bluuebunny/crossref_metadata_2025 huggingface dataset:
Human factors paradigm and customer care perceptions
Authors: Clarke Colin , Eales-Reynolds Lesley-Jane
Published: April 2015

Purpose

– The purpose of this paper is to examine if customer care (CC) can be directly linked to patient safety through a human factors (HF) framework.

Design/methodology/approach

– Data from an online questionnaire, completed by a convenience healthcare worker sample (n=373), was interrogated using thematic analysis within Vincent et al.’s (1998) HF theoretical framework. This proposes seven areas affecting patient safety: institutional context, organisation and management, work environment, team factors, individual, task and patient.

Findings

– Analysis identified responses addressing all framework areas. Responses (597) principally focused on work environment 40.7 per cent (n=243), organisation and management 28.8 per cent (n=172). Nevertheless, reference to other framework areas were clearly visible within the data: teams 10.2 per cent (n=61), individual 6.7 per cent (n=40), patients 6.0 per cent (n=36), tasks 4.2 per cent (n=24) and institution 3.5 per cent (n=21). Findings demonstrate congruence between CC perceptions and patient safety within a HF framework.

Research limitations/implications

– The questionnaire requested participants to identify barriers to rather than CC enablers. Although this was at a single site complex organisation, it was similar to those throughout the NHS and other international health systems.

Practical implications

– CC can be viewed as consonant with patient safety rather than the potentially dangerous consumerisation stance, which could ultimately compromise patient safety.

Originality/value

– This work provides an original perspective on the link between CC and patient safety and has the potential to re-focus healthcare perceptions.
TeamSTEPPS implementation in community hospitals
Authors: Ward Marcia M , Zhu Xi , Lampman Michelle , Stewart Greg L.
Published: April 2015

Purpose

– Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) is being widely promoted in healthcare settings to train staff in evidence-based approaches that promote patient safety. It involves a comprehensive curriculum that spells out key principles and actionable tools for a culture change toward patient-safety-focussed teamwork. Activities begin with selected personnel attending TeamSTEPPS Master Trainer Training (MTT) and then organizing and providing TeamSTEPPS training for staff in their organization. The authors conducted interviews with respondents at community hospitals conducting TeamSTEPPS staff training. To structure the interviews, the authors used 11 key questions identified by Weaver et al. in their in-depth team training literature review. The purpose of this paper is to examine approaches taken by community hospital personnel and compare those to the best practices recommended by Weaver et al.

Design/methodology/approach

– The authors interviewed 57 staff and administrators at 22 community hospitals sending teams to TeamSTEPPS MTT.

Findings

– The authors find that training implementation in community hospitals differs significantly from the established, research-based principles for effective team training described in the research literature, which is largely based in academic medical centers.

Originality/value

– The current findings suggest that several TeamSTEPPS training features could be enhanced in community hospitals including: choosing staff who have the skills to be effective trainers in this train-the-trainer model; emphasizing active learning; and sustaining lessons through on-the-job application, practice and feedback. These principles apply to many training approaches employed in small healthcare organizations.
Cultural education organizations and flexible individualization of taste
Authors: Poprawski Marcin
Published: April 2015

Purpose

– The purpose of this paper is to identify and discuss structure, essence, and quality of a current organizational frameworks for the arts and culture, institutions, NGO’s and enterprises that are core playgrounds for flexible individualization of taste, cultural literacy, individuals’ expressions and their cultural identity.

Design/methodology/approach

– Paper design initiates with an analysis of the organizational landscape of cultural sector, including special focus on cultural education. This subject will be studied with a use of a case of cultural education organization leaders. The paper epilogue brings to the discussion inspirations from aesthetics and marketing studies.

Findings

– In cultural education organizations, there is: an urgency: for more hybrid and flexible organizational forms; cross-sectorial synergy; for more focused leaders competencies fitting into expected categories of: managerial, communicative, sensemaking, and entrepreneurial.

Research limitations/implications

– The paper is a stimulus for further research within cooperating disciplines of organization studies, cultural policy studies, marketing, and aesthetics.

Practical implications

– The text has practical implication for public administration, cultural policy makers and is an insight for cultural organizations leaders from public, private, and civil parts of cultural sector.

Originality/value

– The topic of flexible individuation of taste in relations to cultural education institution practices, is reflected in a complementary approach, from triadic perspective of cultural policy, marketing and aesthetics, bringing new insights for organization change research and practice.
Entrepreneurial orientation and performance of SMEs in the services industry
Authors: Rodríguez-Gutiérrez María José , Moreno Pilar , Tejada Pilar
Published: April 2015

Purpose

– The purpose of this paper is to examine both the sources of competitiveness of small and medium- sized enterprises (SMEs) in the services industry measured by their capability to grow, and the relative importance of each of these sources. More specifically, the resources and capabilities of Spanish SMEs in the services industry that may become sources of competitive advantage are analysed.

