bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality attributes of cactus pear fruit and their role in consumer choice
Authors: Migliore Giuseppina , Galati Antonino , Romeo Pietro , Crescimanno Maria , Schifani Giorgio
Published: May 2015

Purpose

– The purpose of this paper is to detect what experience and credence quality attributes contribute to the consumer decision to consume cactus pear fruit. The authors therefore try to measure the effect of each quality attribute on consumer choice.

Design/methodology/approach

– As a theoretical basis, two principal quality attributes emphasised in the literature on consumer behaviour were analysed and adjusted to the specific fruit features. The empirical strategy was carried out by administering a telephone questionnaire survey of 270 interviewees who consume cactus pears in Italy. The questionnaire, consisting of 14 items expressed on a metric scale (five-point Likert scale), was used to rate the importance of cactus pear fruit quality attributes. An ordered logit model was employed for data analysis.

Findings

– The results show that consumption of cactus pear fruit is mainly based on credence and experience attributes, which have different effects on the consumer decision to consume cactus pear fruit. Among experience quality attributes, the colour red, a low quantity of seeds, and being peeled are the attributes with major effects, following by credence attributes such as environmental sustainability, healthiness, and Italian origin.

Research limitations/implications

– The research was based on a particular fruit, and further comparative research is clearly needed. In fact, further advancement in cactus pear research would require that the validity of the empirical findings and their degree of generalisation be examined in other geographical areas.

Practical implications

– The results of this study could help to identify some factors on which business could intervene to create a more effective consumer-based approach.

Originality/value

– This study contributes to a better definition of cactus pear fruit quality for consumers with the aim of developing marketing strategies to increase farm business. To the best of the knowledge, no study has ever measured the effects of cactus pear fruit quality attributes on consumer choice.
Functional clothing for natural disaster survivors
Authors: Ahsan Nabeela , Tullio-Pow Sandra
Published: May 2015

Purpose

– Natural disasters, occurring with increasing frequency are mobilizing humanitarian agencies to provide relief response. Current protocols that rely heavily on donated clothing as clothing aid are neither effective nor efficient. The purpose of this paper is to investigate survivors’ clothing needs during the relief phase of a natural disaster in order that current protocol might be improved. The focus is on clothing use from the perspectives of survivors who will wear it, relief workers and aid agencies that will disperse it.

Design/methodology/approach

– This qualitative study included needs analysis focus groups with survivors, interviews with relief aid workers and senior humanitarian agency administrators. All respondents were residents of and/or impacted by the 2005 earthquake in Pakistan. Questions focused on relief aid protocol, clothing needs and mandatory requirements for a design solution.

Findings

– Data gathered revealed a myriad of design priorities and participants emphasized that garments be culturally and climatically appropriate and universal in design. Based on these criteria, a prototype (named Survival Plus) was created using the Functional, Expressive and Aesthetic design framework as proposed by Lamb and Kallal (1992).

Research limitations/implications

– Further research may be undertaken to field test proposed Survival Plus prototype to evaluate the design and subsequent findings be incorporated in its design.

Originality/value

– Academic knowledge about this aspect of disaster management and response is scarce. This participatory study of clothing needs of survivors is of particular benefit to emergency preparedness initiatives and humanitarian aid providers in their delivery of clothing aid.
From forest firefighting doctrine to digital battlefield: a case study
Authors: Dumond Yves
Published: May 2015

Purpose

– The purpose of this paper is to describe the use of information technology (IT) in the fight against forest fires in southern France.

Design/methodology/approach

– The focus is on specifying the infrastructure and equipment used during operational interventions, as well as the role and functioning of the mobile command posts, which represent the nerve centers. As part of the firefighters operational practices, the concepts of the “tactical situation” and the “mobile means board” are at the heart of operations management. The purpose of the tactical situations is to present a synthetic overview of the theatre of operations through graphic representation on a background map. The function of the mobile means board is to manage the life cycle of the different resources engaged in the operations. The author first shows how these concepts were developed within the framework of manual management only. This is followed by an IT solution using a geographical information system for each of these operational modes.

Findings

– A profound recognition of operational practices was a prerequisite to enable the personnel to accept a progression towards the use of IT techniques.

Research limitations/implications

– The implemented approach precisely reflects the French forest firefighting doctrine. Application to other countries would thus require some adaptation.

Originality/value

– The software system provides an easy access to geographical information functionalities for firefighters managing forest fires. This is achieved in the framework of strict compliance with their recognized operational methods.
The front-line manager’s role in informal voice pathways
Authors: Townsend Keith , Loudoun Rebecca
Published: May 2015

Purpose

– There is a long line of human resource management and employee relations research that points to the important function that line managers play within organisations. The purpose of this paper is to focus on the level of line manager closest to the employees, the front-line manager (FLM), to understand the role they play in informal voice pathways.

