bluuebunny/crossref_metadata_2025 huggingface dataset:
Chronic melioidosis causing an inguinal sinus in a Sri Lankan male
Authors: Bataduwaarachchi Vipula R. , Jayasundara Champa , Tissera Nirmali
Published: March 2015

Introduction:

Melioidosis is an emerging infection in South Asia. It has a spectrum of presentation causing many difficulties in early diagnosis and the control of infection. Here we report a rare case of melioidosis causing an inguinal sinus in a Sri Lankan male.

Case presentation:

This 54‐year‐old male had recurrent admissions to hospital with multiple acute infections including acute inguinal lymphadenitis, left lobar pneumonia and septic arthritis of the left knee joint. He was treated with short courses of antibiotics. Blood cultures revealed no bacterial growth. Ultrasound scan of the abdomen showed multiple loculated abscess formation typical of melioidosis. Repeat blood culture in selective Ashdown's medium was positive for the growth of Burkholderia pseudomallei. He was treated with ceftazidime and imipenem for 4 weeks but was lost to follow‐up before starting an eradication regimen. Later, he presented with a large left inguinal sinus and a draining sinus in the left thigh.

Conclusion:

Presence of multiple septic foci in this patient within a short span of time was due to discharge of bacilli into the bloodstream from the hidden infection in the spleen. This is a good example of an immune organ itself acting as a source of infection under suboptimal immune response. This case also highlights the importance of full screening and complete eradication of the infection at the initial diagnosis before establishment in relatively avascular tissues.
Corrigenda for three related articles
Authors: Lakshman P. L. Nilantha
Published: March 2015

The schemes and chemical names are corrected in three related papers: Vishnupriya, Suresh, Bharkaviet al.[Acta Cryst.(2014), E70, o968–o969], Vishnupriya, Suresh, Gunasekaranet al.[Acta Cryst.(2014), E70, o978], and Vishnupriya, Suresh, Sakthiet al.[Acta Cryst.(2014), E70, o1120–o1121].
What is architectural management? Towards a pragmatic definition
Authors: Alharbi Mohammed , Emmitt Stephen , Demian Peter
Published: March 2015

Purpose

– The purpose of this paper is to provide a pragmatic definition of architectural management (AM) derived from systematic research.

Design/methodology/approach

– A triangulated approach to data collection was employed, comprising a number of sequential stages. First, a literature review was carried out to analyse the previous attempts to define the term. Then, a preliminary survey was conducted (online questionnaire) to capture the current interpretations of the term. After that, a new definition was formulated based on analysing and synthesising the collected data. The fourth stage was focused on examining the consistency of the new definition through the perspectives of architectural researchers and practitioners. The final stage was refining the definition based on the feedback.

Findings

– After following a pragmatic approach for constructing a new definition of AM; and based on the results of the several testing stages, it was found that AM is associated with the strategic management of the architectural office and its individual projects; and it is responsible for value design and delivery for its adopter and for the different types of stakeholders.

Research limitations/implications

– Although there was some quantitative testing in addition to the qualitative data the response rate was low in terms of the population of UK architectural practices.

Originality/value

– The outcome is the first definition of AM grounded in research. The research is unique in terms of reviewing the scope and limitations of the previous definitions of AM. Based on the research findings, the new definition of AM was found to offer an accepted description of AM that can be used by both researchers, educators and practising architects. The definition provides a common understanding (vocabulary) for those working in the area of AM.
Needs and technology adoption: observation from BIM experience
Authors: Singh Vishal , Holmström Jan
Published: March 2015

Purpose

– Despite the recognized role of motivation of actors in technology adoption decisions, there is limited understanding of the psychological processes underlying the motivation. The purpose of this paper is to explore this gap by investigating Building Information Modeling (BIM) adoption from the viewpoint of Maslow’s motivational theory on hierarchy of needs.

Design/methodology/approach

– This research uses mixed methods. Initially theoretical arguments establish the suitability of Maslow’s hierarchy of needs as the conceptual framework to investigate technology adoption. The hypotheses and research questions are investigated using data collected through focus group interviews, interviews and field observations in Australian architecture engineering and construction (AEC). The findings are validated with a survey of BIM adoption cases reported in literature, and additional interviews conducted in Finnish AEC sector. Finally, abductive reasoning is applied to seek the best possible explanation for the observed patterns.

Findings

– It is found that besides individuals, organizations also demonstrate hierarchical ordering of innovation-related needs. Three broad categories of innovation-related needs are identified. Using abduction, the innovation-related needs of actors are described in terms of stable and excited states.

Research limitations/implications

– The findings are primarily based on studies conducted in regions with developed economies.

Practical implications

– This research shows that Maslow’s hierarchy of needs could be a useful diagnostic framework to assess actors’ response towards technology adoption.

Originality/value

– This investigation into the potential usefulness of Maslow’s theory into understanding technology adoption is by itself a novel research contribution. The finding that hierarchical view of needs can partly explain the adoption decisions of both individual and organizational actors is an original contribution.
Self-vis-à-vis-proxy reported morbidity prevalence among adults in India: a study based on the national sample survey
Authors: Agrawal Gopal
Published: March 2015

Purpose

– Since inception, National Sample Survey (NSS) is the only large-scale household survey in India, periodically collecting data on morbidity and health care conditions in the country. In these surveys, information for all members of sample households was gathered either from head or a key informant of the household. This paper aims to discuss these issues.