Design/methodology/approach

– In order to achieve this objective, this paper is organized as follows. First, a concise overview of prior research on determinants of performance of SMES is provided, outlining the role of factors regarding resources and capabilities. Second, a set of lineal regression models are performed to test the hypothesis research. In line with several previous studies, competitive success and performance of the company are approached through the recent evolution of firms in terms of employment, turnover and productive investment. The data set comes from a survey on Spanish SMEs operating in the services industry that was carried out between the end of 2010 and the beginning of 2011.

Findings

– The findings reveal that entrepreneur characteristics, firm features and managerial attributes have significant effect on the business performance. The results from the empirical analysis indicate that competitive success of the Spanish SMEs in the service industry is conditioned by macroeconomic and social factors related to the general business environment and especially by business factors concerning the entrepreneurial orientation of the firm, these findings are consistent with those of earlier research conducted at both an international level a national level.

Originality/value

– The fundamental contribution of SMEs to the overall performance of the economy constitutes a crucial motive for researchers to investigate and examine the key success factors behind these enterprises. This issue has been analysed exhaustively for the manufactured goods industry, but has scarcely been addressed for the services industry. Thus, further research is needed to clarify the variables explaining survival and success for services SMEs. Furthermore, since this research is focused on the microeconomic level, by considering the firm as the unit of analysis, it contributes towards complementing previous research on this topic that has been conducted from a macroeconomic approach. Thus it attempts to provide certain empirical evidences for support the traditional academic debate between economic and administrative disciplines concerning the appropriate unit of analysis for the understanding and explanation of businesses competitiveness.
Assessing impediments to NPM change
Authors: Steane Peter , Dufour Yvon , Gates Donald
Published: April 2015

Purpose

– When new public management (NPM) emerged in the mid-1980s, most governments such as New Zealand, Australia and Canada embraced it as a better way to provide public services. A more recent assessment of NPM would conclude that its appeal has faded. The purpose of this paper is to assess the serious impediments to NPM-inspired change.

Design/methodology/approach

– The literature is diffuse, and therefore its insights have been limited by the lack of synthesis. In this paper the authors set out to synthesize the main work already available.

Findings

– Change, such as breaking up large public sector hierarchies, or developing internal market-like competition and contracting out public services is indeed disruptive. Such change cannot be achieved without shifting decision-making processes, disrupting existing roles and working relationships and leaving some confusion and uncertainty among staff. Many of the changes feature numerous levels of ill-defined processes, ongoing multi-layered and complex decision making, and no easily agreed or clear path to resolution.

Originality/value

– The terms “wicked problem” and “disruptive innovation” are increasingly familiar to public managers and policy makers. This paper argues that managing NPM-style change represented yet another wicked problem in managing public organizations. The authors set out to synthesize the main work available, and in so doing, frame the various attributes of NPM-inspired change – five basic parts, five types of uncertainty and five fragmenting forces. The conceptual framework suggests hypotheses as the basis for further research.
Integrating the organizational change literature: a model for successful change
Authors: Al-Haddad Serina , Kotnour Timothy
Published: April 2015

Purpose

– The purpose of this paper is to contribute a roadmap to the change management literature, and provide definitions for describing change types, change enablers and change methods. This paper also proposes aligning the change type with the change method to find the effect on the change outcomes. New researchers can use this paper to get an overview of the change management discipline along with the main concepts that help in understanding the different dimensions of and relationships between the change types and methods in the literature. Managers can use this paper to describe and classify their organizational change situation and select an implementation method for systematic change and for change management.

Design/methodology/approach

– This framework is designed based on literature review and experts judgment.

Findings

– The results of the research propose a hypothesis that describes the relationships between the change types and methods and how this relationship can affect the change outcomes.

Originality/value

– The main contribution of this research paper is to connect three main knowledge areas of change types, change methods and change outcomes. These three areas are standalone subjects in several publications in the literature. Some researchers connected the change types and change methods, while other researchers connected the change methods and change outcomes. But connecting the change types, change methods and change outcomes remains a new research territory to explore.
Reacting to and managing change within Juvenile justice
Authors: Dadich Ann , Stout Brian , Hosseinzadeh Hassan
Published: April 2015

Purpose

– As part of the wave of new public management (NPM), the purpose of this paper is to unveil reactions to, and the management of organizational change within a context seldom examined – juvenile justice. This is achieved via a state-wide study on the introduction of a policy framework in eight centers to manage detainee behavior by ensuring risk-based decision-making among staff.

Design/methodology/approach

– Secondary research material was analyzed on organizational characteristics, framework-implementation, and the associated outcomes. The material was synthesized to develop descriptions of each center.

Findings

– Two key findings are apparent. First, there were limited research material to make robust connections between framework-implementation and related outcomes. Second, of the material available, there is clear evidence of center differences. The contexts in which the framework was implemented were varied – this may partly explain the different ways the centers responded to the framework, some of which appear counterintuitive.

Research limitations/implications

– The findings are limited by the use of secondary research material and the limited availability of comprehensive material.

Practical implications

– This study suggests that managing change within the public sector requires an acute understanding of organizational context. This encompasses the situation both within and beyond the organization.