Design/methodology/approach

– The research project from which these data are drawn is of mixed method design in a multi-site case study organisation. The organisation is a quasi-military, public sector organisation with around 2,000 front-line employees. While this paper focuses primarily on one aspect of data collection, survey results are provided to allow a deeper contextual understanding while the qualitative data progresses the theoretical contribution.

Findings

– The findings suggest that the FLMs play an important role in informal voice, however, the context of a strong and militant union means that the power dimension is different from previous studies into informal voice that have been conducted in the poorly unionised hospitality sector. In this context, informal voice with the FLM becomes just one pathway for employees to take when raising issues.

Research limitations/implications

– The single case study used is an exceptional case, therefore, has limited generalisability, nevertheless it does provide the opportunity to progress the theoretical understanding of voice pathways.

Originality/value

– This paper has originality in that the research focus is the role of FLMs in informal voice in an organisation that is strongly unionised and militant. It provides a conceptual development of employee voice pathways that can be further developed and tested in the future.
An investigation into blogging as an opportunity for work-integrated learning for journalism students
Authors: Stoker Ruth
Published: May 2015

Purpose

– Blogging has become a well-established method of online communication and publication, used by individuals and organisations to disseminate news, ideas and information. In their earlier forms, blogs were used as online diaries, but have now evolved into complex digital environments. The purpose of this paper is to consider whether blogging can be framed as a mode of work-integrated learning in the context of journalism and media education, and to ask whether blogging can develop transferable skills useful in graduate-level employment.

Design/methodology/approach

– Semi-structured interviews were conducted with established undergraduate bloggers to investigate which skills and attributes were developed through blogging.

Findings

– When evaluated against the Prospects UK list of graduate attributes (the Government career’s service) blogging allows the development of the vast majority of transferable skills, abilities and behaviours expected of graduates. It is necessary to structure the curriculum to ensure that blogging is taught, and blogging activity monitored and evaluated, so that journalism undergraduates maximise the opportunities offered by blogging and fully reflect on their experiences.

Originality/value

– This paper argues that these online environments, with their associated communities, offer journalism students opportunities for work-integrated learning. It argues that blog environments have the potential to enable students to develop journalism-specific skills, and enhance transferable graduate attributes including creativity, sophisticated communication competencies, initiative and problem solving. It suggests that blogging offers a platform for accessing experiential learning, and as such should be considered within a curriculum for work-integrated learning in the journalism and media subject area.
A vocational qualifications system fit for adults? Revisiting some ideas from the university for industry
Authors: Lester Stan
Published: May 2015

Purpose

– The purpose of this paper is to make a case for creating a strand of negotiated qualifications in the English (and more generally UK) vocational education and training (VET) system, using the approach established through Ufi-Learndirect Learning through Work (LtW).

Design/methodology/approach

– The paper identifies some limitations in the recent Whitehead review of adult vocational education in relation to people already in work. Drawing on research into learning at work, modifications to the VET qualifications system are proposed based on the LtW approach.

Findings

– The VET qualifications system assumes a purpose of preparing people for occupational entry and developing essential competence. The needs of adults already in work can be accommodated provided that they can be fitted within structures reflecting this assumption. It is less able to meet the bespoke needs of individual workers or employers. The LtW approach, which enables individual accredited programmes to be negotiated, offers a way forward that preserves the integrity of the qualification system.

Practical implications

– Implementing a LtW-type approach in the VET sector is structurally more difficult than in higher education, although less likely to encounter academic resistance. The main challenge is likely to come from the need to modify regulatory rules and design principles for vocational qualifications.

Originality/value

– Individually negotiated qualifications have been resisted in VET due to largely unfounded fears about reduced rigour and loss of control of content. The proposed approach offers a means of meeting individual needs while retaining the integrity of the qualifications system and reducing the proliferation of units and content within it.
Teaching business skills to women
Authors: Raven Peter , Le Quan V.
Published: May 2015

Purpose

– There is currently a debate between NGOs and academia on the effectiveness of training microcredit recipients. One side suggests that merely supplying credit will stimulate entrepreneurial business. The other side proposes that training microcredit recipients in business skills will improve business performance and probably have other important effects. This study was undertaken with the cooperation Vietnam Women’s Union and PeaceTrees Vietnam. The purpose of this paper is to examine the effects of business training programmes for women microcredit recipients in rural areas of Vietnam.

Design/methodology/approach

– Using a questionnaire administered to 120 women business owners in several communes in Quang Tri Province, data were collected in 2012 on their business training programmes, perceptions of their business performance, motivation, factors for success, and several other indicators.

Findings

– The findings suggest that business training can improve microenterprise performance and has a number of other positive results, such as increasing motivation, success, and perceptions of entrepreneurs.

Research limitations/implications

– The research is limited by the nature of the sample and sample size. Future research should focus on women entrepreneurs in other parts of Vietnam, other developing countries, and on male entrepreneurs, to help understand differences between regions, countries, and gender.

