bluuebunny/crossref_metadata_2025 huggingface dataset:
The attitudes of accountants towards corporate environmental disclosure (CED) in Libya
Authors: Saleh Mohamad Ahmad Nassr
Published: April 2014

Purpose

– The purpose of this paper is to complement the literature reviews on corporate environmental disclosure (CED) with special focus on the developing countries. The paper focuses on the attitudes of accountants towards CED in Libya.

Design/methodology/approach

– A desk-based research method, using a classification framework of two categories, has been applied in this study. These two categories are the methodologies used to capture empirical data and the results of studies.

Findings

– The results of this study indicate that almost all previous studies related to the attitudes of accountants towards CED in Libya utilised the two-dimensional analysis, which combines a questionnaire with content analysis. This afforded a better understanding of the picture than that provided by the questionnaire alone. Moreover, the results indicate that most such studies show that whilst the accountants have positive attitudes towards CED, progress is limited, with a low level of CED practices.

Originality/value

– Reviews of attitudes of accountants towards CED in different parts of the world are always welcome and are arguably somewhat very limited in developing countries in general and in Libya in particular. This paper provides a foundation for future research and development in the area of CED.
The impact of financial ratios on the financial performance of a chemical company
Authors: Borhan Halimahton , Naina Mohamed Rozita , Azmi Nurnafisah
Published: April 2014

Purpose

– The purpose of this paper is to examine the impact of financial ratios on the financial performance of a chemical company: LyondellBasell Industries (LYB). Some selected ratios: current ratio (CR) and quick ratio (QR) represent the liquidity ratios, debt ratio (DR) and debt equity ratio (DTER) represent the leverage ratios, while operating profit margin (OPM) and net profit margin (NPM) represent the profitability ratios. LYB faced financial problems after its merger and the financial performance of the company shrank to negative due to the world financial crisis. However, this company has bounced back after a year and is now the world's third largest chemical company based on revenue.

Design/methodology/approach

– The financial ratios were measured from 2004 to 2011, quarterly. A multiple regression model has been used and secondary data has been analyzed.

Findings

– The results shows that CR, QR, DR and NPM have a positive relationship while DTER and OPM have a negative relationship with the company's financial performance. Among the six ratios, CR, DR and NPM show the highest significant impact on the company's performance.

Originality/value

– This research paper contributed the result of the impact of financial ratios on the financial performance of a chemical company as the previous studies with this focus are hard to find and some of the sources are not specifically related to the topic.
Heterogeneity in plant–soil feedbacks and resident population dynamics affect mutual invasibility
Authors: Burns Jean H. , Brandt Angela J.
Published: April 2014

Understanding the mechanisms governing coexistence is a central goal in ecology and has implications for conserving and restoring communities, yet the high diversity in many plant communities is difficult to explain. Theory suggests that plant–soil feedbacks (PSF) can lead to frequency‐dependent coexistence by suppressing conspecifics more than heterospecifics, potentially helping to explain high‐diversity plant communities. In addition, species‐specific population dynamics, including the rate at which individuals are replaced in a population or population turnover rate, may influence coexistence outcomes.

We have created a rigorous test of the coexistence predictions of theory by generating a soil heterogeneity experiment in the field and testing for mutual invasibility by establishing resident populations, then experimentally invading them. Experimental tests of mutual invasibility can demonstrate coexistence because, if species are able to invade one another's populations when at low density, they should exhibit long‐term coexistence. We use pairs of congeners in this experiment that coexist at small spatial scales, sometimes within cm, at our field site.

We demonstrate that invader individuals established better in congener's soils than in conspecific soils, consistent with plant–soil feedback mediated coexistence. This effect was often mediated by competition with established resident plants.

Further, we show that soil heterogeneity interacted with the population turnover rate of the resident population to influence invasibility (P < 0.10), consistent with the theoretical prediction that a plant's population dynamics will interact with heterogeneity to influence coexistence.

Synthesis. Plant–soil feedbacks (PSF) can in theory lead to frequency‐dependent coexistence, and reciprocally, negative feedback effects in glasshouse experiments are often consistent with this prediction. We provide the first field test of mutual invasibility structured by PSF, demonstrating that PSF can lead to coexistence when they create a patchy, or heterogeneous, soil environment. This work suggests that understanding the influence of PSF on diversity necessitates understanding the spatial scale at which soil heterogeneity emerges in the field. Thus, high diversity might be maintained in plant communities by heterogeneity created by plants' influence on the soil, and this outcome depends strongly on population dynamics.
Efficiency analysis under uncertainty: a simulation study
Authors: Shankar Sriram
Published: April 2014