Design/methodology/approach

– This study was developed to examine whether the use of proxy respondents influences population estimates of morbidity prevalence rates and factors associated with morbidity prevalence rates among adults based on latest 60th round NSS data on morbidity and health care.

Findings

– The results showed that use of proxy in this survey had severely affected morbidity prevalence rates among adult persons aged 18 years and above. The result showed that use of proxy in the NSS 60th round survey had resulted in underestimation of morbidity prevalence rates among adults in such a way that overall morbidity prevalence rate was 45 per cent higher in direct interviews (148 per 1,000 adult persons) compared to those answered by proxies (81, p<0.001). There were variations in underreporting of morbidities by socio-economic and demographic characteristics of proxies but the direction of the association was the same.

Research limitations/implications

– The study conclude that morbidity data from the NSS can be used regardless of use of proxies and that the association between worse health condition and socio-economic and demographic factors persisted even when information was collected from a proxy. However, suitable adjustments for proxy-reporting should be made while estimating realistic population at risk from the NSS data.

Originality/value

– This is the first manuscript that has made an attempt to examine the effect of proxy-reporting on morbidity prevalence in NSS data. Since its inception in 1955, NSS data are the only data source available in India on morbidity and health care conditions. A large number of research manuscripts have been published using this data and there were serious concerns among the researchers on data quality particularly about the reporting of health status. NSS 60th round first time provided information on reporting status, i.e. proxy vs self. In this context, the present study made an effort in this direction.
Perth (Australia) as one of the world's most liveable cities: a perspective on society, sustainability and environment
Authors: Jones Cheryl , Newsome David
Published: March 2015

Purpose

– Rankings of the world's cities by a liveability factor have become increasingly significant in the media, among governments and city councils in the promotion of cities, as well as academics interested in understanding the impact of quantifying liveability on urban planning and the relationship of liveability indices and tourism. The paper aims to discuss this issue.

Design/methodology/approach

– While examining characteristics of liveable cities according to some of the widely reported liveability indices, such as those produced by Mercer, Monocle magazine and the Economic Intelligence Unit (EIU), the authors provide a snapshot of Perth as a liveable city and consider liveability in relation to urban tourism, sustainability and environment. Perth's liveability ranking is discussed in terms of environmental sustainability, noting that for Perth to retain its position as one of the world's most liveable cities, consideration must be given to sustainable planning and environmental practices at policy, organisational and individual levels, placing the long-term liveability of the environment and Perth's flora and fauna at the forefront of urban, and tourism, planning.

Findings

– The accessibility of nature in Perth and its surrounds, its outdoor recreational opportunities and warm climate are factors that make it unique. Developing and promoting nature-based tourism would further enhance the accessibility of nature for visitors and residents. While Perth's EIU top ten ranking is justified, its major attributes remain unrecognised by the widely used EIU liveable city assessment framework.

Research limitations/implications

– Moreover, the notion of a liveable city is open to contention due to the subjective nature of various assessment criteria. Liveability indices should include quantifiable environmental factors such as green space, remnant vegetation, biodiversity, air quality and unpolluted water.

Originality/value

– This paper thus contributes to the discourse on what constitutes a liveable city, the authors emphasise that liveability is significantly related to the presence of green space and natural areas as well as the opportunity to see and interact with wildlife. Perth has such opportunities for it residents and visitors but as yet the aforementioned natural characteristics are not implicit in international measures of liveability.
CFD analysis of load-carrying capacity of hydrodynamic lubrication on a water-lubricated journal bearing
Authors: Gengyuan Gao , Zhongwei Yin , Dan Jiang , Xiuli Zhang
Published: March 2015

Purpose

– The purpose of this paper is to improve hydrodynamic load-carrying capacity of a water-lubricated journal bearing by a new bush structure. Water-lubricated bearing is becoming more and more popular since it is environmentally friendly and saves energy. However, contrary to oil and grease-lubricated bearings, water-lubricated bearing is limited in many situations due to its low hydrodynamic load-carrying capacity.

Design/methodology/approach

– The present article proposes a new bearing bush, with a transition-arc structure, which is favorable for increasing hydrodynamic load-carrying capacity. Hydrodynamic load-carrying capacity was calculated by means of three-dimensional computational fluid dynamics (3-D CFD) analysis. Several variants of a journal bearing with a transition-arc structure of different dimensions are analyzed, while the radial clearance of the bearing, eccentricity ratio and the velocity of the journal remain unchanged.

Findings

– The results show that obvious changes are found in hydrodynamic load-carrying capacity of a water-lubricated journal bearing. For different width over diameter (L/D) bearing ratios, the relationship between hydrodynamic load-carrying capacity and the magnitude of the transition-arc structure dimension is researched.

