bluuebunny/crossref_metadata_2025 huggingface dataset:
A cultural integration path for cross-border mergers and acquisitions from the perspective of acculturation
Authors: Cui Miao , Dong Crystal , Liu Yuekun , Wang Shujuan
Published: August 2016

Purpose

An increasing number of Chinese enterprises are involved in cross-border mergers and acquisitions (M&As). However, few Chinese enterprises have achieved successful integration, which plays a critical role in enhancing performance. The important field of cultural integration is currently facing major challenges. To identify the reasons for these challenges, studies have analyzed why cultural integration succeeds or fails and have suggested that cultural differences between acquiring and acquired enterprises are the primary obstacles to cultural integration. However, it is unclear how success can be achieved. The paper aims to focus on cultural integration from the perspective of acculturation to describe the penetration of cultural elements in M&As.

Design/methodology/approach

In adopting acculturation as our theoretical lens, the authors use the case study method to answer the following research question: “how can the cultural integration of Chinese enterprises be successfully achieved?” Two typical cases are examined: Lenovo’s cultural integration with IBM’s personal computer (PC) division and Haier’s cultural integration with Sanyo home appliance. First, using the exploratory case study method, the Lenovo–IBM PC division case is analyzed. The characteristics and relationships between cultural environments, employee adoption methods and acculturation patterns are summarized to reveal a cultural integration path. Second, the Haier–Sanyo home appliance case is analyzed using the confirmative case study method to test the findings of the Lenovo–IBM PC division case.

Findings

The results indicate that it is critical to achieve a dynamic fit between cultural environments, employee adoption methods and acculturation patterns during each stage of cultural integration (exploration, experimentation, reinforcement and fixing). The three constructs of these stages reflect the following evolutionary paths: “isolate-introduce-learning-chance taking”, “detecting-icebreaking-interacting-remodeling” and “specialized sections-senior managers-managers-employees”.

Originality/value

These findings contribute to the development of cultural integration and acculturation theories and serve as a reference for Chinese enterprises wishing to implement cultural integration strategies.
Vonoprazanversusconventional proton pump inhibitor‐based triple therapy as first‐line treatment againstHelicobacter pylori: A multicenter retrospective study in clinical practice
Authors: Shichijo Satoki , Hirata Yoshihiro , Niikura Ryota , Hayakawa Yoku , Yamada Atsuo , Mochizuki Satoshi , Matsuo Keigo , Isomura Yoshihiro , Seto Motoko , Suzuki Nobumi , Suzuki Hirobumi , Yamamoto Shinzo , Sugimoto Takafumi , Omae Tomoya , Okamoto Makoto , Watabe Hirotsugu , Togo Goichi , Takano Noriyuki , Fukui Keisuke , Ito Yuri , Koike Kazuhiko
Published: August 2016

Objective

Vonoprazan is a potassium‐competitive acid blocker, a new type of acid‐suppressing drug, and has recently become available for peptic ulcers, gastroesophageal reflux disease, andHelicobacter pylori(H. pylori) eradication. Its efficacy forH.pylorieradication has been reported. However, the evidence for its efficacy and feasibility remains limited. We aimed to compare the feasibility, effectiveness and safety of vonoprazan‐based triple therapy with conventional proton pump inhibitor (PPI)‐based triple therapy in multicenter clinical practice.

Methods

We performed a multicenter retrospective study on patients receiving first‐lineH.pylorieradication therapy between March 2013 and November 2015 with either vonoprazan‐based triple therapy or conventional PPI‐based triple therapy.

Results

A total of 2715 patients aged 63.0 ± 12.1 years (1412 [52.0%] males) were analyzed. Eradication rates were 87.2% (368/422) for vonoprazan‐based therapy and 72.4% (1661/2293) for conventional PPI‐based therapy (P < 0.01). Among the former group, there were 10 cases of diarrhea, six of nausea/vomiting, and five of rash, but the rates of these adverse events were similar to those in the conventional PPI group.

Conclusion

Vonoprazan‐based triple therapy is feasible, and has a higher rate forH. pylorieradication than conventional PPI as a first‐line regimen.
Multicenter Trial of Rivaroxaban for Early Discharge of Pulmonary Embolism From the Emergency Department (MERCURY PE): Rationale and Design
Authors: Singer Adam J. , Xiang Jim , Kabrhel Christopher , Merli Gino J. , Pollack Charles , Tapson Victor F. , Wildgoose Peter , Peacock W. Frank
Published: August 2016

Objectives

Traditionally, patients with pulmonary embolism (PE) are admitted from the emergency department and treated with low‐molecular‐weight heparin followed by warfarin. Several studies now demonstrate that it is possible to identify low‐risk PE patients that can safely be treated as outpatients. The advent of the direct‐acting oral anticoagulants such as rivaroxaban has made it easier than ever to manage patients outside of the hospital. This article describes the design of a randomized controlled trial aimed at testing the hypothesis that low‐risk PE patients can be safely and effectively managed at home using rivaroxaban, resulting in fewer days of hospitalization than standard‐of‐care treatment.

Methods

We have initiated a multicenter, open‐label, randomized clinical trial in which low‐risk adult PE patients (identified by the Hestia criteria) are randomized to outpatient management with oral rivaroxaban 15 mg twice daily for 21 days followed by 20 mg once daily for 90 days versus standard care, determined by the treating physician and based on local practices. The primary clinical endpoint will be the total number of inpatient hospital days (including the index admission) for venous thromboembolic or bleeding‐related events during the first 30 days after randomization. A total of 150 subjects per group will provide 82% power to detect a difference of 1 day or greater in the primary outcome.

