bluuebunny/crossref_metadata_2025 huggingface dataset:
Exercising identity: agency and narrative in identity management
Authors: Van Zoonen Liesbet , Turner Georgina
Published: July 2014

Purpose

– The purpose of this paper is to address the paradox in identity management that sees people happily sharing personal information in some circumstances, such as via social networks, yet defending their right to privacy in others, such as in interactions with the state. The authors examine the predominant explanations and elaborate how these ignore the different types of individual acts and agency involved in identity management. The authors conclude with a proposal to consider alternative, narrative approaches to identity management (IM).

Design/methodology/approach

– This paper has been developed out of the empirical research examining public responses to new forms of IM, based on, among other things, Delphi interviews with experts, films and television series and survey and focus group data about people's feelings and attitudes. The authors have combined these data into an approach that theorises rather than reports about public engagements with IM.

Findings

– Finding any explanation for the paradox that rests on the distinction between state and commercial contexts to be less and less satisfactory, the paper reframes the problem as one of varying degrees of agency, from submission to transaction and expression. The latter, the authors argue, has been written out of modern IM, which is at odds with the centrality of narrative to the human sense of self.

Originality/value

– The field of IM has yet to consider “identity” in terms beyond distinct attributes and bits of information. In this paper the authors set out to demonstrate the value of a notion of IM that is sensitive to degrees of agency and the authors ask how the fundamental human desire to narrate the self might become a part of IM systems.
Information is provisional
Authors: Chapman David
Published: July 2014

Purpose

– The purpose of this paper is to contribute to a transdisciplinary understanding of the nature of information.

Design/methodology/approach

– The work draws from previous work done on information in several disciplines and contexts, and proposes a new framework for describing and understanding information. It applies the framework to several different situations involving information, explores the insights revealed by the use of the framework and discusses some of the implications.

Findings

– Information is usefully described as a situated event that extracts or generates meaning, with the distinction between extracting or generating meaning corresponding to the distinction between semantic and environmental information. A diagrammatic convention based on communications theory and making use of hierarchies of levels is found to provide a powerful means of conveying many of the aspects of the nature of information, and of understanding the role of information in a wide range of applications. An additional specific finding of the work is that information is inherently provisional.

Originality/value

– The diagrammatic framework is a new way of presenting, describing and understanding information, and the suggestion that information is inherently provisional is believed to be new.
Leader emergence: the development of a theoretical framework
Authors: I. Norton Jr William , L. Ueltschy Murfield Monique , S. Baucus Melissa
Published: July 2014

Purpose

– The purpose of this paper is to develop a theoretical framework to explain how leaders emerge in teams that lack a hierarchical structure. This framework emphasizes the perceptual processes through which team members determine whether or not an individual fits with the task, the group, and the situational context.

Design/methodology/approach

– This paper builds on prior leadership research to develop a theoretical framework of emergent leadership, a testable model, and research propositions.

Findings

– The authors suggest that team members’ perceptions of leadership fit depend on the potential leader's domain competence, fluid intelligence, willingness to serve, credibility, and goal attainment. A conceptual framework is developed to suggest these attributes combine to create perceptions of leadership fit that must correspond to the degree of stress in the situational context, which varies according to task criticality and time compression. The framework suggests that an individual perceived by team members to exhibit characteristics that fit with the situation will likely emerge as the leader.

Research limitations/implications

– This paper focusses on emergent leadership, but does not address which path to leadership may be best. Future research may also address group dynamics (i.e. cohesion or group potency) and the implications for leader emergence.

Originality/value

– This research contributes to the discipline by suggesting a potential path of leader emergence in multiple contexts of situational stress and leader behaviors.
Predicting methane emissions from livestock in Malaysia using the ARIMA model
Authors: O. Yusuf Rafiu , Zainon Noor Zainura , Halilu Abba Ahmad , Ariffin Abu Hassan Mohd , Rafee Majid Mohammed , Idris Medugu Nasiru
Published: July 2014

Purpose

– The purpose of this paper is to compute the amount of methane generated from the waste of livestock from 1980 to 2008; then use the information in forecasting subsequent methane emissions by the sector in Malaysia from 2009 to 2020.

Design/methodology/approach

– The research study employed two approaches; computing methane emissions from 1980 to 2008 using the IPCC guidelines, and forecasting methane emissions for the animals from 2009 to 2020 using the autoregressive integrated moving average (ARIMA) model from the predictive analysis software (PASW-SPSS 18.0).

Findings

– Methane emissions from cattle, buffaloes and pigs accounted for over 95 per cent of total emissions and emissions from cattle are predicted to increase from 67.0 Gg in 2009 to 77.0 Gg by 2020. Emissions from the others will not be appreciable although poultry emissions will rise to 11.0 Gg by 2020. Attempt by the Malaysian Government to increase cattle production is not necessary at the moment as protein requirement has been met.

Research limitations/implications

– ARIMA model suffers from linear and data limitation: the future value of a variable assumed to be a linear function of several past observations in ARIMA is sometimes unrealistic. Large amounts of historical data are needed in ARIMA models in order to get desired results. The inventory of the animals was taken from 1980 to 2008.This needs to be improved upon by updating it to cover up to 2011 so that the forecast will start from 2012.