Originality/value

– The research presented here leads to a design reference guideline that could be used by the designer engineer to design smart journal bearings for improving the hydrodynamic load-carrying capacity.
The importance of 2 per cent PTFE/FeF3 additives in engine fully formulated oil for reducing friction and wear under boundary lubrication condition
Authors: Nehme Gabi N , Ghalambor Saeed
Published: March 2015

Purpose

– This paper aims to focus on the topics of phosphorus (P) and sulfur (S) in engine oil. Very reproducible boundary lubrication tests were conducted as part of Design of Experiments software to study the behavior of fluorinated catalyst iron fluoride (FeF3) and polytetrafluoroethylene (PTFE) in the development of environment-friendly (reduced P and S) anti-wear additives for future engine oil formulations. Multi-component fully formulated oils were used with and without the addition of PTFE and fluorinated catalyst to characterize and analyze their performance.

Design/methodology/approach

– A boundary lubrication protocol was used in the DOE tests to study their tribological behavior. Lubricant additives like PTFE and FeF3 catalyst were used at different concentrations to investigate the wear resistance and the time for a full breakdown under extreme loading conditions. Experiments indicated that new sub-micron FeF3 catalyst plays an important role in preventing the breakdown of the tribofilm.

Findings

– This paper explores the effect of PTFE and FeF3 catalyst on the performance of fully formulated engine oils. The purpose was to develop equations for minimum wear volume and maximum time for full breakdown. Emphasis was, therefore, given to conditions where the additives were working effectively for minimizing zinc dialkyl dithio phosphate (P per cent). Lubricating oils are normally multi-component additivated systems. They contain different additives such as viscosity improvers, detergents, dispersants and antioxidants. It is known that these additives interact at the surface, affecting the function of the lubricating oil. Therefore, it is important to note that the performance with PTFE and FeF3 catalyst was significantly improved when compared to fully formulated commercial oils used alone.

Originality/value

– Lubricating oils are normally multi-component additivated systems. They contain different additives such as viscosity improvers, detergents, dispersants and antioxidants. It is known that these additives interact at the surface, affecting the function of the lubricating oil. Therefore, it is important to note that the performance with PTFE and FeF3 catalyst was significantly improved when compared to fully formulated commercial oils used alone.
Getting it right: directors’ assessment of information
Authors: O’Donnell Kerri , Hicks Barry , Streeter John , Shantapriyan Paul
Published: March 2015

Purpose

– The purpose of this paper is to explore the increasing expectation against two concepts, information and process scepticism. In light of theCentrocase judgement, directors’ decisions are held to increasing standards of due care and diligence.

Design/methodology/approach

– This is a conceptual paper, drawing upon archival material, including statute law, case law, regulatory guidance material and media releases in Australasia. The authors review the statutory duty of care, skill and diligence expected of non-executive directors.

Findings

– Whether a director has exercised an appropriate level of reasonable care and skill and/or due diligence has been a matter for the courts to decide. Such retrospective analysis leaves directors vulnerable to the uncertainty of whether their individual interpretation of diligence matches up to that of the presiding judge. The authors provide directors with a framework to apply scepticism to information and processes provided by those on whom the directors may rely.

Research limitations/implications

– Two concepts are identified: reasonable reliance on others and the business judgement rule. The authors present arguments that challenge us to understand reasonable reliance, judgement and actions of directors in light of processing and information scepticism.

Practical implications

– Directors do have a different role to that of auditors; incorporating scepticism can enable directors to fulfil their responsibility towards shareholders. By applying information and process scepticism, directors of companies can reduce the likelihood and magnitude of litigation costs and out-of-court settlements.

Originality/value

– This paper provides a framework to apply scepticism to information and processes provided by people on whom the directors may rely.
Managing risk in mergers and acquisitions activity: beyond ‘good’ and ‘bad’ management
Authors: Bhimani Alnoor , Ncube Mthuli , Sivabalan Prabhu
Published: March 2015

Purpose

– This paper aims to assess the impact of the presence/absence of risk management practices on the risk of merger and acquisition (M&A) failure.

Design/methodology/approach

– An agency theoretic perspective is adopted, along with a mixed-methods approach to study managerial complexity beyond simply “good” and “bad”. The focus is on an agency conflicts.

Findings

– The authors first present an integrated framework that classifies managerial behaviour and risk management, where M&A bids can become vehicles for maximising managerial benefits rather than shareholder value. The authors proceed to consider M&A activity that benefits both managers and shareholders in the presence of risk management strategies.

Research limitations/implications

– The paper highlights the benefits of multiple paradigms and research paths that address dimensions captured by an agency theoretic perspective.

Practical implications

– The authors regard this paper as having particular significance in that the global financial crisis has impacted M&A activities and objectives, shifting the employment and related risks faced by managers.

Originality/value

– The paper suggests future research paths to advance the understanding of the complex behaviour of managers involved in M&A activities that go beyond the classification of “good” and “bad” managers.
Recovery and reliable change rates for patients scoring severe on depression, anxiety or impaired functioning in a psychological therapies service: IAPT
Authors: Griffiths Christopher Alan , Griffiths Laura Jayne
Published: March 2015

Purpose

– The NHS Improving Access to Psychological Therapies (IAPT) programme provides access to psychotherapy in England through a stepped care approach for adults with depression and anxiety disorders. This evaluation sought to investigate IAPT recovery and reliable change rates of those who scored severe on depression (PHQ-9), anxiety (GAD-7) or impaired functioning (WASA). The paper aims to discuss this issue.

