bluuebunny/crossref_metadata_2025 huggingface dataset:
Fibrinogen Plasma Concentration Before Delivery is not Associated With Postpartum Haemorrhage: A Prospective Observational Study
Authors: Karlsson O. , Jeppsson A. , Thornemo M. , Lafrenz H. , Rådström M. , Hellgren M.
Published: August 2016

(BJA. 2015;115(1):99–104)

Postpartum hemorrhage (PPH) is the most common cause of severe morbidity during labor, as well as the most common obstetric cause of intensive care unit admission. Three recent studies have found an association between low fibrinogen concentration after the onset of bleeding and increased risk of severe PPH, but it is unclear whether the reduced fibrinogen concentration is due to low endogenous fibrinogen concentration present before labor, or is the result of consumption, bleeding, or hemodilution. This prospective observational study evaluated any association between fibrinogen concentration at admission to the labor ward and PPH severity. In addition, the present study described fibrinogen concentration before and after labor and identified predictors for severe PPH.
Pregnancy-related Cardiovascular Deaths in California: Beyond Peripartum Cardiomyopathy
Authors: Hameed A.B. , Lawton E.S. , McCain C.L. , Morton C.H. , Mitchell C. , Main E.K. , Foster E.
Published: August 2016

(Am J Obstet Gynecol. 2015;213(3):379.e1–e10)

Cardiovascular disease is currently understood to be the leading cause of pregnancy-related mortality in the United States. The authors of this study analyzed the incidence as well as the type of cardiovascular disease that results in maternal death. Other objectives included analysis of risk factors, including race, ethnicity, and socioeconomic status, as well as birth outcomes, timing and causes of deaths, and symptoms of cardiovascular disease.
Iodine Deficiency in a Study Population of Pregnant Women in Sweden
Authors: Granfors M. , Andersson M. , Stinca S. , Åkerud H. , Skalkidou A. , Sundström Poromaa I. , Wikström A. , Filipsson Nyström H.
Published: August 2016

(Acta Obstet Gynecol Scand. 2015;94):1168–1174)

Iodine requirements for women are approximately 50% greater in early pregnancy than when in the nonpregnant state. However, in Sweden, data on the iodine nutrition status of pregnant women are scarce and there are no current national recommendations concerning iodine supplementation during pregnancy. Therefore, in the present study, authors evaluated iodine nutrition in two cohorts of pregnant women in Sweden.
Implementing an Obstetric Emergency Team Response System: Overcoming Barriers and Sustaining Response Dose
Authors: Richardson M.G. , Domaradzki K.A. , McWeeney D.T.
Published: August 2016

(Jt Comm J Qual Patient Saf. 2015;41(11):514–521)

Rapid response systems were developed to react quickly to the specific symptoms that commonly occur before cardiopulmonary arrest in hospitals. However, response systems for obstetric patients are less well established. In this article, the authors described the implementation of an obstetric emergency team (OBET) response system that uses a unique communication system, response team composition, and interprofessional leadership support to better respond to obstetric emergencies.
Risk Factors for Severe Secondary Postpartum Hemorrhages: A Historical Cohort Study
Authors: Debost-Legrand A. , Rivière O. , Dossou M. , Vendittelli F.
Published: August 2016

(Birth. 2015;42(3):235–241)

Immediate postpartum hemorrhage is a common and dangerous complication for which risk factors have been established. However, there is a distinct lack of research regarding secondary postpartum hemorrhage, with only 2 studies reporting on possible risk factors. These studies found a variety of risk factors, including immediate postpartum hemorrhage, hemorrhage during pregnancy, manual removal of the placenta, a history of secondary postpartum hemorrhage, hospitalization during the third trimester, maternal smoking, and a prolonged or incomplete third stage of labor. The authors of this study sought to determine what factors might indicate an increased risk for severe secondary postpartum hemorrhage with the primary goal being to determine the association with immediate postpartum hemorrhage.
Risk Factors for Persistent Pain and its Influence on Maternal Wellbeing After Cesarean Section
Authors: Niklasson B. , Georgsson Öhman S. , Segerdahl M. , Blanck A.
Published: August 2016

(Acta Obstet Gynecol Scand. 2015;94(6):622–628)

After surgery, patients might develop persistent pain, which is defined as pain that lasts for 3 months or more and continues even after the time it takes for the tissue to heal. Persistent pain is more common after major surgeries, but can also occur after other procedures. The literature reports that pain management might be inadequate following various types of surgeries, including cesarean section. The authors of this study sought to determine the incidence of persistent pain following a cesarean section as well as any possible risk factors.
Clinical, Ethical, and Legal Considerations in Pregnant Women With Opioid Abuse
Authors: Kremer M.E. , Arora K.S.
Published: August 2016

(Obstet Gynecol. 2015;126:474–478)

