bluuebunny/crossref_metadata_2025 huggingface dataset:
Revision Vaginoplasty: A Comparison of Surgical Outcomes of Laparoscopic Intestinal versus Perineal Full-Thickness Skin Graft Vaginoplasty
Authors: Van der Sluis Wouter B. , Bouman Mark-Bram , Buncamper Marlon E. , Mullender Margriet G. , Meijerink Wilhelmus J.
Published: September 2016

Background:

Vaginal (re)construction can greatly improve the quality of life of indicated patients. If primary vaginoplasty fails, multiple surgical approaches exist for revision. The authors compared surgical results of laparoscopic intestinal versus full-thickness skin graft revision vaginoplasty.

Methods:

A retrospective chart review of patients who underwent revision vaginoplasty at the authors’ institution was conducted. Patient demographics, surgical characteristics, complications, hospitalization, reoperations, and neovaginal depth for both surgical techniques were recorded and compared.

Results:

The authors studied a consecutive series of 50 transgender and three biological women who underwent revision vaginoplasty, of which 21 were laparoscopic intestinal and 32 were perineal full-thickness skin graft vaginoplasties, with a median clinical follow-up of 3.2 years (range, 0.5 to 19.7 years). Patient demographics did not differ significantly. There was no mortality. Two intraoperative rectal perforations (10 percent) occurred in the intestinal group versus six (19 percent) in the full-thickness skin graft group. Operative time was shorter for the full-thickness skin graft vaginoplasty group (131 ± 35 minutes versus 191 ± 45 minutes; p < 0.01). Hospitalization length did not differ significantly. Successful vaginal (re)construction was achieved in 19 intestinal (91 percent) and 26 full-thickness skin graft (81 percent) vaginoplasty procedures. A deeper neovagina was achieved with intestinal vaginoplasty (15.9 ± 1.4 cm versus 12.5 ± 2.8 cm; p < 0.01).

Conclusions:

Both laparoscopic intestinal and full-thickness skin graft vaginoplasty can be used as secondary vaginal reconstruction. Intraoperative and postoperative complications do not differ significantly, but rectal perforation was more prevalent in the full-thickness skin graft vaginoplasty group. Although the operative time of laparoscopic intestinal vaginoplasty is longer, adequate neovaginal depth was more frequently achieved than in secondary perineal full-thickness skin graft vaginoplasty.

CLINCAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
A Retrospective Analysis of Secondary Revisions after Face Transplantation: Assessment of Outcomes, Safety, and Feasibility
Authors: Aycart Mario A. , Alhefzi Muayyad , Kueckelhaus Maximilian , Krezdorn Nicco , Bueno Ericka M. , Caterson Edward J. , Pribaz Julian J. , Pomahac Bohdan
Published: September 2016

Background:

Face transplantation has emerged as a viable option for certain patients in the treatment of devastating facial injuries. However, as with autologous free tissue transfer, the need for secondary revisions in face transplantation also exists. The authors’ group has quantified the number of revision operations in their cohort and has assessed the rationale, safety, and outcomes of posttransplantation revisions.

Methods:

A retrospective analysis of prospectively collected data of the authors’ seven face transplants was performed from April of 2009 to July of 2015. The patients’ medical records, preoperative facial defects, and all operative reports (index and secondary revisions) were critically reviewed.

Results:

The average number of revision procedures was 2.6 per patient (range, zero to five procedures). The median time interval from face transplantation to revision surgery was 5 months (range, 1 to 10 months). Most interventions consisted of debulking of the allograft, superficial musculoaponeurotic system plication and suspension, and local tissue rearrangement. There were no major infections, allograft skin flap loss, or necrosis. One patient suffered a postoperative complication after autologous fat grafting in the form of acute rejection that resolved with pulse steroids.

Conclusions:

Secondary revisions after face transplantation are necessary components of care, as they are after most conventional free tissue transfers. Secondary revisions after face transplantation at the authors’ institution have addressed both aesthetic and functional reconstructive needs, and these procedures have proven to be safe in the context of maintenance immunosuppression. Patient and procedure selection along with timing are essential to ensure patient safety, optimal function, and aesthetic outcomes.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, V.
The Concepts of Propeller, Perforator, Keystone, and Other Local Flaps and Their Role in the Evolution of Reconstruction
Authors: Mohan Anita T. , Sur Yoo Joon , Zhu Lin , Morsy Mohamed , Wu Peter S. , Moran Steven L. , Mardini Samir , Saint-Cyr Michel
Published: September 2016

Learning Objectives:

After studying this article, the participant should be able to: 1. Understand the history and physiology of perforator flaps. 2. Understand the concept of “free-style” perforator flaps and principles in design and harvest. 3. Understand the uses of perforator flaps in reconstruction and applications in new settings. 4. Understand new principles in single and multiple perforator flap harvest and adjunct techniques that can be used in perforator flaps. 5. Highlight pertinent anatomy and techniques for selected perforator flaps described.