Results

Patient enrollment is ongoing at present in 45 of 60 planned sites. No interim analysis is planned and the study is being monitored by a data safety management board.

Conclusions

The MERCURY PE study is designed to test the hypothesis that outpatient management of low‐risk PE patients with rivaroxaban reduces the number of hospitalization days from venous thromboembolism and bleeding compared with standard care. This article describes the rationale and methodology for this study.
Hospital Admissions Before an Alcohol‐Related Death Among Middle‐Aged Employed Men and Women: A Cohort Study Using Routine Data
Authors: Paljärvi Tapio , Martikainen Pekka , Vahtera Jussi , Leinonen Taina , Mäkelä Pia
Published: August 2016

Background

Due to lack of appropriate longitudinal data, relatively little is known about how and when persons who ultimately die due to alcohol‐related causes interact with hospitals during the years before death. Using routinely collected nationwide data, we aimed to establish the timing and causes of all hospitalizations during a 10‐year period before an alcohol‐related death.

Methods

We traced back the timing and causes of all hospitalizations occurring during a 10‐year period before death among men and women (n = 2,981) who were aged 35 and in employment at study entry, and who died from alcohol‐related causes at ages 45 to 54 in 1997 to 2007. The study data consisted of 80% of all persons living in Finland who died during the study period. Those who died at ages 45 to 54 without alcohol involvement were used as a reference group.

Results

Persons who ultimately died from alcohol‐related causes had on average 7 (mean 7.4, SD 9.9) hospital admissions, and they spent on average 56 days (mean 56.2, SD 105.1) in hospital during the study period. By the fifth year before death (from the year −10 to year −5), about three‐fifths of these persons had been hospitalized due to any cause at least once, but less than one‐third had a hospital admission with an alcohol‐related diagnosis. Those who died without alcohol involvement had an average 9 hospital admissions (mean 9.3, SD 11.2), and they spent on average 81 days (mean 81.2, SD 163.9) in hospital during the study period.

Conclusions

The majority of employed middle‐aged persons who ultimately died due to alcohol‐related causes interacted with hospitals frequently and already several years before death. Additional research is warranted to evaluate whether enhanced patient management at hospitals targeted to this population could potentially reduce alcohol‐related harms.
Making the hard work of recovery more attractive for those with substance use disorders
Authors: McKay James R.
Published: August 2016

Background

Research has led to improvements in the effectiveness of interventions for substance use disorders (SUD), but for the most part progress has been modest, particularly with regard to longer‐term outcomes. Moreover, most individuals with SUD do not seek out treatment.

Argument/analysis

This paper presents two recommendations on how to improve treatment engagement and long‐term outcomes for those with SUD. First, treatments should go beyond a focus on reducing or eliminating substance use to target greater access to and more time spent in experiences that will be enjoyable or otherwise rewarding to clients. Secondly, there must be sufficient incentives in the environment to justify the effort needed to sustain long‐term abstinence for individuals who often have limited access to such incentives.

Conclusions

To increase rates of long‐term recovery from substance misuse, treatments should link clients to reinforcers that will make continued abstinence more appealing. This work needs to extend beyond interventions focused on the individual or family to include the local community and national policy in an effort to incentivize longer‐term recoveries more strongly.
Anterior iris‐claw intraocular lens implantation for the management of nontraumatic ectopia lentis: long‐term outcomes in a paediatric cohort
Authors: Català‐Mora Jaume , Cuadras Daniel , Díaz‐Cascajosa Jesús , Castany‐Aregall Marta , Prat‐Bartomeu Joan , García‐Arumí José
Published: August 2016

Purpose

To report the feasibility and long‐term safety of lensectomy and iris‐claw intraocular lens (IOL) implantation to treat children with severe ectopia lentis in a paediatric tertiary hospital.

Methods

Prospective cohort study of 21 eyes from 12 patients with severe ectopia lentis and visual acuity <20/63. All eyes underwent 23‐gauge pars plana vitrectomy, lensectomy, iridectomy and Artisan IOL implantation in the anterior chamber with iris‐claw enclavation via pars plana. Mean age at surgery was 8.0 ± 5.3 yo (range 3–17 years). A full ophthalmologic examination including best‐corrected visual acuity (BCVA), biomicroscopy, intraocular pressure (IOP) measurement, fundus evaluation and central endothelial cell count (cECC) was performed pretreatment, at 3 months' postsurgery, and every 6 months thereafter. Ultrasound biomicroscopy (UBM) was performed 12 months after surgery.

Results

Mean follow‐up was 39.3 ± 13.0 months. Best‐corrected visual acuity (BCVA) (mean ± SD) improved from 0.91 ± 0.29 logMar preoperatively to 0.18 ± 0.23 logMar at final follow‐up (p < 0.0001). Mean distance from the endothelium to the anterior IOL surface after surgery was 3.11 ± 0.61 mm. Postsurgically, cECC loss was 5.04% ± 9.58% with an annual cECC loss rate of 3.16% ± 4.46%. One patient developed IOL dislocation and retinal detachment after severe ocular contusion requiring vitrectomy, IOL refixation and gas tamponade. Another patient developed cystoid macular oedema, managed with intravitreal dexamethasone.