Originality/value

– This paper provides empirical evidence to support the argument that business training is effective in improving the performance of microenterprises.
Enrollment of SME managers to growth-oriented training programs
Authors: Bager Torben Eli , Jensen Kent Wickstrøm , Nielsen Pia Schou , Larsen Tue Avbæk
Published: May 2015

Purpose

– Entrepreneurial learning through formal growth-oriented training programs for SME managers promises to enhance the growth competences and growth intentions of the enrolled managers. The impact of such programs, however, depends on who enrolls since initial competence and growth-intention levels vary significantly. Potential participants may suffer from limited ability to transform new knowledge into practice, absence of growth intention and too high or too low a prior competence level to be able to benefit substantially. Selection and self-selection processes therefore have a bearing on the extent to which such programs result in additionality, i.e. improved growth performance compared to non-intervention. The paper aims to discuss these issues.

Design/methodology/approach

– Selection and self-selection processes are explored through a study of a large-scale training program for growth-oriented managers of small Danish firms. This program has, from 2012 to 2015, trained about 700 SME managers. Data are currently available for 366 of these participants. This evidence is compared with survey results from a randomly selected control group of 292 growth-oriented SME managers in the same firm-size group. The data were analyzed through descriptive statistics and logistic regression analysis.

Findings

– A number of selection and self-selection biases were identified in the analysis. While some of the identified biases did not seem to conflict with the ambitions of this growth program, others potentially have consequences for the additionality of the program.

Originality/value

– The paper is the first systematic study of the importance of who enrolls in training programs for SME managers.
The influence of job characteristics on IT and non-IT job professional’s turnover intentions
Authors: Uruthirapathy Aareni A , Grant Gerald G.
Published: May 2015

Purpose

– Information technology (IT) professionals and their intentions to leave an organization have been studied by researchers; however, these studies do not compare the turnover intentions of IT professionals with non-IT professionals from the same institution. The purpose of this paper is to examine how IT and non-IT job professionals relate to motivational and social job characteristics and their impact on job satisfaction, job performance and turnover intentions.

Design/methodology/approach

– Data were collected from IT-shared services employees through a survey and quantitative analyses were performed.

Findings

– Among the motivational job characteristics, IT professionals experienced greater task significance than the non-IT job holders. With social job characteristics, IT professionals had greater outside interaction than the non-IT professionals. However, the non-IT professionals had greater intentions to leave the IT organization than the IT professionals. Additionally, the study examined the differences of the job characteristics and job outcomes among transactional, transformational, and professional advisory work groups. The professionals and advisory group differed from the other groups in terms of feedback from the job, job satisfaction, and turnover intentions.

Research limitations/implications

– The findings are based on a small sample. However, it highlights some unique differences in how IT and non-IT job occupants perceive job characteristics and job outcomes.

Originality/value

– This study compares job characteristics and job outcomes of IT and non-IT job occupations in the same IT work environment.
Use and measurement of social media for SMEs
Authors: McCann Margaret , Barlow Alexis
Published: May 2015

Purpose

– The purpose of this paper is to investigate why small- and medium-sized enterprises (SMEs) are using social media and how they should measure its return on investment (ROI). The measurement of economic value associated with the use of social media by business is discussed in order to construct a model designed for analysing the ROI of social media for SMEs. The importance of a planned entry into the social media arena, formulation of measurable goals and objectives and understanding the business process are presented as vital pre-cursors to measuring, and indeed attaining, ROI.

Design/methodology/approach

– A literature review was compiled to explore the current thinking that exists on business use and measurement of social media in mainstream academic literature and other business-oriented publications. Primary research in the form of a survey was conducted with SMEs to determine the usefulness of social media and how SMEs measure its ROI.

Findings

– SMEs find some social media applications more valuable than others but 65 per cent of the companies surveyed did not measure the ROI. An overarching framework, aimed at SMEs, is presented which advocates that SMEs should take a strategic focus and plan their use of social media, and draw insight from both quantitative and qualitative data when measuring ROI.

Originality/value

– Most existing research on social media is related to large organisations and tends to focus on technical and commercial use rather than examining the value and ROI gained from social media from an SME perspective. This paper offers a simple framework to help SMEs plan their use of social media as well as measure its true value.
Job engagement and work outcomes in a cognitively demanding context
Authors: Lauring Jakob , Selmer Jan
Published: May 2015

Purpose

– Job engagement has attracted much attention recently. However, very little research distinguishes between how the context may affect different engagement dimensions differently. Based on a theory of resource exhaustion, the purpose of this paper is to focus on a cognitively demanding work context in order to explore variations in effect of different engagement dimension and different expatriate work outcomes.

Design/methodology/approach

– The authors use survey results from 102 expatriate academics in Singapore to study the relations between job engagement and expatriate work outcomes. Contrary to most studies, the authors examine physical, emotional, and cognitive engagement separately.

Findings

– The authors found that for expatriate academics, the different dimensions of job engagement have different relationships with work outcomes such that physical engagement and emotional engagement are positively associated with various work outcomes while cognitive engagement is negatively related or not associated at all with the same work outcomes. The authors explain the variation in results by drawing on recent developments in social cognitive neuroscience.