We model production technology in a state‐contingent framework assuming that the firms maximise ex ante their preference function subject to stochastic technology constraint; in other words, firms are assumed to act rationally. We show that rational producers who face the same stochastic technology can make significantly different production choices. Further, we develop an econometric methodology to estimate the risk‐neutral probabilities, efficiency scores and the parameters of stochastic technology when there are two states of nature and only one of which is observed. Finally, we simulate noiseless data based on our state‐contingent specification of technology. Our state‐contingent estimator recovers technology parameters and other economic quantities of interest without any error. But, when we apply conventional efficiency estimators to the simulated data, we obtain biased estimates of technical efficiency.
Freedom of Information and Parliamentary Departments
Authors: Adams Carolyn
Published: April 2014

This article examines whether freedom of information (FOI) legislation should apply to those agencies working to support parliaments. In the past, FOI legislation was characterized as a mechanism to allow greater scrutiny of the executive branch by parliament and the community. On this analysis, there was no reason to extend the legislation to the agencies of the legislative branch. But the role of FOI legislation has developed so that it now forms part of a wider integrity framework of government. The need to ensure integrity is a concern for all three branches of government and this article asks whether there are any convincing reasons in principle or practice to exclude the parliamentary departments from the FOI regime.
Elements of Successful Change: The Service Tasmania Experience to Public Sector Reform
Authors: Blackburn Greg
Published: April 2014

For Tasmanians accessing Government services has traditionally required visits to various Lead Agency locations, as service delivery was fragmented and bureaucratic. The Tasmanian Government adopted a customer‐focused approach implementing ‘Service Tasmania’ a One‐Stop‐Shop service delivery concept. This paper investigates what led to the success of this public service reform and in particular what change management practices were applied during the change effort. Ten common factors of successful change have been identified in the literature; these are explored determining their relevance throughout this initiative. Data were collected with semi‐structured interviews conducted with 63 staff plus senior management. Data were analysed using a grounded theory approach and open coding was applied during the first pass through the data to reach the initial codes identifying critical terms and generic key issues. Findings confirm that several management interventions were necessary to address resistance and conflict issues and keep the government reform project on track.
Exploring Social Capital: as Concept and Practice in Australian Public Health Policies and Programs
Authors: Arthurson Kathy , Baum Fran , Ziersch Anna
Published: April 2014

Over the past twenty years interest has grown in the concept of social capital in international and Australian public policy. We explore how social capital is understood as a concept and used in practice for guiding policy development and program delivery in South Australian public health programs. The empirical research compared policy makers’ and practitioners’ understandings of social capital and how theories about social capital and health inequality were translated into practice in three case study projects. It found that there are shifting discourses between social capital and related concepts, including community capacity building, and social inclusion/exclusion. Policy makers reported less use of the concept of social capital in favour of social inclusion/exclusion reflecting changing political and policy environments where terms come into favour and then go out of fashion. In this transition period the two terms are often used interchangeably although there are some conceptual points of difference.
Consultation, Participation and Policy‐Making: Evaluating Australia's Renewable Energy Target
Authors: Simpson Genevieve , Clifton Julian
Published: April 2014

A Review of Australia's Renewable Energy Target is used to contribute to the concept of negative externalities in consultation processes, including wasted investment by stakeholders and reduced investor confidence. The findings indicate that there is a need to establish clear consultation objectives. The paper concludes with a model for consultation agents to consider when initiating a consultation process. The model stresses the need to make objectives of the consultation process transparent to stakeholders, including the extent to which the outcomes of consultation are likely to result in changes to policy. Consultation agents and policy developers should seek to identify potential negative externalities at the outset of any consultation process, and address these within the consultation framework where possible.
Would Bigger Councils Yield Scale Economies in the Greater Perth Metropolitan Region? A Critique of theMetropolitan Local Government Reviewfor Perth Local Government
Authors: Drew Joseph , Dollery Brian
Published: April 2014

Forced amalgamation is a ubiquitous feature of Australian local government reform – compulsory council consolidation programs have occurred in all states and territories, with the sole exception of Western Australia. However, the Final Report of the Metropolitan Local Government – released in October 2012 – called for a reduction of about 60 per cent of the local authorities in the Greater Perth metropolitan area. The Western Australian Government responded by announcing that the number of Perth councils will fall from 30 to 14 from 1 July 2015. The Final Report recommended amalgamation on seven main counts, including scale economies. However, apart from citing work on Tasmania by commercial consultants Deloitte Access Economics (DAE) (2011), no econometric evidence was produced in support of claims on scale economies. This paper seeks to remedy this deficiency by estimating a number of econometric models on the impact of amalgamation on Perth local government. The results of our empirical modelling suggest that scale economies, cost savings and other pecuniary gains are largely illusory. Indeed, only two of the ten main local government functions provide evidence to suggest potential economies of scale.
Truth and Politics: Thinking About Evidence‐Based Policy in the Age Of Spin
Authors: Watts Rob
Published: April 2014