Design/methodology/approach

– This evaluation employed a within groups design: a single case evaluation follow-up. Routine service data (from services set-up in 2008-2009 to February 2012) from 25,034 patients treated at four IAPT services was analysed.

Findings

– The analysis revealed that 29 per cent (n=7,059) of patients were assessed as being in the WASA severe range, 41 per cent (n=10,208) in the PHQ severe range, and 57 per cent (n=14,612) in the GAD-7 severe range; with 14 per cent (n=3,548) in the severe range on all three measures combined. There were significant falls on all three measures and a large effect size. The percentage of patients who recovered to a point below the recovery threshold was 30 per cent for depression, 34 per cent for anxiety, 18 per cent for impaired functioning, and for those presenting severe on all measures: recovery rates were 21 per cent for anxiety, 26 per cent for depression, and 15 per cent for impaired functioning. Reliable change for anxiety was found to be greater than IAPT patients overall.

Originality/value

– The results show that IAPT enables approximately a third of people scoring severe to recover, lower than IAPT recovery rates overall. Reliable change may be a more effective measure of patient progress.
Sustainability in food service supply chains: future expectations from European industry experts toward the environmental perspective
Authors: Darkow Inga-Lena , Foerster Bernadette , von der Gracht Heiko A.
Published: March 2015

Purpose

– This study aims to examine the management of food supply chains in complex and volatile business environments, where the sustainability requirements of customers and legislation are increasing. This challenging situation gives rise to the question as to how a logistics company can achieve and sustain competitive advantage through environmentally-oriented sustainability.

Design/methodology/approach

– This empirical study gathers insights on emerging practices in European food service supply chains from two parallel Delphi surveys conducted with 145 industry experts from 27 countries. The long-term industry expectations of a leading provider in food service logistics are compared with an industry-wide external panel. The questions were designed to understand how managers perceive the emerging domain of sustainability in supply chains.

Findings

– Environmentally oriented sustainability will remain a key driver of success in the field. However, after applying the dominant logic concept for analyzing results, it becomes apparent that managers have to continuously challenge internal existing expectations to translate an emerging domain into strategy. We show how the senior management team under investigation was challenged in its dominant logic and how it tried to overcome this situation during strategy development.

Originality/value

– The study shows how managers perceive and cope with the emerging domain of environmentally oriented sustainability, how they translate it into strategy, and utilize resources for creating customer value. The research supports managers in adapting to new competitive environments. Furthermore, the study contributes by visualizing the dominant logic of a firm and the approach of top management for adjustment.
The drug logistics process: an innovative experience
Authors: Pinna Roberta , Carrus Pier Paolo , Marras Fabiana
Published: March 2015

Purpose

– The purpose of this paper is to present the latest innovations in the drug distribution processes of hospital companies, which are currently dealing with high inventory and storage costs and fragmented organizational responsibilities.

Design/methodology/approach

– The literature review and the in-depth analysis of a case study support the understanding of the unit dose drug distribution system and the subsequent definition of the practical implications for hospital companies.

Findings

– Starting from the insights offered by the case study, the analysis shows that the unit dose system allows hospitals to improve the patient care quality and reduce costs.

Research limitations/implications

– The limitations of the research are those related to the theoretical and exploratory nature of the study, but from a practical point of view, the work provides important indications to the management of healthcare companies, which have to innovate their drug distribution systems.

Originality/value

– This paper analyzes a new and highly topical issue and provides several insights for the competitive development of a fundamental sector.
Service-based vs. goods-based positioning of the product concept
Authors: Cassia Fabio , Ugolini Marta Maria , Cobelli Nicola , Gill Liz
Published: March 2015

Purpose

– To counteract increasing competition and satisfy evolving customers’ needs, many firms are changing the positioning of their product concepts, from being product-based into service-based. Despite the increasing relevance of this shift, it is still unclear if this choice has a differential impact on customer perceived value. The purpose of this paper is to analyze customer perceived value for a firm’s product concept being positioned either as service-based or goods-based.

Design/methodology/approach

– An experiment was conducted using stimuli for two different product categories (hearing aids and bicycles) and measuring customers perceived value through the PERVAL scale’s four dimensions (quality value, emotional value, price value and social value).

Findings

– The results show that presenting the product concepts as service-based instead of good-based can enhance customer perceived value (in particular: quality, emotional and social value), but only if customers are not familiar with the product.

Research limitations/implications

– The study is based on one experiment and considers only two product categories. Further studies are needed to corroborate findings.

Practical implications

– The findings suggest that, under specific circumstances, the firm may improve customers’ attitude toward the product by emphasizing a service-based instead of a good-based positioning of the product concept.

