bluuebunny/crossref_metadata_2025 huggingface dataset:
Leading the sustainable organization at Vail Resorts
Authors: Galpin Timothy , Jouflas Georgann , Gasta Mark
Published: November 2014

Purpose

– This paper aims to assess Vail Resorts’ sustainability activities by applying a well-substantiated framework titled the “Leading the Sustainable Organization” (LSO) model in order to systematically explore their efforts. Anecdotally the sustainability activities and accomplishments of Vail Resorts appear comprehensive and impressive. Corporate sustainability is a complex, multi-functional endeavor, yet guidance on the issue has tended to be single level, single stage and single disciplinary. Our multi-level assessment of Vail Resorts’ sustainability activities, including the stakeholder and financial impacts, develops a deeper understanding of sustainability and the effect it can have on profitability and value of a company.

Design/methodology/approach

– Vail Resorts’ sustainability activities were assessed by applying a well-substantiated framework titled the “Leading the Sustainable Organization” (LSO) model.

Findings

– The in-role and extra-role sustainability performance of employees at Vail Resorts demonstrates their engagement with the company’s sustainability efforts. Beyond employee sustainability performance, the company-level sustainability performance of Vail Resorts exhibits the payoff of the company’s sustainability efforts.

Research limitations/implications

– The LSO model was applied to only one organization. Future application to multiple firms would provide a broader assessment of the state of sustainability in organizations of various sizes and across industries.

Practical implications

– By examining their sustainability activities through the lens of the LSO model, Vail Resorts provides a rich example of best practices relating to a company’s pursuit of sustainability efforts and their expected benefits. Vail Resorts’ wide-ranging sustainability actions, combined with the LSO model, provide managers with a well-defined road map to lead their own sustainable organization. Vail Resorts’ implementation of the various components of the LSO model, and the results achieved, demonstrate that “sustainability is not just doing good, it is also good business.”

Originality/value

– Applying the LSO model offers both practicing managers and researchers alike a well-substantiated framework to assess organizational sustainability efforts, in order to identify areas of organizational sustainability strength as well as areas needing improvement.
Whither the bully pulpit: leadership communications and corporate transformation
Authors: Hirsch Peter Buell
Published: November 2014

Purpose

– This paper aims to look at some classic business leader communications to assess which ones succeed and which ones fail to meet that standard. From Teddy Roosevelt to Ronald Reagan, from Churchill to Lady Thatcher, we have grown used to the idea that the words of our leaders in times of crisis can change history. Is this also true of business leaders? Can their words transform companies?

Design/methodology/approach

– The paper looks at specific leadership communications examples from IBM, Nokia, Starbucks, as well as McKinsey research, to try to tease out the elements of successful leadership communications in company transformations.

Findings

– What we found is that successful leadership communications in culture transformations share four principal characteristics: they are authentic to the personality of the leader; they are not one-time communications, but the beginnings of a cascade; they are personally relevant to each individual employee; and they are quickly followed by visible actions springing from the strategic direction set by the leader’s communications.

Research limitations/implications

– As a subjective review of a limited number of cases, the elements selected are potentially vulnerable to counter-examples.

Practical implications

– The four characteristics of leadership communications isolated in the research can be applied by any corporate leader or communications team to create effective communications in the context of culture transformation.

Social implications

– To the extent that corporate leaders adopt these principles, their communications will be more credible to external stakeholders and, by extension, enhance the reputation of business leaders as a whole.

Originality/value

– While this subject has been studied by others, the four principles for successful leadership communications have not been articulated in this way before to the best of the author’s knowledge.
When a brand caught fire: the role of brand equity in product-harm crisis
Authors: Rea Brianna , J. Wang Yong , Stoner Jason
Published: November 2014

Purpose

– The purpose of this study is to investigate differences in consumer reactions to high- versus low-equity brands in terms of consumer attitude toward the brand, involvement with the brand, company credibility and consumer purchase intentions.

Design/methodology/approach

– Experimental procedure is conducted to test three hypotheses using 317 consumer participants. The experiment is carried out comparing a high-equity personal computer (PC) brand and a low-equity PC brand involved in product-harm crisis.

Findings

– The results indicate that, in the case of product-harm crisis, negative consumer perceptions regardless of brand equity level; less negative perceptions for a high-equity brand than for a low-equity brand; and smaller loss in consumer perceptions for a high-equity brand than for a low-equity brand.

Research limitations/implications

– The findings highlight the importance of brand equity in crisis management explained by covariation theory of attributions.

Practical implications

– Although product-harm crisis is inevitable for many firms, continuous investment in brand equity can mitigate the negative consequences.

Originality/value

– Product-harm crisis can pose serious consequences for firms on both financial and intangible dimensions. Given the occurrence of numerous product-harm crises involving both reputable and less known brands, it is important to consider potential influences of brand equity on consumer reactions to such crisis.
Emerging promotional and pricing approaches in the US pharmaceutical market
Authors: Elizabeth O’Connor Genevieve
Published: November 2014

Purpose

– This paper aims to review the progression of the pharmaceutical industry through the lens of government legislation in the USA. The goal of this paper is to provide a comprehensive review of pharmaceutical marketing practices while providing direction for emerging pricing and promotional approaches.