Practical implications

– The chosen ARIMA method has demonstrated its correctness in being adequate as a predicting tool for animal methane emissions. Policy makers can apply it so as to take practical steps to avoid these emissions.

Originality/value

– This is a novice idea as animal methane emission forecasting tool. This model will be of immense use and help in predicting methane emissions from livestock.
Recovery, turning points and forensics: views from the ward in an English high secure facility
Authors: Chandley Mark , Rouski Michael
Published: July 2014

Purpose

– The authors offer up an example of recovery in a high-secure setting. The purpose of this paper is to highlight how an individual account of recovery and the academic literature offer up related and important perspectives that have serious clinical utility.

Design/methodology/approach

– First the context is outlined. The biographical account is then deployed to describe the experience of being detained in an English high-secure facility using recovery as a framework for elucidation. This is often referred to in recovery as accessing the views of the “expert by experience”. In a thematic way this author details his understanding of recovery, what worked and what did not. This account is then contrasted with the academic literature and research at the same site. Social anthropology acts as the theoretical backdrop. This debate informs some clinical implications and issues for practice.

Findings

– Recovery can be a highly relevant concept in a high-secure context. The author found that the biographical account of the “patient” can offer the observer some insights for practice. The authors noted that the collective themes of previous research where consistent to this account. The authors found the use of recovery principles helped the person receiving care fulfil his potential. Nevertheless, forensic recovery implies a forensic past. This complicates recovery and placed limits on the own use of the principles.

Social implications

– The authors argue that recovery is highly relevant to the context and particularly important to people who are often stigmatized for multiple reasons including their, “illness”, their “crime”, and their social situation. The paper implies that forensic recovery is more problematic than mainstream recovery. Key events mark out issues.

Originality/value

– This is the first co-produced paper surrounding recovery in high-secure care.
A day in the life of a peer support worker: a visit
Authors: Watson Emma
Published: July 2014

Purpose

– The purpose of this paper is to provide an insight into a day in the life of a peer support worker (PSW).

Design/methodology/approach

– Narrative account of a visit written from the perspective of a PSW.

Findings

– Reflective account, no findings presented.

Originality/value

– An original viewpoint from the perspective of a PSW in a one-to-one setting, very little has previously been published using this approach.
Gastronomy: an approach to studying food
Authors: Maberly Charlotte , Reid Donald
Published: July 2014

Purpose

– The purpose of this paper is to outline the curriculum of the UK’s first MSc in Gastronomy. The programme supports an interdisciplinary approach to understanding food not yet commonly found in academia or beyond. However, it is increasingly recognized that such a perspective, as fostered by the MSc Gastronomy, may be key in effectively addressing complex contemporary problems within food culture and food systems.

Design/methodology/approach

– This is a viewpoint paper that explains the rationale behind the chosen definition of Gastronomy, the context that inspired creation of the programme, an outline of the programme structure and justification of content.

Findings

– The underpinning philosophy stems from a conviction that to address problems of corrupt food systems and problematic societal foodways, a more comprehensive understanding of food is needed. The programme seeks to cultivate this with a truly interdisciplinary approach to the study of food culture and food systems. This approach is recognized as an underrepresented area in academia where the study of food currently tends to be compartmentalized; a reductionist approach also mirrored within politics, commerce and our everyday lives. The MSc Gastronomy investigates how to foster and make commonplace, a more holistic and realistic understanding of food.

Originality/value

– The MSc Gastronomy has been shaped by an understanding that a more comprehensive knowledge of food is required if contemporary problems within the food system are to be effectively addressed. To achieve this, the programme adopts an interdisciplinary approach to studying food only upheld by a small number of other academic institutions. It is the first of its kind in the UK, responding most closely to the specific cultural and political dynamics of Scotland’s food culture.
Stimulus-based inferences about the scientific substantiation of health claims on food
Authors: V. Dobrenova Fanny , Terlutter Ralf , Grabner-Kräuter Sonja
Published: July 2014

Purpose

– This paper aims to examine the effects of qualifying language, functional ingredient, ingredient familiarity and inferences of manipulative intent (IMI) on the likelihood that consumers make stimulus-based inferences about the level of scientific support for health claims on food.

Design/methodology/approach

– An advertisement copy test for a fictitious product bearing a caries risk-reduction claim has been conducted. The test design comprises three claim conditions, each corresponding to one of the sufficient levels of support for nutrient-health relations within the World Health Organization (WHO)-framework.

Findings

– The claim conditions have affected the likelihood of making stimulus-based inferences, which is lower for high-level-of-support claims as opposed to low-level-of-support and moderate-level-of-support claims. No effect of ingredient familiarity has been observed. The effect of the functional ingredient featured is significant at the 10 per cent-level. IMI has a negative effect on the likelihood of making a stimulus-based inference.

Research limitations/implications

– The survey relies on a demographically homogeneous sample.

Practical implications

– Examining the likelihood of stimulus-based inferences about health claim substantiation is essential for assessing the effectiveness of claim formulations and for addressing resulting miscommunication.

Originality/value

– The current paper addresses the research gap on consumer ability to identify the level of support for health claims within the European context.
Culinary-gastronomic tourism – a search for local food experiences
Authors: Björk Peter , Kauppinen-Räisänen Hannele
Published: July 2014

Purpose

– The purpose of this article is to focus on travellers’ perceptions of culinary-gastronomic sensations as experiences and how these relate to the locality. The aim of the study is to explore the factors that contribute to travellers’ culinary-gastronomic dining experiences with an emphasis on the local food markets.

