bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of flooding on marriage: evidence from Pakistan
Authors: Ahmed Riaz
Published: December 2017

Purpose

The purpose of this paper is to examine the effect of the flood on marriages in flooded households compared to marriages in unaffected households by utilizing the 2010 Pakistani flood as a type of natural experiment.

Design/methodology/approach

A difference-in-difference approach is used to estimate the effect of the flood on marriages in 62 flooded districts compared with those in 53 non-flooded districts by utilizing the six waves of the household level surveys data from the Pakistan Social and Living Standards Measurement, 2004-2005 to 2014-2015.

Findings

Results show that the flood decreased marriages; by 17 marriages per 1,000 individuals aged 15-50 years in flooded districts during the flood year and the effect disappeared after the flood year. The negative impact of the flood on rural marriages is significantly higher and robust.

Social implications

The flood seemingly discouraged individuals in flooded districts to be engaged in long term relationship mainly due to the flood related economic and financial losses. In order to acquire and maintain individual overall well-being, sexual health in vital to maintain mental and physical health, so policy makers/humanitarian aid-providers should assist the affected adults financially or by arranging their marriages at least during the flood year. The study also suggests that the delay of marriages means the accumulation of human capital in the form of school attainment of male marriages, so younger adult should be discouraged marrying at early age.

Originality/value

This study contributes to the literature in the following ways: first, the study empirically investigates the impact of flood – both immediate and long term – on marriage rates by using a natural experiment. Second, it examines the relationship based on geographic location and gender. Third, it investigates the impact of natural hazards on child marriage.
Exploring the design process of reconfigurable industrial production systems
Authors: Rösiö Carin , Bruch Jessica
Published: December 2017

Purpose

The purpose of this paper is to explore activities, challenges, and suggest tactics for the design of industrial reconfigurable production systems that can easily adapt to changing market opportunities.

Design/methodology/approach

The paper synthesizes the empirical findings of seven case studies including 47 in-depth interviews at four manufacturing companies.

Findings

A conceptual production system design process and including activities that enables a long-term perspective considering reconfigurability is proposed. Additionally, critical challenges indicating that reconfigurable production system design is not a trivial issue but one that requires separate control and coordination are identified and tactics to overcome the challenges described.

Research limitations/implications

The authors propose a process for designing reconfigurable production systems that are better suited to adjust to future needs. The knowledge of reconfigurability from the reconfigurable manufacturing system literature is applied in the general production system literature field. This study contributes to a clearer picture of managerial challenges that need to be dealt with when designing a reconfigurable production system.

Practical implications

By clarifying key activities facilitating a long-term perspective in the design process and highlighting challenges and tactics for improvement, the findings are particularly relevant to production engineers and plant managers interested in increasing the ability to adapt to future changes through reconfigurability and improve the efficiency of their production system design process.

Originality/value

Although reconfigurable production systems are critical for the success of manufacturing companies, the process of designing such systems is not clear. This paper stretches this by giving a comprehensive picture of the production system design process and the activities that need to be considered to meet these challenges.
Planning and governance issues in the restructuring of the high street
Authors: Peel Deborah , Parker Cathy
Published: December 2017

Purpose

This paper aims to examine the role of “restructuring” in confronting the challenges facing contemporary high streets in the devolved UK. It complements three articles concerned with repositioning, reinventing and rebranding and illustrates the multi-faceted approaches involved in addressing retail change and town centre transformations. This paper emphasises the role of planning and governance in effecting change.

Design/methodology/approach

Informed by a literature review, action research involved inter-related interventions in selected locations, and associated workshops with engaged practitioners and community actors.

Findings

The findings highlight that the “resilience” of contemporary town centres demands resisting efforts to return to the status quo and necessitate forms of adaptive management. Understanding high street degeneration and the limitations of a retail-only led policy focus as a “wicked issue” further demands socially constructing town centres as an ecosystem requiring a holistic response. New forms of joint-working involve selecting appropriate models, attending to relational aspects and defined roles and responsibilities. Land use planning, including masterplanning and creating evidenced policy options, provides an important democratic space for legitimising action, offering leadership and extending participation to new change agents.

Practical implications

Restructuring of governance is an essential prerequisite in effecting change.

Originality/value

The originality of this study lies in the application of the restructuring element of the 4 Rs Framework which enables a focus on the governance dimensions of town centre and high street regeneration. The findings are enhanced through the experiential evidence which stresses both the importance of place-based diversification and value of prioritising holistic and joint actions developed through participatory visioning exercises.
Re-branding the High Street: the place branding process and reflections from three UK towns
Authors: Ntounis Nikos , Kavaratzis Mihalis
Published: December 2017

Purpose

The main aim of this paper is to develop a holistic understanding of place branding and reflect on its practical value and implications, by drawing evidence from the rebranding process of three UK towns (Alsager, Altrincham and Holmfirth) that participated in the HSUK2020 project.

