bluuebunny/crossref_metadata_2025 huggingface dataset:
Micropolar fluid to improve dynamic response of gear pair system supported by journal bearings
Authors: Chang‐Jian Cai‐Wan
Published: June 2013

Purpose

The purpose of this paper is to present a numerical analysis of the nonlinear dynamic response of a gear‐bearing system subject to nonlinear suspension effects, micropolar fluid, journal bearing, nonlinear oil‐film force and nonlinear gear mesh force. The results presented in this study provide some useful insights into the design and development of the system for rotating machinery that operates in highly rotational speed and highly nonlinear regimes.

Design/methodology/approach

The non‐dimensional equation of the gear‐bearing system proposed in this study is solved using the Runge‐Kutta method. The non‐periodic behavior of this system is characterized using phase diagrams, power spectra, Poincaré maps, bifurcation diagrams, Lyapunov exponents and the fractal dimension of the system.

Findings

The numerical results reveal that the system exhibits a diverse range of periodic, sub‐harmonic, quasi‐periodic and chaotic behaviors. The micropolar fluid is a useful lubricating fluid to suppress nonlinear dynamic responses and improve the dynamic regularity of the systems.

Research limitations/implications

The unbalance coefficient, damping coefficient, other control parameters and some experiments are also important to identify dynamic behaviors of those systems and they may be regarded as research directions in the future.

Practical implications

Because of financial constraints, some important experiments are outstanding to identify dynamic behaviors of these systems and await research in the future.

Originality/value

This study has presented a numerical analysis of the nonlinear dynamic response of a gear‐bearing system with nonlinear suspension effects, micropolar fluid, journal bearing, nonlinear oil‐film force and nonlinear gear mesh force.
Thermo‐hygro‐mechanical meso‐scale analysis of concrete as a viscoelastic‐damaged material
Authors: Xotta Giovanna , Salomoni Valentina A. , Majorana Carmelo E.
Published: June 2013

Purpose

Knowledge of the behavior of concrete at mesoscale level requires, as a fundamental aspect, to characterize aggregates and specifically, their thermal properties if fire hazards (e.g. spalling) are accounted for. The assessment of aggregates performance (and, correspondingly, concrete materials made of aggregates, cement paste and ITZ – interfacial transition zone) is crucial for defining a realistic structural response as well as damage scenarios.

Design/methodology/approach

It is here assumed that concrete creep is associated to cement paste only and that creep obeys to the B3 model proposed by Bažant and Baweja since it shows good compatibility with experimental results and it is properly justified theoretically.

Findings

First, the three‐dimensionality of the geometric description of concrete at the meso‐level can be appreciated; then, creep of cement paste and ITZ allows to incorporate in the model the complex reality of creep, which is not only a matter of fluid flow and pressure dissipation but also the result of chemical‐physical reactions; again, the description of concrete as a composite material, in connection with porous media analysis, allows for understanding the hygro‐thermal and mechanical response of concrete, e.g. hygral barriers due to the presence of aggregates can be seen only at this modelling level. Finally, from the mechanical viewpoint, the remarkable damage peak effect arising from the inclusion of ITZ, if compared with the less pronounced peak when ITZ is disregarded from the analysis, is reported.

Originality/value

The fully coupled 3D F.E. code NEWCON3D has been adopted to perform fully coupled thermo‐hygro‐mechanical meso‐scale analyses of concrete characterized by aggregates of various types and various thermal properties. The 3D approach allows for differentiating each constituent (cement paste, aggregate and ITZ), even from the point of view of their rheologic behaviour. Additionally, model B3 has been upgraded by the calculation of the effective humidity state when evaluating drying creep, instead than using approximate expressions. Damage maps allows for defining an appropriate concrete mixture to withstand spalling and to characterize the coupled behaviour of ITZ as well.
A conceptual model for retail productivity
Authors: Mishra Ashis , Ansari Javeed
Published: June 2013

Purpose

The purpose of this paper is to develop a framework for measuring retail productivity. It intends to identify all the constituents of retail productivity exhaustively, along with their measures and integrate them with a comprehensive model.