Design/methodology/approach

– One-hundred and fifty-eight prospective travelers at an annual fair in Helsinki completed a self-administered survey questionnaire. On the questionnaire, the respondents were asked to rate the importance of 17 items related to eating and food experiences when deciding on a destination for their next leisure trip.

Findings

– The findings reveal a frequency distribution of the sample characteristics and travel behavior, the respondents’ use of food and eating experiences as evaluative criteria when choosing travel destinations and latent factors of food and eating experiences. Based on an explorative factor analysis using a varimax abstraction method, the study concludes that eating and food experiences are influenced by the overall service (i.e. the food and where it is served and the dining setting and how it is served). The factors show that culinary-gastronomic food experiences are founded on local, original and authentic food that represents the local food culture.

Practical implications

– The study attempts to provide insights into aspects to consider for promotional activities related to local food and, ultimately, as a means for destination branding. The Finnish sample has a casual attitude to food, where new but also rather mundane experiences are sought. Accordingly, slow food preparation and atmospherics contribute to local food experiences that may lure travelers to revisit certain locations.

Originality/value

– Local food as a means of culinary-gastronomic sensations deserves scholarly attention, as many questions related to its consumption by tourists remain unanswered. Accordingly, the topic of the current study is truly timely and this research contributes by studying a rather unchartered issue.
The relationship between stock prices and exchange rates in Asian markets
Authors: Billah Dar Arif , Shah Aasif , Bhanja Niyati , Samantaraya Amaresh
Published: July 2014

Purpose

– The purpose of this paper is to estimate the relationship between stock prices and exchange rates of eight Asian countries. The analysis is based on methodologies that possess the ability to provide a complete representation of data series from both time and frequency perspectives simultaneously. In addition, instead of limiting the analysis to focus on the conditional mean of the response variable y in the regression equation, the authors investigate the extremes of distribution to reveal a range of hidden relationships between these variables.

Design/methodology/approach

– Given the limitations of classical methodology of Pearson correlation and least-squares regression, this study estimates the relationship between stock prices and exchange rates through wavelet correlation and cross-correlation to serve as a protocol for different traders who view the market with different time resolutions. In addition, quantile regression technique robust to heteroscedasticity, skewness and leptokurtosis is used to understand the relationship between stock prices and a specified quantile of the exchange rates.

Findings

– In accordance with the portfolio balance effect, it is observed that stock prices and exchange rates are negatively correlated at all frequencies. In particular, the negative correlation grows with higher time scales (lower frequency intervals). The findings from quantile regression also suggest that the coefficients are more inclined to be negative when exchange rates are extremely high.

Originality value

– The paper contributes to the literature by focussing on the multi-scale relationship between stock prices and exchange rates. In addition, it also analyzes the relationship between stock prices and a specified quantile of the exchange rates.
The Possibilities and Limitations of Forensic Hand Comparison
Authors: Slot Ana , Geradts Zeno J.M.H.
Published: July 2014

On recordings of certain crimes, the face is not always shown. In such cases, hands can offer a solution, if they are completely visible. An important aspect of this study was to develop a method for hand comparison. The research method was based on the morphology, anthropometry, and biometry of hands. A new aspect of this study was that a manual and automated test were applied, which, respectively, assess many features and provide identification rates quickly. An important observation was that good quality images can provide sufficient hand details. The most distinctive features were the length/width ratio, the palm line pattern and the quantity of highly distinctive features present, and how they are distributed. The results indicate that experience did not improve the identification rates, while the manual test did. Intra‐observer variability did not influence the results, whereas hands of relatives were frequently misjudged. Both tests provided high identification rates.
Meta‐analysis shows that infants who have suffered neonatal sepsis face an increased risk of mortality and severe complications
Authors: Bakhuizen Sabine E. , de Haan Timo R. , Teune Margreet J. , van Wassenaer‐Leemhuis Aleid G. , van der Heyden Jantien L. , van der Ham David P. , Mol Ben Willem J.
Published: July 2014

Infants suffering from neonatal sepsis face an increased risk of early death and long‐term neurodevelopmental delay. This paper analyses and summarises the existing data on short‐term and long‐term outcomes of neonatal sepsis, based on 12 studies published between January 2000 and 1 April 2012 and covering 3669 neonates with sepsis.

Conclusion

Infants who have suffered neonatal sepsis face an increased risk of mortality and severe complications such as brain damage and, or, neurodevelopmental delay.
Risk factors for polyuria in a cross‐section of community psychiatric lithium‐treated patients
Authors: Kinahan James Conor , NiChorcorain Aoife , Cunningham Sean , Freyne Aideen , Cooney Colm , Barry Siobhan , Kelly Brendan D
Published: July 2014

Objectives

Polyuria increases the risk of dehydration and lithium toxicity in lithium‐treated patients. Risk factors have been inconsistently described and the variance of this adverse effect remains poorly understood. This study aimed to establish independent risk factors for polyuria in a community, secondary‐level lithium‐treated sample of patients.