Extended knowledge of vascular anatomy has propagated the development of perforator flaps, which preserve muscle function and reduce morbidity. This has been achieved through the exemplary works of Manchot, Salmon, Milton, Taylor, and many others. With over 350 clinically relevant perforators in the body, this has created new flap options and a sense of creative freedom for reconstruction tailored toward a specific defect, without constraints of specific landmarks and using a “free-style” approach. Dominant perforators may be found in zones of high perforator density or “hot spots,” which can help to conceptualize local flap options and aid flap design. This article aims to outline the history, physiology, and principles of flap design and harvest, and highlight traditional and evolving concepts and modifications of contemporary and traditional flaps that are changing reconstructive practice. This is a broad overview focusing on clinical applications, highlighting key concepts in a selection of new or evolving flaps being used in clinical practice and providing source references to acquire detailed flap descriptions.
Quantification of the Latent HIV-1 Reservoir Using Ultra Deep Sequencing and Primer ID in a Viral Outgrowth Assay
Authors: Lee Sook-Kyung , Zhou Shuntai , Baldoni Pedro L. , Spielvogel Ean , Archin Nancie M. , Hudgens Michael G. , Margolis David M. , Swanstrom Ronald
Published: September 2016

Background:

In this study, we measured the latent HIV-1 reservoir harboring replication-competent HIV-1 in resting CD4+ T cells in participants on highly active antiretroviral therapy, quantitating the frequency of latent infection through the use of a Primer ID-based Ultra Deep Sequencing Assay (UDSA), in comparison to the readout of the quantitative viral outgrowth assay (QVOA).

Methods:

Viral RNA derived from culture wells of QVOA that scored as HIV-1 p24 capsid antigen positive were tagged with a specific barcode during cDNA synthesis, and the sequences within the V1–V3 region of the HIV-1 env gene were analyzed for diversity using the Primer ID-based paired-end MiSeq platform. We analyzed samples from a total of 19 participants, 2 initially treated with highly active antiretroviral therapy in acute infection and 17 treated during chronic infection. Phylogenetic trees were generated with all viral lineages detected from culture wells derived from each participant to determine the number of distinct viral lineages growing out in each well, thus capturing another level of information beyond the well being positive for viral antigen. The infectious units per million (IUPM) cell values estimated using a maximum likelihood approach, based on the number of distinct viral lineages detected (VOA-UDSA), were compared with those obtained from QVOA measured using limiting dilution.

Results:

IUPM estimates determined by VOA-UDSA ranged from 0.14 to 3.66 and strongly correlated with the IUPM estimates determined by QVOA (r = 0.94; P < 0.0001).

Conclusions:

VOA-UDSA may be an alternative readout for that currently used for QVOA.
Molecular stripping, targets and decoys as modulators of oscillations in the NF-κB/IκBα/DNA genetic network
Authors: Wang Zhipeng , Potoyan Davit A. , Wolynes Peter G.
Published: September 2016

Eukaryotic transcription factors in the NF-κB family are central components of an extensive genetic network that activates cellular responses to inflammation and to a host of other external stressors. This network consists of feedback loops that involve the inhibitor IκBα, numerous downstream functional targets, and still more numerous binding sites that do not appear to be directly functional. Under steady stimulation, the regulatory network of NF-κB becomes oscillatory, and temporal patterns of NF-κB pulses appear to govern the patterns of downstream gene expression needed for immune response. Understanding how the information from external stress passes to oscillatory signals and is then ultimately relayed to gene expression is a general issue in systems biology. Recently,
in vitro
kinetic experiments as well as molecular simulations suggest that active stripping of NF-κB by IκBα from its binding sites can modify the traditional systems biology view of NF-κB/IκBα gene circuits. In this work, we revise the commonly adopted minimal model of the NF-κB regulatory network to account for the presence of the large number of binding sites for NF-κB along with dissociation from these sites that may proceed either by passive unbinding or by active molecular stripping. We identify regimes where the kinetics of target and decoy unbinding and molecular stripping enter a dynamic tug of war that may either compensate each other or amplify nuclear NF-κB activity, leading to distinct oscillatory patterns. Our finding that decoys and stripping play a key role in shaping the NF-κB oscillations suggests strategies to control NF-κB responses by introducing artificial decoys therapeutically.
Cytoskeletal architecture and its evolutionary significance in amoeboid eukaryotes and their mode of locomotion
Authors: Tekle Yonas I. , Williams Jessica R.
Published: September 2016