Opioid-dependent pregnant women who undergo acute opioid withdrawal during pregnancy are at increased risk for miscarriage, placental abruption, preterm labor, and stillbirth. Physicians should thus have basic familiarity with the medical, ethical, and legal issues surrounding opioid maintenance therapy, which mitigates the risks of frequent withdrawal during gestation and reduces the risk of relapse after delivery. Longer-lasting therapies like methadone and buprenorphine can increase accessibility to care for this population all while preserving confidentiality, decreasing social stigma, and reducing lengthy resource-intensive hospitalizations. Other benefits include lowered risk of bloodborne infection transmission and improved maternal and neonatal health outcomes.
Patient Satisfaction Between Remifentanil Patient-controlled Analgesia and Epidural Analgesia for Labor Pain
Authors: Frauenfelder S. , van Rijn R. , Radder C.M. , de Vries M.C. , Dijksman L.M. , Godfried M.B.
Published: August 2016

(Acta Obstet Gynecol Scand. 2015;94(9):1014–1021)

Remifentanil is a short-acting opioid that is able to metabolize quickly through nonspecific tissue esterases with peak onset at 60 to 90 seconds. Patient-controlled remifentanil is now used for labor analgesia on some units, and several studies have positively evaluated the safety and efficacy of its use. However, it is associated with infrequent but serious side effects impacting patient respiration. Epidural analgesia is currently seen as the best option for labor analgesia, but it carries its own side effects, including postdural puncture headache, hypotension, an increased risk for instrumental deliveries, and increased body temperature that can make maternal infections more difficult to detect. The authors of this study compared these 2 methods of analgesia according to levels of patient satisfaction.
Differences in Maternal Temperature During Labour With Remifentanil Patient-controlled Analgesia or Epidural Analgesia: A Randomised Controlled Trial
Authors: Douma M.R. , Stienstra R. , Middeldorp J.M. , Arbous M.S. , Dahan A.
Published: August 2016

(Int J Obstet Anesth. 2015;24(4):313–322)

Two popular techniques for the treatment of labor pain are epidural analgesia (EA) and intravenous remifentanil patient-controlled analgesia (RPCA). Remifentanil is a μ-opioid receptor agonist with a rapid onset of action and short latency to peak analgesic effect. This randomized, controlled trial was performed to compare the rate of maternal fever (temperature ≥38°C) in parturients receiving RPCA with those receiving either EA or no analgesia. The authors hypothesized that fever would be more prevalent in patients receiving EA compared with patients receiving either RPCA or no analgesia. The secondary objectives studied included differences in maternal oxygen saturation (SpO2), nausea, vomiting, sedation, pruritus, hypotension, and neonatal outcome.
Real-time Ultrasound-guided Epidural Catheter Insertion in Obese Parturients
Authors: Gnaho A. , Nau A. , Gentili M. E.
Published: August 2016

(Can J Anaesth. 2015;62(11):1226–1227)

Preprocedural and real-time ultrasound assessment can aid practitioners in the placement of epidural catheters, which can be a technique that is particularly difficult to perform on morbidly obese patients. To investigate this, these authors conducted a study to assess real-time ultrasound guidance in patients who had failure of epidural insertion using pre-procedural ultrasound and the loss-of-resistance technique.
Accuracy in Obtaining 100 μg from 10 mg of Morphine for Spinal Anesthesia
Authors: Benkhadra M. , Rivory J.-C. , Wessels C.L. , Guerard P. , Vadot L. , Astruc K. , Dumas M.O. , Girard C.
Published: August 2016

(J Clin Anesth. 2015;27:638–645)

A 100 μg is the recommended dose of morphine for patients following a cesarean section. In France there is a variety of morphine concentrations available, including 1 mg/1 mL and 10 mg/1 mL, and 100 μg/1 mL. These different concentrations may increase the likelihood of an erroneous dosage being administered. There are also many different dilution methods that are used to prepare a dose of morphine, which can further complicate attempts to arrive at the standard postcesarean dose of 100 μg. The authors of this study attempted to evaluate the effectiveness of common dilution procedures by measuring the concentration of morphine obtained when the dilution techniques were used to obtain a dose from a 10-mg/1-mL ampule of morphine.
A Prospective Observational Comparison Between Arm and Wrist Blood Pressure During Scheduled Cesarean Delivery
Authors: Sebbag I. , Massey S.R. , Albert A.Y.K. , Dube A. , Gunka V. , Douglas M.J.
Published: August 2016

(Anesth Analg. 2015;121:767–775)

Monitoring of both absolute values and clinically significant changes in patient blood pressure (BP) during cesarean delivery (CD) is important for patient welfare. A 20% increase or decrease in BP from baseline normally triggers treatment intervention. Common practice is to take the BP measurement from the upper arm. However, shivering or arm movement during delivery can lead to BP inaccuracies. Studies have shown leg measurements to be ineffective at detecting changes in BP in this patient population, and the forearm/wrist area has been suggested as an alternative as it has less muscle mass and is less prone to movement. In this single-center, prospective, observational study, authors compared upper arm measurements to wrist BP measurements in 49 nonobese pregnant women (older than 19 y) undergoing elective CD under spinal or combined spinal-epidural anesthesia. They hypothesized that change in wrist systolic BP (sBP) would trend with change measured at the same time in the upper arm, with an absolute difference between methods of <±10%.
A Randomized Controlled Trial of Abdominal Binders for the Management of Postoperative Pain and Distress After Cesarean Delivery
Authors: Gillier C.M. , Sparks J.R. , Kriner R. , Anasti J.N.
Published: August 2016