Evidence‐based policy and the contemporary politics of spin are said to characterise contemporary politics and policy. The paper asks firstly what sense is to be made of this coincidence, and then documents this coincidence. It then asks how credible is the conception of ‘evidence’ espoused by advocates of evidence‐based policy when it is conventionally represented as an ‘objective’ counter to ideology, spin or opinion? It points to major problems with the conventional understandings of ‘evidence’. It is suggested that while the evidence‐based policy literature relies on the associations ‘evidence’ is presumed to have with ‘sensory data’, this is neither the case nor all that defensible. The paper reprises arguments advanced by Henry Mayer and Hannah Arendt that the relationship of politics to the empirical was and is a far more complex relationship than is conventionally understood to be the case.
Unpacking the Path‐Dependent Process of Institutional Change for PPPs
Authors: Matos‐Castaño Julieta , Mahalingam Ashwin , Dewulf Geert
Published: April 2014

In the recent past, several countries and states have begun to use Public‐Private‐Partnerships (PPPs) for infrastructure development and have attempted to create institutional environments that enable PPPs. Providing an enabling environment for PPPs entails a combination of institutional creation and changing existing institutions relating to project procurement. This paper attempts to understand how path‐dependant institutional change takes place in the context of PPPs and their enabling environments, and why different institutional environments evolve differently, using two cases: the implementation of PPPs in the road sector in the Netherlands and in the Indian state of Tamil Nadu. We identify two factors that can be used as predictors of the direction of institutional change: a long‐term orientation towards institutional change and a willingness to learn and modify transitional institutions. Where these factors exist, and thereby provide a goodness of fit, institutional change is likely to occur.
Analysing Choice in Australian Individual Funding Disability Policies
Authors: Purcal Christiane , Fisher Karen R. , Laragy Carmel
Published: April 2014

The Australian National Disability Insurance Scheme (NDIS) will allocate funding packages to people with disability who are assessed as needing paid support. The NDIS is an example of individual funding, which is currently not the dominant way of organising disability support in Australia. Individual funding aims to increase opportunities for personal choice. We present a framework for understanding current individual funding policies in each Australian jurisdiction according to two policy dimensions that potentially enable greater personal choice for people with disability: who holds their allocated funds and where support can be purchased. The findings show wide disparities in choice across the country, particularly due to constrained funds and the shortage of support to purchase in regional areas. The analysis demonstrates that NDIS implementation will need to consider that, while individual funding can be empowering for some people with disability, enabling choice can be challenging for administrators and service providers.
Englishness Politicised?: Unpicking the Normative Implications of the McKay Commission
Authors: Kenny Michael
Published: April 2014

Research Highlights and Abstract

This article

Analyses a major shift in elite-political perceptions of the national identity of the English and current debates on Englishness. Is the first major evaluation of the arguments and implications of the McKay Commission. Gives a distinctive overview of academic and political debates about Englishness which assesses both sociological and political-science contributions and data, and argues the case for their better integration. Provides an original assessment of the implications of debates about Englishness for constitutional debates about the UK and normative arguments about national representation within the UK legislature

This article draws attention to signs of an emerging consensus within British politics about the significance of recent shifts in the national identity favoured by the English. It focuses on the nature and assumptions of this emergent perspective, and critically evaluates the prevalent understanding of the ‘politicisation’ of Englishness and the different kinds of constitutional and normative argument that have become prominent in response to the resurgence of this form of identity. Drawing upon a bevy of recent social-scientific studies of the qualitative dimensions of Englishness, I make the case for a different, interpretive approach to ‘politicisation’, which reflects a richer and broader understanding of the causes and implications of the renewal of English nationhood. The article then explores the findings and underpinning arguments of one particular expression of this new consensus about the politicisation of English identity—the report published by the McKay Commission in March 2013. Attention is drawn to the particular blend of arguments that undergird its proposals for reform in relation to the West Lothian issue. Tensions between some of its main normative claims are, it is suggested, symptomatic of a deeper set of dilemmas facing the UK policy community.
The arbitrariness and normativity of social conventions
Authors: Al‐Amoudi Ismael , Latsis John
Published: April 2014

This paper investigates a puzzling feature of social conventions: the fact that they are both arbitrary and normative. We examine how this tension is addressed in sociological accounts of conventional phenomena. Traditional approaches tend to generate either synchronic accounts that fail to consider the arbitrariness of conventions, or diachronic accounts that miss central aspects of their normativity. As a remedy, we propose a processual conception that considers conventions as both the outcome and material cause of much human activity. This conceptualization, which borrows from the économie des conventions as well as critical realism, provides a novel perspective on how conventions are nested and defined, and on how they are established, maintained and challenged.
Crisis Communication in Public Organisations: Dimensions of Crisis Communication Revisited
Authors: Olsson Eva‐Karin
Published: April 2014