Conclusion

This technique is both feasible and effective to manage severe ectopia lentis in children. Lifetime ophthalmic follow‐up including cECC measurement, IOL position monitoring and fundus examination is mandatory in these patients.
Changes in biomarkers during a six‐month oral immunotherapy intervention for cow's milk allergy
Authors: Salmivesi Susanna , Paassilta Marita , Huhtala Heini , Nieminen Riina , Moilanen Eeva , Korppi Matti
Published: August 2016

Aim

Oral immunotherapy (OIT) is a promising but still experimental method to treat children with cow's milk (CM) allergy (CMA). We evaluated changes in allergic, immunological and inflammatory parameters, which happened during the six‐month OIT for CMA.

Methods

We treated 28 school‐aged children with CMA using OIT with a double‐blind placebo‐controlled design. After the controlled study finished, the placebo group was treated with the same but open‐label OIT protocol. Sixteen immune variables were tested before and after the six‐month OIT.

Results

Before OIT, the median serum CM‐specific immunoglobulin (Ig) E was 18.0kIU/L in the intervention group and 9.4kIU/L in the placebo group (p = 0.46). At six months, interleukin (IL)‐6 and IL‐10 were significantly higher in the intervention group. When the changes during the blinded and open OIT were analysed together for both groups, blood eosinophils and serum total IgE decreased and milk‐specific IgG and IgG4, serum IL‐4 and IL‐6, and serum leptin and resistin increased significantly.

Conclusion

Preliminary evidence was found that markers of allergy such as blood eosinophils and serum IgE decreased and milk‐specific IgG and IgG4 increased during OIT. Adipokines, leptin and resistin, which functionally are cytokines linked to Th1‐type response, increased during OIT.
Down's syndrome is a risk factor for severe lower respiratory tract infection due to respiratory syncytial virus
Authors: Galleguillos Constanza , Galleguillos Bárbara , Larios Guillermo , Menchaca Gonzalo , Bont Louis , Castro‐Rodriguez Jose A.
Published: August 2016

Aim

Previous studies have suggested that Down's syndrome is an independent risk factor for severe respiratory infection due to respiratory syncytial virus (RSV). We compared the clinical characteristics of children with and without Down's syndrome hospitalised due to RSV.

Methods

This retrospective cohort study compared data from hospitalisations due to RSV lower respiratory tract infections (LRTI) in children under 14 years of age with (n = 58) and without (n = 58) Down's syndrome.

Results

The Down's group had longer hospital stays than the controls of six versus four days (p < 0.0001), even after adjusting for age, weeks of gestation at birth, presence of asthma, bronchopulmonary dysplasia, haemodynamically significant and nonsignificant congenital heart disease. This difference increased when only children under one year of age were analysed to 11 versus five days (p < 0.0001). Children with Down's syndrome were more likely to be admitted to intensive care unit (43.1% versus 22.4%, p = 0.017), need noninvasive mechanical ventilation (36.2% versus 13.7%, p = 0.005) and be prescribed antibiotics and steroids.

Conclusion

Children with Down's syndrome hospitalised due to RSV LRTI had longer hospital stays and worse clinical courses than controls, highlighting the need for RSV prophylaxis for children with Down's syndrome, especially under one year of age.
Upregulations of CRH and CRHR1 in the Epileptogenic Tissues of Patients with Intractable Infantile Spasms
Authors: Yang Xiao‐Lin , Chen Bing , Zhang Xiao‐Qing , Chen Xin , Yang Mei‐Hua , Zhang Wei , Chen Huan‐Ran , Zang Zhen‐Le , Li Wei , Yang Hui , Liu Shi‐Yong
Published: August 2016

Aim

Infantile spasms (IS) are an age‐specific epileptic syndrome with specific clinical symptom and electroencephalogram (EEG) features, lacking treatment options, and a poor prognosis. Excessive endogenous corticotropin‐releasing hormone (CRH) in infant brain might result in IS. However, the data from human IS are limited. In our study, we investigated the expressions of CRH and its receptor type 1 (CRHR1) in surgical tissues from patients with IS and autopsy controls.

Methods

Specimens surgically removed from 17 patients with IS, and six autopsy controls were included in the study. Real‐time PCR, Western blotting, and immunostaining were used to detect the expressions of mRNA, protein expression, and distribution. The correlation between variates was analyzed by Spearman rank correlation.

Results

The expressions of CRH and CRHR1 were significantly upregulated in the epileptogenic tissues of IS patients compared with the control group. CRH was distributed mainly in neurons, while CRHR1 was distributed in neurons, astrocytes, and microglia. The expression levels of CRH and CRHR1 were positively correlated with the frequency of epileptic spasms. Moreover, the expression of protein kinase C (PKC), which was an important downstream factor of CRHR1, was significantly upregulated in the epileptogenic tissues of patients with IS and was positively correlated with the CRHR1 expression levels and the frequency of epileptic spasms.

Conclusion

These results suggest that the CRH signal transduction pathway might participate in the epileptogenesis of IS, supporting the hypothesis that CRH is related to the pathogenesis of IS.
Cognitive and outcome measures seem suboptimal in children with cochlear implants – a cross‐sectional study
Authors: Udholm N. , Aaberg K. , Bloch C. , Sandahl M. , Ovesen T.
Published: August 2016

Objective

This study investigates whether cognition as a single variable significantly influences the hearing and speech outcomes of children with cochlear implants (CIs). More specifically, it identifies various types of cognitive disorders among children with CI, comparing these children's cognitive abilities to the outcomes of CI in terms of hearing and speech performance.