Originality/value

– To our knowledge, this is the first research to evaluate the effects on customer perceived value of repositioning a product which has been traditionally goods-based (such a hearing aid and a bicycle) into service-based.
Applicability of SIRIM Green 5-S Model for productivity
&
business growth in Malaysia
Authors: Ho Sam , Mohd Hashim Abdul Ghani Bin , Mohd Idris Mohd Azman
Published: March 2015

Purpose

– Based on the TQM Model developed in a previous paper published at the TQMJ, the authors have a chance to test out the model in a number of firms in Malaysia through Standards and Industrial Research Institute of Malaysia (SIRIM). Furthermore, riding on the success, SIRIM has named it as the SIRIM Green 5-S Model. As a result, the purpose of this paper is to share the experience of the “SIRIM Green 5-S Model for business sustainability and organisational development”.

Design/methodology/approach

– Based on questionnaire survey of 81 organisations cutting across different industries in Malaysia (+2 in-depth interview), this research is to study three research questions relating to 5-S and Lean Management. RQ1: is the 5-S Practices a necessary and sufficient condition for Organisational Productivity (OP)?; RQ2: is the L5S Practices a necessary and sufficient condition for Business Growth (BG)?; and RQ3: is the SIRIM Green 5-S applicable and effective for OP and BG?

Findings

– There is a ranking of effectiveness of the 5-S and L5S criteria in quality improvement. There is a strong correlation of the 5-S and L5S functions in quality improvement. How to use Green 5-S Model to improve productivity, increase sales and reduced cost. How to use Green 5-S Model to establish and maintain quality environment for OP and BG in order to provide competitiveness for business and industries of Malaysia.

Originality/value

– Since 1993, the authors used the proprietary 5-S Checklist for training and consultancy in no less than ten countries with over 50,000 persons from around 2,000 organisatioins world-wide. On the other hand, HKSAR takes the lead in the global oil energy consumption/GPD. The experience will be shared in this paper.
Understanding fungal functional biodiversity during the mitigation of environmentally dispersed pentachlorophenol in cork oak forest soils
Authors: Varela Adélia , Martins Celso , Núñez Oscar , Martins Isabel , Houbraken Jos A. M. P. , Martins Tiago M. , Leitão M. Cristina , McLellan Iain , Vetter Walter , Galceran M. Teresa , Samson Robert A. , Hursthouse Andrew , Silva Pereira Cristina
Published: March 2015

Pentachlorophenol (PCP) is globally dispersed and contamination of soil with this biocide adversely affects its functional biodiversity, particularly of fungi – key colonizers. Their functional role as a community is poorly understood, although a few pathways have been already elucidated in pure cultures. This constitutes here our main challenge – elucidate how fungi influence the pollutant mitigation processes in forest soils. Circumstantial evidence exists that cork oak forests in N. W. Tunisia – economically critical managed forests are likely to be contaminated with PCP, but the scientific evidence has previously been lacking. Our data illustrate significant forest contamination through the detection of undefined active sources of PCP. By solving the taxonomic diversity and the PCP‐derived metabolomes of both the cultivable fungi and the fungal community, we demonstrate here that most strains (predominantly penicillia) participate in the pollutant biotic degradation. They form an array of degradation intermediates and by‐products, including several hydroquinone, resorcinol and catechol derivatives, either chlorinated or not. The degradation pathway of the fungal community includes uncharacterized derivatives, e.g. tetrachloroguaiacol isomers. Our study highlights fungi key role in the mineralization and short lifetime of PCP in forest soils and provide novel tools to monitor its degradation in other fungi dominated food webs.
Theoretical frameworks for working with harder to reach families: lines, curlicues, and spirals: comment on Donovan and Pocock
Authors: Lord Susan
Published: March 2015

This article comments on the Donovan and Pocock articles appearing in this issue, both of which address the evolution of theory and practice in family therapy. An emphasis is placed on the importance of integration and a shared philosophy of theory and practice in our current political and economic managed care climate, in which it is critically important to embrace the integrated and chaotic whole of what is happening in theory and in practice.
Race/Ethnicity and Overuse of Care: A Systematic Review
Authors: KRESSIN NANCY R. , GROENEVELD PETER W.
Published: March 2015

Policy Points:

Racial/ethnic differences in the overuse of care (specifically, unneeded care that does not improve patients’ outcomes) have received little scholarly attention.

Our systematic review of the literature (59 studies) found that the overuse of care is not invariably associated with race/ethnicity, but when it was, a substantial proportion of studies found greater overuse of care among white patients.

The absence of established subject terms in PubMed for the overuse of care or inappropriate care impedes the ability of researchers or policymakers to synthesize prior scientific or policy efforts.

Context

The literature on disparities in health care has examined the contrast between white patients receiving needed care, compared with racial/ethnic minority patients not receiving needed care. Racial/ethnic differences in the overuse of care, that is, unneeded care that does not improve patients’ outcomes, have received less attention. We systematically reviewed the literature regarding race/ethnicity and the overuse of care.

Methods

We searched the Medline database for US studies that included at least 2 racial/ethnic groups and that examined the association between race/ethnicity and the overuse of procedures, diagnostic (care) or therapeutic care. In a recent review, we identified studies of overuse by race/ethnicity, and we also examined reference lists of retrieved articles. We then abstracted and evaluated this information, including the population studied, data source, sample size and assembly, type of care, guideline or appropriateness standard, controls for clinical confounding and financing of care, and findings.