Research on crisis communication has traditionally focused on private organisations' reputation and blame avoidance strategies. As a result, there is limited knowledge on crisis communication from the perspective of public organisations. This is troublesome as public organisations have substantial responsibilities for preparing, communicating and managing large‐scale crisis events. In order to be able to better conceptualise public organisations' crisis communication, a typology based on communication aims and orientations is introduced. According to the typology, public organisations engage in two dimensions of crisis communication: reputation‐oriented vs. resilience‐oriented and strategic vs. operational. These dimensions are illustrated and discussed by empirical examples from theQueensland floods of 2010/2011. The paper ends with a discussion on how to understand these dimensions of crisis communication in relation to public organisations' priorities, processes and practices.
A Randomized, Controlled Pragmatic Trial of Telephonic Medication Therapy Management to Reduce Hospitalization in Home Health Patients
Authors: Zillich Alan J. , Snyder Margie E. , Frail Caitlin K. , Lewis Julie L. , Deshotels Donny , Dunham Patrick , Jaynes Heather A. , Sutherland Jason M.
Published: April 2014

Objective

To evaluate the effectiveness of a telephonic medication therapy management (MTM) service on reducing hospitalizations among home health patients.

Setting

Forty randomly selected, geographically diverse home health care centers in the United States.

Design

Two‐stage, randomized, controlled trial with 60‐day follow‐up. All Medicare‐ insured home health care patients were eligible to participate. Twenty‐eight consecutive patients within each care center were recruited and randomized to usual care or MTM intervention. The MTM intervention consisted of the following: (1) initial phone call by a pharmacy technician to verify active medications; (2) pharmacist‐provided medication regimen review by telephone; and (3) follow‐up pharmacist phone calls at day seven and as needed for 30 days. The primary outcome was 60‐day all‐cause hospitalization.

Data Collection

Data were collected from in‐home nursing assessments using the OASIS‐C. Multivariate logistic regression modeled the effect of the MTM intervention on the probability of hospitalization while adjusting for patients’ baseline risk of hospitalization, number of medications taken daily, and other OASIS‐C data elements.

Principal Findings

A total of 895 patients (intervention n = 415, control n = 480) were block‐randomized to the intervention or usual care. There was no significant difference in the 60‐day probability of hospitalization between the MTM intervention and control groups (Adjusted OR: 1.26, 95 percent CI: 0.89–1.77, p = .19). For patients within the lowest baseline risk quartile (n = 232), the intervention group was three times more likely to remain out of the hospital at 60 days (Adjusted OR: 3.79, 95 percent CI: 1.35–10.57, p = .01) compared to the usual care group.

Conclusions

This MTM intervention may not be effective for all home health patients; however, for those patients with the lowest‐risk profile, the MTM intervention prevented patients from being hospitalized at 60 days.
The Role of Index Trading in Price Formation in the Grains and Oilseeds Markets
Authors: Gilbert Christopher L. , Pfuderer Simone
Published: April 2014

We use both Granger‐causality and instrumental variables (IV) methods to examine the impact of index fund positions on price returns for the main US grains and oilseed futures markets. Our analysis supports earlier conclusions that Granger‐causal impacts are generally not discernible. However, market microstructure theory suggests trading impacts should be instantaneous. IV‐based tests for contemporaneous causality provide stronger evidence of price impact. We find even stronger evidence that changes in index positions can help predict future changes in aggregate commodity price indices. This result suggests that changes in index investment are in part driven by information which predicts commodity price changes over the coming months.
Characteristics of patients who leave the emergency department without being seen: The first report in China
Authors: Liu Sihuan , Nie Hu , Huang Wenxia , Liu Xiang , Luo Li , Lau Wayne Bond , Cao Yu
Published: April 2014

Objective

The incidence of patients who leave without being seen (LWBS) by a doctor in the ED in China has not been reported. The purpose of this study is to identify the prevalence and characteristics of the LWBS patient population as well as predictors of LWBS in the ED of a tertiary hospital of China.

Methods

We conducted a retrospective cohort study of all ED patients from November 2011 to October 2012 in our hospital. Patient age, sex, nationality, time of day, day of week and month of patient presentation, mode of arrival, and triage category were examined as potential predictors of LWBS. Multivariate logistic regression was performed to identify independent predictors of LWBS patients.

Results

The prevalence of LWBS patients was 10.7%. LWBS patients were nearly equally divided between men and women (52.8% men, 47.2% women). The average age of LWBS patients was significantly younger than non‐LWBS patients (P < 0.001). The majority of LWBS patients (82.2%) arrived on foot, and very few LWBS patients (0.3%) were non‐Chinese. The majority of LWBS patients (94.6%) were assigned to Emergency Severity Index level 3 or 4. Independent predictors of LWBS included paediatric age, lower triage acuity, arrival on foot, time of the day, day of the week and month of presentation.