Methods

This was a cross‐sectional study of the lithium‐treated patients attending a general adult and an old age psychiatry service. Participants completed a 24‐hour urine collection. Urine volume and the presence of polyuria were the outcomes of interest. The relationship between outcome and the participant's demographic and clinical characteristics was explored with univariable and multivariable analysis.

Results

A total of 122 participants were included in the analysis, with 38% being diagnosed with polyuria. Female gender and increased body weight independently predicted the presence of polyuria (standardized regression coefficient 1.01 and 0.94, respectively; p = 0.002 and p = 0.003, respectively). Female gender and increased body weight, lithium dose, and duration of lithium treatment independently predicted higher 24‐hour urine volumes (standardized regression coefficients 0.693, p < 0.0005; 0.791, p < 0.0005; 0.276, p = 0.043; 0.181, p = 0.034, respectively). Of three different weight metrics, lean body weight was the most predictive.

Conclusions

Female gender and increased body weight explain part of the variance of this adverse effect. Both risk factors offer fresh insights into the pathophysiology of this potentially reversible and dangerous adverse effect of lithium treatment. Future research should focus on understanding the differences between the genders and between different body compositions in terms of lithium pharmacokinetics and pharmacodynamics.
Effects of blood transfusion on cytokine profile and pulmonary function in patients with thalassemia major
Authors: Gülhan Bora , Yalçın Ebru , Ünal Şule , Oğuz Berna , Özçelik Uğur , Ersöz Deniz Doğru , Gümrük Fatma , Kiper Nural
Published: July 2014

Background and Aims

Thalassemia major (TM) is characterized by abnormal hemoglobin synthesis, which results in decreased oxygen delivery to the tissues, ineffective erythropoiesis and iron overload. The purpose of this study was to find out the predominant type of lung mechanical abnormalities in TM patients, the prevalence of the change in pulmonary diffusing capacity and to search the association of cytokines with pulmonary function tests (PFTs).

Methods

TM patients (n = 26) who were on regular transfusion program were included in the study. Pretransfusional and posttransfusional PFTs were performed. Before transfusion, blood samples were collected for complete blood count, serum ferritin, zinc, transforming growth factor‐β1 (TGF‐β1), interleukin (IL)‐8 and IL‐10 levels.

Results

Obstructive lung pattern was the predominant pulmonary sequela. Male gender was the main risk factor for pulmonary function abnormality. Because of very low values, serum IL‐10 levels of all patients were undetectable, and serum IL‐8 levels could be measured only in six patients. Median serum IL‐8 level was higher in patients with abnormal PFT. Pretransfusional single breath diffusion of carbon monoxide (DLCO) correlated negatively with serum TGF‐β1 and ferritin levels. After transfusion, there was a statistically significant decrease in forced expiratory volume in 1 s, forced expiratory flow between 25% and 75% of vital capacity, and airway conductance but significant increase in DLCO.

Conclusions

Although they are mostly asymptomatic, TM patients have important PFT abnormalities. Blood transfusion may have an acute deleterious effect on pulmonary functions. The disturbed pulmonary functions were found to correlate with IL‐8 and TGF‐β levels. Relations of different cytokines with different PFT parameters suggest that the immune system is effective pulmonary dysfunction.
Dermatologische Pharmakotherapie bei geriatrischen Patienten
Authors: Kratzsch Dorothea , Treudler Regina
Published: July 2014

Der demographische Wandel in unserer Gesellschaft führt zu einer Zunahme des Anteils alter Menschen. Die mit dem Alter einhergehende Multimorbidität resultiert häufig in einer Polypharmakotherapie, die das Risiko für unerwünschte Arzneimittelwirkungen birgt. Im Alter kommt es zu entscheidenden Veränderungen der Pharmakokinetik und ‐dynamik, allen voran einer Abnahme des Körperwassers, einem veränderten Verhältnis von Muskel‐ zu Fettgewebe und einer reduzierten Nierenfunktion. Zudem konnten Veränderungen der Magen‐Darm‐Passage, der Plasmaproteinbindung, der hepatischen Metabolisierung und eine erhöhte Anfälligkeit für Medikamenten‐induzierte kognitive Störungen nachgewiesen werden. All dies muss bei der dermatologischen Pharmakotherapie im Alter berücksichtigt werden, um iatrogene Komplikationen durch Über‐ oder Unterdosierung und Arzneimittelinteraktionen zu minimieren.
Long‐term irrigation effects on soil organic matter under temperate grazed pasture
Authors: Condron L. M. , Hopkins D. W. , Gregorich E. G. , Black A. , Wakelin S. A.
Published: July 2014

