatial development and a lack of efficient protection measures. This paper points to the importance of follow-up efforts to ensure effective site management and protection.
Interaction of agricultural and ethnographic tourism for the development of Russian regions
Authors: Voinova Natalia , Arcibashev Denis , Aliushin Roman , Malina Viktoria
Published: March 2019

Purpose

The purpose of this paper is to determine the potential of rural and ethnographic tourism for the sustainable socio-economic development of Russian regions.

Design/methodology/approach

A system approach was used as a method to study this problem, which allowed the authors to identify the main trends in the development of rural and ethnographic tourism in Russian regions.

Findings

The research results were obtained using predictive analysis and by determining the prospects for the further development of recreational services and the forms of their territorial organization. The paper claims that it is viable to use the sites famous for traditional folk crafts in combination with rural tourism when creating tourist clusters as this is beneficial for promising large-scale tourism investment projects.

Originality/value

The relevance of the problem stems from the fact that the comprehensive interaction of rural and ethnographic tourism can become an additional “growth area” of domestic travel in Russian regions. This may be possible because of a certain combination of conditions and factors on the territory of the region, the availability of natural, recreational and ethno-cultural resources.
Victimisation and addictive careers amongst women in Malta
Authors: Scicluna Petra , Clark Marilyn
Published: March 2019

Purpose

The purpose of this paper is to provide a theoretical analysis of the pathways of female addicts within the Maltese context by highlighting the complex interrelatedness between substance abuse and victimisation. This paper proposes that female addiction and victimisation trajectories unfold in a non-linear fashion, heavily influenced by particular socio-psychological processes.

Design/methodology/approach

Guided by a career approach conceptual framework, this study was carried out through an in-depth exploration of the victimisation and addictive career trajectories of 12 women, who are either incarcerated or in a residential drug treatment facility. Data were gathered qualitatively through in-depth interviews and analysed using a grounded theory methodology.

Findings

The paper highlights how the victimisation and substance abuse trajectories of women initially unfold and develop over time. This includes an exploration of the strategies employed in order to negotiate gender-based victimisation experiences throughout their lifetime, such as through the development of a victim identity and the self-medication of trauma symptoms, a process that is facilitated by the influence of older, male peers. As the women’s addiction trajectories progress rapidly towards commitment, sex work and IPV feature and the victim identity is reinforced, motivating continued and increased drug use.

Practical implications

The paper includes implications for the development of a gender-responsive framework of intervention when working with women who were present for the treatment.

Originality/value

With a focus on women’s experiences, this study fills a lacuna within the literature by complementing and expanding upon quantitative analyses that examine these phenomena as distinct entities.
Redesign of a continuous passive motion machine for total knee replacement therapy
Authors: Tangjitsitcharoen Somkiat , Lohasiriwat Haruetai
Published: March 2019

Purpose

After knee replacement surgery, rehabilitation is needed to recover to normal levels of mobility. A continuous passive motion (CPM) machine is usually introduced at this stage to aid rehabilitation. However, the redundant structure and complex mechanism of the existing machine has resulted in irregular use. The purpose of this paper is to redesign the current machine.

Design/methodology/approach

The mechanical and electrical systems of the current machine were studied alongside interviews with stakeholders. Problems with the existing machine were identified. Related information was gathered in both the engineering and medical aspects. The redesign concept of the equipment was specified following engineering analyses to develop the final model. Finite element analysis was performed to ensure the appropriate size and dimension of the equipment. The prototype of the redesigned CPM was manufactured in-house. Product testing was conducted with 40 volunteers including experienced therapists, nurses, university students and working-age people.

Findings

Compared to the previous machine, the newly designed model was improved in both functioning and manufacturing costs. The redesigned machine is more durable and consists of a less complex structure.

Originality/value

The redesigned machine introduces some new features and removes unnecessary functions. As a result, the model costs less and hence, is considered beneficial to the general public. More utilization is expected which could eventually reduce the therapists’ workload at the hospital. This research provides well-defined processes of the product development starting from the users’ requirement analysis to the prototype testing stage.
The essence of investing: experiential education with a student-run portfolio
Authors: Tashjian Elizabeth
Published: March 2019

Purpose

Many undergraduates major in business in hopes of being well-prepared for a career. However, Arum and Roksa (2010) find business students perform poorly relative to peers on measures of academic gains and employers report that few college graduates are well-prepared for business careers (Lumina Foundation, 2013). Experiential courses have the potential to engage students deeply and encourage critical thinking while developing important business skills. The paper aims to discuss these issues.