Conclusions

Independent LWBS predictors include paediatric patients arriving on foot in the evening with lower acuity problems. Potential risk management strategies should be implemented to decrease or eliminate the LWBS population by improving communication and providing increased comfort measures.
Satisfaction with emergency department service among non‐English‐speaking background patients
Authors: Mahmoud Ibrahim , Hou Xiang‐Yu , Chu Kevin , Clark Michele , Eley Rob
Published: April 2014

Objective

The present study aims to investigate non‐English‐speaking background (NESB) patients' satisfaction with hospital ED service and compare it with that of English‐speaking background (ESB) patients.

Methods

A cross‐sectional survey was conducted at the ED of an adult tertiary referral hospital in Queensland, Australia. Patients assigned an Australasian Triage Scale score of 3, 4 or 5 were surveyed in the ED, before and after their ED service. Pearson χ2‐test and multivariate logistic regression analyses were performed to examine the differences between the ESB and NESB groups in terms of patient‐reported satisfaction.

Results

In total, 828 patients participated in the present study. Although the overall satisfaction with the service was high – 95.1% (ESB) and 90.5% (NESB) – the NESB patients who did not use an interpreter were less satisfied with their ED service than the ESB patients (odds ratio 0.5, 95% confidence interval 0.3–0.8, P = 0.013). The promptness of service received the lowest satisfaction rates (ESB 85.4% [82.4–88.0], NESB 74.5% [68.5–79.7], P < 0.001), whereas courtesy and friendliness received the highest satisfaction rates (ESB 98.8 [97.6–99.4], NESB 97.0 [93.9–98.5], P = 0.063). All participants reported the promptness of service (33.5%), quality and professional care (18.5%) and communication (17.6%) as the most important elements of ED service.

Conclusion

The NESB patients were significantly less satisfied than the ESB patients with the ED service. Use of an interpreter improved the NESB patients' level of satisfaction. Further research is required to examine what NESB patients' expectations of ED service are.
Understanding emergency department staff needs and perceptions in the provision of palliative care
Authors: Shearer Freya M , Rogers Ian R , Monterosso Leanne , Ross‐Adjie Gail , Rogers Jeremy R
Published: April 2014

Objective

The primary aim of the present study was to investigate Australian ED staff perspectives and needs regarding palliative care provision. Secondary aims were to assess staff views about death and dying, and their awareness of common causes of death in Australia, particularly those where a palliative care approach is appropriate.

Methods

All medical and nursing staff working in a private ED in Perth, Western Australia, were asked to complete a combined quantitative and qualitative survey. The survey tool uses a combination of Likert‐type scales and open‐ended questions. Descriptive statistics and intergroup comparisons were made for all quantifiable variables, whereas formal content analysis was used for text responses.

Results

Surveys were returned by 22 doctors and 44 nurses, with most reporting only working knowledge of palliative care but clinical proficiency in symptom control. Confidence in palliative care provision was lower among nursing than medical staff but educational needs were similar. Cancer diagnoses were consistently overestimated, and dementia and COPD underestimated, as the most common causes of death. Only six of 63 (9.5%) of respondents identified the correct top five causes of death.

Conclusions

Our study suggests that although ED staff expressed confidence regarding symptom management in palliative care, they lacked understanding of the patients in whom a palliative approach could be applied and sought further education in areas, such as end‐of‐life communication and ethical issues. ED specific training and clinical interventions in palliative care provision would seem to be needed and justified.
Review article: Shock Index for prediction of critical bleeding post‐trauma: A systematic review
Authors: Olaussen Alexander , Blackburn Todd , Mitra Biswadev , Fitzgerald Mark
Published: April 2014

Early diagnosis of haemorrhagic shock (HS) might be difficult because of compensatory mechanisms. Clinical scoring systems aimed at predicting transfusion needs might assist in early identification of patients with HS. The Shock Index (SI) – defined as heart rate divided by systolic BP – has been proposed as a simple tool to identify patients with HS. This systematic review discusses the SI's utility post‐trauma in predicting critical bleeding (CB). We searched the databases MEDLINE, Embase, CINAHL, Cochrane Library, Scopus and PubMed from their commencement to 1 September 2013. Studies that described an association with SI and CB, defined as at least 4 units of packed red blood cells (pRBC) or whole blood within 24 h, were included. Of the 351 located articles identified by the initial search strategy, five met inclusion criteria. One study pertained to the pre‐hospital setting, one to the military, two to the in‐hospital setting, and one included analysis of both pre‐hospital and in‐hospital values. The majority of papers assessed predictive properties of the SI in ≥10 units pRBC in the first 24 h. The most frequently suggested optimal SI cut‐off was ≥0.9. An association between higher SI and bleeding was demonstrated in all studies. The SI is a readily available tool and may be useful in predicting CB on arrival to hospital. The evaluation of improved utility of the SI by performing and recording at earlier time‐points, including the pre‐hospital phase, is indicated.
Semi‐subsistence Farms and Alternative Food Supply Chains
Authors: Gorton Matthew , Salvioni Cristina , Hubbard Carmen
Published: April 2014