Irrigation of grazed pasture significantly increases plant and animal production, which may in turn increase soil organic carbon (SOC), depending on the balance between primary production and below‐ground allocation of C on the one hand, and the decomposition and export of C from the soil on the other. To evaluate the effect of irrigation on SOC we sampled a grazed pasture field experiment maintained under different irrigation treatments for 62 years. The dry‐land treatment in this experiment only received rainfall at an average of 740 mm year−1. The 10 and 20% irrigation treatments involved application of 100 mm of irrigation when the soil reached 10 and 20% gravimetric moisture content, respectively. The 10 and 20% irrigation treatments received average total annual irrigation inputs of 260 and 770 mm year−1, respectively. The 10 and 20% irrigation treatments increased pasture production by 44 and 74%, respectively, compared with that from the dry‐land. Analysis of soils taken to 1‐m depth revealed that amounts of SOC were not significantly different between the dry‐land (125.5 Mg ha−1) and 10% irrigation (117.8 Mg ha−1) treatments, but these were significantly greater than the 20% irrigation treatment (93.0 Mg ha−1). At 50–100 cm, SOC was also less (34%) for the 20% irrigation treatment than for the 10% irrigation treatment. The relative quantities of carbon (C) and nitrogen (N) in the light fraction (LF) at all soil depths decreased successively from dry‐land to the 20% irrigation treatment, suggesting that wetter soil conditions accelerated decomposition of the LF fraction, a comparatively labile SOC fraction. The C‐to‐N ratio of the bulk soil was also less for the 20% irrigation treatment, indicating more decomposed SOM in the irrigated than in the dry‐land treatment. There were no significant differences in the microbial biomass between the three different irrigation treatments, but the respiration rate (CO2 production) of soil organisms in the 20% irrigation treatment was consistently greater than in the other two treatments. It was concluded that large increases in plant productivity as a result of irrigation had either no effect or significantly reduced SOC stocks under grazed pasture. The reduced SOC content observed in the 20% irrigation treatment was attributed to a combination of increased C losses in animal products and drainage associated with greater stocking, together with accelerated decomposition of organic C resulting from elevated soil moisture maintained throughout the growing season.
Transmission route and genotype of chronic hepatitis B virus infection in children in Japan between 1976 and 2010: A retrospective, multicenter study
Authors: Komatsu Haruki , Inui Ayano , Fujisawa Tomoo , Takano Tomoko , Tajiri Hitoshi , Murakami Jun , Suzuki Mitsuyoshi
Published: July 2014

Aim

The aim of this study was to clarify the trends of the infectious source of chronic hepatitis B virus (HBV) infection and the HBV genotype in the Japanese pediatric population over the last three decades.

Methods

The present study was a retrospective, nationwide, multicenter study. Patients who were under 20 years of age when diagnosed with chronic HBV infection were eligible for enrollment in this study. A total of 430 patients (male/female, 256/174; age at the time of writing, 1–37 years; median age, 14 years; birth year, 1976–2010) from 11 hospitals were evaluated.

Results

The incidence of chronic HBV infection from 1976 to 1980, 1981–1985, 1986–1990, 1991–1995, 1996–2000, 2001–2005 and 2006–2010 was 56, 52, 34, 37, 81, 92 and 78, respectively. Of the 430 patients, 304 (71%), 61 (14%), 11 (3%) and 54 (13%) were infected via mother‐to‐child transmission, close contact, blood transfusion and unknown source, respectively. After the introduction of perinatal immunoprophylaxis, the rate of mother‐to‐child transmission increased from 62% during the 1991–1995 period to 86% during the 2006–2010 period. The distributions of genotypes A, B, C, D and F were 3%, 9%, 86%, 2% and 1%, respectively. No obvious change was observed in the distribution of genotypes. Genotype C was significantly associated with mother‐to‐child transmission.

Conclusion

Mother‐to‐child transmission remains the primary source of chronic HBV infection after the introduction of immunoprophylaxis. Taking measures to prevent immunoprophylaxis failure is essential to reduce pediatric chronic HBV infection in Japan.
Slight elevation of high‐sensitivity C‐reactive protein to predict recurrence and survival in patients with early stage hepatitis C‐related hepatocellular carcinoma
Authors: Fujiwara Naoto , Tateishi Ryosuke , Nakagawa Hayato , Nakagomi Ryo , Kondo Mayuko , Minami Tatsuya , Sato Masaya , Uchino Koji , Enooku Kenichiro , Kondo Yuji , Asaoka Yoshinari , Shiina Shuichiro , Yoshida Haruhiko , Koike Kazuhiko
Published: July 2014

Aim

Hepatocellular carcinoma (HCC) is associated with chronic inflammation derived from various origins. We investigated whether high‐sensitivity C‐reactive protein (hsCRP) could predict recurrence and survival after curative treatment for early stage hepatitis C virus‐related HCC (C‐HCC).

Methods

We enrolled 387 patients with three or fewer C‐HCC nodules, none of which exceeded 3 cm, and of Child–Pugh class A or B who underwent radiofrequency ablation. We divided the patients into high and low hsCRP groups based on the optimal cut‐off value for recurrence using a split‐sample method and maximally selected rank statistics. Differences in recurrence and survival rates were evaluated by the Kaplan–Meier method and the log–rank test. Hazard ratios of hsCRP were adjusted with confounding factors using a multiple Cox regression model. We also assessed the correlations between hsCRP levels and clinical parameters.

Results

The optimal hsCRP cut‐off value was 0.08 mg/dL. The cumulative recurrence rates after 5 years in the high and low hsCRP groups were 90.0% and 82.2%, respectively (P = 0.028), and the corresponding survival rates were 50.9% and 71.8%, respectively (P < 0.001). Higher hsCRP was an independent predictor for recurrence (adjusted hazard ratio [aHR], 1.32; 95% confidence interval [CI], 1.03–1.67; P = 0.026) and survival (aHR, 1.59; 95% CI, 1.14–2.22; P = 0.007). hsCRP was correlated with central obesity as well as tumor burden and liver dysfunction.