Originality/value

– This is one of the first empirical studies to examine job engagement in an international setting and the application of a social cognitive neuroscience provides a novel perspective. An engagement theory of resource exhaustion could enhance theory building as well as facilitate the understanding of the association between job engagement and work outcomes in varying contexts.
How NHS Sutton Clinical Commissioning Group is working with care homes to improve the health and wellbeing of older residents
Authors: Harger Christine
Published: May 2015

Purpose

– The purpose of this paper is to describe how NHS Sutton Clinical Commissioning Group (Sutton CCG) is working with nursing homes, residential homes and other health and social care organisations in Sutton to improve the quality of provision for residents in nursing and residential homes “care homes”.

Design/methodology/approach

– The paper explains how Sutton CCG engaged with care homes initially to seek their views on whether they wanted support and what support they would value. It describes what arrangements Sutton CCG put in place for managers and staff in local care homes to provide support face-to-face. The paper outlines the key areas for improvement that Sutton CCG and the care homes are focusing on. It includes examples of work carried out jointly by the care homes and Sutton CCG to improve the quality of care for residents. It goes on to describe joint-working arrangements between the CCG, London Borough of Sutton and other health and social care organisations to ensure the overall quality of care homes in Sutton.

Findings

– The paper outlines feedback from care home managers and staff who were invited to share their views about what support they wanted from Sutton CCG. It includes early feedback from care homes about the support put in place and the areas where they have found it most useful.

Practical implications

– In the UK many older people live in care homes. Britain has an ageing population so the need for residential and nursing homes and the numbers of people living in care homes is only likely to increase. Our ageing population also places additional demands on the NHS, with residents in care homes often spending time in A&E and lengthy spells in hospital. This paper highlights how CCGs and other health and social care organisations can work with care homes to improve the health and wellbeing of older residents in care homes and reduce pressures on other health services.

Originality/value

– Sutton CCG has put in place new arrangements for working with care homes that aim to support carers to improve the lives of their older residents. The paper shares practical examples of support that the CCG has provided which has successfully improved care and decision making in care homes; early indications show this has reduced 999 calls and conveyances to hospital. Sutton CCG, London Borough of Sutton and other statutory organisations with responsibility for care homes in Sutton have also set up a joint intelligence group to gain an overall picture of the quality of the borough’s care homes.
Contracts and commissioning: what’s happening to social care services for black and minority ethnic older people
Authors: Lipman Valerie
Published: May 2015

Purpose

– The purpose of this paper is to explore current provision of targeted social care services for the growing populations of Black and Minority Ethnic (BAME) older people in England and Wales.

Design/methodology/approach

– This was a mixed study. Following a review of the policy and research literature, 12 semi-structured interviews were undertaken in 2013/2014. Most participants were recruited from BAME policy and service provider organisations and organisations focusing on older people.

Findings

– There is some evidence that BAME voluntary organisations are experiencing disproportionately greater funding cuts than mainstream voluntary service providers: moreover some mainstream providers reported reducing services targeted at BAME older people, while others expressed the view that choices for BAME older people are likely to become more limited following recent health and equalities policy changes.

Practical implications

– Practitioners should contribute to data collection about protected characteristics, such as race/ethnicity to establish if BAME older people’s needs are being assessed equitably, whether access to care and support is easy; and how market-shaping at local levels can ensure a range of providers.

Originality/value

– This study provides an overview of voluntary sector provision for the growing numbers of BAME older people in need of care and support that should be useful to practitioners and service commissioners.
Diet complexity in early life affects survival in released pheasants by altering foraging efficiency, food choice, handling skills and gut morphology
Authors: Whiteside Mark A. , Sage Rufus , Madden Joah R.
Published: May 2015

Behavioural and physiological deficiencies are major reasons why reintroduction programmes suffer from high mortality when captive animals are used. Mitigation of these deficiencies is essential for successful reintroduction programmes.

Our study manipulated early developmental diet to better replicate foraging behaviour in the wild. Over 2 years, we hand‐reared 1800 pheasants (Phasianus colchicus), from 1 day old, for 7 weeks under different dietary conditions. In year one, 900 pheasants were divided into three groups and reared with (i) commercial chick crumb, (ii) crumb plus 1% live mealworm or (iii) crumb plus 5% mixed seed and fruit. In year two, a further 900 pheasants were divided into two groups and reared with (i) commercial chick crumb or (ii) crumb plus a combination of 1% mealworm and 5% mixed seed and fruit. In both years, the commercial chick crumb acted as a control treatment, whilst those with live prey and mixed seeds and fruits mimicking a more naturalistic diet. After 7 weeks reared on these diets, pheasants were released into the wild.

Postrelease survival was improved with exposure to more naturalistic diets prior to release. We identified four mechanisms to explain this. Pheasants reared with more naturalistic diets (i) foraged for less time and had a higher likelihood of performing vigilance behaviours, (ii) were quicker at handling live prey items, (iii) were less reliant on supplementary feed which could be withdrawn and (iv) developed different gut morphologies.