Design/methodology/approach

– This paper offers a comprehensive review of pharmaceutical marketing practices through an exhaustive review of the literature. Further, suggestions are made based on emerging marketing techniques found in the literature.

Findings

– Changes in government legislation will continue to play a significant role in promotional activities of the pharmaceutical industry. This study identifies specific pricing and promotional tools the pharmaceutical industry can use in response to these emerging changes. Specific actions such as enhancing public image, reconfiguring sales forces, outsourcing and optimizing the pricing mix are suggested.

Practical implications

– This paper presents clear guidelines for managers by affording applicable practical tools to offset changes posed by government legislation.

Originality/value

– This paper seeks to fill a gap in research surrounding pricing and promotion in the pharmaceutical industry. Further, this paper offers concrete pricing and promotional approaches for pharmaceutical management.
Clinical trials and American Indians/Alaska Natives with substance use disorders: identifying potential strategies for a new cultural-based intervention
Authors: L. Dickerson Daniel , L. Venner Kamilla , Duran Bonnie
Published: November 2014

Purpose

– The purpose of this paper is to address a significant public mental health disparity affecting American Indians/Alaska Natives (AI/ANs): the shortage of clinical trials research analyzing the benefits of AI/AN traditional-based treatments, e.g. drumming.

Design/methodology/approach

– A total of four focus groups were conducted among outpatient and inpatient AI/AN substance abuse patients and providers serving AI/ANs. The purpose of these focus groups was to obtain insights relating to the recent challenges of conducting a clinical trial within the outpatient treatment setting seeking to analyze the benefits of a new substance abuse treatment intervention utilizing drumming for AI/ANs [Drum-assisted Recovery Therapy for Native Americans (DARTNA)] and to obtain recommendations to successfully conduct a similar study within an inpatient treatment setting.

Findings

– The most prevalent barriers to conducting a clinical trial within an outpatient setting were transportation and child care issues. Recommendations were obtained with regard to optimizing recruitment and retention for a future study within an inpatient setting.

Originality/value

– This research offers the field rare information that helps toward identifying strategies to successfully conduct clinical trials investigating the benefits of culturally-appropriate treatments for AI/ANs with substance use disorders.
Patient experience of MDT care and decision-making
Authors: O'Driscoll William , Livingston Gill , Lanceley Anne , Nic a' Bháird Caoimhe , Xanthopoulou Penny , Wallace Isla , Manoharan Manonmani , Raine Rosalind
Published: November 2014

Purpose

– The purpose of this paper is to explore physical and mental health patients’ experience of multidisciplinary team (MDT) care and decision making in order to highlight factors underlying effective care and to identify areas in which patient experience could be improved.

Design/methodology/approach

– Totally, 12 MDTs within the North Thames area participated; the authors recruited 13 patients from physical health MDTs and seven patients from mental health MDTs. The authors conducted semi-structured interviews with each participant and thematically analysed the transcripts.

Findings

– The study found a marked contrast in patient experience: physical health patients emphasised their faith in the judgement of MDT clinicians, described experiencing high quality care and expressed a strong preference not to attend MDT meetings; mental health patients highlighted a range of negative experiences, were frequently sceptical about their diagnosis, and expressed a desire to have greater involvement in the decisions directing their care.

Research limitations/implications

– It was necessary to revise the initial target of interviewing six patients per MDT due to recruitment difficulties.

Practical implications

– In order to improve care, mental health MDTs should focus on promoting a shared understanding of illness by increasing the transparency of the diagnostic process. Key factors underlying effective MDT care in physical health services include enabling patients to determine their level of involvement in decision making and ensuring patients have a clear understanding of their care plan.

Originality/value

– The paper highlights the importance of mental health MDTs focusing on developing a shared understanding of illness with their patients.
Effective interventions for mental health in male-dominated workplaces
Authors: K. Lee Nicole , Roche Ann , Duraisingam Vinita , A. Fischer Jane , Cameron Jacqui
Published: November 2014

Purpose

– The purpose of this paper is to identify mental health interventions within male-dominated industries.

Design/methodology/approach

– A systematic literature review was undertaken, examining mental health interventions within male-dominated industries. Major electronic databases, grey literature and reference lists for English language studies published January 1990-June 2012 were searched. Independent extraction of the studies was completed by two reviewers using predefined data fields including study quality measures.

Findings

– Five studies met inclusion criteria. The available evidence suggests that effective interventions to address anxiety and depression in male-dominated industries include: improving mental health literacy and knowledge, increasing social support, improving access to treatment, providing education for managers and addressing workload issues.

Practical implications

– Working conditions and the workplace can have a significant impact on a worker's mental health. Work-related factors including working conditions, job demands and social support in the workplace are particularly important for the mental health workers. Indeed, poor work conditions have been associated with poorer mental health outcomes in particular anxiety and depression, however, little work has been conducted on mental health interventions in the workplace and further the impact on male-dominated industries.