Originality/value

– This study casts doubt on whether NPM, which espouses accountability, holds value for juvenile justice. This is largely because: the introduction of the framework was not complemented by the collection of complete data and information; and that which is available suggests considerable variation among the centers, which may circumvent the ability to establish causal relationships between policy and practice.
Can enhanced performance management support public sector change?
Authors: Buick Fiona , Blackman Deborah Ann , O'Donnell Michael Edward , O'Flynn Janine Louise , West Damian
Published: April 2015

Purpose

– The purpose of this paper is to focus on the potential role that performance management could play in enabling employees’ adaptability to change and, therefore, successful change implementation.

Design/methodology/approach

– This research adopted a qualitative case study research design, focussed on seven case studies within the Australian Public Service (APS). This study utilized documentary analysis, semi-structured individual and group interviews.

Findings

– The findings of this research demonstrate that adaptability to change is integral for high performance; however, the constant change faced by many public servants is disruptive. The authors posit that applying a performance framework developed by Blackmanet al. (2013a, b) to change implementation will help overcome, or at least mitigate, these issues. The authors argue that applying this framework will: enable adaptability to change; and provide an ongoing management function that enables change to occur.

Research limitations/implications

– This research has been limited to seven organizations within the APS, yet it does reveal interesting implications in terms of the apparent role of performance management in both developing change capacity and supporting espoused outcomes.

Practical implications

– This research identifies the potential role that performance management can play in supporting effective change implementation through enabling employees to cope better with the change through enabling clarity, purpose and alignment with the organizational direction.

Originality/value

– The originality of this paper stems from the synthesis of different strands of literature, specifically high performance, performance management and change management, and empirical research in the public sector to provide a new way of looking at performance management as a change enabler.
Financial reporting for commercial service charges in the retail sector
Authors: Holt Andrew , Eccles Timothy
Published: April 2015

Purpose

– The purpose of this paper is to assess whether financial reporting practices for commercial service charges in the UK retail sector match the best practice requirements of the Royal Institution of Chartered Surveyors (RICS) Code of practice for commercial service charges. This assessment was performed by benchmarking commercial service charge documents provided to retail occupiers at UK shopping centres against the RICS Code’s financial reporting requirements.

Design/methodology/approach

– Data were generated from direct analysis of actual service charge documents supplied to commercial retail occupiers. This ensures authenticity by removing reliance upon third party reporting of said data. The paper uses a sample size that is representative of the financial reporting practices for commercial service charges at UK shopping centres.

Findings

– Levels of compliance with the financial reporting requirements of the RICS Code of Practice for commercial service charges are found to be poor, especially in terms of the disclosure of the accounting policies used during the preparation of the service charge accounts. These results contrast with claims by the professional body.

Research limitations/implications

– The work analyses service charge documents prepared during 2010-2012 by 44 managing agents and 87 landlords at 126 UK retail shopping centres located in Great Britain. Content analysis was utilised to interpret the data and required some subjective judgement by the researchers.

Originality/value

– Data are original and the paper provides a unique benchmarking test for assessing Code compliance. This contrasts markedly with the anecdotal evidence offered by the profession in defending current standards of practice and whilst the paper has limitations, it is the largest and most in-depth study of commercial service charge practices at UK retail shopping centres.
Combatting bacterial infections by killing persister cells with mitomycin C
Authors: Kwan Brian W. , Chowdhury Nityananda , Wood Thomas K.
Published: April 2015

Persister cells are a multi‐drug tolerant subpopulation of bacteria that contribute to chronic and recalcitrant clinical infections such as cystic fibrosis and tuberculosis. Persisters are metabolically dormant, so they are highly tolerant to all traditional antibiotics which are mainly effective against actively growing cells. Here, we show that the FDA‐approved anti‐cancer drug mitomycin C (MMC) eradicates persister cells through a growth‐independent mechanism. MMC is passively transported and bioreductively activated, leading to spontaneous cross‐linking of DNA, which we verify in both active and dormant cells. We find MMC effectively eradicates cells grown in numerous different growth states (e.g. planktonic cultures and highly robust biofilm cultures) in both rich and minimal media. Additionally, MMC is a potent bactericide for a broad range of bacterial persisters, including commensal Escherichia coli K‐12 as well as pathogenic species of E. coli, Staphylococcus aureus and Pseudomonas aeruginosa. We also demonstrate the efficacy of MMC in an animal model and a wound model, substantiating the clinical applicability of MMC against bacterial infections. Therefore, MMC is the first broad‐spectrum compound capable of eliminating persister cells, meriting investigation as a new approach for the treatment of recalcitrant infections.
Rare taxa have potential to make metabolic contributions in enhanced biological phosphorus removal ecosystems
Authors: Lawson Christopher E. , Strachan Blake J. , Hanson Niels W. , Hahn Aria S. , Hall Eric R. , Rabinowitz Barry , Mavinic Donald S. , Ramey William D. , Hallam Steven J.
Published: April 2015