The engagement of small farms, including semi‐subsistence farms (SSFs), in short/direct food supply chains varies significantly across EU Member States (MSs). It is far more prevalent in Southern EU MSs and in some New Member States (NMSs), such as Poland and Romania, than in North‐West Europe. Farmers' markets, the most prevalent form of short/direct food supply chains, are most successful where they target ‘ethically concerned’ consumers and those for whom direct relationships with producers are considered as the main guarantee of quality. Such consumers are typically middle‐class urban residents, so that successful farmers' markets are often located some distance from the point of production. Engagement with geographical indication schemes e.g. Protected Designation of Origin and Protected Geographical Indication labels also varies significantly between MSs. In some MSs, for example, Romania, despite the importance of the small‐farm sector, the number of protected designations is negligible, and this is unlikely to change soon. In some cases, particularly in Italy, the involvement in quality schemes has led to farmers receiving a significantly higher share of the final retail price. Generally, however, protected designations have had most impact in safeguarding products with pre‐existing widespread prestige, rather than serving as a mechanism for creating it.
Networking, Small Farms and EU Rural Development Policy
Authors: Peters Rob , Gregory Michael
Published: April 2014

The European Network for Rural Development and National Rural Networks form part of the EU policy framework. They engage different stakeholder groups to promote knowledge development, cooperation and exchange. To date, small farm issues have been considered mainly within the context of thematic analyses, such as environmental services and short supply chains. The 2014–20 Common Agricultural Policy will offer Member States with many small farms the possibility of developing sustainable ‘pathways of development’ for farming communities. Under Pillar I there will be a simplified, optional, direct payments regime for small farms. In the rural development programmes, possible ways to support small farms include restructuring and modernisation, tackling generational renewal, measures for food chain integration and other revenue generation opportunities. Environmental priorities can also be tailored towards small farmers, such as methods for collective nature conservation services. Involving farmers in decision‐making processes promotes local commitment to development actions and support is tailored to local need. The challenge for EU rural networking activities therefore, will be to improve links between small farmers and the administrations to ensure that benefits are realised. Effective knowledge transfer between stakeholders will be further developed through increased use of social media whilst traditional networking tools will continue to be needed.
Small Farm Survival in Greece, Italy and Portugal
Authors: Salvioni Cristina , Papadopoulou Eleni , Santos Maria Dos
Published: April 2014

Until the end of the 20th century, farming in Greece, Italy and Portugal was characterised by inflexible land and labour markets and thus had persistently high proportions of small farms and aged holders. Over time, several policy interventions in these countries have aimed at increasing average farm size. Nevertheless, small farms still account for a very large percentage of all holdings, due to institutional, social and market factors. Small farms are mainly concentrated in two kinds of area. First, mountainous and economically depressed inland regions where outmigration has often resulted more in farmland abandonment rather than in land concentration. Second, peri‐urban areas and other economically diversified rural contexts where many small farms survive thanks to the adoption of household strategies based on pluriactivity and outsourcing. Although it is still difficult to predict the impact of the current recession on small farms, it is possible to distinguish two emerging trajectories. In one, reduced chances of off‐farm work may challenge the resilience of pluriactive small farms. Former pluriactive farmers may focus on scale economies in order to increase their farming incomes. On the other, small‐scale farming is increasingly relied on for household budgets and food security, and could cause a ‘return to the land’.
External evaluation of the Radiation Therapy Oncology Group brachial plexus contouring protocol: Several issues identified
Authors: Min Myo , Roos Daniel , Keating Elly , Penniment Michael , Carruthers Scott , Zanchetta Lydia , Wong Karen , Shakeshaft John , Baxi Siddhartha
Published: April 2014

Introduction

The aims of the study were to evaluate interobserver variability in contouring the brachial plexus (BP) using the Radiation Therapy Oncology Group (RTOG)‐approved protocol and to analyse BP dosimetries.

Methods

Seven outliners independently contoured the BPs of 15 consecutive patients. Interobserver variability was reviewed qualitatively (visually by using planning axial computed‐tomography images and anteroposterior digitally reconstructed radiographs) and quantitatively (by volumetric and statistical analyses). Dose–volume histograms of BPs were calculated and compared.