Originality/value

– Overall, the body of evidence supporting effective interventions for mental health problems among workers in male-dominated industries is limited. Nonetheless, the evidence does suggest that mental health interventions in male-dominated industries is logistically feasible and can have some positive impact on the mental health of workers, particularly for high prevalence low severity disorders such as anxiety and depression.
Modelling mechanical and chemical treatment of biofilms with two phenotypic resistance mechanisms
Authors: Szomolay Barbara , Cogan N. G.
Published: November 2014

Bacterial biofilms are notoriously difficult to eradicate owing to a number of tolerance mechanisms including physiological, physical, genotypic and phenotypic variations. Recent focus has shifted to phenotypic tolerance which is apparently the main defence mechanism that protects biofilms against long‐term disinfection. Previous mathematical models have addressed phenotypic dynamics by considering adaptive response and persister formation separately. The aim of this manuscript is to consider a combined model to understand the interplay between these two defence mechanisms. We find that each mechanism protects the biofilm differently and hence responds differently to antibiotic challenge. We focus on on–off dosing that has been shown to eradicate each subpopulation alone. Our results indicate that the combined resistance exhibits qualitatively similar behavior to persister formation for short dosing times, and similar behavior to adaptive resistance for long dosing times. To further contrast the behavior of the model under different parameter regimes, we explore two classes of combination treatment that include mechanical and chemical treatments. The examples focus on different applications – pipe clearance and dental carrie prevention – and demonstrate the underlying conclusion that adaptive and persister mechanism provide protection for different challenges and are thus not redundant systems and each may require specific treatment plans.
Three perspectives on the mismatch between measures of material poverty
Authors: Hick Rod
Published: November 2014

The two most prominent measures of material poverty within contemporary European poverty analysis are low income and material deprivation. However, it is by now well‐known that these measures identify substantially different people as being poor. In this research note, I seek to demonstrate that there are at least three ways to understand the mismatch between low income and material deprivation, relating to three different forms of identification: identifying poor households, identifying groups at risk of poverty and identifying trends in material poverty over time. Drawing on data from the British Household Panel Survey, I show that while low income and material deprivation identify very different households as being poor, and display distinct trends over time, in many cases they identify the same groups at being at risk of material poverty.
Risk factors for seizures and antiepileptic drug‐associated adverse effects in high‐grade glioma patients: A multicentre, retrospective study in Hong Kong
Authors: Woo Peter Yat‐Ming , Chan Danny Tat‐Ming , Chan Kwong‐Yau , Wong Wai‐Kei , Po Yin‐Chung , Kwok John Ching‐Kong , Poon Wai‐Sang
Published: November 2014

Aim

The aim of this present study was to determine the frequency, as well as risk factors, for seizures and antiepileptic drug (AED)‐associated adverse effects among high‐grade glioma (HGG) patients.

Patients and Methods

A multicentre, retrospective study of adult Chinese Hong Kong patients from three neurosurgical centres diagnosed with supratentorial HGG between 1 January 2001 and 31 December 2010 was performed.

Results

A total of 198 patients, with a mean age of 55 years (range: 18–88) and a mean follow up of 15 months, was recruited. Most suffered from glioblastoma multiforme (GBM) (63 per cent) followed by anaplastic astrocytoma (25 per cent). Median overall survival for patients with GBM was 8 months, and 11 months for those with grade III gliomas. Prophylactic AED was prescribed in 165 patients (83 per cent), and 64 per cent of patients were continued until end of life or last follow up. A total of 112 patients (57 per cent) experienced seizures at a mean duration of 8 months postoperatively (range: 1 day–75 months). Independent predictors for seizures were a diagnosis of GBM [adjusted odds ratio (OR): 2.33, 95 per cent confidence interval (CI): 1.21–4.52] and adjuvant radiotherapy (adjusted OR: 2.97, 95 per cent CI: 1.49–6.62). One‐fifth of patients (21 per cent) experienced AED adverse effects, with idiosyncratic cutaneous reactions and hepatotoxicity most frequently observed. An independent predictor for adverse effects was exposure to aromatic AED, such as phenytoin, carbamazepine and phenobarbital (adjusted OR: 3.32, 95 per cent CI: 1.32–8.40).

Conclusions

Antiepileptic drug prescription for primary seizure prophylaxis is both pervasive and prolonged for HGG patients. Seizures occur frequently, but most were delayed and none were life threatening. Judicious prescription of AED is required, especially when a significant proportion of patients experience adverse effects. Patients with a diagnosis of GBM and exposure to radiotherapy are at risk. We suggest, contrary to present practice, that primary seizure prophylaxis be given only during the perioperative period and resumed when they occur. We also recommend avoidance of aromatic AED due to their association with idiosyncratic adverse effects.
B‐mode ultrasound is effective in guiding percutaneous nephrolithotomy
Authors: Duan Bo , Chen Bin , Liu Rongfu , Wang Huiqiang , Xing Jinchun
Published: November 2014

Aim

The aim of the present study was to assess the application value of B‐mode ultrasound in percutaneous nephrolithotomy (PCNL).

Methods and Patients

PCNL was performed in 218 consecutive patients with upper urinary calculi using B‐mode ultrasound. The percutaneous renal access was established, and residual stone was detected by nephroscope through B‐mode ultrasound.