Enhanced biological phosphorus removal (EBPR) relies on diverse but specialized microbial communities to mediate the cycling and ultimate removal of phosphorus from municipal wastewaters. However, little is known about microbial activity and dynamics in relation to process fluctuations in EBPR ecosystems. Here, we monitored temporal changes in microbial community structure and potential activity across each bioreactor zone in a pilot‐scale EBPR treatment plant by examining the ratio of small subunit ribosomal RNA (SSU rRNA) to SSU rRNA gene (rDNA) over a 120 day study period. Although the majority of operational taxonomic units (OTUs) in the EBPR ecosystem were rare, many maintained high potential activities based on SSU rRNA : rDNA ratios, suggesting that rare OTUs contribute substantially to protein synthesis potential in EBPR ecosystems. Few significant differences in OTU abundance and activity were observed between bioreactor redox zones, although differences in temporal activity were observed among phylogenetically cohesive OTUs. Moreover, observed temporal activity patterns could not be explained by measured process parameters, suggesting that other ecological drivers, such as grazing or viral lysis, modulated community interactions. Taken together, these results point towards complex interactions selected for within the EBPR ecosystem and highlight a previously unrecognized functional potential among low abundance microorganisms in engineered ecosystems.
Barriers to Coordination? Examining the Impact of Culture on International Mediation Occurrence and Effectiveness
Authors: Bakaki Zorzeta , Böhmelt Tobias , Bove Vincenzo
Published: April 2015

‘Culture’ features prominently in the literature on international mediation: if belligerents share cultural characteristics, they are likely to have a common understanding and norms. This creates a common identity and makes coordination less costly, which ultimately facilitates mediation occurrence and effectiveness. Surprisingly, existing quantitative research largely neglects any cultural ties the antagonists might share with the mediator. This article addresses this gap by offering one of the first joint analyses of fighting parties’ and mediators’ culture – and the interaction thereof. Based on existing work, a theoretical framework for mediation occurrence and effectiveness is developed and innovative measures for belligerents’ cultural ties and the links to the mediator are used. Contrary to expectations the results suggest that larger cultural distances between antagonists make mediation more likely, while cultural dissimilarities between them and the mediator have the opposite effect. Evidence is also found for a conditional effect between the two culture variables on mediation occurrence.
Just Returns?
Authors: Weale Albert
Published: April 2015

Democratic Justice and the Social Contract offered a contractarian theory of democratic justice. This article responds to criticisms that its arguments either assume premises that are not genuinely constructivist or that the premises imply untoward conclusions. It also discusses the role of deliberation in a democracy and seeks to refute some alleged shortcomings of its method.
Binge Drinking During Adolescence Disrupts Se Homeostasis and Its Main Hepatic Selenoprotein Expression
Authors: Ojeda María Luisa , Rua Rui Manuel , Murillo María Luisa , Carreras Olimpia , Nogales Fátima
Published: April 2015

Background

Binge drinking (BD) is the most common ethanol (EtOH) intake consumption model among teenagers, but little is known about its effects on the liver. During its hepatic metabolism, acute alcohol exposure produces a great amount of reactive oxygen species which contributes to alcohol‐induced liver injury. Selenium (Se) plays a key role in antioxidant defense as it forms part of selenoproteins, such as the antioxidant glutathione peroxidases (GPxs) or the selenoprotein P (SelP), synthesized mainly in liver. Chronic EtOH consumption decreases both Se deposits and this tissue's antioxidant activity.

Methods

Two BD administration routes (oral and intraperitoneal) were used in adolescent rats to analyze Se homeostasis; the main hepatic selenoproteins’ expression: GPx1, GPx4, and SelP, and their biological roles related to oxidation. Their relationship with inflammatory processes was also determined by analyzing the expression of the transcriptional factor nuclear factor‐kappa beta (NF‐κB).

Results

It has been demonstrated for the first time that BD in adolescents alters Se homeostasis regardless of the administration route employed, despite the fact that the BD oral group ingested less Se in diet. This decrease of Se in serum and liver is directly related to a decrease in serum GPx3 and hepatic GPx1 activity, contributing to the oxidative imbalance found. The depletion of Se detected in liver affects GPx1 expression and, surprisingly, GPx4 expression. This could be related to the lower expression of the transcriptional factor NF‐κB in the liver, a key player in the regulation of inflammatory processes.

Conclusions

Due to the above, and to find whether a Se supplementation therapy improves these situations, it would be interesting to explore in more depth the relationship between Se, the high oxidation found, and the depressed immune response reported in BD adolescents.
Polygenic risk for alcohol dependence associates with alcohol consumption, cognitive function and social deprivation in a population‐based cohort
Authors: Clarke Toni‐Kim , Smith Andrew H. , Gelernter Joel , Kranzler Henry R. , Farrer Lindsay A. , Hall Lynsey S. , Fernandez‐Pujals Ana M. , MacIntyre Donald J. , Smith Blair H. , Hocking Lynne J. , Padmanabhan Sandosh , Hayward Caroline , Thomson Pippa A. , Porteous David J. , Deary Ian J. , McIntosh Andrew M.
Published: April 2015