Conclusion

Slight elevation of the hsCRP level, even within the normal range, can predict recurrence and survival after curative treatment among patients with early stage C‐HCC.
Huntingtin interacting protein 1 as a histopathologic adjunct in the diagnosis of Merkel cell carcinoma
Authors: Marghalani Siham , Feller John Kyle , Mahalingam Meera , Mirzabeigi Marjan
Published: July 2014

Background

Huntington interacting protein 1 (HIP1), an antiapoptotic protein normally expressed in the brain, is highly expressed in Merkel cell carcinomas (MCCs). Given this, the aim of the current study was to ascertain the value of HIP1 as a histopathologic adjunct in the diagnosis of MCC.

Methods

In this retrospective study, archival material from 26 cases with a diagnosis of MCC and/or neuroendocrine carcinoma were retrieved from the pathology files of the Skin Pathology Laboratory (Boston University School of Medicine, Boston, MA, USA). Histopathologic sections of all cases were re‐reviewed and the diagnosis confirmed. All patient data were de‐identified. Immunohistochemical studies were performed using antibodies to HIP1 and cytokeratins (CK) 20 and 7.

Results

A semiquantitative scoring system for immunohistochemical expression of HIP1 was utilized by deriving a cumulative score (based on percentage positivity of cells and intensity of expression). Using a cut‐off total score of 3 or more as positive, the total number of positive cases was 22 for HIP1, 24 for CK20, and 11 for CK7.

Conclusion

Comparing the results of HIP1 and CK20, there were four discordant pairs (three positive for CK20 but negative for HIP1 and one positive for HIP1 but negative for CK20). McNemar's test indicated that there was no statistical significance (P = 0.625), thereby implying a close agreement between the expression of HIP1 and CK20 in these neuroendocrine neoplasms.
The significance of hypersensitivity to autologous sweat and serum in cholinergic urticaria: cholinergic urticaria may have different subtypes
Authors: Kim Jung Eun , Jung Kwan Ho , Cho Hyun Hee , Kang Hoon , Park Young Min , Park Hyun Jeong , Lee Jun Young
Published: July 2014

Background

The pathogenesis of cholinergic urticaria (ChU) has been unclear except for the involvement of acetylcholine. Attempts to classify ChU according to etiology have rarely been performed.

Objective

To evaluate the significance of responsiveness to autologous sweat and serum in ChU in relation to their clinical characteristics.

Methods

This study involved 18 patients diagnosed with ChU between January 2010 and April 2011 in the Catholic Medical Center‐St. Paul's Hospital. History taking included symptom duration, association with atopy, decreased sweat secretions, seasonal variation, and response to treatment. Intradermal autologous serum skin test (ASST) and autologous sweat skin test (ASwST) and basophil histamine release test with sweat were done.

Results

Sweat hypersensitivity was proven by a positive ASwST and basophil histamine release test in only 37.5% of patients with ChU, and in none of the healthy controls. The weal size of ASwST correlated with percentage basophil histamine release. A positive response to autologous serum was displayed by 38.9% of patients, whereas 10% of healthy controls showed a positive ASST response. Intriguingly, patients with a positive ASwST had a negative ASST, and vice versa. Despite this, there was no difference in the clinical characteristics between positive ASST and positive ASwST groups.

Conclusions

The frequency of hypersensitivity to autologous sweat and serum was significantly higher in patients with ChU, compared with healthy controls. This suggests that autoimmunity to an unknown serum factor as well as sweat hypersensitivity may be involved in the pathogenesis of ChU.
Sticking to minimum standards: implementing antibiotic stewardship in intensive care
Authors: Chaves N. J. , Ingram R. J. , MacIsaac C. M. , Buising K. L.
Published: July 2014

Background

In Australia, antimicrobial stewardship programmes are a compulsory component of hospital accreditation. Good documentation around anti‐microbial prescribing aids communication and can improve prescribing practice in environments with multiple decision makers.

Aim

This study aims to develop and implement an intervention to improve antimicrobial prescribing practice in a 24‐bed intensive care unit in a tertiary referral adult hospital.

Methods

We conducted a four‐phase (observation, reflection, implementation, evaluation) prospective collaborative before–after quality improvement study. Baseline audits and surveys of antimicrobial prescribing practices identified barriers to and enablers of good prescribing practice. A customised intervention was then implemented over 6 weeks and included a yellow medication record sticker, quarterly education sessions and intensive care unit‐specific empiric antimicrobial prescribing guidelines. Post‐implementation, the effects were monitored by serial antimicrobial prescribing audits for 1 year. The primary outcomes were clear documentation of the start date, the planned stop date or review date and the indication for an antibiotic. These were all considered the ‘minimum standards’ for an antimicrobial prescription on the medication record.

Results

Documentation of minimum standards specifically addressed by the sticker improved (start date (72% to 90%, P < 0.001), stop date (16% to 63%, P < 0.001), antimicrobial indication documented on medication chart (58% to 83%, P < 0.01)). Overall, adherence to all three minimum standards (start date, stop date and indication) improved from 41/306 (13%) to 306/492 (63%) (P < 0.001). One‐year post‐implementation, the yellow sticker had become embedded into daily practice.