Study design

Cross‐sectional cognitive testing of children with CIs.

Setting

West Danish CI Centre, Aarhus University Hospital, Denmark.

Materials and methods

Fifty‐eight CI children underwent postoperative cognitive evaluation. Cognitive tests included Bayley Scales of Infant Development (Bayley‐III), Snijders‐Oomen Nonverbal Intelligence Test Revised (SON‐R) and Wechsler Intelligence Scale for Children, Fourth Edition (WISC‐IV), depending on the age of the child. Outcome measures of hearing and speech capacity after CI consisted of Categories of Auditory Performance (CAP), Speech Intelligibility Rating (SIR) and Peabody Picture Vocabulary Test‐4 (PPVT‐4).

Results

Only PPVT‐4 correlated significantly with cognition scores. Over time, the value of CAP and SIR seems limited by a pronounced ceiling effect.

Conclusion

The most widely used outcome tests after CI, that is CAP and SIR, may not reflect cognitive disabilities sufficiently due to pronounced ceiling effects. International guidelines suggesting a panel of robust age‐matched tests are warranted to optimise rehabilitation programmes as well as the counselling of parents.
Quality indicators of integrated care for patients with head and neck cancer
Authors: van Overveld L.F.J. , Braspenning J.C.C. , Hermens R.P.M.G.
Published: August 2016

Objectives

Oncological care is very complex, and delivery of integrated care with optimal alignment and collaboration of several disciplines is crucial. To monitor and effectively improve high‐quality integrated oncological care, a dashboard of valid and reliable quality indicators (QIs) is indispensable. The aim was to develop multidisciplinary QIs to measure quality of integrated oncological care, specifically for head and neck cancer (HNC) patients.

Design

The RAND‐modified Delphi method was used to decide on the outcome, process and structure QIs form three different perspectives. In addition, case‐mix factors were determined.

Setting

Integrated HNC in the Netherlands.

Participants

Head and neck cancer patients, chairmen of both patient organisations and medical specialists and allied health professionals involved in HNC care in the Netherlands.

Main outcome measures

Outcome, process and structure indicators.

Results

Outcome indicators were assigned to healthcare status, tumour recurrence, complications, quality of life and patient experiences. The process indicators focused on the (allied health) care aspects during the diagnostic, treatment and follow‐up phases, for example regarding waiting times, multidisciplinary team meetings and screening for the need of allied health care.

Conclusions

This is the first set of multidisciplinary QIs for HNC care, to assess quality of integrated care agreed by patients and professionals. This set can be used to build other oncological quality dashboards for integrated care.
A Short Note on the Net Stable Funding Ratio Requirement with Endogenous Money
Authors: Kauko Karlo
Published: August 2016

The Net Stable Funding Ratio (NSFR) regulation stipulates that banks’ available stable funding shall be at least equal to the required stable funding. This should reduce banks’ liquidity risks. In the current monetary system, deposit money is created by lending, but the NSFR requirement restricts the possibilities to grant loans, limiting the availability of stable funding. In a closed economy, this contradiction poses no macroeconomic problems. However, the outcome may be unstable if there is a substantial amount of foreign debt financed via the international interbank market; a minor shock can have a drastic impact on loan and deposit stocks.
Reducing falls in Parkinson's disease: interactions between donepezil and the 5‐HT6 receptor antagonist idalopirdine on falls in a rat model of impaired cognitive control of complex movements
Authors: Kucinski Aaron , de Jong Inge E. M. , Sarter Martin
Published: August 2016

Falls are a leading cause of death in the elderly and, in a majority of patients with Parkinson's disease (PD), the leading levodopa‐insensitive cause of hospitalization and long‐term care. Falling in PD has been attributed to degeneration of forebrain cholinergic neurons that, in interaction with striatal dopamine losses, impairs the cognitive control of balance, gait, and movement. We previously established an animal model of these dual cholinergic–dopaminergic losses (“DL rats”) and a behavioral test system (Michigan Complex Motor Control Task, MCMCT) to measure falls associated with traversing dynamic surfaces and distractors. Because the combined treatment of the acetylcholinesterase inhibitor donepezil and the 5‐HT6 receptor antagonist idalopirdine (Lu AE58054) was reported to exhibit synergistic pro‐cholinergic activity in rats and improved cognition in patients with moderate Alzheimer's disease, here we assessed the effects of this treatment on MCMCT performance and attention in DL rats. Compared with the vehicle‐treated group, the combined treatment greatly reduced (Cohen's d = 0.96) falls in DL rats when traversing dynamic surfaces and when exposed to a passive distractor. However, falls associated with a dual task distractor and sustained attentional performance did not benefit from this treatment. Analyses of the behavior in fall‐prone moments suggested that this treatment improved the efficacy and speed of re‐instating forward movement after relatively short stoppages. This treatment may reduce fall propensity in PD patients via maintaining planned movement sequences in working memory and improving the vigor of executing such movements following brief periods of freezing of gait.
Sweden, the first country to achieve the Joint United Nations Programme on HIV/AIDS (UNAIDS)/World Health Organization (WHO) 90‐90‐90 continuum of HIV care targets
Authors: Gisslén M , Svedhem V , Lindborg L , Flamholc L , Norrgren H , Wendahl S , Axelsson M , Sönnerborg A
Published: August 2016

Objectives

The Joint United Nations Programme on HIV/AIDS (UNAIDS)/World Health Organization (WHO) 90‐90‐90 goals propose that 90% of all people living with HIV should know their HIV status, 90% of those diagnosed should receive antiretroviral therapy (ART), and 90% of those should have durable viral suppression. We have estimated the continuum of HIV care for the entire HIV‐1‐infected population in Sweden.