(Int J Gynaecol Obstet. 2016;133(2):188–191)

Many patients who have undergone cesarean delivery prefer nonpharmacological interventions, such as abdominal compression devices, for pain management. However, the use of these interventions is currently based on preference with little or no evidence-based supporting data. The authors of the present study thus evaluated the effectiveness of an abdominal binder on managing post-cesarean delivery pain and distress in patients.
Management of a Rare Complication of Epidural Analgesia in an Obese Laterally Positioned Parturient: Catheter Entrapment Next to the Inferior Vena Cava
Authors: Amir A. , Lash V. , Moore A. , Rao P. , Torres C. , Kaufman I.
Published: August 2016

(Reg Anesth Pain Med. 2015;40(6):726–728)

Although epidural analgesia is an excellent choice for labor, catheters are usually placed without visual confirmation and can be misplaced. Common locations for misplaced epidural catheters include intravascular, subdural, and intrathecal. However, it is possible for them to be misplaced into the retroperitoneum, leading to potentially disastrous results. This paper reports the case of an obese patient who presented with an epidural catheter embedded next to her inferior vena cava.
Cell Phones in the Neonatal Intensive Care Unit
Authors: Kirkby Sharon , Biggs Christine
Published: August 2016

Background:

Infants admitted to the neonatal intensive care unit (NICU) are more susceptible to infections due to immature immune systems or invasive procedures that compromise protection from bacteria. These infants may stay in the NICU for extended periods of time, are exposed to many caregivers, and may be exposed to other infections. Cell phone use by both family and staff introduce unwanted bacteria into the NICU environment, thereby becoming a threat to this high-risk population.

Purpose:

A quality improvement initiative to evaluate and improve the cleanliness of cell phones used in the NICU.

Methods:

A convenience sample of 18 NICU parents and staff. The participants' cell phones were sampled for bacteria pre- and postcleaning with disinfectant wipes and sent to the microbiology laboratory for a 2-day incubation period. In addition, each participant completed a survey on cell phone cleaning habits.

Results:

Microbial surface contamination was evident on every phone tested before disinfecting. All phones were substantially less contaminated after disinfection.

Implications for Practice:

A standardized cleaning process with a surface disinfectant reduced the amount of germs and potential transmission of nosocomial pathogens within the NICU. The simple exercise illustrated the importance of cell phone hygiene in a high-risk population. The implementation of a simple cleaning process has been an easy and effective way to rid unwanted organisms from this high-risk population.

Implications for Research:

Further research evaluating transmission of nosocomial infections from cell phones would enhance the evidence to establish hospital policies on cleaning devices.
Vaccination Against Human Papilloma Viruses Leads to a Favorable Cytokine Profile of Specific T Cells
Authors: Luckau Stefanie , Wehrs Tim P. , Brandau Sven , Horn Peter A. , Lindemann Monika
Published: August 2016

Several human papilloma viruses (HPV) are known to cause malignant transformation. The high-risk type HPV 16 is associated with cervical carcinoma and head and neck squamous cell carcinoma. HPV 16-positive tumor cells exclusively carry the HPV 16 oncogenes E6 and E7. These oncogenes appear as excellent targets for an adoptive immunotherapy. We here addressed the question whether specific T cells from HPV-vaccinated healthy volunteers could be especially suitable for an HPV-specific cellular immunotherapy. Of note, vaccines contain HPV 16. To quantify HPV 16 E6-specific and E7-specific cells, enzyme-linked immunospot assays to measure interferon-γ (IFN-γ) and interleukin-10 (Th1–Th2 balance) and the secretion of the cytotoxic molecules granzyme B and perforin have been optimized. The frequency of peripheral blood mononuclear cells secreting IFN-γ and perforin was significantly (P<0.05) increased in HPV-vaccinated versus nonvaccinated volunteers. Overall, however, the median frequency of HPV 16-specific cells with a favorable secretion profile (Th1 balanced and cytotoxic) was low even in vaccinated volunteers (IFN-γ: 0.0018% and 0.0023%, perforin: 0.01% and 0.0087% for E6-specific and E7-specific cells, respectively). But some vaccinated volunteers showed up to 0.1% HPV-specific, IFN-γ or perforin-secreting cells. In conclusion, our data suggest that vaccinated volunteers are superior to nonvaccinated donors for HPV-specific cellular cancer immunotherapy.
Endoscopic Management of Pancreatic Fluid Collections
Authors: Muniraj Thiruvengadam , Jamidar Priya A. , Nealon William H. , Aslanian Harry R.
Published: August 2016

Pancreatic fluid collections (PFCs) may develop due to inflammation secondary to acute and/or chronic pancreatitis, trauma, surgery, or obstruction from solid or cystic neoplasms. PFCs can be drained percutaneously, surgically, or endoscopically with endoscopic ultrasound-guided cyst gastrostomy and/or transpapillary drainage through endoscopic retrograde cholangiopancreatography. There has been a paradigm shift in the endoscopic management of PFCs in the past few years with newer techniques including utilization of self-expanding metal stents and multiport devices. This review is a comprehensive update on the classification of PFC, indications for drainage, optimal approach, and techniques.
Management of Medicare Part D Prescription Drug Plans and Medication Adherence
Authors: Young Gary J. , Rickles Nathaniel M. , Benzer Justin K. , Dangi Ankit
Published: August 2016

Background:

Although contractors that offer prescription drug plans through the Medicare Part D program are evaluated in part on enrollees’ medication adherence scores, little evidence addresses contractors’ ability to influence these scores.