Design/methodology/approach

This paper proposes several attributes of successful experiential courses and uses a student-managed portfolio as an example of a successful model.

Findings

Student-managed portfolios can improve educational and career outcomes for students.

Practical implications

Student-managed investment funds can provide a vehicle for teaching students research, critical thinking and writing skills while encouraging them to integrate knowledge from a broad range of business disciplines to understand a firm’s business model.

Originality/value

While experiential programs are touted as addressing these shortcomings, many academics remain skeptical of experiential programs which too often focus on showy trips, passively listening to important people or performing shallow analyses at the expense of developing a deep understanding of how to identify and solve complex problems. This paper offers some insight into important features of a successful experiential program.
With respect to prejudice
Authors: Maitra Begum
Published: March 2019

The basic assumptions of psychotherapy must necessarily reflect the cultural orientations and dilemmas of the western societies, and historical periods, in which these originated. This paper considers how the racialised biases of that period, namely, the era of European domination built upon the conquest, colonisation and enslavement of non‐European peoples, may linger in psychotherapeutic training and practice today. This not only limits the potential usefulness of the discipline in the multicultural populations of the west, but also risks it being read as covert neo‐colonialism in the ‘non‐west’. In a world that ever more clearly demonstrates the human costs of prejudice psychotherapists in general, and Jungians in particular, might wish to consider how, wittingly or otherwise, they maintain prejudiced ways of thinking. This paper examines material from the author's professional and personal experience, using literature that lies outside the specifically Jungian canon, to expose how such bias might work.
The Palace of Westminster: Another Window of Opportunity?
Authors: Cotter Leanne‐Marie , Flinders Matthew
Published: March 2019

The Palace of Westminster is in need of urgent, substantial repairs. This provides a ‘window of opportunity’ for change. This essay traces the restoration and transformation (or lack of) that the Palace of Westminster has seen in the last half a century, before assessing its current state, and considering whether parliament is fit for purpose. It provides a ‘long‐view’ understanding of previous missed ‘windows of opportunity’. The essay focuses on drawing insights from history in order to add a depth of understanding to the contemporary issue. An understanding of the preceding renewal and restoration projects enables us, potentially, to avoid some of the problems that have been previously experienced, and finally seize this opportunity to build a parliament which is fit for purpose.
Physical decoupling of XylS/Pm regulatory elements and conditional proteolysis enable precise control of gene expression in Pseudomonas putida
Authors: Volke Daniel C. , Turlin Justine , Mol Viviënne , Nikel Pablo I.
Published: March 2019

Most of the gene expression systems available for Gram‐negative bacteria are afflicted by relatively high levels of basal (i.e. leaky) expression of the target gene(s). This occurrence affects the system dynamics, ultimately reducing the output and productivity of engineered pathways and synthetic circuits. In order to circumvent this problem, we have designed a novel expression system based on the well‐known XylS/Pm transcriptional regulator/promoter pair from the soil bacterium Pseudomonas putida mt‐2, in which the key functional elements are physically decoupled. By integrating the xylS gene into the chromosome of the platform strain KT2440, while placing the Pm promoter into a set of standard plasmid vectors, the inducibility of the system (i.e. the output difference between the induced and uninduced state) improved up to 170‐fold. We further combined this modular system with an extra layer of post‐translational control by means of conditional proteolysis. In this setup, the target gene is tagged with a synthetic motif dictating protein degradation. When the system features were characterized using the monomeric superfolder GFP as a model protein, the basal levels of fluorescence were brought down to zero (i.e. below the limit of detection). In all, these novel expression systems constitute an alternative tool to altogether suppress leaky gene expression, and they can be easily adapted to other vector formats and plugged‐in into different Gram‐negative bacterial species at the user's will.
Assessing Campus Alcohol Policies: Measuring Accessibility, Clarity, and Effectiveness
Authors: Jernigan David H. , Shields Kelsey , Mitchell Molly , Arria Amelia M.
Published: March 2019

Background

Excessive alcohol consumption poses significant hazards to health and safety on college campuses. While substantial research exists regarding effective policies for preventing alcohol‐related problems in the communities surrounding campuses, on‐campus alcohol policies have received far less attention.