These mechanisms allowed the pheasants to (i) reduce the risk of predation by reducing exposure time whilst foraging and allowing more time to be vigilant; (ii) be better at handling and discriminating natural food items and not be solely reliant on supplementary feed; and (iii) have a better gut system to cope with the natural forage after the cessation of supplementary feeding in the spring.

Learning food discrimination, preference and handling skills by the provision of a more naturalistic diet is essential prior to the release of pheasants in a reintroduction programme. Subsequent diet, foraging behaviour, gut morphology and digestive capabilities all work together as one nutritional complex. Simple manipulations during early development can influence these characteristics to better prepare an individual for survival upon release.
A Faster and Economical Approach to Floodplain Mapping Using Soil Information
Authors: Sangwan Nikhil , Merwade Venkatesh
Published: May 2015

Flood inundation maps play a key role in assessment and mitigation of potential flood hazards. However, owing to high costs associated with the conventional flood mapping methods, many communities in the United States lack flood inundation maps. The objective of this study is to develop and examine an economical alternative approach to floodplain mapping using widely available soil survey geographic (SSURGO) database. In this study, floodplain maps are developed for the entire state of Indiana, and some counties in Minnesota, Wisconsin, and Washington states by identifying flood‐prone soil map units based on their attributes. For validation, the flood extents obtained from SSURGO database are compared with the extents from other floodplain maps such as the Federal Emergency Management Agency issued flood insurance rate maps (FIRMs), flood extents observed during past floods, and flood maps derived using digital elevation models. In general, SSURGO‐based floodplain maps (SFMs) are largely in agreement with other flood inundation maps. Specifically, the floodplain extents from SFMs cover 78‐95% area compared to FIRMs and observed flood extents. Thus, albeit with a slight loss in accuracy, the SSURGO approach offers an economical and fast alternative for floodplain mapping. In particular, it has potentially high utility in areas where no detailed flood studies have been conducted.
Comparison of Clinical Prediction Models for Resistant Bacteria in Community‐onset Pneumonia
Authors: Self Wesley H. , Wunderink Richard G. , Williams Derek J. , Barrett Tyler W. , Baughman Adrienne H. , Grijalva Carlos G.
Published: May 2015

Objectives

Six recently published algorithms classify pneumonia patients presenting from the community into high‐ and low‐risk groups for resistant bacteria. Our objective was to compare performance of these algorithms for identifying patients infected with bacteria resistant to traditional community‐acquired pneumonia antibiotics.

Methods

This was a retrospective study of consecutive adult patients diagnosed with pneumonia in an emergency department and subsequently hospitalized. Each patient was classified as high or low risk for resistant bacteria according to the following algorithms: original health care–associated pneumonia (HCAP) criteria, Summit criteria, Brito and Niederman strategy, Shorr model, Aliberti model, and Shindo model. The reference for comparison was detection of resistant bacteria, defined as methicillin‐resistant Staphylococcus aureus or Gram‐negative bacteria resistant to ceftriaxone or levofloxacin.

Results

A total of 614 patients were studied, including 36 (5.9%) with resistant bacteria. The HCAP criteria classified 304 (49.5%) patients as high risk, with an area under the receiver operating characteristic curve (AUC) of 0.63 (95% confidence interval [CI] = 0.54 to 0.72), sensitivity of 0.69 (95% CI = 0.52 to 0.83), and specificity of 0.52 (95% CI = 0.48 to 0.56). None of the other algorithms improved both sensitivity and specificity or significantly improved the AUC. Compared to the HCAP criteria, the Shorr and Aliberti models classified more patients as high risk, resulting in higher sensitivity and lower specificity. The Shindo model classified fewer patients as high risk, with lower sensitivity and higher specificity.

Conclusions

All algorithms for identification of resistant bacteria included in this study had suboptimal performance to guide antibiotic selection. New strategies for selecting empirical antibiotics for community‐onset pneumonia are necessary.
Measurement and Monitoring of Nausea Severity in Emergency Department Patients: A Comparison of Scales and Exploration of Treatment Efficacy Outcome Measures
Authors: Meek Robert , Egerton‐Warburton Diana , Mee Michaela J. , Braitberg George
Published: May 2015

Objectives

The objective was to investigate the correlation of the visual analog scale (VAS) and numeric rating scale (NRS) for nausea severity measurement and to explore options for improved reporting of antiemetic efficacy trial results.

Methods

This was a multicenter observational study of adult emergency department (ED) patients with nausea. Participants rated severity at enrollment and 30 minutes posttreatment using an adjectival scale, a VAS, and an NRS. Posttreatment, patients described symptom change and rated satisfaction.