Findings

We identified 59 unique studies, of which 11 had a low risk of methodological bias. Studies with multiple outcomes were counted more than once; collectively they assessed 74 different outcomes. Thirty‐two studies, 6 with low risks of bias (LRoB), provided evidence that whites received more inappropriate or nonrecommended care than racial/ethnic minorities did. Nine studies (2 LRoB) found evidence of more overuse of care by minorities than by whites. Thirty‐three studies (6 LRoB) found no relationship between race/ethnicity and overuse.

Conclusions

Although the overuse of care is not invariably associated with race/ethnicity, when it was, a substantial proportion of studies found greater overuse of care among white patients. Clinicians and researchers should try to understand how and why race/ethnicity might be associated with overuse and to intervene to reduce it.
Resilience and Justice
Authors: Fainstein Susan
Published: March 2015

The term resilience has become the popular formulation for plans that deal with preparedness for disaster. It implies adaptation rather than returning to a pre‐crisis state. Its use has been extended from environmental events to social and economic crises. Its fault is that it obfuscates underlying conflict and the distribution of benefits resulting from policy choices. Development of resilience policies is cloaked in complicated models showing complexity and indeterminacy. Marxist analysis provides insights that cut through the failure of these models to assign agency, but it does not offer approaches short of revolution to assist present‐day planning. The conclusion of the essay presents strategies that can lead to greater justice in planning to cope with the impacts of devastating events.
Application value of MRI combined with positron emission tomography (PET)/CT in diagnosis and preoperative staging of tongue squamous cell carcinoma
Authors: Chen Wenbo , Zhang Chunxing , Zhang Shuixing , Liang Long , Zhang Bin , Liu Chunling , Zhang Zhonglin , Liang Changhong
Published: March 2015

Introduction

This study aimed to compare and analyse the findings of tongue squamous cell carcinoma (TSCC) on MRI and positron emission tomography (PET)/CT and explore the diagnostic utility of combined MRI‐PET/CT in the diagnosis and preoperative staging of TSCC.

Methods

A prospective analysis of MRI and PET/CT data in 18 TSCC cases was performed. Cases were comprehensively staged on MRI and PET/CT preoperatively according to American Joint Committee on Cancer (AJCC) staging criteria and confirmed by pathological results.

Results

The highest and lowest sensitivities of preoperative AJCC staging I–IV using MRI alone, PET/CT alone and combined MRI‐PET/CT were 100.0%, 100.0% and 100.0% (stage II) and 50.4%, 55.6% and 55.6% (stage I), respectively. The highest specificities were 100.0%, 100.0% and 100.0% (stage II), and the highest correct rates were 100.0%, 96.5% and 100.0% (stage II). Compared with the postoperative pathological staging, preoperative staging showed no significant difference for stages I–II and IV (P > 0.05); however, stage III showed a significant difference (P < 0.05). When combined MRI‐PET/CT was compared with MRI alone in the accuracy of preoperative TSCC staging, there was no significant difference for stages I–III (P > 0.05), but there was a significant difference for stage IV (P < 0.05).

Conclusions

Combined MRI and PET/CT could serve as an important tool for the accurate diagnosis and preoperative staging of TSCC and could improve the accuracy of preoperative TSCC staging.
Use of implanted gold fiducial markers with MV‐CBCT image‐guided IMRT for pancreatic tumours
Authors: Packard Matthew , Gayou Olivier , Gurram Krishna , Weiss Brandon , Thakkar Shyam , Kirichenko Alexander
Published: March 2015

Introduction

Visualisation of soft tissues such as pancreatic tumours by mega‐voltage cone beam CT (MV‐CBCT) is frequently difficult and daily localisation is often based on more easily seen adjacent bony anatomy. Fiducial markers implanted into pancreatic tumours serve as surrogates for tumour position and may more accurately represent absolute tumour position. Differences in daily shifts based on alignment to implanted fiducial markers vs. alignment to adjacent bony anatomy were compared.

Methods

Gold fiducial markers were placed into the pancreatic tumour under endoscopic ultrasound (EUS) guidance in 12 patients. Patients subsequently received image‐guided intensity‐modulated radiation therapy (IG‐IMRT). MV‐CBCT was performed prior to each fraction and isocentre shifts were performed based on alignment to the fiducial markers. We retrospectively reviewed archived MV‐CBCT datasets and calculated shift differences in the left‐right (LR), superior‐inferior (SI) and anterior‐posterior (AP) axes relative to shifts based on alignment to adjacent bony anatomy.

Results

Two hundred forty‐three fractions were analysed. The mean absolute difference in isocentre shifts between the fiducial markers and those aligned to bony anatomy was 3.4 mm (range 0–13 mm), 6.3 mm (range 0–21 mm) and 2.6 mm (range 0–12 mm), in LR, SI and AP directions, respectively. The mean three‐dimensional vector shift difference between markers vs. bony anatomy alignment was 8.6 mm.