Design/methodology/approach

A comprehensive place branding process that includes the interrelated stages of research, deliberation, consultation, action and communication is presented. The practical value of this theoretical proposition is linked to the experiences of three UK towns that participated in the HSUK2020 project.

Findings

The importance of research, the challenges of participation and the role of communications in place branding processes were identified as primary issues in all towns. The results of the project demonstrate the significance of the initial research stage of the place branding process and show that the process as a whole is valuable in helping places deal effectively with identity issues.

Research limitations/implications

Participatory place branding processes can flourish when place stakeholders are engaged in the right context and are encouraged to work together. In addition, place brands are important cues and empower stakeholders’ participation in all stages of place brand processes.

Practical implications

Knowledge exchange projects that have the potential to engage a plethora of place stakeholders should be considered by practitioners for future place branding strategies.

Originality/value

The paper offers a refreshing practical grounding on participatory place branding concepts and theories. The value of knowledge exchange strategies for examining the field of place branding is also highlighted and can become a useful research approach for future research.
Effects of online consumer reviews on firm-based and expert-based communications
Authors: Zhu Jianjun , Tse David K.C. , Fei Qiang
Published: December 2017

Purpose

To explain and empirically test how different marketing communication channels interact with each other and contribute to brands’ diverging marketplace performance.

Design/methodology/approach

With a unique data set combining key variables of major passenger car brands, the paper takes a source-based perspective to investigate how firm-based communications, expert opinions and online consumer reviews interact and affect brands’ marketplace performance. Then the paper studies the three special boundary conditions under which online consumer reviews’ influence varies in competition with the other two established information sources. Lastly, a study was done to demonstrate the financial significance of investing in different information sources.

Findings

The results show that online consumer reviews mitigate the effectiveness of the other two information sources in driving brand sales. This mitigation effect is also magnified when the brand is weak, firm-based communications are modest and expert opinions are less favorable. The findings further suggest that in the emerging communication enterprise, firm-based and expert-based communications remain the core while user-based communication plays an indispensable competing and complementary role.

Practical implications

In the new digital era, firms are facing the daunting task of understanding and integrating multiple communication channels. The study provides important implications for both researchers and practitioners with respect to brand management and integrated communications.

Originality/value

Existing studies have demonstrated that each of the three communication efforts (by firms, experts and consumers) exerts a significant influence on product sales, but few studies have been conducted in settings marked by the coexistence of these efforts. In addition, the three communication efforts are likely to have different effects on brands with different market positions. The current study is contributing to the literature by filling the above gaps.
Enhancing sustainable urban development through smart city applications
Authors: Angelidou Margarita , Psaltoglou Artemis , Komninos Nicos , Kakderi Christina , Tsarchopoulos Panagiotis , Panori Anastasia
Published: December 2017

Purpose

This paper investigates the potential contribution of smart city approaches and tools to sustainable urban development in the environment domain. Recent research has highlighted the need to explore the relation of smart and sustainable cities more systematically, focusing on practical applications that could enable a deeper understanding of the included domains, typologies and design concepts, and this paper aims to address this research gap. At the same time, it tries to identify whether these applications could contribute to the “zero vision” strategy, an extremely ambitious challenge within the field of smart cities.

Design/methodology/approach

This objective is pursued through an in-depth investigation of available open source and proprietary smart city applications related to environmental sustainability in urban environments. A total of 32 applications were detected through the Intelligent/Smart Cities Open Source (ICOS) community, a meta-repository for smart cities solutions. The applications are analyzed comparatively regarding (i) the environmental issue addressed, (ii) the associated mitigation strategies, (iii) the included innovation mechanism, (iv) the role of information and communication technologies and (v) the overall outcome.

Findings

The findings suggest that the smart and sustainable city landscape is extremely fragmented both on the policy and the technical levels. There is a host of unexplored opportunities toward smart sustainable development, many of which are still unknown. Similar findings are reached for all categories of environmental challenges in cities. Research limitations pertain to the analysis of a relatively small number of applications. The results can be used to inform policy making toward becoming more proactive and impactful both locally and globally. Given that smart city application market niches are also identified, they are also of special interest to developers, user communities and digital entrepreneurs.

Originality/value

The value added by this paper is two-fold. At the theoretical level, it offers a neat conceptual bridge between smart and sustainable cities debate. At the practical level, it identifies under-researched and under-exploited fields of smart city applications that could be opportunities to attain the “zero vision” objective.
Revisiting impact in the context of workplace research: a review and possible directions
Authors: Wall Tony , Bellamy Lawrence , Evans Victoria , Hopkins Sandra
Published: December 2017

Purpose

The purpose of this paper is to revisit the scholarly impact agenda in the context of work-based and workplace research, and to propose new directions for research and practice.