Objective:

We used data from the Centers for Medicare and Medicaid Services and US Census to investigate contractors’ ability to influence their medication adherence scores. In accordance with a conceptual model, we hypothesized that contractors can directly and indirectly influence their medication adherence scores based on how effectively they manage prescription drug benefits for enrollees. We focused on 4 plan management variables: service reliability, stability/accuracy of drug prices, accessibility of prescription drugs, and availability of drug information. We examined indirect effects via enrollees’ satisfaction with the plan.

Research Design:

We conducted a cross-sectional study based on 2012 data for which the contractor was the unit of analysis. We conducted path regression models that accounted for plan type (ie, Medicare Advantage vs. stand alone) and enrollee characteristics.

Results:

Among contractors, enrollee satisfaction scores were positively and significantly associated with medication adherence scores. Two of the 4 plan management variables were observed to have both direct and indirect effects on medication adherence scores: accessibility of prescription drugs and service reliability.

Conclusions:

Our study indicates that Part D contractors do appear to have some level of influence over their medication adherence scores based on how effectively they manage prescription drug benefits for enrollees. Accessibility to prescriptions and better service delivery appear important in this regard and should be explored further in future research.
Clinical Evaluation of 2 Point-of-Care Lateral Flow Tests for the Diagnosis of Syphilis
Authors: Nakku-Joloba Edith , Kiragga Agnes , Mbazira Joshua Kimeze , Kambugu Fred , Jett-Goheen Mary , Ratanshi Rosalind Parkes , Gaydos Charlotte , Manabe Yukari C.
Published: August 2016

A diagnostic performance study comparing the only Food and Drug Administration–approved, point-of-care (POC) treponemal test (Syphilis Health Check) and the World Health Organization pre-qualified SD Bioline POC treponemal test against a treponemal hemagglutination test (TPHA) and a sequential algorithm of nontreponemal rapid plasma reagin and TPHA found both POC tests had >85% sensitivity compared with the TPHA and >85% sensitivity and >95% specificity compared with the rapid plasma reagin and TPHA standards.
Cross-sectional Survey of Canadian Pediatric Critical Care Transport
Authors: Kawaguchi Atsushi , Gunz Anna , de Caen Allan
Published: August 2016

Objectives

This study aimed to better understand the unique aspects of pediatric critical care transport programs across Canada by characterizing the current workforce of each transport program.

Methods

A cross-sectional questionnaire was sent to the 13 medical directors of Canada's pediatric critical care transport teams, and to 2 nonhospital-affiliated transport services. If a children's hospital did not have a dedicated team for pediatric transport, the regional transport team providing this service was identified.

Results

Eight of the 13 pediatric intensive care units surveyed have unit-based pediatric transport teams. The median annual transport volume for the 8 hospital-based teams was 371 (range, 45–2300) with a total of 5686 patients being transported annually. Among patients transported by the 8 teams, 45% (2579 patients) were pediatric patients (older than 28 days and younger than 18 years) and 40% (1022 patients) of the pediatric patients were admitted to the pediatric intensive care units. Eighty-eight percent of the responding teams also transported neonates (older than 28 days), and 38% transported premature infants.

A team composition of registered nurse–respiratory therapist–physician was used by 6/13 teams (75%); however, it accounted for only a small proportion of the transports for most of the teams (median, 2%; range, 2%–100%).

The average transport time from dispatch (from team home site) to arrival at receiving facility was reported by 6 teams, and has a median of 195 minutes (range, 90–360 minutes). The median distance from home site to the farthest referral site in the catchment area was 700 km (range, 15–2500 km).

Conclusions

This is the first Canadian nationwide study of pediatric critical care transport programs. It revealed a complexity and variability in transport team demographics, transport volume, team composition, and decision-making process.
The world’s toughest mountain race
Authors: Kler Balvinder Kaur
Published: August 2016

Purpose

The Climbathon is an annual mountain running championship that takes place in Kinabalu Park, Sabah, Malaysian Borneo. Participants race to the peak (4,095.2 metres) and back, a distance of 21 kilometres of rainforest and mountain terrain, with a steep vertical gain of 2,300 metres. The purpose of this paper is to evaluate the first 25 years of the Climbathon and to identify the key success factors behind the staging of this small-scale international sports event in Southeast Asia.

Design/methodology/approach

The research design for this study is interpretive, utilises a qualitative case study approach incorporating analysis of documents, oral history interviews, and personal observations gained through attendance and volunteering at the event which produced six insights, suggested as key success factors for the Climbathon. This study was guided by one key research question, to understand what has ensured the continuity of this small-scale international sports event known as the Climbathon.