Alcohol dependence is frequently co‐morbid with cognitive impairment. The relationship between these traits is complex as cognitive dysfunction may arise as a consequence of heavy drinking or exist prior to the onset of dependence. In the present study, we tested the genetic overlap between cognitive abilities and alcohol dependence using polygenic risk scores (PGRS). We created two independent PGRS derived from two recent genome‐wide association studies (GWAS) of alcohol dependence (SAGE GWAS: n = 2750; Yale‐Penn GWAS: n = 2377) in a population‐based cohort, Generation Scotland: Scottish Family Health Study (GS:SFHS) (n = 9863). Data on alcohol consumption and four tests of cognitive function [Mill Hill Vocabulary (MHV), digit symbol coding, phonemic verbal fluency (VF) and logical memory] were available. PGRS for alcohol dependence were negatively associated with two measures of cognitive function: MHV (SAGE: P = 0.009, β = −0.027; Yale‐Penn: P = 0.001, β = −0.034) and VF (SAGE: P = 0.0008, β = −0.036; Yale‐Penn: P = 0.00005, β = −0.044). VF remained robustly associated after adjustment for education and social deprivation; however, the association with MHV was substantially attenuated. Shared genetic variants may account for some of the phenotypic association between cognitive ability and alcohol dependence. A significant negative association between PGRS and social deprivation was found (SAGE: P = 5.2 × 10−7, β = −0.054; Yale‐Penn: P = 0.000012, β = −0.047). Individuals living in socially deprived regions were found to carry more alcohol dependence risk alleles which may contribute to the increased prevalence of problem drinking in regions of deprivation. Future work to identify genes which affect both cognitive impairment and alcohol dependence will help elucidate biological processes common to both disorders.
Lack of genetic association of 5‐HTR2A 102 T/C and ‐1438A/G polymorphisms with Tourette syndrome in a family‐based association study in a Chinese Han population
Authors: Xu Longqiang , Zheng Lanlan , Ma Jianhua , Su Nailun , Liu Yujun , Ma Xu , Zhang Xinhua , Liu Shiguo
Published: April 2015

Introduction

Our purpose is to investigate whether polymorphisms of 102 T/C and ‐1438A/G in 5HTR2A are associated with Tourette syndrome (TS) in Chinese Han population.

Methods

A total of 178 TS trios were recruited in this study. After the allelic and genotypic distributions of two polymorphisms were genotyped using polymerase chain reaction and restriction fragment length polymorphism (PCR‐RFLP), we compared their genetic distributions with what is expected with Hardy–Weinberg to explore whether there might be an association of these polymorphisms with TS by haplotype relative risk (HRR) and transmission disequilibrium test (TDT) statistics.

Results

Our results showed that no significant associations were found between the HTR2A 102 T/C and ‐1438A/G polymorphisms and TS (for HTR2A 102 T/C: TDT = 2.041, df = 1, P = 0.175; HRR = 1.468, χ2 = 1.905, P = 0.168, 95% confidence interval: 0.850–2.535; for HTR2A: ‐1438A/G, TDT = 0.093, df = 1, P = 0.819; HRR = 0.965, χ2 = 0.018, P = 0.894, 95% confidence interval: 0.574–1.624).

Discussion

Our study suggested that the HTR2A 102T/C and ‐1438A/G polymorphisms may not be associated with susceptibility to TS, and thus do not play a major role in the development of TS in the Chinese Han population. However, these results need to be confirmed in a larger sample collected from different populations.
Shades of green andREDD: Local and global contestations over the value of forest versus plantation development on the Indonesian forest frontier
Authors: Eilenberg Michael
Published: April 2015

In a time of increasing land enclosures sparked by large‐scale environmental initiatives and agricultural expansion, this paper examines local and global contestations over the value of forest on an Indonesian forest frontier. Engaging with recent debates on carbon forestry, the paper problematises the emerging initiatives of ‘ReducingEmissions fromDeforestation and ForestDegradation’ known asREDD+ in the province ofWestKalimantan,Indonesia. The paper argues that the general rush to implementREDD+ without intimate knowledge of the political landscape of resource struggle is in danger of generating new enclosures of land that may be easily appropriated by local elites, thus excluding less fortunate sections of local society. The paper shows how divergent interpretations ofREDD+ are triggering land disputes, and how powerful actors readily appropriateREDD+ discourses as a tool to support divergent claims of land ownership. Government and villagers, through overlapping and contradictory engagements, negotiateREDD+ initiatives with global environmental actors and private plantation companies. The paper highlights the implications of these local realities for the successes ofREDD+. TheKalimantan case highlights some of the dilemmas of carbon mitigation initiatives experienced in frontier regions throughoutSoutheastAsia, places that have become prime battlefronts of large‐scale climate change initiatives and agrarian expansion.
The portable sawmill and other challenges toREDD+ inPapuaNewGuinea
Authors: Dalsgaard Steffen , Pedersen Marianne
Published: April 2015