Conclusions

These data suggest that fiducial markers used in conjunction with MV‐CBCT improve the accuracy of daily target delineation compared with localisation using adjacent bony anatomy and that gold fiducial markers using MV‐CBCT alignment are a viable option for target localisation during IG‐IMRT.
Effect of fund size on the performance of Australian superannuation funds
Authors: Cummings James R.
Published: March 2015

This study examines the relationship between fund size and performance for two major superannuation industry sectors in Australia: retail and not‐for‐profit, using a unique but confidential database. Results suggest that members benefit from being invested in larger superannuation funds for three reasons: (i) larger not‐for‐profit funds provide diversification benefits of investing in more asset classes including unlisted property and private equity, (ii) larger funds in both sectors avoid the scale diseconomies in investment returns documented in studies of equity mutual funds and (iii) larger funds make substantial savings by spreading fixed operating costs (such as IT infrastructure) over a larger asset base.
Inter‐observer reliability of the PASI in a clinical setting
Authors: Cabrera Samantha , Chinniah Niranthari , Lock Nannette , Cains Geoffrey D. , Woods Jane
Published: March 2015

Background

With the evolving emphasis on evidence‐based practice, the use of reliable clinical scales forms an important foundation for clinical assessment. The psoriasis area and severity index (PASI) is the most widely used tool for the measurement of psoriasis severity; however, there has been some debate over the potential reproducibility of PASI scoring.

Objectives

To determine the inter‐observer reliability of the PASI at a large tertiary hospital with a psoriasis treatment centre.

Methods

In total, 34 patients who were due for their 3‐monthly follow up at a psoriasis treatment centre were independently evaluated by five clinical staff (observers) from the Department of Dermatology. Each observer independently determined the PASI score of each patient and the inter‐observer reliability coefficient was determined by employing intra‐class correlation coefficients (ICC).

Results

There was a significant degree of concordance among the PASI scoring of observers (ICC = 0.804; CI 95%: 0.706–0.883).

Conclusions

Our cross‐sectional study suggests that the PASI provides a reproducible method of assessing psoriasis severity among patients seen in a busy dermatology clinic at a large tertiary hospital.
Biological therapies for psoriasis: Adherence and outcome analysis from a clinical perspective
Authors: Ross Christopher , Marshman Gillian , Grillo Marianne , Stanford Tyman
Published: March 2015

We evaluated and compared patients' long‐term adherence to biological therapies in a real‐life clinical setting. Secondary aims included weight changes on biological therapy and reporting adverse effects. This prospective case‐note review included 58 patients, undergoing 84 treatment series including etanercept (21), adalimumab (24), infliximab (14) and ustekinumab (25). Patients' adherence was greatest with ustekinumab (being 6.7‐fold less likely to withdraw from treatment than etanercept, P = 0.014), while the difference in treatment adherence of adalimumab and infliximab compared to etanercept was not statistically significant. Adalimumab and infliximab were associated with an increase in weight, while ustekinumab was associated with weight loss compared with etanercept (not statistically significant). Long‐term patient adherence to biologic therapy in patients with psoriasis is greatest with ustekinumab.
Prophylactic antibiotics in dermatological surgery
Authors: Lee Michael R , Paver Robert
Published: March 2015

This is a review of the common pathogens of surgical site infections, antibiotic coverage for particular anatomical sites, mechanisms by which surgical site infections occur and the latest data and recommendations for prophylactic antibiotics in the prevention of surgical site infections, infective endocarditis and haematogenous joint infections. Recent evidence‐based guidelines on surgical prophylaxis is for restricted indications and a shorter duration of antibiotic prophylaxis in situations where no clinical benefit of prolonged therapy has been proven, in order to minimise the potential adverse ecological and clinical effects associated with antibiotic therapy. This review recommends the cautious use of prophylactic antibiotics in dermatological surgery to help prevent the growing problem of bacterial resistance as well as other morbidity and health‐care costs.
Estimated glomerular filtration rates cannot replace measured GFR in type 1 diabetes patients with hyperfiltration
Authors: Perrin NES , Berg UB
Published: March 2015

Aim

This study of children and young adults with type 1 diabetes with normal to high glomerular filtration rates (GFR) compared estimated GFR (eGFR) with measured GFR (mGFR).

Methods

GFR was measured by inulin clearance, and we carried out simultaneous analyses of standardised creatinine and cystatin C. eGFR was calculated using different formulas.

Results

We enrolled 106 patients, including 56 males, aged 21.9 (standard deviation 9.2) years with 13.7 (9.1) years' duration of diabetes and a mean haemoglobin A1c (HbA1c) of 7.7% (61 mmol/mol). The median mGFR was 128 (111–143) mL/min/1.73 m2. Most of the eGFR estimations failed to detect a significant proportion of hyperfiltration based on inulin clearance. The best accuracy (P30) between eGFR and mGFR was seen with eGFRCKD‐EPI (92%), eGFRcys C Berg (86%), eGFRcys C CAPA (78%) and eGFRcys C Inker (84%) where eGFRCKD‐EPI and eGFR cys C Berg showed the lowest bias. Most eGFRcys C measurements showed greater accuracy when combined with eGFRcr (P30 92–94%).