Findings

Findings suggest the Climbathon has endured the test of time due to an innovative use of the summit trail, adherence to international sporting regulations, a pro sports tourism public policy led by the tourism ministry, membership to international sports organisations, corporate sponsorship, and a special sense of place towards Mount Kinabalu and the Climbathon for the event organisers, volunteers and officials.

Research limitations/implications

This case study presents knowledge about the Climbathon but findings are not generalisable. Any application of the success factors would have to be as guidelines adapted for a specific sport event. The use of oral history as part of a case study is subjective and open to interpretation. Future work could incorporate interviews with participants, spectators, volunteers and the local sub-committees to gain alternative perspectives.

Originality/value

This study makes an original contribution to the events and tourism field by presenting a case study on the success factors of the Mount Kinabalu International Climbathon. The study suggests a three pillar model of “Place-Plan-People” which may be used as a guiding philosophy for event development and delivery of small-scale international sports tourism events in Asia and elsewhere. The inclusion of oral history as part of a case study research design is novel and useful when knowledge is not available in any published form.
The Effects of Regulations on the Performance of Banks: Evidence from the Turkish Banking Industry
Authors: Kale Süleyman , Eken Mehmet Hasan , Selimler Hüseyin
Published: August 2016

Purpose

To investigate the effects of regulations, macroeconomic changes, and political events on the efficiency of the Turkish banks during the period 1997-2013, when crucial changes were experienced. To analyze the effects of an extensive set of bank-specific and environmental factors on the efficiency, since the diversions could not only be related to new regulations.

Design/methodology/approach

A two-stage procedure is employed. First, the productivity changes of each bank and of the whole sector are measured by a DEA-based Malmquist Productivity Index (DEA-MPI). Second, the effects of selected internal and external factors on productivity are analyzed with regression analysis. The sector is especially handled before and after 2001, when one of the most catastrophic crises is observed and moment after which a series of new regulations are implemented.

Findings

During the period 1997-2001, the efficiency deteriorated due to the 2001 crisis; after the crisis, an improvement was observed. All models indicate the source of improvements as efficiency instead of technological changes. Rather than external, internal factors seem to be more effective on productivity. Therefore, the importance of regulations for the soundness of banks, management quality and monitoring may be more crucial than what is thought. In general, a new macroeconomic environment, particularly new regulations, have positive effects on productivity. Tighter regulations, monitoring, restrictions, strong supervision, more capital, and new reforms have a positive impact on efficiency.

Originality/value

The study spans a wide period to analyze the sector using three different perspectives. It analyzes the effect of the 2001 financial crisis and subsequent regulations. It handles an extensive set of internal and external factors; and it tests each factor with nine different DEA-MPI models for consistency. Turkey's unique environmental factors, such as the unstable macroeconomic conditions, high inflation and a subsequent disinflation period, high interest rates, new regulations and crisis experience, among others, also make the study distinctive.
The value of being a conscientious learner
Authors: Woods Stephen A. , Patterson Fiona C. , Koczwara Anna , Sofat Juilitta A.
Published: August 2016

Purpose

The aim of this paper is to examine the impact of personality traits of the Big Five model on training outcomes to help explain variation in training effectiveness.

Design/methodology/approach

Associations of the Big Five with self-reported learning following training were tested in a pre- and post-design in a field sample of junior medical practitioners (N = 99), who attended a training workshop on self-awareness. Associations are reported of personality traits with post-training learning measured immediately following the workshop and one-month later controlling for pre-training learning.

Findings

Conscientiousness was related to post-training learning at both times. None of the remaining Big Five factors were associated with post-training learning.

Research limitations/implications

The study contributes to the literature on personality and training outcomes, clarifying the associations of traits with outcomes in a pre-and-post design. Although the study sample has limitations, the findings have implications for numerous lines of future research, in particular in understanding the role of training in relations of personality and job performance.

Practical implications

Practitioners should consider ways to encourage training participants to approach training conscientiously. Personality assessment might help people reflect on their approach to learning to adapt it during training.

Originality/value

No study has previously examined the role of personality traits in training outcomes using a pre- and post-design. The role of conscientiousness in workplace learning is underlined by the findings. While dimensions such as openness and extraversion may encourage people to participate in training, conscientiousness may make the difference in promoting internalized individual development and change following training.
Administrative assistants’ informal learning and related factors
Authors: Cho Hyun Jung , Kim Jin-Mo
Published: August 2016

Purpose

The purpose of this study is to identify the causal relationship among informal learning, leader-member exchange (LMX), empowerment, job characteristics and job self-efficacy and the impact on administrative assistants in corporations. The study aims at providing information for administrative assistants who have worked with their current supervisors for more than one year in a one-to-one administrative assistant role in corporations.

Design/methodology/approach

To ensure the reliability and validity of the questions, statistical analysis was performed using SPSS 18.0. AMOS 18.0 was also used to estimate the causal relationship of the proposed research model.

Findings

The analyses show the following results. Indirect factor loading of LMX and empowerment to informal learning and direct factor loading of job characteristics and job self-efficacy were observed. In the relationship between LMX and informal learning, empowerment had a negative mediating effect and job self-efficacy had a positive mediating effect. In the relationship between empowerment and informal learning, job self-efficacy and job characteristics both had a mediating effect. However, job self-efficacy did not have a mediating effect in the relationship between job characteristics and informal learning.