Results

We found significant interobserver variability among outliners in both qualitative and quantitative analyses. These were most pronounced for the T1 nerve roots on visual inspection and for the BP volume on statistical analysis. The BP volumes were smaller than those described in the RTOG atlas paper, with a mean volume of 20.8 cc (range 11–40.7 cc) compared with 33 ± 4 cc (25.1–39.4 cc). The average values of mean dose, maximum dose, V60Gy, V66Gy and V70Gy for patients treated with conventional radiotherapy and IMRT were 42.2 Gy versus 44.8 Gy, 64.5 Gy versus 68.5 Gy, 6.1% versus 7.6%, 2.9% versus 2.4% and 0.6% versus 0.3%, respectively.

Conclusion

This is the first independent external evaluation of the published protocol. We have identified several issues, including significant interobserver variation. Although radiation oncologists should contour BPs to avoid dose dumping, especially when using IMRT, the RTOG atlas should be used with caution. Because BPs are largely radiologically occult on CT, we propose the term brachial‐plexus regions (BPRs) to represent regions where BPs are likely to be present. Consequently, BPRs should in principle be contoured generously.
Bone complications after pelvic radiation therapy: Evaluation with MRI
Authors: Ugurluer Gamze , Akbas Tugana , Arpaci Taner , Ozcan Nazli , Serin Meltem
Published: April 2014

Introduction

The purpose of this study was to assess the incidence, distribution and MRI characteristics of pelvic bone complications after radiation therapy.

Methods

The medical charts of 345 patients who received pelvic radiation therapy were retrospectively reviewed. A total of 122 patients, 99 women and 23 men, with a mean age of 57 (range 32–87 years) were included in this study. The MR images were retrospectively reviewed by two radiologists.

Results

Fatty replacement of bone marrow was seen in all patients. Pelvic bone complications and focal red marrow changes were identified in a total of 38 patients (31.1%). Pelvic insufficiency fracture was diagnosed in 17 patients (13.9%, with a total of 64 lesions) and radiation osteitis was diagnosed in 5 patients (4.1%, with a total of 13 lesions). Avascular necrosis of the femoral head was detected in one patient (0.8%). Focal red bone marrow changes were seen in 15 patients (12.3%). The median time from the end of radiotherapy to the diagnosis of pelvic bone complications or changes was 25 months (range 2–45 months). The 1‐, 2‐, and 3‐year cumulative incidences were 22%, 41% and 49%, respectively. The distribution of insufficiency fractures was as follows: sacral ala, sacral body, ilium, acetabulum, pubis and lumbar spinal vertebra. The distribution of radiation osteitis was as follows: sacral ala, ilium and pubis.

Conclusion

Radiation‐induced pelvic bone complications are not uncommon, and knowledge of characteristic imaging patterns is essential in order to rule out bone metastases and to avoid inaccurate or excessive treatment.
Recombinant human growth hormone improves cognitive capacity in a pain patient exposed to chronic opioids
Authors: RHODIN A. , von EHREN M. , SKOTTHEIM B. , GRÖNBLADH A. , ORTIZ‐NIETO F. , RAININKO R. , GORDH T. , NYBERG F.
Published: April 2014

During recent decades, the increasing use of opioids for chronic non‐cancer pain has raised concerns regarding tolerance, addiction, and importantly cognitive dysfunction. Current research suggests that the somatotrophic axis could play an important role in cognitive function. Administration of growth hormone (GH) to GH‐deficient humans and experimental animals has been shown to result in significant improvements in cognitive capacity. In this report, a patient with cognitive disabilities resulting from chronic treatment with opioids for neuropathic pain received recombinant human growth hormone (rhGH) replacement therapy. A 61‐year‐old man presented with severe cognitive dysfunction after long‐term methadone treatment for intercostal neuralgia and was diagnosed with GH insufficiency by GH releasing hormone‐arginine testing. The effect of rhGH replacement therapy on his cognitive capacity and quality of life was investigated. The hippocampal volume was measured using magnetic resonance imaging, and the ratios of the major metabolites were calculated using proton magnetic resonance spectroscopy. Cognitive testing revealed significant improvements in visuospatial cognitive function after rhGH. The hippocampal volume remained unchanged. In the right hippocampus, the N‐acetylaspartate/creatine ratio (reflecting nerve cell function) was initially low but increased significantly during rhGH treatment, as did subjective cognitive, physical and emotional functioning. This case report indicates that rhGH replacement therapy could improve cognitive behaviour and well‐being, as well as hippocampal metabolism and functioning in opioid‐treated patients with chronic pain. The idea that GH could affect brain function and repair disabilities induced by long‐term exposure to opioid analgesia is supported.
Alcohol Affordability and Alcohol Demand: Cross‐Country Trends and Panel Data Estimates, 1975 to 2008
Authors: Nelson Jon P.
Published: April 2014

Background

Relatively little is known about cross‐country differences in alcohol affordability or factors that determine differences in affordability over time. This information is potentially important for alcohol policy, especially policies that focus on higher taxes or prices to reduce total alcohol consumption. This study estimates cross‐country alcohol consumption relationships using economic models incorporating income and prices and alternative models based on alcohol affordability. The data and analysis are restricted to higher income countries.