Methods

Official campus alcohol policies (CAPs) were retrieved from the websites of the 15 member schools of the Maryland Collaborative to Reduce College Drinking and Related Problems, a voluntary statewide collaborative. CAPs were assessed for accessibility, clarity, and effectiveness. In addition to assessing whether campuses were in compliance with federal regulations for comprehensiveness of policies, a measure of likely policy effectiveness was developed through the use of 2 Delphi panels drawing on alcohol policy researchers and on‐campus and community practitioners, respectively. The panels rated 35 potential policies and 13 possible sanctions; lists of policies and sanctions were compiled primarily from what was already in existence at 1 or more member schools.

Results

For most campuses, the CAPs could be located within 30 seconds, but tended to be spread across multiple web pages. Language used to communicate the policies tended to be complex and above the reading level of someone with a high school education. At least half of the schools had less than half of the possible policies rated most or somewhat effective by the Delphi panels. Schools were more likely to employ the most effective sanctions, but somewhat and ineffective sanctions were also not uncommon.

Conclusions

CAPs are an important element in reducing negative consequences of alcohol consumption on college campuses. A higher level of research scrutiny is warranted to understand the extent to which CAPs are associated with excessive drinking, but this research describes an evidence‐ and expert‐informed assessment approach that colleges can use to regularly analyze and update their CAPS.
The association between mixed symptoms, irritability and functioning measured using smartphones in bipolar disorder
Authors: Faurholt‐Jepsen M. , Frost M. , Christensen E. M. , Bardram J. E. , Vinberg M. , Kessing L. V.
Published: March 2019

Objective

To (i) validate patient‐evaluated mixed symptoms and irritability measured using smartphones against clinical evaluations; (ii) investigate associations between mixed symptoms and irritability with stress, quality of life and functioning, respectively, in patients with bipolar disorder.

Methods

A total of 84 patients with bipolar disorder used a smartphone‐based system for daily evaluation of mixed symptoms and irritability for nine months. Clinically evaluated symptoms, stress, quality of life and clinically rated functioning were collected multiple times during follow‐up.

Results

Patients presented mild affective symptoms. Patient‐reported mixed symptoms and irritability correlated with clinical evaluations. In analyses including confounding factors there was a statistically significant association between both mixed symptoms and irritability and stress (P < 0.0001) and between irritability and both quality of life and functioning (P < 0.0001) respectively. There was no association between mixed mood and both quality of life and functioning.

Conclusion

Mixed symptoms and irritability can be validly self‐reported using smartphones in patients with bipolar disorder. Mixed symptoms and irritability are associated with increased stress even during full or partial remission. Irritability is associated with decreased quality of life and functioning. The findings emphasize the clinical importance of identifying inter‐episodic symptoms including irritability pointing towards smartphones as a valid tool.
Meta‐analysis of suicide rates among people discharged from non‐psychiatric settings after presentation with suicidal thoughts or behaviours
Authors: Wang M. , Swaraj S. , Chung D. , Stanton C. , Kapur N. , Large M.
Published: March 2019

Objective

To quantify the suicide rate among people discharged from non‐psychiatric settings after presentations with suicidal thoughts or behaviours.

Method

Meta‐analysis of studies reporting suicide deaths among people with suicidal thoughts or behaviours after discharge from emergency departments or the medical or surgical wards of general hospitals.

Results

A total of 115 studies reported 167 cohorts and 3747 suicide deaths among 248 005 patients during 1 263 727 person‐years. The pooled suicide rate postdischarge was 483 suicide deaths per 100 000 person‐years (95% confidence interval (CI) 445–520, prediction interval (PI) 200–770) with high between‐sample heterogeneity (I2 = 92). The suicide rate was highest in the first year postdischarge (851 per 100 000 person‐years) but remained elevated in the long term. Suicide rates were elevated among samples of men (716 per 100 000 person‐years) and older people (799 per 100 000 person‐years) but were lower in samples of younger people (107 per 100 000 person‐years) and among studies published between 2010 and 2018 (329 per 100 000 person‐years).

Conclusions

People with suicidal thoughts or behaviours who are discharged from non‐psychiatric settings have highly elevated rates of suicide despite a clinically meaningful decline in these suicide rates in recent decades.
The impact of flavors, health risks, secondhand smoke and prices on young adults’ cigarette and e‐cigarette choices: a discrete choice experiment
Authors: Buckell John , Sindelar Jody L.
Published: March 2019

Aims

To estimate young adults’ preferences for cigarettes and e‐cigarettes, and how preferences vary by policy‐relevant factors. A related aim was to provide information on potential substitution/complementarity across cigarettes and e‐cigarettes ahead of policy selection.