Design/methodology/approach

This paper combines a contemporary literature review with case vignettes and reflections from practice to develop more nuanced understandings, and highlights future directions for making sense of impact in the context of work-based learning research approaches.

Findings

This paper argues that three dimensions to making sense of impact need to be more nuanced in relation to workplace research: interactional elements of workplace research processes have the potential for discursive pathways to impact, presence (and perhaps non-action) can act as a pathway to impact, and the narrative nature of time means that there is instability in making sense of impact over time.

Research limitations/implications

The paper proposes a number of implications for practitioner-researchers, universities/research organisations, and focusses on three key areas: the amplification of research ethics in workplace research, the need for axiological shifts towards sustainability and the need to explicate axiological orientation in research.

Originality/value

This paper offers a contemporary review of the international impact debate in the specific context of work-based and workplace research approaches.
Beyond Text: the co-creation of dramatised character and iStory
Authors: Pässilä Anne , Owens Allan , Kuusipalo-Määttä Paula , Oikarinen Tuija , Benmergui Raquel
Published: December 2017

Purpose

In exploring the impact of reflective and work applied approaches, the authors are curious how vivid new insights and collective “Eureka” momentums occur. These momentums can be forces for work communities to gain competitive advantages. However, the authors know little of how learning is actively involved in the processing of creating new insights and how such a turning to learning mode (Pässilä and Owens, 2016) can be facilitated. In the light of cultural studies and art education, the purpose of this paper is to explore how the method of dramatising characters (DC) in a specific innovation culture can be facilitated. In this viewpoint, the authors are suggesting one approach for this type of turning to learning which the authors call Beyond Text, outlining its theoretical underpinnings, its co-creative development and its application.

Design/methodology/approach

In this Beyond Text context, the authors are introducing the method of DC and the method of iStory both of which are the authors’ own design based on the theory of the four existing categories of a research-based theatre.

Findings

The findings of this viewpoint paper are that both iStory as well as DC methods are useful and practical learning facilitation processes and platforms that can be adopted for use in organisations for promoting reflexivity. Especially they can act as a bridge between various forms of knowing and consummate the other knowledge types (experiential, practical and propositional) in a way that advances practice-based innovation.

Originality/value

The originality and value of iStory and DC is that they can be utilised as dialogical evaluation methods when traditional evaluation strategies and pre-determined indicators are unusable.
Partnership, inclusion and innovation in occupational therapy: Essential or optional ingredients to flourish in a changing environment?
Authors: Gilbert Hunt Susan
Published: December 2017

Background/aim

Historically occupational therapy has evidenced a tenacity to adjust and adapt to societal changes. Currently in Australia we are in the midst of significant change in health, disability and aged care service delivery alongside increasing numbers of new graduates seeking employment. Both of these changes create challenges and opportunities for the profession. How the profession adjusts to new service delivery models and supports new graduates in this changing work environment will influence our future.

Methods

Using examples from practice the paper explores ways in which partnership, inclusion and innovation can be effective in a changing environment.

Results

Doing effective partnership takes time, energy and a shared commitment of all involved and often requires negotiations and compromise. Inclusion can be tricky and requires vigilance and ongoing reflection on actions to determine if the outcomes are what was intended. Innovation can play two roles; it can be used to conserve current practice in new ways or it can offer agency to disrupt and redefine practice.

Conclusion

The way in which the profession chooses to enact partnerships and inclusion will play a vital role in shaping the future. Similarly the space and support made for conservative or disruptive innovation will determine how we choose to define ourselves going forward. Moreover, these choices and actions will govern how effective we are in navigating the changing environment and supporting new graduates transitioning into the profession.
Zinc against advanced glycation end products
Authors: Kheirouri Sorayya , Alizadeh Mohammad , Maleki Vahid
Published: December 2017