Results

Phase I percutaneous renal access was successfully established in all 218 patients. Operation time ranged from 40 min to 132 min. The nephrostomy tube was retained 2–7 days. After PCNL treatment, 12 patients received blood transfusion because of obvious bleeding, 19 had severe fever and three had reactive hydrothorax. No serious complications, such as pleural injury, pneumothorax, abdominal visceral injury or renal penetrating injury, occurred. The phase I stone‐free rate was 81.19 per cent (177/218), and the total stone‐free rate was 92.66 per cent (202/218), as revealed by postoperative computed tomography.

Conclusions

B‐mode ultrasound is a safe, simple, clear, real‐time and helpful method to improve the accuracy and safety of the establishment of percutaneous renal access during PCNL.
Benzodiazepine use among mothers of small children: a register‐based cohort study
Authors: Raitasalo Kirsimarja , Holmila Marja , Autti‐Rämö Ilona , Martikainen Jaana E , Sorvala Veli‐Matti , Mäkelä Pia
Published: November 2014

Aims

To compare benzodiazepine (BZD) purchases in different groups of mothers of small children.

Design

Prospective population‐based cohort study based on the Finnish social and health care registers.

Setting

Finnish women of child‐bearing age.

Participants

All women who gave birth in 2002 in Finland (n = 54 519).

Measurements

Latent class analysis (LCA) was used to create a typology of mothers according to their substance abuse status, psychiatric disorders and socio‐demographic characteristics. The mothers were followed‐up yearly for purchases of benzodiazepines, starting 4 years before the child's birth and continuing up to the child's 7th birthday. BZD purchases in different mother groups were compared using negative binomial hurdle models.

Findings

The five mother types identified by LCA were mothers with substance abuse (1%), mothers with psychiatric disorders (1%), mothers with a risk of social marginalization (11%), mothers with minor social problems (18%) and mothers with no identified problems (69%; the comparison group). Mothers with substance abuse problems had the highest odds of purchasing BZDs [odds ratio OR = 27.5, 95%CI = 22.9‐33.0; RR = 20.2, 95%CI = 14.9‐27.3. The change in time was similar in all groups: the probability of purchasing and the number of purchases were lowest during pregnancy and the year of the child's birth.

Conclusions

In Finland, among mothers of young children, prevalence of benzodiazepine use is reduced during pregnancy and the child's first year, and then increases as the child grows older. Mothers with substance abuse and psychiatric disorders are at particularly high risk of benzodiazepine use.
Analysis of retinal vessels in eyes with retinitis pigmentosa by retinal oximeter
Authors: Ueda‐Consolvo Tomoko , Fuchizawa Chiharu , Otsuka Mitsuya , Nakagawa Takuya , Hayashi Atsushi
Published: November 2014

Purpose

To study changes in the oxygen saturation and calibre of retinal vessels in the eyes of patients with retinitis pigmentosa (RP).

Method

In this cross‐sectional study, 63 eyes of 63 patients with RP and 14 eyes of 14 healthy subjects were enrolled and examined at Toyama University Hospital. Retinal oximetry measurements were performed using a spectrophotometric oximetry unit (Oxymap T1, Reykjavik, Iceland), which is coupled to a fundus camera base (TRC‐50DX; Topcon Corporation, Tokyo, Japan). Retinal arterioles of 28 eyes and retinal venules of 35 eyes with adequate image quality were selected for analyses. We calculated the residual areas of visual field (I‐4e and V‐4e isopters) in each eye and determined the correlations between the data of retinal vessels and the areas of visual field in the RP eyes.

Results

The mean oxygen saturation of the venules in the RP eyes (60.2 ± 6.5%) was significantly higher than that in healthy eyes (54.6 ± 6.3%, p = 0.0089). The oxygen saturation of the venules in the RP eyes correlated significantly with the residual areas of the visual field of V‐4e (r = −0.50; p = 0.0030). The mean calibres of the retinal arterioles (91.1 ± 9.1 μm) and retinal venules (116 ± 13 μm) of the RP eyes were significantly narrower than those of the healthy eyes (115 ± 11 μm and 152 ± 15 μm, respectively, p < 0.01). The retinal arteriolar and venular calibres in the RP eyes correlated with the residual areas of the visual field of V‐4e (r = 0.43; p = 0.033 and r = 0.45; p = 0.011, respectively).

Conclusions

The severity of RP was correlated with increased oxygen saturations in the retinal venules and decreased retinal vessel calibres.
Is there really a link between exact‐number knowledge and approximate number system acuity in young children?
Authors: Negen James , Sarnecka Barbara W.
Published: November 2014

Although everyone perceives approximate numerosities, some people make more accurate estimates than others. The accuracy of this estimation is called approximate number system (ANS) acuity. Recently, several studies have reported that individual differences in young children's ANS acuity are correlated with their knowledge of exact numbers such as the word ‘six’ (Mussolin et al., 2012, Trends Neurosci. Educ., 1, 21; Shusterman et al., 2011, Connecting early number word knowledge and approximate number system acuity; Wagner & Johnson, 2011, Cognition, 119, 10; see also Abreu‐Mendoza et al., 2013, Front. Psychol., 4, 1). This study argues that this correlation should not be trusted. It seems to be an artefact of the procedure used to assess ANS acuity in children. The correlation arises because (1) some experimental designs inadvertently allow children to answer correctly based on the size (rather than the number) of dots in the display and/or (2) young children with little exact‐number knowledge may not understand the phrase ‘more dots’ to mean numerically more. When the task is modified to make sure that children respond on the basis of numerosity, the correlation between ANS acuity and exact‐number knowledge in normally developing children disappears.
Breaking bad: an attachment perspective on youth mentoring relationship closures
Authors: Zilberstein Karen , Spencer Renée
Published: November 2014