Results

Ratings were performed by 258 patients. Both the VAS (0 to 100 mm) and the NRS (0 to 10) discriminated between adjectival severity categories. Median ratings with interquartile ranges (IQRs) were “severe” VAS 90.5 (IQR = 79 to 97) and NRS 9 (IQR = 8 to 9), “moderate” VAS 59 (IQR = 48 to 71) and NRS 6 (IQR = 5 to 7), “mild” VAS 34 (IQR = 25 to 49) and NRS 4 (IQR = 3 to 5), and “none” VAS 5 (IQR = 0 to 9) and NRS 0 (IQR = 0 to 1). Correlation between the VAS and NRS was high (0.83, Spearman). For the VAS, median mm (IQR) reductions for posttreatment change were “a lot less” –42 (IQR = –26 to –58.5), “a little less” –20.5 (IQR = –11 to –33), “the same” –2 (IQR = –8 to 3.5), “a little more” 14 (IQR = –2 to 22), and “a lot more” 17 (IQR = 6 to 23) and for satisfaction were “very satisfied” –45 (IQR = –27 to 63), “satisfied” –27 (IQR = –13 to 46), “unsure” –15 (IQR = –3 to –24), “dissatisfied” 4.5 (IQR = –5.5 to 13.5), and “very dissatisfied” 8.5 (IQR = 0 to 23). A VAS cutoff of ≥–5 mm detected symptom improvement with sensitivity 91.6% (95% CI = 86.7% to 95.1%), specificity 72.1% (95% CI = 59.9% to 82.3%), and positive predictive value 90.2% (95% CI = 85.1% to 94.0%).

Conclusions

The VAS and NRS correlate highly. A VAS cutoff level of ≥–5 mm was a good predictor of symptom improvement, suggesting that its inclusion as an outcome measure would enhance reporting in antiemetic efficacy trials.
Evaluating Emergency Nurse Practitioner Service Effectiveness on Achieving Timely Analgesia: A Pragmatic Randomized Controlled Trial
Authors: Jennings Natasha , Gardner Glenn , O'Reilly Gerard , Mitra Biswadev
Published: May 2015

Objectives

The rapid uptake of nurse practitioner (NP) services in Australia has outpaced evaluation of this service model. A randomized controlled trial was conducted to compare the effectiveness of NP service versus standard medical care in the emergency department (ED) of a major referral hospital in Australia.

Methods

Patients presenting with pain were randomly assigned to receive either standard ED medical care or NP care. Primary investigators were blinded to treatment allocation for data analyses. The primary outcome measure was the proportion of patients receiving analgesia within 30 minutes from being seen by care group. Secondary outcome measures were time to analgesia from presentation and documentation of and changes in pain scores.

Results

There were 260 patients randomized; 128 received standard care (medical practitioner led), and 130 received NP care. Two patients needed to be excluded due to incomplete consent forms. The proportion of patients who received analgesia within 30 minutes from being seen was 49.2% (n = 64) in the NP group and 29.7% (n = 38) in the standard group, a difference of 19.5% (95% confidence interval [CI] = 7.9% to 31.2%; p = 0.001). Of 165 patients who received analgesia, 64 (84.2%) received analgesia within 30 minutes in the NP group compared to 38 (42.7%) in the standard care group, a difference in proportions of 41.5% (95% CI = 28.3% to 54.7%; p < 0.001). The mean (±SD) time from being seen to analgesia was 25.4 (±39.2) minutes for NP care and 43.0 (±35.5) minutes for standard care, a difference of 17.6 minutes (95% CI = 6.1 to 29.1 minutes; p = 0.003). There was a difference in the median change in pain score of 0.5 between care groups, but this was not statistically significant (p = 0.13).

Conclusions

Nurse practitioner service effectiveness was demonstrated through superior performance in achieving timely analgesia for ED patients.
Use of benchmarks in predicting earnings management?
Authors: Kent Richard , Routledge James
Published: May 2015

This study conducts multiple approaches to identify whether earnings benchmarks are an indicator for earnings management within the Australian market. We investigate firms reporting small positive earnings and small positive earnings changes, referred to as benchmark beaters. Accrual quality models, earnings distributions and earnings persistence measures are applied to identify whether benchmark beating firms are manipulating earnings. Our findings suggest that the small positive earnings benchmark attracts earnings managers. However, we do not identify any evidence to indicate that the positive earnings change benchmark is a signal for earnings management.
Banding the Right Ventricular Assist Device Outflow Conduit: Is It Really Necessary With Current Devices?
Authors: Lo Casey , Gregory Shaun , Stevens Michael , Murphy Deirdre , Marasco Silvana
Published: May 2015