The cytoskeleton is the hallmark of eukaryotic evolution. The molecular and architectural aspects of the cytoskeleton have been playing a prominent role in our understanding of the origin and evolution of eukaryotes. In this study, we seek to investigate the cytoskeleton architecture and its evolutionary significance in understudied amoeboid lineages belonging to Amoebozoa. These amoebae primarily use cytoplasmic extensions supported by the cytoskeleton to perform important cellular processes such as movement and feeding. Amoeboid structure has important taxonomic significance, but, owing to techniques used, its potential significance in understanding diversity of the group has been seriously compromised, leading to an under-appreciation of its value. Here, we used immunocytochemistry and confocal microscopy to study the architecture of microtubules (MTs) and F-actin in diverse groups of amoebae. Our results demonstrate that all Amoebozoa examined are characterized by a complex cytoskeletal array, unlike what has been previously thought to exist. Our results not only conclusively demonstrate that all amoebozoans possess complex cytoplasmic MTs, but also provide, for the first time, a potential synapomorphy for the molecularly defined Amoebozoa clade. Based on this evidence, the last common ancestor of amoebozoans is hypothesized to have had a complex interwoven MT architecture limited within the granular cell body. We also generate several cytoskeleton characters related to MT and F-actin, which are found to be robust for defining groups in deep and shallow nodes of Amoebozoa.
Geochemistry, faunal composition and trophic structure in reducing sediments on the southwest South Georgia margin
Authors: Bell James B. , Aquilina Alfred , Woulds Clare , Glover Adrian G. , Little Crispin T. S. , Reid William D. K. , Hepburn Laura E. , Newton Jason , Mills Rachel A.
Published: September 2016

Despite a number of studies in areas of focused methane seepage, the extent of transitional sediments of more diffuse methane seepage, and their influence upon biological communities is poorly understood. We investigated an area of reducing sediments with elevated levels of methane on the South Georgia margin around 250 m depth and report data from a series of geochemical and biological analyses. Here, the geochemical signatures were consistent with weak methane seepage and the role of sub-surface methane consumption was clearly very important, preventing gas emissions into bottom waters. As a result, the contribution of methane-derived carbon to the microbial and metazoan food webs was very limited, although sulfur isotopic signatures indicated a wider range of dietary contributions than was apparent from carbon isotope ratios. Macrofaunal assemblages had high dominance and were indicative of reducing sediments, with many taxa common to other similar environments and no seep-endemic fauna, indicating transitional assemblages. Also similar to other cold seep areas, there were samples of authigenic carbonate, but rather than occurring as pavements or sedimentary concretions, these carbonates were restricted to patches on the shells of
Axinulus antarcticus
(Bivalvia, Thyasiridae), which is suggestive of microbe–metazoan interactions.
Male courtship decisions are influenced by light environment and female receptivity
Authors: Cole Gemma L. , Endler John A.
Published: September 2016

The appearance of animal colour signals depends jointly upon the ambient light spectrum and the signal's reflectance spectra. Light environment heterogeneity might, therefore, allow individuals to enhance their signal by signalling in an environment that increases signal efficacy. We tested this hypothesis by providing male guppies (Poecilia reticulata), a choice of three light environments in which to display their colour signal to females: green, lilac, and clear. We paired males with both receptive and non-receptive females to test whether female response might affect male behavioural decisions. Males preferred the clear environment in all trials and this environment also resulted in males having the highest average visual contrast. Sexual behaviour was influenced by complex interactions between female receptivity, light environment, and male colour pattern contrast. Males spent significantly more time in the environment in which their colour signal had the highest contrast, but only when paired with receptive females. Significant interactions between light environment and individual male colour components were also seen only in receptive trials. Our results suggest that males use light environment to enhance their colour pattern, but only in the presence of receptive females.
Genome-wide profiling of heritable andde novoSTR variations
Authors: Willems Thomas , Zielinski Dina , Gordon Assaf , Gymrek Melissa , Erlich Yaniv
Published: September 2016

Short tandem repeats (STRs) are highly variable elements that play a pivotal role in multiple genetic diseases, population genetics applications, and forensic casework. However, STRs have proven problematic to genotype from high-throughput sequencing data. Here, we describe HipSTR, a novel haplotype-based method for robustly genotyping, haplotyping, and phasing STRs from whole genome sequencing data and report a genome-wide analysis and validation ofde novoSTR mutations.
Co-operation, competition and crowding: a discrete framework linking Allee kinetics, nonlinear diffusion, shocks and sharp-fronted travelling waves
Authors: Johnston Stuart T. , Baker Ruth E. , McElwain D.L. Sean , Simpson Matthew J.
Published: September 2016