Endings in youth mentoring relationships have received little attention to date despite the frequency with which they occur. In this paper, we bring an attachment theory perspective to bear on youth mentoring relationship closures and consider how the rich empirical and theoretical literature on attachment can inform mentoring programme practice and possibly help prevent premature and poorly handled mentoring relationship endings. We consider what is known about endings in youth mentoring relationships, articulate an attachment perspective on mentoring relationships and their endings and offer recommendations informed by these literatures for how mentoring programmes can promote positive closure when relationships come to an end.
Eosinophils in biopsy specimens of lichen sclerosus: a not uncommon finding
Authors: Lester Elizabeth B. , Swick Brian L.
Published: November 2014

Background

Evolving lesions of lichen sclerosus (LS) pose a diagnostic challenge owing to an absence of classic findings of epidermal atrophy, dermal sclerosis, a band‐like lymphocytic infiltrate and the presence of eosinophils.

Methods

Retrospective specimens of LS were reviewed. Demographic information, biopsy vs. excision and the following histopathological characteristics were noted: presence and number of eosinophils, epidermal hyperplasia, spongiosis, early/transitional LS, well‐developed LS and coexisting squamous cell carcinoma (SCC). Linear regression analysis was performed.

Results

The data consisted of 66 biopsies (36 male [M], 30 female [F]), from 53 individuals (33M, 20F), including 57 genital and 9 extragenital biopsies. Seven biopsies showed SCC, 28 showed epidermal hyperplasia and 14 exhibited spongiosis. Thirty‐five specimens were early/transitional LS and commonly exhibited epidermal hyperplasia (57%), epidermotropism of lymphocytes (97%) and basement membrane thickening (97%). Thirty‐five biopsies (53%) contained eosinophils (23 early/transitional lesions). Male gender (p = 0.074) was associated with increased eosinophils. The presence of SCC (p = 0.014) was a significant predictors of eosinophil number.

Conclusions

Epidermal hyperplasia, epidermotropism of lymphocytes and basement membrane thickening are helpful features in identifying early LS. Eosinophils are not an uncommon finding in LS and are most common in male genital lesions and in LS associated with SCC.
Factors associated with physical activity in children and adolescents with a physical disability: a systematic review
Authors: Bloemen Manon A T , Backx Frank J G , Takken Tim , Wittink Harriet , Benner Joyce , Mollema Jurgen , de Groot Janke F
Published: November 2014

Aim

The aim of this review was to summarize the important factors associated with participation in physical activity in children and adolescents with physical disabilities.

Method

A systematic mixed‐studies review was conducted using the databases Academic Search Elite, CINAHL, The Cochrane Library, EMBASE, PEDro, PsycINFO, PubMed, and SPORTDiscus, searching for studies conducted from January 2000 to May 2013. The studies were identified by two independent researchers following predetermined inclusion and exclusion criteria. The methodological quality was determined using the McMaster University critical review forms for qualitative or quantitative research and was numerically rated according to the criteria developed by Imms.

Results

The initial electronic search yielded 10 161 articles, of which six were qualitative and 12 were quantitative studies. These studies showed that a diverse range of positive and negative factors were associated with participation in physical activity, such as self‐efficacy, physical fitness, increasing age, and the availability of equipment and local facilities.

Interpretation

Future intervention studies could use these results, within the context of an individual child and his or her environment, as the basis for increasing physical activity levels, starting in early childhood and continuing throughout adolescence and into adulthood. An increased awareness of and focus on providing appropriate equipment and adapted sports in the child's own environment by policy makers might increase physical activity levels.
RASopathies: a window into the molecular mechanisms underlying neurodevelopmental disorders
Authors: Frye Richard E
Published: November 2014

This commentary is on the original article by Pierpont et al. on pages 385–392 of this issue.
TAX POLICY AND INCOME INEQUALITY IN THE UNITED STATES, 1979–2007
Authors: Bargain Olivier , Dolls Mathias , Immervoll Herwig , Neumann Dirk , Peichl Andreas , Pestel Nico , Siegloch Sebastian
Published: November 2014

This paper assesses the effects of U.S. tax policy reforms on inequality over around three decades, from 1979 to 2007. It applies a new method for decomposing changes in government redistribution into (1) a direct policy effect resulting from policy changes and (2) the effects of changing market incomes. Over the period as a whole, the tax policy changes increased income inequality by pushing up the income share of high‐income earners (the top 20%). (JEL H23, H31, H53, P16)
Ecological factors influencing movement of creek chub in an intermittent stream of the Ozark Mountains, Arkansas
Authors: Walker Richard H. , Adams Ginny L.
Published: November 2014