Design

An online discrete choice experiment (DCE) in which respondents chose their preferred option among cigarettes, two types of e‐cigarettes (disposable/reusable) and ‘none’. Each cigarette‐type was characterized by policy‐relevant attributes: flavors, short‐term health risks to self, secondhand smoke risks and price. A latent class model identified smoking types that respond differently to these.

Setting

US tobacco market.

Participants

A total of 2003 young adults (aged 18–22 years) who ever tried either cigarettes or e‐cigarettes, recruited via the survey platform Qualtrics, matched to the 2015 National Health Interview Survey by age, gender, education and census region.

Measurements

Respondents’ DCE choices.

Findings

Young adults fell into two broad categories. One latent group, termed ‘prefer smoking group’, preferred cigarettes and another, ‘prefer vaping group’, preferred e‐cigarettes. The ‘prefer smoking group’ preferred lower prices and lower health harms more than other attributes. The ‘prefer vaping group’ valued these, although price less intensely, and valued health and fruit/candy flavors more.

Conclusion

Banning all flavors in cigarettes and e‐cigarettes might improve the health of young adults who ever tried either cigarettes or e‐cigarettes. Young adult ever‐triers might be deterred from smoking by increasing cigarette prices and encouraged to switch to e‐cigarettes by reducing the health harms of e‐cigarettes. Reducing health harms of e‐cigarettes could also make the ‘prefer vaping group’ less likely to quit, resulting in increased health harm.
The natural history of the sleepy lizard, Tiliqua rugosa (Gray, 1825) – Insight from chance observations and long‐term research on a common Australian skink species
Authors: Norval Gerrut , Gardner Michael G.
Published: March 2019

In an effort to better understand the dynamics of the parapatric boundary in South Australia of the ticks Amblyomma limbatum and Bothriocroton hydrosauri the late Professor C. Michael Bull initiated studies into the ecology of sleepy lizards (Tiliqua rugosa), a common host of these parasites. These studies spanned a period of about 40 years and examined aspects such as monogamy, long‐term mate fidelity, social networks, personality, resource use and the transmission of parasites and other pathogens. This review incorporates the results of these studies with other information about this species to provide a comprehensive overview of its natural history, highlighting not only what is known, but also indicates areas that require further study.
Does successful treatment of overactive bladder improve co‐morbidities in patients with nocturia?
Authors: Chin Kai Sin , Rose Georgie E. , Ervin Claire F. , Ong Tee Juan , Whishaw David M. , Bower Wendy F.
Published: March 2019

Objective

To investigate whether treatment of overactive bladder (OAB), one comorbidity of nocturia, could reduce waking to void and improve other co‐existing symptoms.

Methods

A prospective cohort study was conducted at Royal Melbourne Hospital. Participants received 12 weeks of standard treatment, including lifestyle interventions and pharmacotherapy. Outcome measures were nocturia episodes, severity of urinary urgency/incontinence, sleep quality, daytime somnolence, anxiety and depression scores, quality of life and change in blood pressure.

Results

Twenty participants completed the study. Nocturia frequency improved by one void per night. Overactive Bladder Symptom Score, sleep quality, first uninterrupted sleep time and systolic blood pressures improved. There were no significant changes in daytime somnolence, mood or quality of life.

Conclusions

In this pilot study, nocturia and other co‐morbid dysfunctions appeared to improve when the severity of OAB was reduced. Treatment of OAB co‐morbid with nocturia reduces urinary symptoms and may improve sleep parameters and positively impact return to health.
Role of obinutuzumab exposure on clinical outcome of follicular lymphoma treated with first‐line immunochemotherapy
Authors: Jamois Candice , Gibiansky Ekaterina , Gibiansky Leonid , Buchheit Vincent , Sahin Denis , Cartron Guillaume , Marcus Robert , Hiddemann Wolfgang , Seymour John F. , Strefford Jonathan C. , Hargreaves Chantal E. , Meneses‐Lorente Georgina , Frey Nicolas , Fingerle‐Rowson Günter
Published: March 2019

Aims

Obinutuzumab (G) is a humanized type II, Fc‐glycoengineered anti‐CD20 monoclonal antibody used in various indications, including patients with previously untreated front‐line follicular lymphoma. We investigated sources of variability in G exposure and association of progression‐free survival (PFS) with average concentration over induction (CmeanIND) in front‐line follicular lymphoma patients treated with G plus chemotherapy (bendamustine, CHOP, or CVP) in the GALLIUM trial.