Advanced glycation end products (AGEs) are destructive compounds with pathogenic importance in age‐related chronic diseases. Zinc has antioxidant, anti‐inflammatory and anti‐apoptotic potential. This study aimed to summarize effects of zinc on AGE formation and AGE‐induced damaging agents. Pubmed, Google scholar, Web of Sciences, and Scopus databases were searched. There was no limitation for publication date. English language original articles (in vitro, experimental and human studies) which examined the effect of external zinc on AGE formation, AGE‐induced apoptosis, or oxidative stress in mammals were included. To review the effect of zinc on AGE generation, the search keywords were as follows: “zinc” in title and “AGEs” or “methylglyoxal” or “pentosidine” or “carboxymethyllysine” or “glucosylation” or “carbonyl stress” or “AGEs‐induced apoptosis or oxidative stress or inflammation” in title/abstract. In total, 90 titles and abstracts were identified. Fifty‐two studies were screened after duplicates were removed. Six articles were chosen for review following analysis of both titles and summaries. Finally, based on intensive critical appraisal, 5 articles were included in the study. The evidence presented indicates that zinc has anti‐glycation, anti‐oxidative and anti‐apoptotic effects. Zinc insufficiency may stimulate AGEs formation. Whereas, zinc supplementation could inhibit formation of AGEs, AGE‐induced cell apoptosis and oxidative stress status, and protein carbonyl formation possibly through various signalling pathways.
Sexual harassment training: explaining differences in Australian and US approaches
Authors: Bainbridge Hugh TJ , Perry Elissa L , Kulik Carol T
Published: December 2017

Sexual harassment (SH) is an increasingly prominent issue for organisations across the Asia Pacific. However, despite the costs of SH, there has been little consideration of why approaches to SH training vary so widely across countries. We report findings from two national surveys that document the prevalence and characteristics of SH training in Australian and US organisations. Results indicate that training was more prevalent in US organisations. We also examined whether differences in provision and type of training across the two countries was a function of differences in practitioner knowledge about training (a knowing gap) or the ability to use training best practices (a doing gap). There was some evidence of a doing gap reflecting differences in resource availability across the two countries. Findings suggest that practitioners in US organisations have access to more training resources, and are more likely to devote those resources to SH training.
The Determinants of Individual Union Membership in Australia: A Structural Approach Using Panel Data
Authors: Dobbie Michael , Nahm Daehoon
Published: December 2017

This paper uses The Household, Income and Labour Dynamics in Australia survey to estimate a structural probit model of the determinants of individual union membership. The paper finds that union membership responds positively to the wage differential between union and non‐union workers. Consistent with other Australian and overseas research, we find that job rather than individual characteristics are the most important determinants of the probability of union membership. We contrast our research with previous Australian research from the 1980s when unionism was compulsory for many workers. We find significant similarity between the major drivers of individual union membership.
Insecticide resistance and control failure likelihood of the whitefly Bemisia tabaci (MEAM1; B biotype): a Neotropical scenario
Authors: Dângelo R.A.C. , Michereff‐Filho M. , Campos M.R. , da Silva P.S. , Guedes R.N.C.
Published: December 2017

Insecticide resistance is a standing concern for arthropod pest species, which may result in insecticide control failure. Nonetheless, while insecticide resistance has remained a focus of attention for decades, the incurring risk of insecticide control failure has been neglected. The recognition of both problems is paramount for arthropod pest management and particularly so when invasive species notoriously difficult to control and exhibiting frequent cases of insecticide resistance are considered. Such is the case of the putative whitefly species Middle East‐Asia Minor I (MEAM1) (Bemisia tabaci B‐biotype), for which little information is available in the Neotropics. Thus, the likely occurrence and levels of resistance to seven insecticides were surveyed among Brazilian populations of this species. The likelihood of control failure to the five insecticides registered for this species was also determined. Resistance was detected to all insecticides assessed reaching instances of high (i.e. >100×) to very high levels (>1000×) in all of them. Overall efficacy was particularly low (<60%) and the control failure likelihood was high (>25%) and frequent (70%) for the bioinsecticide azadirachtin, followed by spiromesifen and lambda‐cyhalothrin. In contrast, the likelihood of control failure was low for diafenthiuron, and mainly imidacloprid. As cartap and chlorantraniliprole are not used against whiteflies, but are frequently applied on the same host plants, inadvertent selection probably took place leading to high levels of resistance, particularly for the latter. The resistance levels of cartap and chlorantraniliprole correlated with imidacloprid resistance (r > 0.65, P < 0.001), suggesting that the latter use may have somewhat favoured inadvertent selection for resistance to both compounds not used against the whitefly. A further concern is that chlorantraniliprole use in the reported scenario may allow cross selection to cyantraniliprole, a related diamide with recent registration against whiteflies demanding attention in designing resistance management programmes.
“We will never forget 1964!” Shopfloor Organisation and the Class Politics of Trade Union Officials at General Motors‐Holden
Authors: Tierney Robert
Published: December 2017

The article outlines the theory of contingent bureaucratic conservatism of trade union officials, which contends that elected officials represent a conservative stratum in the class struggle. The article also examines arguments made by those who oppose it, partly on the basis that it does not stand up to rigorous empirical analysis. The article tests the theory in the context of the important dispute at General Motors‐Holden's in Australia in October 1964. The events which emerged in the strike demonstrated the unwillingness of the union officials, conservative, moderate and Left alike, to support the strikers at General Motors‐Holden's during the final stages of the dispute, and validates the theory of contingent bureaucratic conservatism of union officials.
Where Greens Support Conservatives: Lessons from the Rundle Minority Government in Tasmania 1996–98
Authors: Crowley Kate , Tighe Megan
Published: December 2017