Methods

Data for alcohol consumption per capita (ages 15+) are analyzed for 2 samples: first, 17 countries in the Organisation for Economic Co‐operation and Development for the period 1975 to 2000; second, 22 countries in the European Union for the period from 2000 to 2008. Panel data models are utilized, with country and time fixed‐effects to control for confounding influences. In economic demand models, covariates are real per capita income and real alcohol price indices. In affordability models, income is divided by prices to yield an index of alcohol affordability.

Results

Analysis of data trends reveals that much of the increase in affordability is due to rising real incomes, and not falling real prices. Economic models of demand perform slightly better statistically, but differences are not substantial as income and affordability are highly correlated. For both samples, exogenous rates of growth of alcohol consumption are negative. Price and income elasticities, on average, are within the range of prior estimates. Affordability elasticities are between 0.21 and 0.25.

Conclusions

Although alcohol affordability is a valid concept statistically, its use in policy discussions tends to hide underlying causes of changes in affordability. A better approach is a comparison and analysis of trends and cross‐country differences in real incomes and real alcohol prices together with the affordability index. Country‐level analysis of income and price elasticities also is required.
Lower limb linear morphoea in a pregnant woman with known Graves' disease and cytomegalovirus immunoglobulin M positivity
Authors: Wong Brittany , Piliouras Peter , Mortimore Rohan , Zonta Mark , Tucker Simon
Published: April 2014

We report a case of linear morphoea in a 21‐year‐old woman with known Graves' disease who was also cytomegalovirus (CMV) IgM‐positive and in her early first trimester of pregnancy. The histopathology showed hyalinisation of the dermis with perivascular superficial and deep lymphocytic infiltrates extending into the septae of the subcutis and impinging on adjacent lobules; there was also fibrosis of the subcutis. Magnetic resonance imaging showed T2 high intensity of the subcutaneous tissue and intermuscular planes of the thigh and leg. It is well known that morphoea can follow pregnancy and thyroid disease and that CMV is postulated to contribute in some patients. This case highlights a combination of risk factors for this disease that have not been reported collectively in the literature to our knowledge.
The Fates of Challengers in U.S. House Elections: The Role of Extended Party Networks in Supporting Candidates and Shaping Electoral Outcomes
Authors: Desmarais Bruce A. , La Raja Raymond J. , Kowal Michael S.
Published: April 2014

Extended party network (EPN) theory characterizes political parties in the United States as dynamic networks of interest groups that collaboratively support favored candidates for office. Electoral predictions derived from EPN theory have yet to be tested on a large sample of races. We operationalize EPNs in the context of organized interest contributions to U.S. House campaigns. We deduce that support by a partisan community of interests signals the ideological credibility and appeal of a candidate. EPN integration overcomes voter ambiguity surrounding challengers’ ideological preferences, and resources provided by these coordinating interest groups promote a consistent message about the candidate. Using data from the 1994–2010 cycles, we apply network analysis to detect EPN support of challengers and find that EPN integration substantially improves the electoral prospects of challengers. The effect of EPN integration is distinct from that of campaign resources. The findings provide support for EPN theory, as applied to congressional elections.
‘Beware the lump in the foot!’: predictors of recurrence and survival in bone and soft‐tissue sarcomas of the foot and ankle
Authors: Salipas Andrew , Dowsey Michelle M. , May Deborah , Choong Peter F. M.
Published: April 2014

Background

Although benign lumps around the foot and ankle are common, sarcomas in this area are frequently missed, and the consequences can be disastrous. Patients are often referred to tumour centres after suboptimal prior surgical excision. The predictors of local recurrence, metastasis and survival in this cohort have yet to be elucidated.

Methods

We performed a retrospective review of 61 consecutive patients that were surgically treated for a bone (BS) or soft‐tissue sarcoma (STS) of the foot and ankle between 1996 and 2012 at a specialist tumour centre. Factors such as tumour versus non‐tumour centre surgery and BS versus STS were examined. Univariate and multivariate analyses were performed to determine which factors predicted local recurrence, metastasis and survival.

Results

The overall 5‐year survival rates were 74% in the STS group and 90% in the BS group. Furthermore, 33 (54%) patients had STS. Non‐tumour centre surgery was performed in 23 (38%) patients. Overall local recurrence rate was 6.6%. Intra‐lesional margins predicted a local recurrence, whereas non‐tumour centre surgery was a predictor for developing a metastasis post‐treatment. Tumour size, STS, radical margins (i.e. entire anatomical compartment removed with tumour) and metastasis, either at the time of referral or post‐treatment, were associated with higher mortality.

Conclusion

STSs of the foot and ankle appear to have a worse prognosis than BSs. Early referral to a specialist tumour centre before surgical intervention is recommended.