Conclusion

The best accuracy (P30) and lowest bias were found with eGFRCKD‐EPI and eGFR Berg. in this cohort. However, eGFR cannot accurately replace mGFR to detect hyperfiltration and follow GFR over time in young patients with type 1 diabetes.
Setting stream naturalisation goals to achieve ecosystem improvement in urbanising greenfield catchments
Authors: Sammonds M J , Vietz G J
Published: March 2015

Expanding cities worldwide are gradually absorbing peripheral greenfield streams that often require some level of improvement to fulfil their role as central public spaces in the urban landscape. Restoration is often impossible due to physical constraints imposed by urban development coupled with fundamental biophysical modification from previous land use. However, it is possible to provide social amenity and improve stream ecosystem condition through the process of naturalisation – an implicitly social undertaking reliant on the well‐informed participation of stakeholders. Urbanising greenfield sites present a special case of naturalisation that does not include a local community as it is absent in advance of development. The authors present a case study where they were involved as advising scientists in a stream naturalisation project in Melbourne, Australia. In the case study, the lack of this founder community in the consultation process coupled with limited integration between other stakeholders resulted in naturalisation goals unlikely to result in improved in‐stream ecosystem condition. The final design adopted some features that extended beyond baseline regulatory standards for drainage schemes in new developments, but with insufficient provision for catchment‐scale treatment of stormwater runoff, which has been recognised as a primary source of urban stream degradation. This study expands the concept of naturalisation – originally developed in the context of rural stream management – to include urbanising greenfield catchments where advocacy groups and urban planning officials from local government hold chief responsibility to represent the values and attitudes of the founder community in the consultation process.
Evidence for a vasomotor cyclo‐oxygenase dependent mechanism of sensitization at the cutaneous level
Authors: Mahé G. , Abraham P. , Humeau‐Heurtier A. , Gascoin L. , Lefthériotis G. , Durand S.
Published: March 2015

Aims

Current‐induced vasodilation (CIV) is an axon‐reflex response observed during monopolar current application such as iontophoresis. Cyclo‐oxygenase derivates (COD) participate in CIV and act as sensitizing agents at the anodal level. Mechanisms involved during cathodal current application (CCA) are partially unknown. In a randomized double‐blind crossover trial, we tested in 16 healthy subjects (i) the influence of the inter‐stimulation interval (I‐I) by comparing CIV following all‐at‐once 10 s CCA against 2 × 5 s CCA with intervals ranging from15 s–16 min and (ii) the participation of COD in CIV using 1 g aspirin or placebo intake.

Methods

Measurements were repeated 2 h and 14 days after treatment. Laser Doppler flowmetry assessed cutaneous blood flow, reported in multiples of baseline.

Results

Before treatment, peak vasodilation 10 min after the last current application (CVCstim2) increased compared with baseline whatever the I‐I. Increase in CVCstim2 from baseline was greater for the 4 min (9.4 (5.3, 10.9) times; median (1st percentile, 3rd percentile)) and higher I‐Is compared with all‐at‐once delivery (3.0 (2.1, 4.3) times, P < 0.05). The response was similar after placebo but aspirin abolished this vasodilation (increase by 1.2 (1.1, 1.3) times for all‐at‐once delivery and by 1.5 (1.3, 1.7) ± 0.3 times for 4 min interval, 2 h after aspirin intake) that recovered after 14 days.

Conclusions

This confirms the participation of COD in CIV with CCA and their sensitizing action. This model can represent an attractive way to study the axon‐reflex and sensitizing function of COD in humans.
Delayed haemolytic transfusion reaction in adults with sickle cell disease: a 5‐year experience
Authors: Vidler Jennifer B. , Gardner Kate , Amenyah Kenneth , Mijovic Aleksandar , Thein Swee L.
Published: March 2015

Delayed haemolytic transfusion reactions (DHTR) are potentially life‐threatening complications in patients with sickle cell disease (SCD). Between 1 August 2008 and 31 December 2013, 220 of 637 adult patients in our centre had at least one red blood cell (RBC) transfusion in 2158 separate transfusion episodes. Twenty‐three DHTR events occurred in 17 patients (13 female) including 15 HbSS, one HbSC and one HbSβ0 thalassaemia, equating to a DHTR rate of 7·7% of patients transfused. Mean interval from RBC transfusion to DHTR event was 10·1 ± 5·4 d, and typical presenting features were fever, pain and haemoglobinuria. Twenty of the 23 (87·0%) DHTR episodes occurred following transfusion in the acute setting. Notably, 11/23 (47·8%) of DHTRs were not diagnosed at the time of the event, most were misdiagnosed as a vaso‐occlusive crisis. 16/23 DHTRs had ‘relative reticulocytopenia’, which was more common in older patients. Seven of 23 episodes resulted in alloantibody formation, and three caused autoantibody formation. DHTRs are a severe but uncommon complication of RBC transfusion in SCD and remain poorly recognized, possibly because they mimic an acute painful crisis. Most of the DHTRs are triggered by RBC transfusion in the acute setting when patients are in an inflammatory state.