Conclusion

A systematic approach to quality improvement combined with the implementation of a tailored, multi‐faceted intervention can improve antimicrobial prescribing practices.
A prospective study of acute inpatient gout diagnoses and management in a tertiary hospital: the determinants and outcome of a rheumatology consultation
Authors: Teichtahl A. J. , Clemens L. , Nikpour M. , Romas E.
Published: July 2014

Background

Despite acute gout frequently complicating hospital admissions, diagnosis and management are variable. Rheumatology input may improve patient outcomes.

Aim

To examine acute episodes of inpatient gout in a tertiary hospital to determine (i) factors that may lead to rheumatology input being sought and (ii) the differences in outcomes when rheumatology input occurs.

Methods

Data collection occurred between February and October 2012 for inpatients in a tertiary Australian hospital. Data were prospectively collected for all rheumatology consultations with a diagnosis of gout. Subjects who had an inpatient admission complicated by acute gout and who did not have rheumatology input were identified through health information coding from discharge summaries.

Results

Fifty‐eight patients (41% with rheumatology input) were included in the study. Rheumatology input was significantly more likely when the patient was younger (68.9 years vs 78.4 years; P = 0.04) with knee joint involvement (41.7% vs 3.0%; P < 0.001). When rheumatology input occurred, subjects were more likely to have had a serum urate measured (83% vs 50%; P = 0.009), joint aspiration performed (54.2% vs 0%; P < 0.001), been prescribed acute gout medications at discharge (95.8% vs 61.3%; P = 0.001), a documented discharge plan (91.7% vs 23.5%; P < 0.001) and outpatient follow up (41.7% vs 0%; P < 0.001).

Conclusion

Among inpatients with acute gout, rheumatology input was more likely to be sought in younger patients with knee joint disease. When rheumatology input occurred, patients were more likely to have a synovial fluid confirmed diagnosis of gout with appropriate acute management and a follow‐up plan.
Metoclopramide for patients with intractable hiccups: a multicentre, randomised, controlled pilot study
Authors: Wang T. , Wang D.
Published: July 2014

Background

Limited data exist regarding the efficacy of metoclopramide in the treatment of intractable hiccups.

Aim

This study aimed to assess the feasibility efficacy of metoclopramide in the treatment of patients with intractable hiccups.

Methods

A total of 36 patients with intractable hiccups was randomly assigned to arm A (n = 18) or arm B (n = 18) in a multicentre, double‐blind, randomised, controlled pilot study. Participants in arm A received 10‐mg metoclopramide thrice daily for 15 days, whereas those assigned to arm B received 10‐mg placebo thrice daily for 15 days. The primary outcome measure was total efficacy against hiccups (including cessation and improvement of hiccups). Secondary outcome measures included a comparison of overall efficacy and adverse events between the two arms.

Results

Of the 36 patients enrolled, 34 participants completed the study. The total efficacy was higher in arm A than in arm B (relative risk, 2.75; 95% confidence interval: 1.09–6.94, P = 0.03). Furthermore, comparison between the two arms revealed that overall efficacy was higher in arm A than that in arm B (P < 0.05). No serious adverse events related to the treatment were documented in either arm. The most common adverse events occurring in patients in arm A included fatigue, upset mood and dizziness.

Conclusion

Metoclopramide appears to be a promising candidate for the treatment of patients with intractable hiccups, with mild adverse events. However, further clinical trials are required to confirm these results.
Quantifying Compositional Homogeneity in Pb(Zr,Ti)O3 Using Atom Probe Tomography
Authors: Kirchhofer Rita , Diercks David R. , Gorman Brian P. , Ihlefeld Jon F. , Kotula Paul G. , Shelton Christopher T. , Brennecka Geoff L.
Published: July 2014

Atom probe tomography (APT) is a powerful materials characterization technique capable of ppm chemical resolution and near atomic scale spatial resolution. However, owing to a number of factors, the technique has not been widely applied to insulating materials and even less to complex oxides. In this study, we outline the methodology necessary to obtain high‐quality results on a technologically relevant complex oxide Pb(Zr,Ti)O3 (or PZT) using laser‐assisted APT on both bulk and thin film specimens. We show how, with optimized and well‐controlled conditions, APT complements conventional techniques such as STEM‐EDS. The correlative information can be used to obtain the nanoscale 3‐D chemical information and investigate the nanoscale distribution of cations. Using nearest‐neighbor cluster analysis routines, 5–10 nm segregation of B‐site cations was detected in bulk sintered PZT 53/47 from chemically prepared powders. No statistically significant segregation of B‐site cations was observed in thin film specimens. This work opens new avenues toward understanding the process‐structure properties in complex materials at length scales heretofore unachievable.
Predicting institutional long‐term care admission in dementia: a mixed‐methods study of informal caregivers’ reports
Authors: Afram Basema , Verbeek Hilde , Bleijlevens Michel H.C. , Challis David , Leino‐Kilpi Helena , Karlsson Staffan , Soto Maria E. , Renom‐Guiteras Anna , Saks Kai , Zabalegui Adelaida , Hamers Jan P.H. ,   the RightTimePlaceCare consortium
Published: July 2014

Aim

To investigate agreement between: (1) expected reasons and actual reasons for admission of people with dementia according to informal caregivers; (2) scores on measurement instruments prior to admission and the actual reasons for admission according to informal caregivers.