Increasing our understanding of the traits and adaptations that promote the survival and persistence of organisms in highly dynamic environments will aid in the conservation of populations and communities. Projected effects of climate change and land alterations suggest headwater streams may become more intermittent and less predictable, consequently altering biological processes (i.e. dispersal or movement) that govern population dynamics. Few studies have provided insight into movement dynamics of nongame fishes in small headwater streams that commonly experience intermittent conditions. The purpose of this study was to investigate movement of a fish species adapted to intermittent stream conditions. Our objectives were to (i) describe the general movement patterns of creek chub, Semotilus atromaculatus, in an intermittent stream and (ii) investigate which ecological factors may influence movement in patchy environments. Creek chub displayed some of the longest distances moved compared to many other stream fishes in perennial streams (179–1069 m seasonal averages; 4678 m maximum distance). Directional movement was significant only in May with more individuals moving upstream. The probability of creek chub movement was inversely related to habitat complexity and pool area. Creek chub adapted to intermittent stream conditions not only exhibited increases in the frequency and distance of movement compared to other nongame fishes, but also exhibited movements in relation to local habitat metrics. These results demonstrate some of the potential adaptations that are likely to promote the survival and persistence of populations in highly dynamic environments such as intermittent streams.
Virtual classroom helps medical education for both Chinese and foreign students
Authors: Shi C. , Wang L. , Li X. , Chai S. , Niu W. , Kong Y. , Zhou W. , Yin W.
Published: November 2014

Aims

The rapid development of computer and internet technology has a strong influence over one's quality of education within different fields of study. To determine the potential benefits of introducing internet into medical school classes, a pilot study was conducted in three different Chinese medical schools.

Materials and methods

Seven hundred and eight medical school undergraduates, 385 dental school students and 366 foreign students were randomly recruited to complete a self‐administered questionnaire. The contents included personal information, current usage of computer and internet, and attitudes towards the computerised teaching methods. Two forum groups were created using instant message software and were randomly assigned to two classes, allowing students to freely ask or discuss questions with the help of their teachers in these two virtual classrooms.

Results

All 1539 questionnaires were accepted and analysed. Although there were some differences between Chinese and foreign undergraduates, both group of students were highly proficient in internet usage and navigation. Overwhelmingly, 88.37% of the students owned a computer and frequently logged onto the internet. Most of them believed that the internet is a helpful adjunct to their studies and held positive attitudes towards computerised teaching. Compared to the classes that were not assigned internet forums, the two experimental classes performed significantly better on the examination.

Conclusions

Our results suggest that computerised teaching methods have significant potential to assist in learning for both Chinese and foreign medical undergraduates.
The face of chiropractic: evidence‐based?
Authors: Shelley Jacob , Clark Marianne , Caulfield Timothy
Published: November 2014

Background

Chiropractors are the most accessed providers of complementary and alternative medicine care in Canada. However, some scepticism exists around the evidentiary base of the chiropractic profession.

Objectives

To examine the messages utilised by the chiropractic profession around issues of scope and efficacy through website communication with the public.

Methods

Website content of major Canadian chiropractic associations and colleges (n=11), and commercial clinics (n=80) was submitted to a mixed‐methods analysis. Content was reviewed to quantify specific health conditions described as treatable by chiropractic care. A qualitative textual analysis identified the primary messages related to evidence and efficacy utilised by the websites.

Results

Website content claimed that chiropractic is capable of addressing a wide range of health issues. Quantitative analysis revealed that association and college websites identified a total of 41 unique conditions treatable by chiropractic, while private clinic websites named 159 distinct conditions. The most commonly cited conditions included back pain, headaches/migraines and neck pain. Qualitative analysis revealed three prominent themes drawn upon in discussions of efficacy and evidence: grounded in science, the conflation of safety and efficacy and “natural” healing.

Conclusions

The chiropractic profession claims the capacity to treat health conditions that exceed those more traditionally associated with chiropractic. Website content persistently declared that such claims are supported by research and scientific evidence, and at times blurred the lines between safety and efficacy. The chiropractic profession may be struggling to define themselves both within the paradigm of conventional science as well as an alternative paradigm that embraces natural approaches.
Spontaneous calf hematoma in a patient with diabetic nephropathy receiving maintenance hemodialysis: A case report and review of the literature
Authors: Xiao Li , Ling Fengxia , Tan Lihua , Li Huabing , Hu Chun , Luo Ying , Tang Dang , Liu Fuyou , Kanwar Yashpal S. , Sun Lin
Published: November 2014