Implantable left ventricular assist devices (LVADs) have been adapted clinically for right‐sided mechanical circulatory support (RVAD). Previous studies on RVAD support have established the benefits of outflow cannula restriction and rotational speed reduction, and recent literature has focused on assessing either the degree of outflow cannula restriction required to simulate left‐sided afterload, or the limitation of RVAD rotational speeds. Anecdotally, the utility of outflow cannula restriction has been questioned, with suggestion that banding may be unnecessary and may be replaced simply by varying the outflow conduit length. Furthermore, many patients have a high pulmonary vascular resistance (PVR) at the time of ventricular assist device (VAD) insertion that reduces with pulmonary vascular bed remodeling. It is therefore important to assess the potential changes in flow through an RVAD as PVR changes. In this in vitro study, we observed the use of dual HeartWare HVAD devices (HeartWare Inc., Framingham, MA, USA) in biventricular support (BiVAD) configuration. We assessed the pumps' ability to maintain hemodynamic stability with and without banding; and with varying outflow cannulae length (20, 40, and 60 cm). Increased length of the outflow conduit was found to produce significantly increased afterload to the device, but this was not found to be necessary to maintain the device within the manufacturer's recommended operational parameters under a simulated normal physiological setting of mild and severe right ventricular (RV) failure. We hypothesize that 40 cm of outflow conduit, laid down along the diaphragm and then up over the RV to reach the pulmonary trunk, will generate sufficient resistance to maintain normal pump function.
Incident retinal vein occlusions and estimated cerebrospinal fluid pressure. The Beijing Eye Study
Authors: Jonas Jost B. , Wang Ningli , Wang Ya Xing , You Qi Sheng , Yang Diya , Xie Xiaobin , Xu Liang
Published: May 2015

Purpose

To examine whether the incidence of retinal vein occlusions (RVOs) is associated with estimated cerebrospinal fluid pressure (CSFP).

Methods

The population‐based Beijing Eye Study, which included 4439 subjects (age: 40 + years) in 2001, was repeated in 2011 with 2695 subjects participating (66.4% of the survivors). Fundus photographs were examined for the new development of RVOs, differentiated into central RVOs (CRVOs) and branch RVOs (BRVOs). CSFP was calculated as CSFP [mmHg] = 0.44 × Body Mass Index [kg/m2] + 0.16 × Diastolic Blood Pressure [mmHg]−0.18 × Age[Years].

Results

Incident BRVOs were detected in 50 eyes and incident CRVOs in 8 eyes. BRVOs were located at arterio‐venous crossings in 39 eyes. In multivariate analysis, a higher estimated CSFP was associated with a higher incidence of CRVOs (p = 0.004; standardized coefficient beta: 0.06; regression coefficient B: 5.35; 95% confidence interval (CI):1.73, 8.96) after adjusting for urban region (p < 0.001; beta: −0.52; B: −3.93; 95% CI: −4.29, −3.57), higher educational level (p = 0.001; beta: 0.13; B: 0.44; 95% CI: 0.28, 0.60), higher blood concentrations of triglycerides (p < 0.001; beta: 0.08; B: 0.11; 95% CI: 0.05, 0.16) and higher intraocular pressure (p < 0.001; beta: 0.16; B:0.21; 95% CI: 0.16, 0.27). As a corollary, a higher incidence of RVOs as a whole, as well as a higher incidence of CRVOs combined with a higher incidence of BRVOs originating at the optic nerve head, both were significantly associated with higher estimated CSFP (p = 0.002; odds ratio (OR): 1.15; 95% CI: 1.05, 1.25; and p = 0.037; OR: 1.17; 95% CI: 1.01, 1.35, respectively) after adjusting for older age.

Conclusions

A higher estimated CSFP was associated with a higher incidence of RVOs originating at the optic nerve head (i.e. CRVOs, hemi‐central RVOs and BRVOs originating at the optic nerve head), and vice versa, a higher incidence of RVOs was associated with a higher estimated CSFP. It suggested an influence of higher estimated CSFP on higher central retinal vein pressure.
Elderly donor liver grafts are not associated with a higher incidence of biliary complications after liver transplantation: results of a national multicenter study
Authors: Westerkamp Andrie C. , Korkmaz Kerem S. , Bottema Jan T. , Ringers Jan , Polak Wojciech G. , van den Berg Aad , van Hoek Bart , Metselaar Herold J. , Porte Robert J.
Published: May 2015

Background

Liver transplantation with livers grafts from elderly donors has been associated with a higher risk of biliary complications. The aim of this study was to examine whether our national protocol could contribute to a lower incidence of biliary complications.

Methods

All adult recipients in the Netherlands transplanted with a liver from an elderly donor (≥65 yrs; n = 68) in the period January 2000–July 2011 were matched with recipients of a liver from a donor <65 yr (n = 136). Outcome parameters were 90‐d, one‐yr, and three‐yr patient/graft survival rates, biliary complications (non‐anastomotic stricture, anastomotic stricture, biliary leakage, and post‐transplant cholangitis), and postoperative hepatic ischemic injury serum markers (AST/ALT).

Results

The median cold ischemia time (CIT) was 7:25 (h:min) in the group recipients of an elderly donor liver graft. Ninety‐day, one‐yr, and three‐yr patient/graft survival rates were similar between the group with an elderly donor liver and their younger controls. Moreover, no differences were found in the incidence of biliary complications and postoperative levels of AST/ALT between the two groups.