Originality/value

When considering informal learning, planners should consider both individual characteristics and organizational characteristics. However, informal learning is not directly correlated to the impact of factors related to the executives and organization itself, but rather linked to individual and job characteristics. Hence, promoting job self-efficacy not only requires the individual efforts of employees but also a systematic strategy at the corporate level.
Implementing basic e-learning tools into an undergraduate taxation curriculum
Authors: van Oordt T. , Mulder Ingrid
Published: August 2016

Purpose

Educators in the accounting discipline are faced with the challenge of finding innovative ways to accommodate the flexible learning styles of Millennial students, using “in classroom/contact time” effectively and decreasing transactional distance between students and educators in large classes. In an attempt to address these challenges, this paper aims to describe the implementation of basic e-learning tools (podcasts, vodcasts and voice-over-PowerPoint) as supplementary and substitutional tools in an undergraduate taxation curriculum. The tools were implemented as part of a student-centred approach to the facilitation of learning, embedded in the Blended Learning Theory. The paper reports on students’ use and experience of various basic e-learning tools, as well as the impact of the use of these tools on student performance.

Design/methodology/approach

An action research methodology was followed, and data were collected by way of a voluntary, descriptive student survey and student class lists. A total of 387 students completed the survey.

Findings

Students appear to have access to devices and data to use e-learning tools. They perceive these tools as helpful study aids and prefer synchronous, substitutional tools. Use of the tools does not have a significant impact on performance; however, it does appear to have a positive impact on the learning environment and student engagement.

Originality/value

The results of the study may be of benefit to educators and curriculum designers who are responsible for reviewing and updating the content delivery methods of undergraduate taxation curricula in large classes with diverse student populations. These results add to the limited body of knowledge on the implementation of basic e-learning tools in a South African accounting education setting.
Contextualizing a social enterprise opportunity process in an emerging market
Authors: Diochon Monica , Ghore Yogesh
Published: August 2016

Purpose

The purpose of this paper is to contribute to a better understanding of how a social enterprise opportunity is brought to fruition in an emerging market.

Design/methodology/approach

This real-time longitudinal case study tracks the emergence of a micro-franchise start-up from conception to inception. Using a narrative perspective as a conceptual lens focuses attention on the relational, temporal and performative elements of the interactive process that occurs between social entrepreneur(s) and the environment(s). While interviewing provides the primary source of evidence, multiple data collection methods were utilized.

Findings

The analysis of the process elements centres on the narratives of the micro-franchise co-founders and other key informants that prompt action aimed at bringing the opportunity to fruition, showing how the social entrepreneurs bring the inside out and the outside in.

Research limitations/implications

Despite challenges to the appropriateness of Western management theory within emerging markets, this study has shown that theory at a sufficiently high level of abstraction can be useful. It also demonstrates the need to study process over time and be inclusive of the range of stakeholders and contexts that influence it.

Social implications

The findings indicate that social enterprise start-up is a co-creative process that evolves in unpredictable ways over time. Beyond start-up, only time and further study will determine whether social enterprise will prove to be the panacea for poverty and marginalization that governments expect.

Originality/value

This research gains real-time insight into social enterprise emergence. It underscores the multi-dimensional nature of context and provides evidence indicating that the relationship and influence between social entrepreneur(s) and their environment is not one way.
Phenotypic diversity of circulating tumour cells in patients with metastatic castration‐resistant prostate cancer
Authors: McDaniel Andrew S. , Ferraldeschi Roberta , Krupa Rachel , Landers Mark , Graf Ryon , Louw Jessica , Jendrisak Adam , Bales Natalee , Marrinucci Dena , Zafeiriou Zafeiris , Flohr Penelope , Sideris Spyridon , Crespo Mateus , Figueiredo Ines , Mateo Joaquin , de Bono Johann S. , Dittamore Ryan , Tomlins Scott A. , Attard Gerhardt
Published: August 2016

Objectives

To use a non‐biased assay for circulating tumour cells (CTCs) in patients with prostate cancer (PCa) in order to identify non‐traditional CTC phenotypes potentially excluded by conventional detection methods that are reliant on antigen‐ and/or size‐based enrichment.

Patients and Methods

A total of 41 patients with metastatic castration‐resistant PCa (mCRPC) and 20 healthy volunteers were analysed on the Epic CTC platform, via high‐throughput imaging of DAPI expression and CD45/cytokeratin (CK) immunofluorescence (IF) on all circulating nucleated cells plated on glass slides. To confirm the PCa origin of CTCs, IF was used for androgen receptor (AR) expression and fluorescence in situ hybridization was used for PTEN and ERG assessment.

Results

Traditional CTCs (CD45−/CK+/morphologically distinct) were identified in all patients with mCRPC and we also identified CTC clusters and non‐traditional CTCs in patients with mCRPC, including CK− and apoptotic CTCs. Small CTCs (≤white blood cell size) were identified in 98% of patients with mCRPC. Total, traditional and non‐traditional CTCs were significantly increased in patients who were deceased vs alive after 18 months; however, only non‐traditional CTCs were associated with overall survival. Traditional and total CTC counts according to the Epic platform in the mCRPC cohort were also significantly correlated with CTC counts according to the CellSearch system.