Methods

The Swedish InfCare HIV Cohort Study collects viral loads, CD4 counts, and viral sequences, along with demographic and clinical data, through an electronic clinical decision support system. Almost 100% of those diagnosed with HIV infection are included in the database, corresponding to 6946 diagnosed subjects living with HIV‐1 in Sweden by 31 December 2015.

Results

Using HIV surveillance data reported to the Public Health Agency of Sweden, it was estimated that 10% of all HIV‐infected subjects in Sweden remain undiagnosed. Among all diagnosed patients, 99.8% were linked to care and 97.1% of those remained in care. On 31 December 2015, 6605 of 6946 patients (95.1%) were on ART. A total of 6395 had been on treatment for at least 6 months and 6053 of those (94.7%) had a viral load < 50 HIV‐1 RNA copies/mL.

Conclusions

The 2014 UNAIDS/WHO 90‐90‐90 goals for HIV care means that > 73% of all patients living with HIV should be virologically suppressed by 2020. Sweden has already achieved this target, with 78% suppression, and is the first country reported to meet all the UNAIDS/WHO 90‐90‐90 goals.
Detained and Distressed: Persistent Distressing Symptoms in a Population of Older Jail Inmates
Authors: Bolano Marielle , Ahalt Cyrus , Ritchie Christine , Stijacic‐Cenzer Irena , Williams Brie
Published: August 2016

Distressing symptoms are associated with poor function, acute care use, and mortality in older adults. The number of older jail inmates is increasing rapidly, prompting calls to develop systems of care to meet their healthcare needs, yet little is known about multidimensional symptom burden in this population. This cross‐sectional study describes the prevalence and factors associated with distressing symptoms and the overlap between different forms of symptom distress in 125 older jail inmates in an urban county jail. Physical distress was assessed using the Memorial Symptom Assessment Scale. Several other forms of symptom distress were also examined, including psychological (Generalized Anxiety Disorder Scale, Patient Health Questionnaire), existential (Patient Dignity Inventory), and social (Three Item Loneliness Scale). Information was collected on participant sociodemographic characteristics, multimorbidity, serious mental illness (SMI), functional impairment, and behavioral health risk factors through self‐report and chart review. Chi‐square tests were used to identify factors associated with physical distress. Overlap between forms of distress was evaluated using set theory analysis. Overall, many participants (74%) reported distressing symptoms, including having one or more physical (44%), psychological (37%), existential (54%), or social (45%) symptoms. Physical distress was associated with poor health (multimorbidity, functional impairment, SMI) and low income. Of the 93 participants with any symptom, 49% reported three or more forms of distress. These findings suggest that an optimal model of care for this population would include a geriatrics–palliative care approach that integrates the management of all forms of symptom distress into a comprehensive treatment paradigm stretching from jail to the community.
Victor P. Whittaker (1919–2016)
Authors: Zimmermann Herbert , Fonnum Frode
Published: August 2016

image

This Obituary honors Victor P. Whittaker, one of the pioneers in the field of neurochemistry. Victor Whittaker died on 5th July 2016 aged 97 in Cambridge (UK) after a short illness. Victor is best known for his landmark advances in the subcellular fractionation of brain tissue which led to the isolation of synaptosomes and subsequently synaptic vesicles at the beginning of the 1960s and for the cellular and molecular analysis of the cholinergic synapse.
Implementing Dementia Care Mapping to develop person‐centred care: results of a process evaluation within the Leben‐QD II trial
Authors: Quasdorf Tina , Riesner Christine , Dichter Martin Nikolaus , Dortmann Olga , Bartholomeyczik Sabine , Halek Margareta
Published: August 2016

Aims and objectives

To evaluate Dementia Care Mapping implementation in nursing homes.

Background

Dementia Care Mapping, an internationally applied method for supporting and enhancing person‐centred care for people with dementia, must be successfully implemented into care practice for its effective use. Various factors influence the implementation of complex interventions such as Dementia Care Mapping; few studies have examined the specific factors influencing Dementia Care Mapping implementation.

Design

A convergent parallel mixed‐methods design embedded in a quasi‐experimental trial was used to assess Dementia Care Mapping implementation success and influential factors.

Methods

From 2011–2013, nine nursing units in nine different nursing homes implemented either Dementia Care Mapping (n = 6) or a periodic quality of life measurement using the dementia‐specific instrument QUALIDEM (n = 3). Diverse data (interviews, n = 27; questionnaires, n = 112; resident records, n = 81; and process documents) were collected. Each data set was separately analysed and then merged to comprehensively portray the implementation process.