This paper examines the Greens’ support of the conservative Liberal Rundle minority government in Tasmania (1996–98) in the context of Tasmania's political greening, and with an interest in the operation and experience of this government, and its policy impact in a number of key areas. Although Green support of a conservative government is a unique experience thus far in Australia's history, it is not unknown for Greens to support or even to serve in conservative governments elsewhere at the subnational and the national level. The paper begins by examining these circumstances, before turning to account for Tasmania's political greening, the Liberal‐Green minority government experience, its breakdown, policy impacts, and lessons relevant to the broader literature. It addresses the lack of attention to minority government and support parties in political scholarship, and the experience of green parties participating in government at the subnational level.
Accidental awareness during general anaesthesia – a narrative review
Authors: Tasbihgou S. R. , Vogels M. F. , Absalom A. R.
Published: December 2017

Unintended accidental awareness during general anaesthesia represents failure of successful anaesthesia, and so has been the subject of numerous studies during the past decades. As return to consciousness is both difficult to describe and identify, the reported incidence rates vary widely. Similarly, a wide range of techniques have been employed to identify cases of accidental awareness. Studies which have used the isolated forearm technique to identify responsiveness to command during intended anaesthesia have shown remarkably high incidences of awareness. For example, the ConsCIOUS‐1 study showed an incidence of responsiveness around the time of laryngoscopy of 1:25. On the other hand, the 5th Royal College of Anaesthetists National Audit Project, which reported the largest ever cohort of patients who had experienced accidental awareness, used a system to identify patients who spontaneously self‐reported accidental awareness. In this latter study, the incidence of accidental awareness was 1:19,600. In the recently published SNAP‐1 observational study, in which structured postoperative interviews were performed, the incidence was 1:800. In almost all reported cases of intra‐operative responsiveness, there was no subsequent explicit recall of intra‐operative events. To date, there is no evidence that this occurrence has any psychological consequences. Among patients who experience accidental awareness and can later remember details of their experience, the consequences are better known. In particular, when awareness occurs in a patient who has been given neuromuscular blocking agents, it may result in serious sequelae such as symptoms of post‐traumatic stress disorder and a permanent aversion to surgery and anaesthesia, and is feared by patients and anaesthetists. In this article, the published literature on the incidence, consequences and management of accidental awareness under general anaesthesia with subsequent recall will be reviewed.
Supportive palliative care should be integrated into routine care for paediatric patients with life‐limiting kidney disease
Authors: Thumfart Julia , Reindl Tobias , Rheinlaender Cornelia , Müller Dominik
Published: December 2017

Paediatric palliative care is no longer restricted to patients with cancer and has been extended to patients with other chronic conditions, such as cystic fibrosis or neuromuscular disorders. This review focused on the current state of palliative care for children and adolescents with chronic kidney disease (CKD). We assessed the literature on CKD published up to August 2017. All the papers, except one from 1996, were published this century. This review discusses the role that palliative care plays in the process of decision‐making and explores the possibilities of implementing palliative care into the routine therapy of affected patients and providing support for their families. Offering early palliative care as an integral part of the kidney, supportive care provided by the nephrology care team is both necessary and feasible for patients with CKD. As a minimum, a specialised palliative care team should be involved in patients with multiple comorbidities, in conservative treatment scenarios and in acute life‐threatening complications. Further studies and guidelines are required to improve the care of patients with CKD and their families.

Conclusion

Supportive palliative care should be implemented into the routine care of patients with life‐limiting kidney disease.
Changing landscapes as text: Geography and national education in Singapore
Authors: Ramdas Kamalini , Ho Elaine Lynn‐Ee , Woon Chih Yuan
Published: December 2017

Textbooks are a repository for canonical material that serve as important guides for students as they embark on their journey of learning and discovery. In a discipline as varied as Geography, it is often challenging for authors to decide what to include. We negotiate these concerns as editors of a textbook for a course on Changing Landscapes of Singapore, which is taught primarily to non‐Geography majors who are required by the university to acquire knowledge about Singapore before they graduate. This paper discusses how textbook authors often balance a multiplicity of concerns that extend beyond disciplinary content. These concerns are situated within the broader context of how geographical education plays a key role in making student‐citizens critically aware of the trade‐offs in nation‐building projects and encouraged to apply geographical concepts to engage in active and informed public debates.
Jesus Centered Leadership and Business Applications: An Alternative Approach
Authors: Peters Richard , Ricks Joe M. , Doval Christopher
Published: December 2017