We report the outcome of a 52‐year‐old patient with diabetic nephropathy and receiving maintenance hemodialysis (HD) using low molecular weight heparin (LMWH) as an anticoagulant for 2 years. He presented right lower limb pain accompanied with difficulty in walking for 2 months, and had no history of bleeding tendency or trauma. Physical examination revealed marked swelling and tenderness on his right lower limb. By ultrasound and magnetic resonance imaging (MRI) diagnoses, the calf hematoma was diagnosed and identified with venous thrombosis. Following treatment with heparin‐free HD, the swelling regressed and pain subsided, and a follow‐up MRI showed complete dissolution of hematoma. However, similar symptoms recurred in the right upper limb after 2 months without any predisposition, he was just placed on HD with LMWH, and symptoms regressed following the aforementioned therapy. This suggests that HD patients, especially with diabetic nephropathy having extremity hematoma, should be watched for the development of spontaneous hemorrhage that can be differentially diagnosed by imaging tests, such as MRI, and can be effectively treated with heparin‐free HD.
HIV and aging: insights from the Asia Pacific HIV Observational Database (APHOD)
Authors: Han N , Wright ST , O'Connor CC , Hoy J , Ponnampalavanar S , Grotowski M , Zhao HX , Kamarulzaman A ,   Australian HIV Observational Database (AHOD),   TREAT Asia HIV Observational Database (TAHOD)
Published: November 2014

Objectives

The proportion of people living with HIV/AIDS in the ageing population (> 50 years old) is increasing. We aimed to explore the relationship between older age and treatment outcomes in HIV‐positive persons from the Asia Pacific region.

Methods

Patients from the Australian HIV Observational Database (AHOD) and the TREAT Asia HIV Observational Database (TAHOD) were included in the analysis. We used survival methods to assess the association between older age and all‐cause mortality, as well as time to treatment modification. We used regression analyses to evaluate changes in CD4 counts after combination antiretroviral therapy (cART) initiation and determined the odds of detectable viral load, up to 24 months of treatment.

Results

A total of 7142 patients were included in these analyses (60% in TAHOD and 40% in AHOD), of whom 25% were > 50 years old. In multivariable analyses, those aged > 50 years were at least twice as likely to die as those aged 30–39 years [hazard ratio (HR) for 50–59 years: 2.27; 95% confidence interval (CI) 1.34–3.83; HR for > 60 years: 4.28; 95% CI 2.42–7.55]. The effect of older age on CD4 count changes was insignificant (p‐trend = 0.06). The odds of detectable viral load after cART initiation decreased with age (p‐trend = < 0.0001). The effect of older age on time to first treatment modification was insignificant (p‐trend = 0.21). We found no statistically significant differences in outcomes between AHOD and TAHOD participants for all endpoints examined.

Conclusions

The associations between older age and typical patient outcomes in HIV‐positive patients from the Asia Pacific region are similar in AHOD and TAHOD. Our data indicate that ‘age effects’ traverse the resource‐rich and resource‐limited divide and that future ageing‐related findings might be applicable to each setting.
Longitudinal associations between asthma and general and abdominal weight status among Norwegian adolescents and young adults: the HUNT Study
Authors: Egan K. B. , Ettinger A. S. , DeWan A. T. , Holford T. R. , Holmen T. L. , Bracken M. B.
Published: November 2014

Background

In adolescents the temporal directionality to the asthma and adiposity association remains unclear. Asthma may be a consequence of obesity; however, asthma may increase adiposity.

Objectives

This study aimed to assess the associations between (i) baseline weight status and subsequent asthma and (ii) baseline asthma and subsequent weight status after 4 and 11 years of follow‐up (N = 1543 and N = 1596, respectively) using data from three, sequentially enrolled population‐based surveys of Norwegians aged 12–30 years from 1995 to 2008.

Methods

Weight status was defined as general (body mass index) or abdominal (waist circumference) underweight, normal weight, overweight or obesity. Self‐report physician‐diagnosed asthma defined asthma status.

Results

Over the longitudinal 11‐year follow‐up, baseline generally overweight or abdominally obese adolescents had increased risk of asthma. Likewise, baseline asthmatics had increased risk of general overweight or abdominal obesity. After sex stratification, these associations were stronger in males. Generally (odds ratio [OR] 1.90; 95% confidence interval [CI] 1.32, 2.73) or abdominally (OR 1.66; 95% CI 1.13, 2.44) overweight males were at increased risk of asthma. Baseline asthmatic males were also at increased risk of general (OR 2.14; 95% CI 1.54, 2.98) and abdominal (OR 1.77; 95% CI 1.27, 2.47) overweight.

Conclusions

Among Norwegian adolescents, a bidirectional association of asthma and adiposity was observed in males. Each baseline condition increased the risk of the other condition over time. No association was observed in females.
Botulinum toxin A injection for the treatment of neurogenic detrusor overactivity secondary to spinal cord injury: Multi‐institutional experience in Japan
Authors: Sengoku Atsushi , Okamura Kikuo , Kimoto Yasusuke , Ogawa Takatoshi , Namima Takashige , Yamanishi Tomonori , Yokoyama Teruhiko , Akino Hironobu , Maeda Yoshiko
Published: November 2014

Objectives

To examine the efficacy and safety of onabotulinumtoxinA (Botox) injection into the bladder wall for the treatment of neurogenic detrusor overactivity secondary to spinal cord injury in Japanese patients.

Methods

We enrolled Japanese spinal cord injury patients with cystometrically confirmed neurogenic detrusor overactivity who experienced urinary incontinence at least once a week either because they were refractory to anticholinergics or had to discontinue treatment because of adverse events. Patients received 200 units of onabotulinumtoxinA injected into the bladder wall after a 2‐week washout of anticholinergics, and urodynamic variables were assessed before and 1 month after injection. Catheterization and urinary incontinence data, as well as International Consultation on Incontinence Questionnaire – Short Form scores, were assessed before injection and every month thereafter until the cessation of treatment effects.