Results

Four nursing units implemented the particular intervention without deviating from the preplanned intervention. Translating Dementia Care Mapping results into practice was challenging. Necessary organisational preconditions for Dementia Care Mapping implementation included well‐functioning networks, a dementia‐friendly culture and flexible organisational structures. Involved individuals’ positive attitudes towards Dementia Care Mapping also facilitated implementation. Precisely planning the intervention and its implementation, recruiting champions who supported Dementia Care Mapping implementation and having well‐qualified, experienced project coordinators were essential to the implementation process.

Conclusions

For successful Dementia Care Mapping implementation, it must be embedded in a systematic implementation strategy considering the specific setting. Organisational preconditions may need to be developed before Dementia Care Mapping implementation. Necessary steps may include team building, developing and realising a person‐centred care‐based mission statement or educating staff regarding general dementia care. The implementation strategy may include attracting and involving individuals on different hierarchical levels in Dementia Care Mapping implementation and supporting staff to translate Dementia Care Mapping results into practice.

Relevance to clinical practice

The identified facilitating factors can guide Dementia Care Mapping implementation strategy development.
Can a community‐based peer‐led diabetic self‐management programme be effective: 12‐week evaluation
Authors: Shen Huixia , Wang Yanbo , Edwards Helen
Published: August 2016

Aims and objectives

To evaluate a self‐management programme collaborating with communities and mobilising peer leaders for patients with diabetes in mainland China.

Background

The rapidly increasing diabetic epidemic is an overwhelming burden in China. Diabetic self‐management programmes that are both effective and feasible despite health resource shortages should be developed and evaluated.

Design

Quasi‐experimental.

Methods

In total, 181 patients with diabetes completed the study (89 in the experimental group and 92 in the control group). Diabetic instruction and peer‐led group activities were two major parts of the programme. Outcome variables, including self‐efficacy, social support, self‐management behaviours and quality of life, were measured. Participants' perceptions towards the programme were also collected. anova/ancova and content analysis were used for data analysis.

Results

Social support, self‐efficacy and self‐management behaviours significantly improved during the study period. Although quality of life did not change significantly, the participants provided positive feedback for the programme.

Conclusions

The effectiveness of this programme was partially verified. The delivery mode, through trained peer leaders and collaboration with communities, appeared to be feasible. Using a cluster randomised controlled design with full cost‐effectiveness analysis would provide a more rigorous examination for this programme.

Relevance to clinical practice

This study adds to the growing evidence of the importance of self‐efficacy and social support as a mechanism for achieving behavioural change. This programme appears to be promising in promoting diabetic self‐management in China and may be applied to individuals with other chronic diseases and dwelling in other regions.
ManLMN is a glucose transporter and central metabolic regulator in Streptococcus pneumoniae
Authors: Fleming Eleanor , Camilli Andrew
Published: August 2016

Streptococcus pneumoniae is a common colonizer of the human nasopharynx and a leading cause of bacterial pneumonia and otitis media, among other invasive diseases. During both colonization and invasive disease S. pneumoniae ferments host‐derived carbohydrates as its primary means of generating energy. This pathogen is adept at transporting and metabolizing a wide variety of carbohydrates. We found the highly conserved PTS ManLMN contributes to growth on glucose and is also essential for growth on a variety of nonpreferred carbohydrates, suggesting it is a multisubstrate transporter. Exploration of this phenotype revealed ManLMN is required for inducing expression of downstream metabolic genes in response to carbohydrate stimuli. We further demonstrate that ManLMN's role as a constitutively expressed transporter is likely unique and integral to pneumococcus's strategy of carbon catabolite repression (CCR). Using a selection for suppressors, we explored how ManLMN is integrated into the CCR regulatory framework in S. pneumoniae. We identified two hypothetical small proteins and the virulence regulator SmrC as potential mediators of CCR in connection with ManLMN. Characterization of these two hypothetical proteins revealed they influence transcriptional regulation of carbohydrate transporters. We propose a model unifying these observations in which ManLMN is a versatile surveyor of available carbohydrates in S. pneumoniae.
The Significance of Significant Fundamental Moral Disagreement1
Authors: COSKER‐ROWLAND RACH
Published: August 2016

This paper has four parts. In the first part I argue that moral facts are subject to a certain epistemic accessibility requirement. Namely, moral facts must be accessible to some possible agent. In the second part I show that because this accessibility requirement on moral facts holds, there is a route from facts about the moral disagreements of agents in idealized conditions to conclusions about what moral facts there are. In the third part I build on this route to show that (*) if there is significant moral disagreement in idealized conditions, then our understanding of morality is fatally flawed and we should accept relativism over non‐naturalism and quasi‐realism. So, if, like many, you think that there would be significant moral disagreement in idealized conditions, you should hold that our understanding of morality is fatally flawed and reject non‐naturalism and quasi‐realism. In the fourth part of this paper I show that (*) undermines the plausibility of non‐naturalism, quasi‐realism, and the view that our understanding of morality is not fatally flawed even if we do not have sufficient reason to believe that there would be significant moral disagreement in idealized conditions.
Association between perinatal outcomes and maternal pre‐pregnancy body mass index
Authors: Liu P. , Xu L. , Wang Y. , Zhang Y. , Du Y. , Sun Y. , Wang Z.
Published: August 2016

Objective

To quantify the association between maternal pre‐pregnancy body mass index (BMI) and perinatal outcomes.