In this article we evaluate Jesus Centered Leadership (JCL), a new concept that has emerged in the realm of spirituality and business management. JCL questions the “Christianity” of Christian business leadership, and proposes principles for ethical leadership that provide a truer representation of the teachings and traits of Jesus. We consider these principles and contribute principles of our own, thereby providing an alternative approach to JCL that remains consistent with the JCL message of morality but addresses issues that offer greater opportunities for adoption within existing business and institutional models.
John Calvin on the Christian's Social Responsibility: Cultural Activist or “Modest Social Reformer”?
Authors: Vorster Nico
Published: December 2017

Recently there have been heated discussions between Reformed theologians who embrace the two‐kingdoms doctrine and proponents of the Neo‐Calvinist tradition on whether Calvin held social transformationist views. This article examines the debate and argues that Calvin did not interpret the kingdom as a progressive social‐transforming reality that gradually establishes God's future eschatological reign on earth. Instead, he regarded Christ's present reign as a “backward”‐reaching reality that restores God's original created order. At the same time Calvin did not make a sharp categorical distinction between the spiritual and civil realms but depicted the civil and spiritual order as two regiments of God's one reign that mutually aid and assist each other.
The Graduating European Dentist: A New Undergraduate Curriculum Framework
Authors: Field J. C. , Cowpe J. G. , Walmsley A. D.
Published: December 2017

With “The Graduating European Dentist”, ADEE provides a new approach that reflects best academic practice for European undergraduate dental education. The new suite of documents sees increased emphasis on important curriculum components such as patient safety, working as a team and patient‐centred care. There is also an increased emphasis on teaching excellence, student satisfaction and student preparedness and support. Guidance relating to methods of teaching and learning, and assessment (educational measurement), is also provided. It is anticipated that this new format will further increase accessibility and utility for educators, institutions, societies and regulators, across the sector.
A longitudinal cohort study on the impact of the clobazam shortage on patients with epilepsy
Authors: Lukmanji Sara , Sauro Khara M. , Josephson Colin B. , Altura K. Chelsea , Wiebe Samuel , Jetté Nathalie
Published: December 2017

Objective

Drug shortages are occurring at an increasing rate. From May to October 2016, there was a shortage of a level I critical antiepileptic drug, clobazam. We aimed to study the impact of this shortage on patients with epilepsy.

Methods

Adult patients from Calgary's Comprehensive Epilepsy Program who were taking clobazam were approached to participate in the study. Baseline data from the clinic prospective registry included clinical variables and presurvey patient‐reported outcomes (PROs) such as the Global Assessment of Severity of Epilepsy, the Global Assessment of Disability Associated with Seizures, and the Quality of Life in Epilepsy questionnaire. We used a mixed‐methods cross‐sectional questionnaire via telephone. We analyzed quantitative data using descriptive methods and qualitative data using a phenomenological approach.

Results

Of the 85 eligible patients, 84% (n = 71) agreed to participate. Participants ranged from 18 to 78 years old, and 59.2% of participants were female. Overall, 80% of participants experienced some form of medication change due to the shortage. No significant differences were found in the pre‐ and during‐shortage PRO data. However, 6 important themes emerged regarding the impact of the antiepileptic drug shortage on patients: (1) communication and awareness, (2) burden on patients and caregivers, (3) physical impact, (4) psychological impact, (5) health care provider assistance in navigating the shortage, and (6) policy change.

Significance

We examined the impact of the clobazam shortage on patients with epilepsy from the patient's perspective and identified 6 important themes. As a result, we were able to gain insight into what patients need to cope with drug shortages and make recommendations that can help mitigate the impact of shortages on patients in the future. Further research is needed to better understand drug shortages from the patient's perspective in various settings and conditions.
Equal Temperament: Autonomy and Identity in Chinese Public Speaking Clubs
Authors: Hampel Amir
Published: December 2017

Young professionals in China are eagerly studying what are called communication skills, particularly public speaking. This article reads technologies of self‐presentation in the context of tentatively liberal social imaginaries, and as therapeutic resources for connecting with others. Entering Toastmasters public speaking clubs in Beijing, we see psychosocial techniques and institutional forms that anchor people otherwise floating in a fragmented urban space. Club members actively seek to be objectified on stage, to become self‐aware under the gaze of an audience. They practice locating themselves within an imagined public, as individuals. However, members also repurpose their clubs into comprehensive social resources, and they construct a critical historical consciousness. While members of public speaking clubs pursue self‐definition, they do so in ways that challenge liberal understandings of autonomy and identity. We can hear these tensions by listening to how Chinese therapists use psychology to articulate social critiques. While both psychotherapists and members of public speaking clubs participate in a modernist cultural politics, club members do not regard personal relationships as antagonistic. Young adults in urban China are getting on stage in order to connect with other people. Like their peers elsewhere, they are learning the power of self‐definition in a world of strangers.
Therapists’ and Clients’ Perceptions of Bonding as Predictors of Outcome in Multisystemic Therapy®
Authors: Glebova Tatiana , Foster Sharon L. , Cunningham Phillippe B. , Brennan Patricia A. , Whitmore Elizabeth A.
Published: December 2017