The future forReducingEmissions fromDeforestation andForestDegradationPlus (REDD+) inPapuaNewGuinea (PNG) is uncertain. Logging companies have been accessing land via a controversial legal framework calledSpecialAgriculturalBusinessLease, while conservation non‐government organisations are struggling to find schemes to stop the deforestation.REDD+ has been the new favoured approach. However, there are as yet only a few pilot projects, several of which are in areas without large‐scale logging. WhetherREDD+ has a future inPNGis difficult to know. It may come to share the fate of the portable sawmill – a technology previously assumed to promote sustainable community logging, but is now adopted by the commercial logging industry and providing new challenges to conversation efforts. This article argues that to understand the possibility for successfully implementingREDD+, it is necessary to look at the development of the forestry sector in the widest possible terms. This involves analysing the different competing actors, technologies and forms of social organisation that are employed to gain control of species deemed valuable to either conservation or commercial resource exploitation.
l‐Arginine Attenuates Cardiac Dysfunction, But Further Down‐Regulates α‐Myosin Heavy Chain Expression in Isoproterenol‐Induced Cardiomyopathy
Authors: Kralova Eva , Doka Gabriel , Pivackova Lenka , Srankova Jasna , Kuracinova Kristina , Janega Pavol , Babal Pavel , Klimas Jan , Krenek Peter
Published: April 2015

In view of previously reported increased capacity for nitric oxide production, we suggested that l‐arginine (ARG), the nitric oxide synthase (NOS) substrate, supplementation would improve cardiac function in isoproterenol (ISO)‐induced heart failure. Male Wistar rats were treated with ISO for 8 days (5 mg/kg/day, i.p.) or vehicle. ARG was given to control (ARG) and ISO‐treated (ISO+ARG) rats in water (0.4 g/kg/day). ISO administration was associated with 40% mortality, ventricular hypertrophy, decreased heart rate, left ventricular dysfunction, fibrosis and ECG signs of ischaemia. RT‐PCR showed increased mRNA levels of cardiac hypertrophy marker atrial natriuretic peptide, but not BNP, decreased expression of myosin heavy chain isoform MYH6 and unaltered expression of pathological MYH7. ISO increased the protein levels of endothelial nitric oxide synthase, but at the same time it markedly up‐regulated mRNA and protein levels of gp91phox, a catalytical subunit of superoxide‐producing NADPH oxidase. Fibrosis was markedly increased by ISO. ARG treatment moderately ameliorated left ventricular dysfunction, but was without effect on cardiac hypertrophy and fibrosis. Combination of ISO and ARG led to a decrease in cav‐1 expression, a further increase in MYH7 expression and a down‐regulation of MYH6 that inversely correlated with gp91phox mRNA levels. Although ARG, at least partially, improved ISO‐impaired basal left ventricular systolic function, it failed to reduce cardiac hypertrophy, fibrosis, oxidative stress and mortality. The protection of contractile performance might be related to increased capacity for nitric oxide production and the up‐regulation of MYH7 which may compensate for the marked down‐regulation of the major MYH6 isoform.
Doubly‐robust dynamic treatment regimen estimation via weighted least squares
Authors: Wallace Michael P. , Moodie Erica E. M.
Published: April 2015

Personalized medicine is a rapidly expanding area of health research wherein patient level information is used to inform their treatment. Dynamic treatment regimens (DTRs) are a means of formalizing the sequence of treatment decisions that characterize personalized management plans. Identifying the DTR which optimizes expected patient outcome is of obvious interest and numerous methods have been proposed for this purpose. We present a new approach which builds on two established methods: Q‐learning and G‐estimation, offering the doubly robust property of the latter but with ease of implementation much more akin to the former. We outline the underlying theory, provide simulation studies that demonstrate the double‐robustness and efficiency properties of our approach, and illustrate its use on data from the Promotion of Breastfeeding Intervention Trial.
Set‐based tests for genetic association in longitudinal studies
Authors: He Zihuai , Zhang Min , Lee Seunggeun , Smith Jennifer A. , Guo Xiuqing , Palmas Walter , Kardia Sharon L. R. , Roux Ana V. Diez , Mukherjee Bhramar
Published: April 2015

Genetic association studies with longitudinal markers of chronic diseases (e.g., blood pressure, body mass index) provide a valuable opportunity to explore how genetic variants affect traits over time by utilizing the full trajectory of longitudinal outcomes. Since these traits are likely influenced by the joint effect of multiple variants in a gene, a joint analysis of these variants considering linkage disequilibrium (LD) may help to explain additional phenotypic variation. In this article, we propose a longitudinal genetic random field model (LGRF), to test the association between a phenotype measured repeatedly during the course of an observational study and a set of genetic variants. Generalized score type tests are developed, which we show are robust to misspecification of within‐subject correlation, a feature that is desirable for longitudinal analysis. In addition, a joint test incorporating gene–time interaction is further proposed. Computational advancement is made for scalable implementation of the proposed methods in large‐scale genome‐wide association studies (GWAS). The proposed methods are evaluated through extensive simulation studies and illustrated using data from the Multi‐Ethnic Study of Atherosclerosis (MESA). Our simulation results indicate substantial gain in power using LGRF when compared with two commonly used existing alternatives: (i) single marker tests using longitudinal outcome and (ii) existing gene‐based tests using the average value of repeated measurements as the outcome.
Acute myeloid leukaemia: challenges and real world data from India
Authors: Philip Chepsy , George Biju , Ganapule Abhijeet , Korula Anu , Jain Punit , Alex Ansu Abu , Lakshmi Kavitha M. , Sitaram Usha , Abubacker Fouzia N. , Abraham Aby , Viswabandya Auro , Srivastava Vivi M. , Srivastava Alok , Balasubramanian Poonkuzhali , Mathews Vikram
Published: April 2015