Abstract

Invasion processes are ubiquitous throughout cell biology and ecology. During invasion, individuals can become isolated from the bulk population and behave differently. We present a discrete, exclusion-based description of the birth, death and movement of individuals. The model distinguishes between individuals that are part of, or are isolated from, the bulk population by imposing different rates of birth, death and movement. This enables the simulation of various co-operative or competitive mechanisms, where there is either a positive or negative benefit associated with being part of the bulk population, respectively. The mean-field approximation of the discrete process gives rise to 22 different classes of partial differential equation, which can include Allee kinetics and nonlinear diffusion. Here we examine the ability of each class of partial differential equation to support travelling wave solutions and interpret the long time behaviour in terms of the individual-level parameters. For the first time we show that the strong Allee effect and nonlinear diffusion can result in shock-fronted travelling waves. We also demonstrate how differences in group and individual motility rates can influence the persistence of a population and provide conditions for the successful invasion of a population.
Interaction between distinct actin pools controls activity-dependent actin dynamics in the dendritic spine
Authors: Glebov Oleg O. , Burrone Juan
Published: September 2016

Actin cytoskeleton is composed of functionally distinct pools of filamentous (F)-actin defined by their regulatory machinery and dynamics. Although these networks may compete for actin monomers and regulatory factors1–4, the interaction between them remains poorly understood. Here, we show that disruption of the labile F-actin pool in neurons by limited actin depolymerization5,6unexpectedly triggers rapid enhancement of the F-actin content at the dendritic spine. Long-term blockade of NMDA-type receptors decreases spine actin polymerization, which is specifically restored by the labile pool ablation. Increase in the spine actin is triggered by blockade of formin-induced actin polymerization in a manner dependent on Arp2/3 complex activity. Finally, limited actin depolymerization increases F-actin levels in a cultured cell line, suggesting the generality of the two-tiered actin dynamics. Based on these findings, we propose a model whereby the labile pool of F-actin controlled by formin restricts the polymerization state of the Arp2/3-regulated stable spine actin, suggesting a feedback principle at the core of cytoskeletal organization in neurons.

Highlights

Disruption of labile F-actin by limited depolymerization rapidly increases the synaptic F-actin content;

The depolymerization-induced F-actin boost reverses decrease in synaptic F-actin induced by long-term NMDA receptor blockade;

Blockade of formin-dependent actin polymerization boosts synaptic F-actin in an Arp2/3-dependent manner;

Limited actin depolymerization enhances overall F-actin content in a mammalian cell line.
“Carrot and stick” leadership style
Authors: Dartey-Baah Kwasi , Ampofo Emmanuel
Published: September 2016

Purpose

The purpose of this paper is to examine the relevance of “carrot and stick” (transactional) leadership style in predicting employees’ job satisfaction in a modern business organization.

Design/methodology/approach

The study was cross-sectional in nature and made use of structured questionnaire to collect data. Stratified and simple random sampling techniques were used to select the respondents. In total, 215 questionnaires were returned by respondents out of the 220 administered. Taylor and Bowers (1974) overall job satisfaction questionnaire and Bass and Avolio (2004) multifactor leadership questionnaire, were used to measure job satisfaction (α=0.812) and transactional leadership style (α=0.761), respectively. Simple linear regression was also used to predict the relationship between the constructs.

Findings

Results indicated significant and positive relationship between managers transactional leadership style and employees overall job satisfaction (β=0.292,p<0.001). Moreover, contingent reward (β=0.313,p<0.001) and management by exception (active) (β=0.208,p<0.001) were, respectively, found to be statistically significant and positively related with job satisfaction. However, there was no significant relationship between management by exception (passive) and job satisfaction.

Originality/value

This study adds to research that transactional leadership is broadly ideal for employees of manufacturing firms in Ghana where tasks are routine, objectives are clearly stated and work outputs can easily be measured.
The impact of institutional culture on change initiatives in an electric utility company in Africa
Authors: Jumbe Moses , Gerwel Proches Cecile N.
Published: September 2016

Purpose

Organisational culture is increasingly being recognised as a critical determinant of the success or failure of organisational change efforts. A power utility company in Africa was undergoing planned change driven by its ambitious vision of becoming one of the top five performing utilities in the world. The purpose of this paper is to explore how the organisation’s culture was impacting on the change initiatives of one of the organisation’s operating units. The study also sought to investigate the robustness of the change model employed to inform the change process.

Design/methodology/approach

The study employed qualitative research methods for data collection, sampling and analysis. Ten semi-structured, in-depth interviews were conducted with managers, supervisory and non-supervisory staff in the operating unit. Data analysis was by means of thematic analysis.

Findings

Organisational culture was found to be impacting the operating unit’s change efforts. According to the participants, cultural analysis to determine organisational readiness for change was not adequately undertaken. The cultural factors of, among others, communication, feedback, involvement, and consultations negatively impacted the change efforts. The participants’ perceptions were that leadership failed to connect employees to the vision.