Conclusion

Transplantation of livers from elderly donors (≥65 yr) is not associated with a higher incidence of biliary complications, in a national policy wherein the CIT is kept short.
A Plan for Academic Biobank Solvency—Leveraging Resources and Applying Business Processes to Improve Sustainability
Authors: Uzarski Diane , Burke James , Turner Barbara , Vroom James , Short Nancy
Published: May 2015

Researcher‐initiated biobanks based at academic institutions contribute valuable biomarker and translational research advances to medicine. With many legacy banks once supported by federal funding, reductions in fiscal support threaten the future of existing and new biobanks. When the Brain Bank at Duke University's Bryan Alzheimer's Disease Center (ADRC) faced a funding crisis, a collaborative, multidisciplinary team embarked on a 2‐year biobank sustainability project utilizing a comprehensive business strategy, dedicated project management, and a systems approach involving many Duke University entities. By synthesizing and applying existing knowledge, Duke Translational Medicine Institute created and launched a business model that can be adjusted and applied to legacy and start‐up academic biobanks. This model provides a path to identify new funding mechanisms, while also emphasizing improved communication, business development, and a focus on collaborating with industry to improve access to biospecimens. Benchmarks for short‐term Brain Bank stabilization have been successfully attained, and the evaluation of long‐term sustainability metrics is ongoing.
Bioengineered Corneas Grafted as Alternatives to Human Donor Corneas in Three High‐Risk Patients
Authors: Buznyk Oleksiy , Pasyechnikova Nataliya , Islam M. Mirazul , Iakymenko Stanislav , Fagerholm Per , Griffith May
Published: May 2015

Corneas with severe pathologies have a high risk of rejection when conventionally grafted with human donor tissues. In this early observational study, we grafted bioengineered corneal implants made from recombinant human collagen and synthetic phosphorylcholine polymer into three patients for whom donor cornea transplantation carried a high risk of transplant failure. These patients suffered from corneal ulcers and recurrent erosions preoperatively. The implants provided relief from pain and discomfort, restored corneal integrity by promoting endogenous regeneration of corneal tissues, and improved vision in two of three patients. Such implants could in the future be alternatives to donor corneas for high‐risk patients, and therefore, merits further testing in a clinical trial.
‘Beltway Bandits’ and ‘Poverty Barons’: For‐Profit International Development Contracting and the Military‐Development Assemblage
Authors: Nagaraj Vijay Kumar
Published: May 2015

This article examines the political economy of for‐profit international development contracting and its growing convergence with private military contracting. It attempts a genealogy of contemporary for‐profit development contracting, underlining how the ability of for‐profit development firms to leverage their simultaneous integration into the global corporate‐financial architecture and the global development regime has been central to their spectacular growth. The article maps specific modalities and opportunity structures — contracting vehicles and procurement practices; the politics of the market structure; the contract culture and vendorism; shared circuitries of knowledge and power — which are enabling for‐profit contractors to consolidate their influence over the international development regime. It also traces the blurring of boundaries between development and security and how this is shaped and used by development contractors and private military firms alike. The author highlights how a combination of corporate diversification and mergers and acquisitions has paved the way for a market‐led development‐security assemblage and the birth of the ‘private military‐development corporation’, which profits equally from war, peace, reconstruction and development. The study focuses largely on the USA and UK owing to the scale of their international development regimes and for‐profit development markets.
Reliability of phenotypic early‐onset ataxia assessment: a pilot study
Authors: Lawerman Tjitske F , Brandsma Rick , van Geffen Joke T , Lunsing Roelineke J , Burger Huibert , Tijssen Marina A J , de Vries Jeroen J , de Koning Tom J , Sival Deborah A
Published: May 2015

Aim

To investigate the interobserver agreement on phenotypic early‐onset ataxia (EOA) assessment and to explore whether the Scale for Assessment and Rating of Ataxia (SARA) could provide a supportive marker.

Method

Seven movement disorder specialists provided independent phenotypic assessments of potentially ataxic motor behaviour in 40 patients (mean age 15y [range 5–34]; data derived from University Medical Center Groningen medical records 1998–2012). We determined interobserver agreement by Fleiss' kappa. Furthermore, we compared percentage SARA subscores ([subscore/total score]×100%) between ‘indisputable’ (primary ataxia recognition by at least six observers) and ‘mixed’ (ataxia recognition, unfulfilling ‘indisputable’ criteria) EOA phenotypes.

Results

Agreement on phenotypic EOA assessment was statistically significant (p<0.001), but of moderate strength (Fleiss' kappa=0.45; 95% CI 0.38–0.51). During mild disease progression, percentage SARA gait subscores discriminated between ‘indisputable’ and ‘mixed’ EOA phenotypes. In patients with percentage SARA gait subscores >30%, primary ataxia was more frequently present than in those with subscores <30% (p=0.001).

Interpretation

Among movement‐disorder professionals from different disciplines, interobserver agreement on phenotypic EOA recognition is of limited strength. SARA gait subscores can provide a supportive discriminative marker between EOA phenotypes. Hopefully, future phenotypic insight will contribute to the inclusion of uniform, high‐quality data in international EOA databases.