The management of acute myeloid leukaemia (AML) in India remains a challenge. In a two‐year prospective study at our centre there were 380 newly diagnosed AML (excluding acute promyelocytic leukaemia, AML‐M3) patients. The median age of newly diagnosed patients was 40 years (range: 1–79; 12·3% were ≤ 15 years, 16·3% were ≥ 60 years old) and there were 244 (64·2%) males. The median duration of symptoms prior to first presentation at our hospital was 4 weeks (range: 1–52). The median distance from home to hospital was 580 km (range: 6–3200 km). 109 (29%) opted for standard of care and were admitted for induction chemotherapy. Of the 271 that did not take treatment the major reason was lack of financial resources in 219 (81%). There were 27 (24·7%) inductions deaths and of these, 12 (44·5%) were due to multidrug‐resistant gram‐negative bacilli and 12 (44·5%) showed evidence of a fungal infection. The overall survival at 1 year was 70·4% ± 10·7%, 55·6% ± 6·8% and 42·4% ± 15·6% in patients aged ≤15 years, 15 ‐ 60 years and ≥60 years, respectively. In conclusion, the biggest constraint is the cost of treatment and the absence of a health security net to treat all patients with this diagnosis.
The genes Scgb1a1, Lpo and Gbp2 characteristically expressed in peri‐implant epithelium of rats
Authors: Mori Gentaro , Sasaki Hodaka , Makabe Yasushi , Yoshinari Masao , Yajima Yasutomo
Published: April 2015

Objectives

The peri‐implant epithelium (PIE) plays an important role in the prevention against initial stage of inflammation. To minimize the risk of peri‐implantitis, it is necessary to understand the biological characteristics of the PIE. The aim of this study was to investigate the characteristic gene expression profile of PIE as compared to junctional epithelium (JE) using laser microdissection and microarray analysis.

Methods

Left upper first molars of 4‐week‐old rat were extracted, and titanium alloy implants were placed. Four weeks after surgery, samples were harvested by laser microdissection, and total RNA samples were isolated. Comprehensive analyses of genes expressed in the JE and PIE were performed using microarray analysis. Confirmation of the differential expression of selected genes was performed by quantitative real‐time polymerase chain reaction and immunohistochemistry.

Results

The microarray analysis showed that 712 genes were more than twofold change upregulated in the PIE compared with the JE. Genes Scgb1a1 were significantly upregulated more than 19.1‐fold, Lpo more than 19.0‐fold, and Gbp2 more than 8.9‐fold, in the PIE (P < 0.01). Immunohistochemical localization of SCGB1A1, LPO, and GBP2 was observed in PIE.

Conclusion

The present results suggested that genes Scgb1a1, Lpo, and Gbp2 are characteristically expressed in the PIE.
Tests of Eustachian tube function: a review
Authors: Smith M.E. , Tysome J.R.
Published: April 2015

Background

Eustachian tube (ET) dysfunction is a common but poorly understood cause of patient symptoms, and an important aetiological factor in the development of middle ear pathology. Despite this, there are no specific tests of ET function in widespread clinical use and no identified ‘gold standard’ with which to diagnose the disease.

Objective

This review aims to review the literature to identify currently available tests of ET function and, where possible, report on their accuracy.

Type of review

Narrative systematic review.

Search strategy

MEDLINE, EMBASE, Biosis and the Cochrane library were searched and reference lists reviewed for relevant articles.

Evaluation method

Tests in included studies were required to measure a physiological function of the ET, or play a role in the diagnosis of poor ET function. Significant variation in demographic characteristics, disease presentation and severity, and technological approaches only permitted narrative systematic review.

Results

While many tests of ET function have been developed, with some in routine clinical use, all have significant limitations. Published accuracy data are limited and of differing quality due to the variability incomparative tests, and the spectrum of otological disorders associated with ET dysfunction.

Conclusions

Currently, no single test could be considered a ‘gold standard’ for the diagnosis of ET dysfunction, but there is some evidence that diagnostic accuracy can be improved by combining the results of different objective tests and patient‐reported outcome measures. Further development of ET function tests is required to facilitate the accurate diagnosis of patients and allow outcome reporting for new interventions.
Use of HSI to measure oxygen saturation in the lower limb and its correlation with healing of foot ulcers in diabetes
Authors: Jeffcoate W. J. , Clark D. J. , Savic N. , Rodmell P. I. , Hinchliffe R. J. , Musgrove A. , Game F. L.
Published: April 2015

Aim

To explore the use of hyperspectral imaging (HSI) to predict healing of diabetic foot ulcers in patients with diabetes.