Originality/value

The paper provides insight into the importance of leadership’s understanding and consideration of organisational culture in change initiatives. Cultural analyses before embarking on change assists leaders in identifying and then strengthening or changing cultural tenets implicated by the change initiatives.
Performance measures for road managers facing diverse environments
Authors: Richmond Craig M. , Kielhauser Clemens , Adey Bryan T.
Published: September 2016

Purpose

A key difficulty that plagues benchmarking in the public sector is heterogeneity in the production process. The purpose of this paper is to present a strategy for overcoming that difficulty using physical production models and demonstrate it using road renewal management as an example.

Design/methodology/approach

A physical production model is used to linking required prices, inputs and exposures to environmental factors to the desired services to be delivered. A measure is derived from this that adjusts for the additional expected costs from operating in a more difficult environments. A case study is used to present methods for addressing specific parameterization issues that arise in an empirical application.

Findings

The method was found to be implementable and empirically better than naïve ratio measures commonly found in practice.

Research limitations/implications

Data and modeling issues were identified that can be addressed by public supervisors that are expected to greatly improve the quality of the measures.

Social implications

According to the raw data and simple ratios, a very large degree of inefficiency can potentially be eliminated by applying the recommended measures. In all likelihood the real potential is much smaller, but still significant.

Originality/value

Most applied benchmarking exercises use simple ratios as KPI’s. These are easily dismissed where environments are heterogeneous. Data envelopment analysis and stochastic frontier analysis are generally difficult to relate to KPI’s. The use of an explicit and specific process model with an engineering content is therefore exceptional.
A qualitative investigation of benchmarking barriers in Nigeria
Authors: Adewunmi Yewande Adetoro , Koleoso Hikmot , Omirin Modupe
Published: September 2016

Purpose

The purpose of this paper is to examine benchmarking barriers among Nigerian facilities management (FM) practitioners.

Design/methodology/approach

Data collection were through semi-structured interviews with 34 FM heads from three selected cities in Nigeria. Out of this number, 16 were from Lagos, ten from Abuja while eight managers were from Port Harcourt, respectively. These managers were selected using purposive sampling based on their experience in the field of FM across the various sectors of the economy. The interviews were analysed with Nvivo 10 software qualitative computer software.

Findings

Those that do informal benchmarking face challenges with data, employees lack of confidence in new initiatives and poor support of senior management, the companies that use best practice benchmarking face constraints of access to information and employees unwillingness to change and comply to company set standards, unwillingness of benchmarking partners to understand the usefulness of the project, and problems that emanate from the quality of data obtained.

Practical implications

The results therefore suggest that to improve the practice of best practice benchmarking there is need to improve both quantity and quality of data for the exercise and enhance standard practice.

Originality/value

The study established a new category of benchmarking barriers called the market category of benchmarking barriers and further distinguished benchmarking barriers based on two forms of benchmarking which is informal and formal benchmarking. Also there are limited studies on benchmarking barriers in developing countries.
Supplier selection in agile supply chain
Authors: Matawale Chhabi Ram , Datta Saurav , Mahapatra S.S.
Published: September 2016

Purpose

The recent global market trend is seemed enforcing existing manufacturing organizations (as well as service sectors) to improve existing supply chain systems or to take up/adapt advanced manufacturing strategies for being competitive. The concept of the agile supply chain (ASC) has become increasingly important as a means of achieving a competitive edge in highly turbulent business environments. An ASC is a dynamic alliance of member enterprises, the formation of which is likely to introduce velocity, responsiveness, and flexibility into the manufacturing system. In ASC management, supplier/partner selection is a key strategic concern. Apart from traditional supplier/partner selection criteria; different agility-related criteria/attributes need to be taken under consideration while selecting an appropriate supplier in an ASC. The paper aims to discuss these issues.

Design/methodology/approach

Therefore, evaluation and selection of potential supplier in an ASC have become an important multi-criteria decision making problem. Most of the evaluation criteria being subjective in nature; traditional decision-making approaches (mostly dealing with objective data) fail to solve this problem. However, fuzzy set theory appears an important mean to tackle with vague and imprecise data given by the experts. In this work, application potential of the fuzzy multi-level multi-criteria decision making (FMLMCDM) approach proposed by Chu and Velásquez (2009) and Chu and Varma (2012) has been examined and compared to that of Fuzzy-techniques for order preference by similarity to ideal solution (TOPSIS) and Fuzzy-MOORA in the context of supplier selection in ASC.

Findings

It has been observed that similar ranking order appears in FMLMCDM as well as Fuzzy-TOPSIS. In Fuzzy-MOORA, the best alternative appears same as in case of FMLMCDM as well as Fuzzy-TOPSIS; but for other alternatives ranking order differs. A comparative analysis has also been made in view of working principles of FMLMCDM, Fuzzy-TOPSIS as well as Fuzzy-MOORA.