This longitudinal study examined whether strength of and balance in self‐reported caregiver, youth, and therapist emotional bonds in mid‐ and late treatment predicted outcomes in Multisystemic Therapy of adolescent behavior problems in a sample of 164 caregiver‐youth dyads. Strength of and balance in bonds related to outcome in different ways, depending on the source of the report and time. Results showed a limited association between family members’ emotional connection with the therapist and treatment outcome, whereas therapists’ perceptions of bond with the caregiver showed highly significant associations across time. Caregiver‐therapist agreement on emotional connection at both time points predicted therapist evaluation of treatment success and successful termination, but this was largely explained by therapists’ level of alliance. Balance in bonds with the therapist between caregiver and youth had no significant associations with any outcome. The study major limitations such as examining only one component of alliance and possible implications are discussed.
In vitro modeling of HIV proviral activity in microglia
Authors: Campbell Lee A. , Richie Christopher T. , Zhang Yajun , Heathward Emily J. , Coke Lamarque M. , Park Emily Y. , Harvey Brandon K.
Published: December 2017

Microglia, the resident macrophages of the brain, play a key role in the pathogenesis of HIV‐associated neurocognitive disorders (HAND) due to their productive infection by HIV. This results in the release of neurotoxic viral proteins and pro‐inflammatory compounds which negatively affect the functionality of surrounding neurons. Because models of HIV infection within the brain are limited, we aimed to create a novel microglia cell line with an integrated HIV provirus capable of recreating several hallmarks of HIV infection. We utilized clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 gene editing technology and integrated a modified HIV provirus into CHME‐5 immortalized microglia to create HIV‐NanoLuc CHME‐5. In the modified provirus, the Gag‐Pol region is replaced with the coding region for NanoLuciferase (NanoLuc), which allows for the rapid assay of HIV long terminal repeat activity using a luminescent substrate, while still containing the necessary genetic material to produce established neurotoxic viral proteins (e.g. tat, nef, gp120). We confirmed that HIV‐NanoLuc CHME‐5 microglia express NanoLuc, along with the HIV viral protein Nef. We subsequently exposed these cells to a battery of experiments to modulate the activity of the provirus. Proviral activity was enhanced by treating the cells with pro‐inflammatory factors lipopolysaccharide (LPS) and tumor necrosis factor alpha and by overexpressing the viral regulatory protein Tat. Conversely, genetic modification of the toll‐like receptor‐4 gene by CRISPR/Cas9 reduced LPS‐mediated proviral activation, and pharmacological application of NF‐κB inhibitor sulfasalazine similarly diminished proviral activity. Overall, these data suggest that HIV‐NanoLuc CHME‐5 may be a useful tool in the study of HIV‐mediated neuropathology and proviral regulation.
Older Korean adults have lower physical function despite longer exercise times compared to their Japanese counterparts: A Japan‐Korea comparative study
Authors: Jung Songee , Okubo Yoshiro , Osuka Yosuke , Seino Satoshi , Park Joonsung , Nho Hosung , Tanaka Kiyoji
Published: December 2017

Aim

We aimed to compare the level of physical function (PF) and habitual exercise between older Japanese and Korean adults.

Methods

A comparative study was carried out on 1069 community‐dwelling older Japanese and Korean adults (mean age 73.9 ± 5.2 years). The participants were asked to complete a self‐reported questionnaire regarding habitual exercise and covariates. PF age, a composite measure of PF, was derived from the 12 items, using principal component analysis. PF age and habitual exercise were compared between the Japanese and Korean adults, using analysis of covariance (ancova) and multivariable logistic regression analysis adjusted for all covariates using propensity scores.

Results

ancova showed that PF age in older Japanese adults was significantly younger than in their Korean counterparts. Older Japanese adults exercised significantly less frequently than their Korean counterparts. Furthermore, older Japanese adults practiced significantly less walking, mountain climbing and bicycling, but more calisthenics, resistance training, ball games and dances than their Korean counterparts.