Conclusions

Heterogeneous non‐traditional CTC populations are frequent in mCRPC and may provide additional prognostic or predictive information.
Cutaneous mantle cell lymphoma: a clinicopathologic review of 10 cases
Authors: Gru Alejandro A. , Hurley M. Yadira , Salavaggione Andrea L. , Brodell Lindsey , Sheinbein David , Anadkat Milan , Porcu Pierluigi , Frater John L.
Published: August 2016

Cutaneous mantle cell lymphoma (MCL) is exceedingly rare, almost always occurring as a dissemination of systemic MCL. To date, only 32 cases have been described. We report a series of 10 cases of MCL in the skin, and provide a comprehensive clinicopathologic review with clinical follow‐up. Our cases occurred in older individuals (mean age = 70) and were more frequently in men (90%). Half of them presented in the head and neck region as a mass/nodule, and the remainder in the trunk and extremities as nodules. All patients have stage IV disease. In two of the 10 cases (20%) the cutaneous lesions preceded the diagnosis of disseminated disease. In two of the seven cases with available clinical follow‐up information (33%) the skin was immediately involved after the diagnosis of MCL, and in three of the seven the skin was the first site of recurrence (mean interval = 57 months). The mean time to recurrence of the disease was 45.4 months and the overall survival was 66.3 months. Histologically six out of 10 cases (60%) had either pleomorphic or blastoid morphology (four out of 10 and two out of 10, respectively). The mean number of mitoses per 10 high‐power fields was 18.44. While nine out of 10 cases expressed cyclin‐D1, one case was not positive for cyclin‐D1 but did label with SOX‐11. Limited cytogenetic data showed trisomy 14 in one case, in addition to the t(11;14) translocation.
Full‐blown cardiac manifestations in ankylosing spondylitis
Authors: Hwang Hui‐Jeong , Kim Jung Im , Lee Sang‐Hoon , Park Chang‐Bum , Sohn Il Suk
Published: August 2016

Ankylosing spondylitis often involves a heart, such as aortic or mitral regurgitation, conduction disorder, or cardiomyopathy. We present a 34‐year‐old male patient with ankylosing spondylitis who has severe aortic regurgitation, mild mitral stenosis, and a conduction disturbance of the left bundle branch block, identified using multimodal images.
Action spectrum of melanoblast maturation and involvement of the aryl hydrocarbon receptor
Authors: Nakamura Motoki , Nishida Emi , Morita Akimichi
Published: August 2016

The aryl hydrocarbon receptor (AHR) mediates melanocyte activation and skin tanning. We hypothesized that the AHR also mediates melanoblast‐to‐melanocyte maturation. In a cloned cell line, NCCmelb4, derived from mouse neural crest cells, we investigated AHR expression in melanoblasts stimulated by UV irradiation and AHR agonists. We irradiated the cells with UV, ranging from 280 to 380 nm in 10‐nm increments, using a multiwavelength irradiation spectral apparatus. Tyrosinase expression significantly increased with bimodal peaks at 310 and 360 nm. Although melanoblast activation peaked 48 hours after irradiation, the most suitable irradiation interval was 24 hours. AHR expression significantly increased at 360 nm, but not at 310 nm. The AHR agonist, VAF347, and water‐soluble tobacco smoke extract induced melanoblast maturation and AHR activation. The culture supernatant derived from the NS47 fibroblast cell line also induced melanoblast maturation and AHR activation. These findings suggest that UV and environmental stimulation of melanoblast‐to‐melanocyte maturation are enhanced via the AHR pathway.
The temporal structure of the environment may influence range expansions during climate warming
Authors: Fey Samuel B. , Wieczynski Daniel J.
Published: August 2016

Understanding the processes that influence range expansions during climate warming is paramount for predicting population extirpations and preparing for the arrival of non‐native species. While climate warming occurs over a background of variation due to cyclical processes and irregular events, the temporal structure of the thermal environment is largely ignored when forecasting the dynamics of non‐native species. Ecological theory predicts that high levels of temporal autocorrelation in the environment – relatedness between conditions occurring in close temporal proximity – will favor populations that would otherwise have an average negative growth rate by increasing the duration of favorable environmental periods. Here, we invoke such theory to explain the success of biological invasions and evaluate the hypothesis that sustained periods of high environmental temperature can act synergistically with increases in mean temperature to favor the establishment of non‐native species. We conduct a 60‐day field mesocosm experiment to measure the population dynamics of the non‐native cladoceran zooplankter Daphnia lumholtzi and a native congener Daphnia pulex in ambient temperature environments (control), warmed with recurrent periods of high environmental temperatures (uncorrelated‐warmed), or warmed with sustained periods of high environmental temperatures (autocorrelated‐warmed), such that both warmed treatments exhibited the same mean temperature but exhibited different temporal structures of their thermal environments. Maximum D. lumholtzi densities in the warmed‐autocorrelated treatment were threefold and eightfold higher relative to warmed‐uncorrelated and control treatments, respectively. Yet, D. lumholtzi performed poorly across all experimental treatments relative to D. pulex and were undetectable by the end of the experiment. Using mathematical models, we show that this increase in performance can occur alongside increasing temporal autocorrelation and should occur over a broad range of warming scenarios. These results provide both empirical and theoretical evidence that the temporal structure of the environment can influence the performance of species undergoing range expansions due to climate warming.
Application of the metabolic scaling theory and water–energy balance equation to model large‐scale patterns of maximum forest canopy height
Authors: Choi Sungho , Kempes Christopher P. , Park Taejin , Ganguly Sangram , Wang Weile , Xu Liang , Basu Saikat , Dungan Jennifer L. , Simard Marc , Saatchi Sassan S. , Piao Shilong , Ni Xiliang , Shi Yuli , Cao Chunxiang , Nemani Ramakrishna R. , Knyazikhin Yuri , Myneni Ranga B.
Published: August 2016