Originality/value

Application feasibility of FMLMCDM approach has been verified in comparison with Fuzzy-TOPSIS and Fuzzy-MOORA in the context of agile supplier selection.
Prioritization of Six-Sigma project selection
Authors: Adebanjo Dotun , Samaranayake Premaratne , Mafakheri Fereshteh , Laosirihongthong Tritos
Published: September 2016

Purpose

With increasing choice from a range of programs, improvement project selection within broader supply chain context and resource constraints has become a major research challenge. The purpose of this paper is to investigate the different criteria for selecting Six-Sigma (SS) projects based on previous studies. The study is supported by two grounded theories: resource-based view and institutional norms. The criteria include: first, business drivers for improvement and the common performance metrics deployed; second, the organization’s stakeholders needs; and third, process owner’s needs.

Design/methodology/approach

To determine the relative importance of influencing factors, opinions were collected from 30 experienced practitioners including SS champions/master black-belts, company directors, consultants, and process owners through a series of interviews in small, medium, and large organizations including multi-national organizations. The evaluation of criteria is based on analytical hierarchy process.

Findings

The results show that impact on customer, financial impacts, and impact on operational goals are the most significant factors in selecting SS improvement project.

Originality/value

This study is a first attempt to determine the relative weight among SS project selection criteria, which help the practitioner to allocate their limited resources in implementing SS project.
An analysis of financial inclusion initiatives at Odisha Gramya Bank
Authors: Bapat Dhananjay , Sidharthan S. , Yogalakshmi C.
Published: September 2016

Subject area

Financial Services Marketing, Financial Inclusion, Emerging Market Studies.

Study level/applicability

The case is suitable for graduate management students in courses such as general management and marketing courses. It is also suitable for a specialised rural marketing course and marketing of financial services. In business schools outside India, the case can be used in a course on marketing strategies for emerging economies. The case is suitable for executive development programmes for the areas pertaining to rural banking, marketing of banking services and financial inclusion programmes.

Case overview

The case analyses the financial inclusion initiative by Odisha Gramya Bank, a regional rural bank set up after amalgamation of three banks in the state of Orissa, India. The topic of financial inclusion has been the attraction from bankers, policymakers and academia in light of linkage between formal financial system and inclusive growth. To harness the fortunes at the bottom of pyramid, the case looks into the development of financial inclusion, business strategies and strategies for various customer segments.

Expected learning outcomes

To introduce students to analyse and compare various financial inclusion options. The case is useful to comprehend the various methods of financial inclusion. To analyse the evolution of regional rural banks and Odisha Gramya Bank after its amalgamation. To appreciate the issues faced by Odisha Gramya Bank. To understand various market segment and to evaluate its potential. To suggest appropriate strategies for each market segment. To appreciate how technology can be harnessed for business correspondents. To recommend the roadmap for financial inclusion to Mr Sidharthan, Chairman, Odisha Gramya Bank.

Supplementary materials

Teaching notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes.

Subject code

CSS 8: Marketing.
Improving patient and staff outcomes using practice development
Authors: Hennessey Catherine Elizabeth , Fry Margaret
Published: September 2016

Purpose

The purpose of this paper is to examine the impact of a practice development program, “Essentials of Care” (EOC), on patient and staff outcomes, workplace culture and service delivery.

Design/methodology/approach

A descriptive study design was used to explore the impact of EOC in a district hospital rehabilitation ward. EOC focuses on embedding a person-centered culture within clinical areas and is structured from practice development methodologies. EOC was implemented in a metropolitan district hospital rehabilitation, older person 20-bed, ward.

Findings

Two projects were implemented during EOC. These projects led to nine significant patient and staff outcomes for medication and continence care practices. Outcomes included a reduction in older person complaints by 80 percent, pressure injuries by 62 percent, ward multi resistant staphylococcus aureus infection rates by 50 percent, clinical incidents by 22 percent, older person falls by 14 percent (per 1,000 bed days) and nursing sick leave by 10 percent. There was also a 13 percent improvement in the post nursing workplace satisfaction survey.

Research limitations/implications

This is a single site study and findings may not be suitable for generalizing across ward settings and broader population groups.

Originality/value

The EOC program led to significant improvements for and in clinical practices, staff satisfaction and ward culture. Specifically, the EOC program also identified significant cost savings and brought together the healthcare team in a cohesive and integrated way not previously experienced by staff. Practice development strategies can champion service quality improvement, optimal patient outcomes and consistency within healthcare.
Health providers’ perception of quality of care for neonates in health facilities in a municipality in Southern Ghana
Authors: Elikplim Pomevor Kokui , Adomah-Afari Augustine
Published: September 2016

Purpose

The purpose of this paper is to assess available human resources for neonatal care and their skills, in order to explore health providers’ perceptions of quality of neonatal care in health facilities in Ghana.

Design/methodology/approach

Data were gathered using qualitative interviews with health providers working in the maternity and paediatric wards and midwives; direct observation; and documentary review at a regional hospital, a municipal hospital and four health centres in a municipality in a region in Southern Ghana. Data were analysed using thematic framework through the process of coding in six phases to create and establish meaningful patterns.