Results

The study enrolled 19 patients (13 men, six women, age range 22–67 years). One month after injection, the mean number of urinary incontinence episodes decreased from 4.3 to 1.5 times/day (P = 0.004), and the maximum cystometric capacity increased from 100 mL to 296 mL (P = 0.0004). The rate of effective cases whose daily urinary incontinence frequency was decreased to less than 50% was 74%. The duration of efficacy without anticholinergic medication ranged from 3 to 12 months (median 8.5 months). Clinically significant adverse events were not observed.

Conclusions

The present findings show the efficacy and tolerability of onabotulinumtoxinA injection for the treatment of neurogenic detrusor overactivity in Japanese spinal cord injury patients.
Enteric fever in the Pacific: a regional retrospective study from Auckland, New Zealand
Authors: Lane R. J. , Holland D. , McBride S. , Perera S. , Zeng I. , Wilson M. , Read K. , Jelleyman T. , Ingram R. J. H.
Published: November 2014

Background

There are limited clinical data on enteric fever in the Pacific and New Zealand (NZ) compared with the Indian subcontinent (ISC) and South‐East Asia (SEA). Our objective was to describe enteric fever in Auckland – a large Pacific city, focusing on disease acquired in these regions.

Methods

We reviewed enteric fever cases hospitalised in Auckland from January 2005 to December 2010.

Results

Microbiologically confirmed EF was identified in 162 patients. Travel regions: Pacific, 40 cases (25%) (Samoa, 38; Fiji, two), ISC, 72 (44%), SEA, seven (4%), other, three (2%), no travel, 40 (25%). Enteric fever rates for Auckland resident travellers were: India 50.3/100 000; Samoa 19.7/100 000.All Pacific cases were Salmonella Typhi. Of local isolates (without travel history), 38 were S. Typhi (36 fully susceptible, one multi‐drug resistant (MDR) + nalidixic acid resistant (NAR), one unknown) and two S. Paratyphi (both NAR). Of non‐Pacific travel, 56/82 (69%) isolates were S. Typhi, the remainder S. Paratyphi (15 isolates were fully susceptible, only 1% were MDR). Significant associations of serotype and antibiotic resistance with different travel regions and similarity of phage types (local and Pacific) were observed.

Headache, vomiting and acute kidney injuries were more frequent with Pacific travel, while abdominal distension and cholecystitis with local disease. Shorter duration of treatment in the Pacific group was seen despite length of stay in hospital not being reduced. Local cases were associated with longer hospital admissions.

Conclusions

One half of cases in Auckland are acquired either from Pacific or locally. Similarities mean that disease acquired locally is likely of Pacific origin.
Immigrants’ Attitudes toward Homosexuality: Socialization) Religion, and Acculturation in European Host Societies
Authors: Röder Antje
Published: November 2014

With increasing diversity of migrants in Europe, questions around cultural integration are gaining importance. This study focuses on attitudes towards homosexuality amongst first and second generation immigrants from 186 origin countries to examine the role of religion, origin country socialization and acculturation. There is clear evidence for intra- and intergenerational acculturation of attitudes with declining importance of origin country context. While individual characteristics of migrants and origin country context can explain a substantial part of religious group differences particularly amongst the first generation, Muslims and to a lesser extent other non-Christian and Eastern Orthodox migrants hold overall more negative attitudes.
Stabilization of postprandial blood glucose fluctuations by addition of glucagon like polypeptide‐analog administration to intensive insulin therapy
Authors: Ogawa Susumu , Nako Kazuhiro , Okamura Masashi , Sakamoto Takuya , Ito Sadayoshi
Published: November 2014

Aims/Introduction

The nature of the action of concomitant liraglutide to stabilize postprandial blood glucose level (PBG) in patients on intensive insulin therapy with unstable PBG remains unclear. The aim was to identify the nature of liraglutide's actions to stabilize PBGs.

Materials and Methods

The study participants consisted of 20 diabetes patients showing unstable PBGs after dinner despite undergoing intensive insulin therapy. The dose of bolus insulin was reduced by three units for each meal, and 0.9 mg/day of liraglutide was added and used in combination. We evaluated the participants' data after the first evaluation (immediately before using liraglutide in combination) and the second evaluation (16 weeks after starting concomitant therapy). PBGs after dinner were measured every day for a period of 28 days immediately before carrying out both evaluations. The mean value of the 28 sets of blood glucose data and their standard deviation (SD) values were established as PBGs after dinner, as well as the SD for each participant. The changes in the mean values of the 20 participants, as well as their SD between before and after concomitant therapy, were evaluated.

Results

The mean value of PBGs (12.0 ± 1.0 to 10.1 ± 0.9 mmol/L) and SD values (5.1 ± 0.7–3.5 ± 0.8) after dinner both declined. A multiple regression analysis showed that the combined use of liraglutide was a significant independent variable of the SD values of PBGs after dinner.

Conclusion

The treatment of reducing the dose of insulin and using liraglutide in combination not only suppresses PBGs, but also stabilizes their blood glucose fluctuations.