Methods

We systematically reviewed and collected studies on maternal pre‐pregnancy BMI and perinatal outcomes published up to 31 August 2015. For each study, we constructed separate two‐by‐two tables to calculate the odds ratios (ORs) and 95% confidence intervals (CI).

Results

A total of 60 studies involving 1,392,799 women were included, and the proportions of obesity, overweight, normal weight and underweight pregnant women were 11.72%, 22.08%, 58.03% and 8.18%, respectively. When mothers were overweight or obese, their infants had a significantly higher risk of being large for gestational age (OR, 1.45, 95%CI, 1.29–1.63 and 1.88, 95%CI, 1.67–2.11, respectively), having macrosomia (OR, 1.70, 95%CI, 1.55–1.87 and 2.92, 95%CI, 2.67–3.20, respectively), being admitted to the neonatal intensive care unit (OR, 1.29, 95%CI, 1.12–1.48 and 1.91, 95%CI, 1.60–2.29, respectively) and being stillborn (OR, 1.27, 95%CI, 1.18–1.36 and 1.81, 95%CI, 1.69–1.93, respectively). When mothers were underweight, their infants had a lower risk of the aforementioned outcomes. However, mothers who were underweight had a higher risk of preterm birth (OR, 1.30, 95%CI, 1.13–1.49) and delivering an infant small for gestational age (OR, 1.67, 95%CI, 1.49–1.87). Importantly, infants had a higher risk of having a low birth weight (LBW) when their mothers were underweight (OR, 1.67, 95%CI, 1.39–2.02) or obese (OR, 1.24, 95%CI, 1.09–1.41).

Conclusion

Being overweight or obese was associated with an increased risk of still birth, large for gestational age, macrosomia, admission to the neonatal intensive care unit and LBW, while being underweight was associated with an increased risk of preterm birth, small for gestational age, and LBW. Women of childbearing age should maintain a normal body mass index before pregnancy.
Genetic variants of 20q12 contributed to non‐syndromic orofacial clefts susceptibility
Authors: Yin X , Ma L , Li Y , Xu M , Wang W , Wang H , Yuan H , Du Y , Li S , Ma J , Jiang H , Wang L , Zhang W , Pan Y
Published: August 2016

Objective

Previous genomewide association studies (GWAS) identified a region near MAFB at chr20q12 associated with non‐syndromic orofacial clefts (NSOC) susceptibility. However, whether other SNPs in this area could independently contribute to non‐syndromic orofacial clefts in Chinese populations remained obscure.

Materials and Methods

We selected 24 SNPs based on a haplotype‐tagging SNP strategy and evaluated their associations with risk of non‐syndromic orofacial clefts in a large‐scale two‐stage case–control study with 1278 cases and 1295 controls. Genotyping was performed with Sequenom and TaqMan assay. Associations between the SNPs and risk of non‐syndromic orofacial clefts were estimated from unconditional logistic regression analyses.

Results

Overall, six SNPs were found to be the susceptible factors of non‐syndromic orofacial clefts. The most significant and independent SNP was rs6129653 (additive model of P value = 1.4E‐06). In subgroup analysis, its significant associations with cleft lip only (CLO) and cleft lip and palate (CLP) were observed. Furthermore, in silico bioinformatics analysis indicated that rs6129653 was located in the transcriptionally active region and associated with MAFB expression in human brain tissues.

Conclusions

Rs6129653 was an independent locus of non‐syndromic orofacial clefts among Chinese populations possibly due to its potential of distal transcriptional regulation of MAFB expression.
Total internal biliary diversion during liver transplantation for type 1 progressive familial intrahepatic cholestasis: a novel approach
Authors: Mali V. P. , Fukuda A. , Shigeta T. , Uchida H. , Hirata Y. , Rahayatri T. H. , Kanazawa H. , Sasaki K. , de Ville de Goyet J. , Kasahara M.
Published: August 2016

LT for PFIC type 1 is often complicated by postoperative diarrhea and recurrent graft steatosis. A 26‐month‐old female child with cholestatic jaundice, pruritus, diarrhea, and growth retardation revealed total bilirubin 9.1 mg/dL, gamma‐glutamyl transpeptidase 64 IU/L, and TBA 295.8 μmol/L. Genetic analysis confirmed ATP8B1 defects. A LT (segment 2, 3 graft) from the heterozygous father was performed. Biliary diversion was performed by a 35‐cm jejunum conduit between the graft hepatic duct and the mid‐transverse colon. Stools became pigmented immediately. Follow‐up at 138 days revealed resolution of jaundice and pruritus and soft‐to‐hard stools (6–8 daily). Radioisotope hepato‐biliary scintigraphy (days 26, 68, and 139) confirmed unobstructed bile drainage into the colon (t1/2 34, 27, and 19 minutes, respectively). Contrast meal follow‐through at day 62 confirmed the absence of any colo‐jejuno‐hepatic reflux. At 140 days, contrast follow‐through via the biliary stent revealed patent jejuno‐colonic anastomosis and satisfactory transit. Graft biopsy at LT, 138 days, and 9 months follow‐up revealed comparable grades of macrovesicular steatosis (<20%). TIBD during LT may be a clinically effective stoma‐free biliary diversion and may prevent recurrent graft steatosis following LT for PFIC type 1.
Satisfaction with the Political Domain of Local Government in a Contemporary British City
Authors: Broadstock David C. , Collins Alan
Published: August 2016