Findings

The study revealed that health providers were concerned about the number of staff available, their competence and also equipment available for them to work more efficiently. Some essential equipment for neonatal care was either not available or was non-functional where it was available, while aseptic procedures were not adhered to. Moreover, personal protective equipment such as facemask, caps, aprons were not used except in the labour wards where staff had to change their footwear before entering.

Research limitations/implications

Limited number of health providers and facilities used, lack of exploration of parents of neonates’ perspective of quality of neonatal care in this study and other settings, including the teaching hospitals. The authors did not examine issues related to the ineffective use of IV cannulation for neonates by nurses as well as referral of neonates. Additionally, the authors did not explore the perspectives of management of the municipal and regional health directorates or policy makers of the Ministry of Health and Ghana Health Service regarding the shortage of staff, inadequate provision of medical equipment and infrastructure.

Practical implications

This paper suggests the need for policy makers to redirect their attention to the issues that would improve the quality of neonatal health care in health facilities in Ghana and in countries with similar challenges.

Social implications

The study found that the majority of nursing staff catering for sick newborns were not trained in neonatal nursing. Babies were found sleeping in separate cots but were mixed with older children. The study suggests that babies should be provided with a separate room and not mixed with older babies.

Originality/value

There seemed to be no defined policy framework for management of neonatal care in the country’s health care facilities. The study recommends the adoption of paediatric and neonatal care nursing as a specialty in the curricula of health training institutions. In-service trainings should encompass issues related to management of sick babies, care of preterm babies, neonatal resuscitation and intravenouscannulation, among others.
The impact of Lean bundles on hospital performance: does size matter?
Authors: Al-Hyari Khalil , Abu Hammour Sewar , Abu Zaid Mohammad Khair Saleem , Haffar Mohamed
Published: September 2016

Purpose

The purpose of this paper is to study the effect of the implementation of Lean bundles on hospital performance in private hospitals in Jordan and evaluate how much the size of organization can affect the relationship between Lean bundles implementation and hospital performance.

Design/methodology/approach

The research is considered as quantitative method (descriptive and hypothesis testing). Three statistical techniques were adopted to analyse the data. Structural equation modeling techniques and multi-group analysis were used to examine the research’s hypothesis, and to perform the required statistical analysis of the data from the survey. Reliability analysis and confirmatory factor analysis were used to test the construct validity, reliability and measurement loadings that were performed.

Findings

Lean bundles have been identified as an effective approach that can dramatically improve the organizational performance of private hospitals in Jordan. Main Lean bundles – just in time, human resource management, and total quality management are applicable to large, small and medium hospitals without significant differences in advantages that depend on size.

Originality/value

According to the researchers’ best knowledge, this is the first research that studies the impact of Lean bundles implementation in healthcare sector in Jordan. This research also makes a significant contribution for decision makers in healthcare to increase their awareness of Lean bundles.
Significant themes in developing the theory and practice of lesson study
Authors: Elliott John
Published: September 2016

Purpose

The purpose of this paper is to pull together articles published in the journal over the last five years in terms of their relevance to the main themes and issues that have shaped its development.

Design/methodology/approach

The idea is that the paper enables teachers and researchers in schools and higher education institutions to access a substantial and unique collection of lesson and learning studies, and articles about the theoretical and methodological issues they raise, in the context of a rapidly globalising phenomenon.

Findings

The paper sets a framework for evaluating the growth and development of lesson studies as a form of practice-based teacher research.

Originality/value

This paper, authored by the founding chief editor of the IJLLS, establishes conceptual links between the theory and practice of lesson study and the wider field of practice-based pedagogical research.
The learning study approach to comparing two typologies of the cost concept for project management teaching
Authors: Cheng Eddie W.L.
Published: September 2016

Purpose

The epistemology of project management has been considered imperfect because the gap between theory and practice has not become closer due to unsatisfactory project performance. Without effective learning, the transfer of learning to the workplace would be uncertain. Therefore, the purpose of this paper is to use the learning study approach, exploring the value of Variation Theory in comparing two typologies of the cost concept for project management teaching.

Design/methodology/approach

To illustrate the application of the theory of variation, a case of teaching the two major cost typologies was demonstrated. A pedagogical setting was designed from the theory for helping students discern the object of learning.

Findings

Students of the target cohort had much fewer errors than previous cohorts in transforming the costs of the first typology used in project management textbooks to those of the second typology used in Microsoft Project.

Originality/value

This is perhaps the first case study to appreciate the use of Variation Theory in project management teaching. Apparently, thinking of how to induce learning and facilitate the transfer of learning should be a productive way for creating excellence in practice.
Food production and the growth of manufacturing: the case of Tanzania
Authors: Grabowski Richard
Published: September 2016

Purpose

The purpose of this paper is to analyze the impact that slow growth in staple food productivity can have on the process of structural change and, more importantly, on the development of labor intensive industry.