Aim

Forest height, an important biophysical property, underlies the distribution of carbon stocks across scales. Because in situ observations are labour intensive and thus impractical for large‐scale mapping and monitoring of forest heights, most previous studies adopted statistical approaches to help alleviate measured data discontinuity in space and time. Here, we document an improved modelling approach which links metabolic scaling theory and the water–energy balance equation with actual observations in order to produce large‐scale patterns of forest heights.

Methods

Our model, called allometric scaling and resource limitations (ASRL), accounts for the size‐dependent metabolism of trees whose maximum growth is constrained by local resource availability. Geospatial predictors used in the model are altitude and monthly precipitation, solar radiation, temperature, vapour pressure and wind speed. Disturbance history (i.e. stand age) is also incorporated to estimate contemporary forest heights.

Results

This study provides a baseline map (c. 2005; 1‐km2 grids) of forest heights over the contiguous United States. The Pacific Northwest/California is predicted as the most favourable region for hosting large trees (c. 100 m) because of sufficient annual precipitation (> 1400 mm), moderate solar radiation (c. 330 W m−2) and temperature (c. 14 °C). Our results at sub‐regional level are generally in good and statistically significant (P‐value < 0.001) agreement with independent reference datasets: field measurements [mean absolute error (MAE) = 4.0 m], airborne/spaceborne lidar (MAE = 7.0 m) and an existing global forest height product (MAE = 4.9 m). Model uncertainties at county level are also discussed in this study.

Main conclusions

We improved the metabolic scaling theory to address variations in vertical forest structure due to ecoregion and plant functional type. A clear mechanistic understanding embedded within the model allowed synergistic combinations between actual observations and multiple geopredictors in forest height mapping. This approach shows potential for prognostic applications, unlike previous statistical approaches.
Reflective Equilibrium as an Ameliorative Framework for Feminist Epistemology
Authors: Mühlebach Deborah
Published: August 2016

As Helen Longino's overview ofHypatia's engagement with feminist epistemology suggests, the last twenty‐five years’ contributions to this field reveal a strong focus on the topic of knowledge. In her short outline, Longino questions this narrow focus on knowledge in epistemological inquiry. The main purpose of this article is to provide a framework for systematically taking up the questions raised by Longino, one that prevents us from running the risk of becoming unreflectively involved in sexist, racist, or otherwise problematic inquiry. I argue that a specific form of the method of Reflective Equilibrium, as it is widely discussed in moral epistemology, logic, and theories of rationality, enables us to cope with the problems of traditional epistemology, which feminist theorizers such as Sally Haslanger have pointed to. With the account of Reflective Equilibrium I am offering—drawing in many respects on the model provided by Catherine Z. Elgin—we have an ameliorative method that allows us to rethink epistemological values, goals, and standards in a systematic way, and that largely avoids implicit and explicit biases in epistemology.
The condom imperative in anal sex – one size may not fit all: a qualitative descriptive study of men who have sex with men
Authors: Neville Stephen , Adams Jeffery , Moorley Calvin , Jackson Debra
Published: August 2016

Aims and objectives

To explore men who have sex with men's views about condom use when having anal intercourse.

Background

Internationally, health promotion campaigns use behavioural change strategies to support men who have sex with men to always use condoms when having anal sex with other men. The health promotion message given to this group is consistent and explicitly stated that ‘use a condom every time for anal sex regardless of relationship status’.

Design

Qualitative analysis of data from a cohort of New Zealand men who have sex with men.

Methods

A total of 960 useable questionnaires were completed: 571 online and 389 in hard copy. Qualitative data were analysed using a thematic data analytic process.

Results

Three themes relating to condom use in men who have sex with men were identified. These are as follows: ‘Safer sex is good sex’, ‘Condom use is good but …’ and ‘I use condoms sometimes’.

Conclusions

The range of responses towards condom use for anal sex in men who have sex with men in our sample reveal this as a complex public health issue, with not all men who have sex with men willing to consistently use condoms.

Relevance to clinical practice

It is important that nurses do not assume that all men who have sex with men are willing to use condoms for anal sex, and should create opportunities for men who have sex with men to raise any concerns about the use of condoms. In this way, nurses can assist in providing information that may help men who have sex with men to make decisions that will minimise risk of contracting infections associated with sexual activity.