This paper explores satisfaction with the political domain of local government performance, using survey data from a contemporary British city as the empirical context. It employs a factor‐augmented ordered logit analysis of data emerging from a representative city‐wide series of over 1,000 household interviews. Affective reactions to local economic performance and policy effectiveness are constructed in the spirit of the approach used in earlier work by social scientists. The key significant influences that raise or depress satisfaction at this geographical level are presented. Affective reactions to past policy and the economy are both shown to be statistically significant, but with reactions to the economy being negative while those for other policy reactions seemingly positive.
Multiscale Simulations of Anisotropic Grain Growth Using Wavelet Based Multiresolution Analysis
Authors: Allen J. B.
Published: August 2016

The present work serves to document the development and findings associated with a wavelet-based multiscale simulation analysis for anisotropic grain growth of a two-dimensional polycrystalline material. In particular, lattice-based Monte Carlo and atomically-based Molecular Dynamics simulations are used to compute the grain boundary energies over their respective spatial domains. Serial coupling is performed utilizing an orthonormal set of Haar wavelet transforms embedded within a corresponding multiresolution analysis. For the Monte Carlo approach, anisotropies in grain boundary energies, caused by differences in grain orientation (texturing), are examined using two distinct methods, while the molecular dynamics simulations, offering inherent anisotropy, are conducted assuming the interatomic Lennard Jones potential. Among other findings, under the present context, the results confirm the viability of the wavelet-based multiresolution analysis (MRA) method for use as a potential coupling agent, and provide substantiation for its use with other applications. The results further offer quantitative comparisons between isotropic and anisotropic modeling results, and demonstrate their range of applicability.
A Geometrically Exact Contact Model for Polytopes in Multirigid-Body Simulation
Authors: Williams Jedediyah , Lu Ying , Trinkle J. C.
Published: August 2016

We present a formulation of nonpenetration constraint between pairs of polytopes which accounts for all possible combinations of active contact between geometric features. This is the first formulation that exactly models the body geometries near points of potential contact, preventing interpenetration while not overconstraining body motions. Unlike many popular methods, ours does not wait for penetrations to occur as a way to identify which contact constraints to enforce. Nor do we overconstrain by representing the free space between pairs of bodies as convex, when it is in fact nonconvex. Instead, each contact constraint incorporates all feasible potential contacts in a way that represents the true geometry of the bodies. This ensures penetration-free, physically correct configurations at the end of each time step while allowing bodies to accurately traverse the free space surrounding other bodies. The new formulation improves accuracy, dramatically reduces the need for ad hoc corrections of constraint violations, and avoids many of the inevitable instabilities consequent of other contact models. Although the dynamics problem at each time step is larger, the inherent stability of our method means that much larger time steps can be taken without loss of physical fidelity. As will be seen, the results obtained with our method demonstrate the effective elimination of interpenetration, and as a result, correction-induced instabilities, in multibody simulations.
Discrete Sliding Mode Adaptive Vibration Control for Space Frame Based on Characteristic Model
Authors: Zhong Hua , Wang Qing , Yu Jun-hong , Wei Yi-heng , Wang Yong
Published: August 2016

A novel characteristic model-based discrete adaptive sliding mode control (SMC) scheme is proposed for vibration attenuation of the space frame. First, this paper establishes a characteristic model as real time model for the space structure. The characteristic model is simple and accurate. Furthermore, a novel discrete sliding mode control strategy is proposed with low chattering and strong robustness. In addition, the stability of the closed-loop control system is proved. Finally, simulation results show the effectiveness and strong robustness of the proposed scheme.
A Comparison of Network-Based Metrics of Behavioral Degradation in Complex Engineered Systems
Authors: Haley Brandon M. , Dong Andy , Tumer Irem Y.
Published: August 2016

It has been assumed, but not yet tested, that the topological disintegration of networks is relatable to degradations in complex engineered system behavior and that extant network metrics are capable of capturing these degradations. This paper tests three commonly used network metrics used to quantify the topological robustness of networks for their ability to characterize the degree of failure in engineered systems: average shortest path length, network diameter, and a robustness coefficient. A behavioral network of a complex engineered system is subjected to “attack” to simulate potential failures to the system. Average shortest path length and the robustness coefficient showed topological disintegration patterns which differed between nominal and failed cases, regardless of failure implementation location. The network diameter metric is not sufficiently dependent on local cluster topology to show changes in topology with edge removal failure strategies. The results show that topological metrics from the field of complex networks are applicable to complex engineered systems when they account for both local and global topological changes.
The Effect of Rotor Casing on Low-Pressure Steam Turbine and Diffuser Interactions
Authors: Singh Gursharanjit , Wheeler Andrew P. S. , Singh Gurnam
Published: August 2016

The present study aims to investigate the interaction between a last-stage steam turbine blade row and diffuser. This work is carried out using computational fluid dynamics (CFD) simulations of a generic last-stage low-pressure (LP) turbine and axial–radial exhaust diffuser attached to it. In order to determine the validity of the computational method, the CFD predictions are first compared with data obtained from an experimental test facility. A computational study is then performed for different design configurations of the diffuser and rotor casing shapes. The study focuses on typical flow features such as effects of rotor tip leakage flows and subsequent changes in the rotor–diffuser interactions. The results suggest that the rotor casing shape influences the rotor work extraction capability and yields significant improvements in the diffuser static pressure recovery.