Methods

We used a HSI technique that incorporated novel software to account for tissue scattering of light, and was validated using blood samples of varying oxygen saturation assessed by blood gas analysis. HSI was then performed on a population newly presenting with diabetic foot ulcers to a specialist clinic, and associations were sought with healing at 12 and 24 weeks.

Results

The correlation between the results of HSI and blood gas analysis was strong (r = 0.994). A total of 43 patients (mean ± sd age 62.7 ± 12.2 years; 31 men, 12 women; 37 with Type 2 diabetes, six with Type 1 diabetes) with foot ulcers were included in the prospective clinical study and underwent HSI within 16 days of presentation. In all, 26 ulcers healed within 12 weeks and 28 within 24 weeks. There was a negative association between tissue oxygenation assessed by HSI at baseline and healing by 12 weeks (P = 0.009), and this was observed in both infected and non‐infected ulcers. There was a significant positive correlation between oxygenation assessed by HSI and time to healing (P = 0.03). No correlations were observed at 24 weeks.

Conclusions

These findings suggest that HSI may predict healing in routine practice. The fact that the correlation between HSI and healing was negative could be explained by HSI being a measure of oxygenation of haemoglobin and there may be an inverse relationship between this and the oxygenation of extravascular tissue in people with neuropathy and/or microvascular disease.
Longitudinal relationship between diabetes‐specific emotional distress and follow‐up HbA1c in adults with Type 1 diabetes mellitus
Authors: Strandberg R. B. , Graue M. , Wentzel‐Larsen T. , Peyrot M. , Thordarson H. B. , Rokne B.
Published: April 2015

Aim

To examine whether diabetes‐specific emotional distress was related to follow‐up glycaemic control in adults with Type 1 diabetes mellitus.

Methods

Adults with Type 1 diabetes mellitus completed the Diabetes Distress Scale and reported sociodemographic information when attending a clinical consultation at a university endocrinology unit. Blood samples to determine baseline HbA1c were taken during consultations. All respondents' HbA1c measurements registered from January 2009 to December 2011 were collected from medical records. The relationship between baseline diabetes‐specific emotional distress and HbA1c was examined with linear mixed‐effects models in 175 patients with complete data.

Results

After controlling for confounders, baseline diabetes‐specific emotional distress and glycaemic control were significantly associated (fixed‐effect coefficient 0.40, P < 0.001) and the regimen‐related distress subscale had the strongest association with glycaemic control (fixed‐effect coefficient 0.47, P < 0.001). The two‐item measure of diabetes‐specific distress had a weaker but still significant association with glycaemic control (fixed‐effect coefficient 0.31, P < 0.001). None of these relationships was significant after adjusting for the baseline HbA1c.

Conclusions

People with elevated baseline diabetes‐specific emotional distress are at risk of prolonged suboptimum glycaemic control; therefore, elevated diabetes‐specific emotional distress, especially regimen‐related distress, might be an important marker for prolonged suboptimum glycaemic control, and might indicate a need for special attention regarding patient self‐management.
Impact of a half marathon on cellular immune system, pro‐inflammatory cytokine levels, and recovery behavior of breast cancer patients in the aftercare compared to healthy controls
Authors: Zimmer Philipp , Baumann Freerk T. , Bloch Wilhelm , Zopf Eva Maria , Schulz Saskia , Latsch Joachim , Schollmayer Friederike , Shimabukuro‐Vornhagen Alexander , von Bergwelt‐Baildon Michael , Schenk Alexander
Published: April 2015

Introduction

Exercise has beneficial effects on cancer prevention as well as on prognosis of patients with cancer. To optimize the outcomes of exercise programs, more knowledge about the underlying mechanisms is needed. This study investigates the short‐term effects of a half marathon on immune cell proportions, pro‐inflammatory cytokine levels, and recovery behavior of patients with breast cancer in the aftercare compared to healthy controls.

Methods

Nine patients with breast cancer in the aftercare and 9 healthy age‐matched controls participated in a half marathon. Blood samples were collected before, after, and 24 h after the run. Immune status was measured by flow cytometer analysis, while serum levels of the pro‐inflammatory cytokines TNF‐α, IL‐6, and MIF were assessed using ELISA. Recovery behavior was determined using an ADL monitor.

Results

Both groups showed a similar recovery behavior and time courses in changes of granulocytes, monocytes, lymphocytes, and cytokine serum levels. Patients revealed increased proportions of cytotoxic and memory T cells, whereas helper and naïve T cells were decreased compared to healthy controls. Naïve and memory T‐cell proportions were not affected by the intervention.

Conclusions

Patients with breast cancer in the aftercare and healthy subjects show a similarly recovery behavior and immune response to the intervention. The detected differences in T‐cell subsets need further investigation. Based on the results of the study, we hypothesize that immune cell subsets with known relevance in cancer were mobilized through the intervention. We confirm that the hypothesis of a midterm anti‐inflammatory effect of exercise is also valid for patients with breast cancer in the aftercare.