Background

Timely admission of people with dementia is a crucial issue. Information is highly warranted on whether informal caregivers are capable of prior identification of causes of admission and, can thus be considered a reliable prospective source on causes of admission.

Design

A cohort study among informal caregivers of people with dementia who made a transition to institutional long‐term care.

Methods

Qualitative data on the expected and actual reasons for admission were collected via open‐ended questions at baseline and follow‐up. Furthermore, at baseline, data were collected using measurement instruments to measure pre‐admission characteristics. Interviews took place between November 2010–April 2012. After categorizing the answers, the agreement between the expected and actual reasons was calculated. Furthermore, bivariate associations were calculated between the actual reasons for admission and scores on corresponding measurement instruments.

Results/Findings

For most informal caregivers, there was agreement between their statements on the expected reason and the actual reason for admission. A third of the caregivers showed no conformity. Bivariate associations showed that there is also agreement between the actual reasons for admission and scores on corresponding measurement instruments.

Conclusion

Informal caregivers can be considered reliable sources of information regarding what causes the admission of a person with dementia. Professional care should anticipate informal caregivers’ statements and collaborate with them to strive for timely and appropriate admission.
Relationship‐centred care: antidote, guidepost or blind alley? The epistemology of 21st century health care
Authors: Wyer Peter C. , Alves Silva Suzana , Post Stephen G. , Quinlan Patricia
Published: July 2014

Contemporary health care is increasing in complexity and lacks a unifying understanding of epistemology, methodology and goals. Lack of conceptual consistency in concepts such as ‘patient‐centred care’ (PCC) typifies system‐wide discordance. We contrast the fragmented descriptions ofPCCand related tools to its own origins in the writings ofBalint and to a subsequent construct, relationship‐centred care (RCC). We identify the explicit and elaborated connection betweenRCCand a defined epistemological foundation as a distinguishing feature of the construct and we demonstrate that this makes possible the recognition of alignments betweenRCCand independently developed constructs. Among these, we emphasizeSchon's reflective practice,Nonaka's theory of organizational knowledge creation and the research methodology of realist synthesis. We highlight the relational principles common to these domains and to their common epistemologies and illustrate unsatisfying consequences of adherence to less adequate epistemological frameworks such as positivism. We offerRCCnot as an ‘antidote’ to the dilemmas identified at the outset but as an example that illuminates the value and importance of explicit identification of the premises and assumptions underlying approaches to improvement of the health care system. We stress the potential value of identifying epistemological affinities across otherwise disparate fields and disciplines.
BCLC stage B hepatocellular carcinoma and transcatheter arterial chemoembolization: a 20‐year survey by the Italian Liver Cancer group
Authors: Farinati Fabio , Vanin Veronica , Giacomin Anna , Pozzan Caterina , Cillo Umberto , Vitale Alessandro , Di Nolfo Anna Maria , Del Poggio Paolo , Benvegnu' Luisa , Rapaccini Gianludovico , Zoli Marco , Borzio Franco , Giannini Edoardo G. , Caturelli Eugenio , Trevisani Franco ,   the Italian Liver Cancer (ITA.LI.CA) group
Published: July 2014

Background & Aims

Significant proportion of Hepatocellular Carcinoma (HCC) cases are diagnosed in stage B of Barcelona Clinic Liver Cancer (BCLC) algorithm, in which the standard of care is Transcatheter Arterial ChemoEmbolization (TACE). We aimed to ascertain adherence to current guidelines, survival and prognostic factors in BCLC stage B patients.

Methods

From 3027 HCC cases recruited from 1986 to 2008 by the Italian Liver Cancer group (2430 with data allowing a correct allocation in the BCLC system), a retrospective analysis was conducted on those diagnosed in BCLC stage B (405 patients, 17%). Statistics were performed with Kaplan–Meier (log rank) method and Cox multivariate analysis.

Results

Median overall survival in BCLC stage B patients was 25 months (Confidence Interval ‐ C.I. ‐ 22–28 months) with a 5‐year survival of 18%. Child–Pugh class, oesophageal varices and Alpha‐foetoprotein (AFP) were the independent predictors of survival. TACE was applied in 40% of cases and did not offer the longest survival in comparison with surgical or percutaneous treatments (median 27 months vs. 37 and 36 months, respectively) (P < 0.001). BCLC stage B patients undergoing radical treatments were more frequently in Child‐Pugh class A and had a significantly lower number of lesions; patients undergoing best supportive care were frequently in Child‐Pugh class B and had a multifocal disease. Survival after TACE did not significantly increase over time.

Conclusions

In clinical practice, TACE cannot be considered the best approach for BCLC stage B patients who represent a heterogeneous population and are often suitable for more aggressive therapies, which lead to a better survival.
Herbert McCabe's Genius: Language, Natural Law and Unity
Authors: Mayrand Nicholas
Published: July 2014

The work of Herbert McCabe offers a model for thinking about the world and human life in it that has yet to be fully appreciated. In this essay, I argue that McCabe's linguistic model provides invaluable insight into human communication and the moral life, showing the natural law to be more like scaffolding than a list of stipulations.