Methods

Individual exposures (CmeanIND) were obtained from a previously established population pharmacokinetic model updated with GALLIUM data. Multivariate Cox proportional hazard models and univariate Kaplan–Meier plots investigated relationships of PFS with exposure and other potential prognostic factors.

Results

Overall, G exposure was lower in high body‐weight patients and in males, and slightly lower in patients with high baseline tumour burden. Analysis of clinical outcomes showed that variability in G exposure did not impact PFS in G‐bendamustine‐treated patients; PFS was inferior in males and patients with FCGR2a/2b T232 T low‐affinity receptor variant, and superior in patients with FCGR2a/2b I232T variant. In G‐CHOP/CVP arms, PFS improved with increasing CmeanIND (hazard ratio = 1.74 and 0.394 at 5th and 95th percentile compared to median CmeanIND) and was inferior in patients with high baseline tumour size and B symptoms.

Conclusions

It remains unclear whether for G‐CHOP/CVP patients lower G exposure is a consequence of adverse disease biology and/or resistance to chemotherapy backbone (higher clearance in nonresponder patients, as demonstrated for rituximab) rather than being the cause of poorer clinical outcome. A study with >1 dose level of G could help resolve this uncertainty.
Therapeutic gene editing in haematological disorders with CRISPR/Cas9
Authors: Jensen Trine I. , Axelgaard Esben , Bak Rasmus O.
Published: March 2019

The Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)/CRISPR‐associated (Cas)9 platform offers an efficient way of making precise genetic changes to the human genome. This can be employed for disruption, addition and correction of genes, thereby enabling a new class of genetic therapies that can be applied to haematological disorders. Here we review recent technological advances in the CRISPR/Cas9 methodology and applications in haematology for curing monogenic genetic disorders and for engineering novel chimeric antigen receptor (CAR) T cells to treat haematological malignancies. Furthermore, we discuss current challenges for full clinical implementation of CRISPR/Cas9, and reflect on future trajectories of the technology.
Diversity in warning coloration: selective paradox or the norm?
Authors: Briolat Emmanuelle S. , Burdfield‐Steel Emily R. , Paul Sarah C. , Rönkä Katja H. , Seymoure Brett M. , Stankowich Theodore , Stuckert Adam M. M.
Published: March 2019

Aposematic theory has historically predicted that predators should select for warning signals to converge on a single form, as a result of frequency‐dependent learning. However, widespread variation in warning signals is observed across closely related species, populations and, most problematically for evolutionary biologists, among individuals in the same population. Recent research has yielded an increased awareness of this diversity, challenging the paradigm of signal monomorphy in aposematic animals. Here we provide a comprehensive synthesis of these disparate lines of investigation, identifying within them three broad classes of explanation for variation in aposematic warning signals: genetic mechanisms, differences among predators and predator behaviour, and alternative selection pressures upon the signal. The mechanisms producing warning coloration are also important. Detailed studies of the genetic basis of warning signals in some species, most notably Heliconius butterflies, are beginning to shed light on the genetic architecture facilitating or limiting key processes such as the evolution and maintenance of polymorphisms, hybridisation, and speciation. Work on predator behaviour is changing our perception of the predator community as a single homogenous selective agent, emphasising the dynamic nature of predator–prey interactions. Predator variability in a range of factors (e.g. perceptual abilities, tolerance to chemical defences, and individual motivation), suggests that the role of predators is more complicated than previously appreciated. With complex selection regimes at work, polytypisms and polymorphisms may even occur in Müllerian mimicry systems. Meanwhile, phenotypes are often multifunctional, and thus subject to additional biotic and abiotic selection pressures. Some of these selective pressures, primarily sexual selection and thermoregulation, have received considerable attention, while others, such as disease risk and parental effects, offer promising avenues to explore. As well as reviewing the existing evidence from both empirical studies and theoretical modelling, we highlight hypotheses that could benefit from further investigation in aposematic species. Finally by collating known instances of variation in warning signals, we provide a valuable resource for understanding the taxonomic spread of diversity in aposematic signalling and with which to direct future research. A greater appreciation of the extent of variation in aposematic species, and of the selective pressures and constraints which contribute to this once‐paradoxical phenomenon, yields a new perspective for the field of aposematic signalling.