Conclusions

We found that older Korean adults had lower PF (3.7 years older in PF age) than their Japanese counterparts. Although the overall frequency and amount of habitual exercise in older Korean adults were higher than those in their Japanese counterparts, particular types of exercise might have contributed to the higher PF levels among older Japanese adults. Thus, older Korean adults might need to engage more in habitual exercises that are specifically effective in maintaining PF. Geriatr Gerontol Int 2018; 18: 576–583.
Association between number of teeth, use of dentures and musculoskeletal frailty among older adults
Authors: Lee Seoyoung , Sabbah Wael
Published: December 2017

Aim

To assess whether there is a relationship between musculoskeletal frailty and number of teeth/denture use, and whether nutritional intake explains this relationship, in a sample of older Americans.

Methods

Data from the National Health and Nutrition Examination Survey 2011/2012 were used. Handgrip strength was used to show musculoskeletal frailty. Number of teeth and denture use were examined by calibrated dentists. Information on sociodemographic factors, nutrients intake and general health status were collected through interviews. Logistic regression models were used to assess the association between number of teeth/denture use by participants having <20 teeth and musculoskeletal frailty. Poisson regression analyses were used to assess the association between number of teeth/denture use and nutritional intake.

Results

There was no statistically significant difference in musculoskeletal frailty between denture users with <20 teeth and those with ≥20 teeth. Non‐denture users with <20 teeth had higher odds for musculoskeletal frailty (OR 1.32, 95% CI 1.04–1.68). Accounting for nutritional intake explained >30% of this relationship. Having fewer teeth was associated with deficiency of nutritional intake regardless of denture use.

Conclusions

Denture use is associated with lower chances of musculoskeletal frailty among older Americans. Nutritional intake explained approximately one‐third of the association, but most of the relationship was attributed to comorbidity. The findings imply that dental status might play a role in musculoskeletal frailty. Geriatr Gerontol Int 2018; 18: 592–598.
Genetic polymorphism of human leucocyte antigen and susceptibility to multidrug‐resistant and rifampicin‐resistant tuberculosis in Han Chinese from Hubei Province
Authors: Zhou X. , Zhou Q. , Yang Z.‐F. , Li W.‐X.
Published: December 2017

We determined the high‐resolution allele and haplotype frequencies at the human leucocyte antigen (HLA)A, B and DRB1 loci in the Han population of Hubei province, the TB endemic area of Central China, with pulmonary tuberculosis (PTB), and established the relationship between HLA‐A, B and DRB1 alleles as well as haplotypes and susceptibility to multidrug‐resistant and rifampicin‐resistant tuberculosis (MDR/RR‐TB). Blood samples were drawn from 174 patients with MDR/RR‐TB and 838 patients with drug‐susceptible PTB in ethnic Han population from Hubei province (central China). Four‐digit allele genotyping of HLA‐ A, B and DRB1 loci was performed using polymerase chain reaction with sequence‐specific oligonucleotide probes (PCR‐ SSOP). The allele and haplotype frequencies of HLA‐A, B and DRB1 were determined and compared between patients with MDR/RR‐TB and patients with drug‐susceptible PTB. Statistical analysis of the generated data indicated no departure from expectation of Hardy–Weinberg equilibrium (HWE) at all loci of the control group. Multivariate analysis identified allele DRB1*08:01 (p < .0001; OR = 174.5, 95% CI 15.3–1987.2) as independent predictor of MDR/RR‐TB, except for old age (p < .0001; OR = 10. 9, 95% CI 7.6–15.8), previous treatment history (p < .0001; OR = 11.0, 95% CI 7.2–16.7) and poor compliance to treatment (p < .0001; OR = 12.9, 95% CI 8.4–20.0). While in the subgroup of new TB cases, DRB1*08:01 (p < .0001; OR = 80.3, 95% CI 7.0–917.1) and older age (p < .0001; OR = 3.9, 95% CI 2.4–6.4) were independent susceptibility factors for primary MDR/RR‐TB. Our results suggest that a combination of clinical and host genetic information about tuberculosis patients may contribute to prediction and early detection of MDR/RR‐TB.
Assessing the Effectiveness of Pay-to-Go Policies: Evidence from Spain’s Voluntary Return Program1
Authors: Amuedo-Dorantes Catalina , Pozo Susan
Published: December 2017

Pay-to-go programs are incentive-based policies implemented by immigrant-receiving nations with the intention of enticing migrants home. Spain introduced such a program following its recent economic downturn. We assess its effectiveness using a difference-in-differences methodology. We test if the policy lowered the unemployment likelihood of eligible migrants by comparing changes in their propensity to be unemployed from before to after program implementation to changes experienced by similar non-eligible migrants. The Spanish pay-to-go policy did not entice immigrants to return home, except among Latin Americans, who enjoyed statistically and economically significant reductions in their unemployment likelihood following program implementation.