Design/methodology/approach

A theory of a semi-open economy is developed to analyze the role of staple food productivity on structural change. A case study is used to illustrate the workings of the model.

Findings

Slow growth in food staple productivity will mean that even when labor is physically abundant, it will not be economically cheap. Thus it will be extremely difficult to promote the expansion of labor intensive manufacturing. The key to rapid structural change is rapid growth in food staple productivity.

Practical implications

Investment in raising agricultural productivity is critical in the development of labor intensive manufacturing.

Social implications

Rapid growth can occur without leading to structural change. The bulk of the population remains locked in the rural sector.

Originality/value

The food sector is shown to be largely non-tradable. As a result solving the food problem domestically is crucial for structural change and economic development. Labor intensive manufacturing needs relatively cheap labor. For labor to be cheap, agricultural productivity (food staples) must rise rapidly.
Knowledge transfer in knowledge-intensive organizations: the crucial role of improvisation in transferring and protecting knowledge
Authors: Krylova Ksenia O. , Vera Dusya , Crossan Mary
Published: September 2016

Purpose

This paper aims to answer the question: how do knowledge workers’ improvisation processes promote both knowledge transfer and protection in knowledge-intensive organizations (KIOs)? A model is proposed identifying how effective improvisation can strengthen the effect of four specific knowledge transfer mechanisms – an experimental culture, minimal structures, the practice of storytelling and shared mental models – on knowledge transfer inside the organization and knowledge protection outside of it.

Design/methodology/approach

The paper builds on a knowledge translation perspective to position improvisation as intrinsically intertwined with knowledge transfer and knowledge protection.

Findings

Improvisation is proposed as the moderating factor enhancing the positive impact of an experimental culture, minimal structures, storytelling practice and shared mental models on knowledge transfer and knowledge protection.

Practical implications

The paper argues against a “plug-and-play” approach to knowledge transfer that seeks to replicate knowledge without considering how people relate to the routines and the context and highlights to leaders of KIOs the importance of developing awareness, understanding and motivation to improvise to internalize new knowledge being transferred and to create imitation barriers.

Originality/value

The paper proposes that KIOs’ success in transferring and protecting knowledge emerges not directly from formal knowledge transfer mechanisms but from knowledge workers’ improvisation processes.
How transactive memory systems relate to organizational innovation: the mediating role of developmental leadership
Authors: Kwon Kibum , Cho Daeyeon
Published: September 2016

Purpose

The purpose of this paper is to explore the relationship between transactive memory systems and organizational innovation. Several recent studies have discussed the positive relationship between these two entities. Yet, very few studies have demonstrated how transactive memory systems are related to leadership and innovation. This study investigates this tripartite relationship, finding that developmental leadership exerts a mediating effect on the relationship between transactive memory systems and organizational innovation.

Design/methodology/approach

In examining this relationship, 224 participants from an electronics company in South Korea were surveyed. Structural equation modeling was used to enable the identification of simultaneous interactive relationships among the three research variables.

Findings

Contrary to previous research results, transactive memory systems were found not to be significantly related to organizational innovation. Results also indicated that transactive memory systems comprise a statistically significant variable that influences developmental leadership. Subsequently, developmental leadership can be considered to be a valid construct in predicting organizational innovation; it can also be seen to fully mediate the relationship between transactive memory systems and organizational innovation.

Originality/value

These results have theoretical and managerial implications. As transactive memory systems do not always precede organizational innovation, knowledge of “who knows what” is not enough to ensure innovative performances. To accelerate organizational innovation, intentional managerial interventions such as developmental leadership are accordingly necessary.
Understanding knowledge creation in the context of knowledge-intensive business processes
Authors: Little Todd A. , Deokar Amit V.
Published: September 2016

Purpose

This paper aims to investigate knowledge creation in the context of knowledge-intensive business processes (KIBPs) and seeks to identify the challenges and opportunities associated with this phenomenon.

Design/methodology/approach

This study used a grounded theory approach to develop a framework based on 30 interviews across three different types of organizations.

Findings

The findings argue knowledge creation in the context of KIBP is negatively influenced by the lack of support for process-competency requirements within knowledge-intensive (KI) processes. These process-competency requirements center on the ability to effectively engage with the process, develop reasoning skills to handle KIBP and gain a higher-level perspective of the KIBP within the organization.

Practical implications

For practitioners, the opportunity exists to explore their organizational influences on the process-competencies to reduce the negative impact of any gaps identified within their KIBPs.

Originality/value

Although previous studies explore knowledge creation in a broad sense, this paper examines the phenomenon specifically within the context of KIBPs and analyze the potential for organizations to enhance their knowledge creation initiatives in this context.