Design/methodology/approach

The paper summarizes the significant empirical works from the literature along with their study methods and identifies the gaps. The proposed methodology is a combination of various exploratory methods consisting of secondary data analysis, group interviews, depth interviews, observation and questionnaire survey.

Findings

A regression‐based conceptual model including each of the output and input variables of retail productivity. It also provides conception logic and measurement method for each of the variables. It identifies the control parameters too and proposes to handle them in the model. The empirical validation provides the significance of various input parameters.

Research limitations/implications

The empirical validation is restricted to one retail format and one vertical (medium‐sized stores and apparel‐life style vertical). However, it provides significant input regarding the way to utilise retail productivity and the strategic directions to improve store level productivity.

Practical implications

The most significant usage of the model is the standardization of retail productivity concept as a performance measurement tool and its applicability in individual retail stores (micro level). Hence, it is possible to determine the reasons for performance of retail stores and develop appropriate as well as effective strategies. The identification and elaboration of the various parameters of retail productivity would help retailers to redefine and focus on key decision areas.

Originality/value

The paper presents the exhaustive framework for retail productivity with data from the Indian retail sector that is applicable at micro level. It provides direct measure of value component (services) in retail output determination.
Towards the reconciliation of knowledge management and e‐collaboration systems
Authors: Le Dinh Thang , Rinfret Louis , Raymond Louis , Dong Thi Bich‐Thuy
Published: June 2013

Purpose

The purpose of this paper is to propose an intelligent infrastructure for the reconciliation of knowledge management and e‐collaboration systems.

Design/methodology/approach

Literature on e‐collaboration, information management, knowledge management, learning process, and intellectual capital is mobilised in order to build the conceptual framework.

Findings

This paper presents a conceptual framework including a set of concepts and guidelines that can be used to specify an efficient knowledge infrastructure for networked enterprises.

Research limitations/implications

Results from this study uphold the emerging research area of knowledge management in e‐collaboration systems. The proposed framework derived purely from theory and conceptual analysis; more work needs to be done in order to validate and experiment with the framework. Future research remains be carried out to apply the framework on a broader scale, and in particular to determine its applicability relative to various collaboration patterns and current technology development.

Practical implications

Results from this study are important for networked enterprises, especially knowledge‐intensive enterprises, who intend to build e‐collaboration systems to organize their knowledge base and to share it with their partners.

Originality/value

This paper is one of the first to address collaborative knowledge management in e‐collaboration systems with a focus on the promotion of learning process and the creation of intellectual capital.
Designing mobile LMS interfaces: learners' expectations and experiences
Authors: Ssekakubo Grace , Suleman Hussein , Marsden Gary
Published: June 2013

Purpose

This paper aims to present findings of a study that was carried out to identify strategies of enabling learners in developing countries to fully exploit the potential of learning management systems (LMSs). The study set out to: identify the services of learning management systems that are most needed and desired by university learners in developing countries; and identify appropriate access strategies that would guide design decisions on how to effectively and satisfactorily deliver such services to the university students in developing countries.

Design/methodology/approach

A total of 144 students from two African universities participated in the study by responding to an online survey questionnaire. The questionnaire asked students: how often they accessed LMSs to obtain, create and exchange information and knowledge; their preference for the different devices used for accessing the LMS; the LMS services they are most often required to access; and the services they most desire to use.

Findings

The findings of the survey indicate that the most desired and most accessed LMS services by the students include: assignments, announcements, resources, course outlines and the chat room. At the same time, mobile phones are rated the least used devices for accessing the LMS services, mainly due to inadequate design of LMSs for mobile interaction.

Originality/value

The paper also presents mobile LMS interface designs and ideas achieved through a participatory design process for enhancing the accessibility of the most needed and desired LMS services on mobile phones.
Research on the effects of WTO accession on China's economic growth
Authors: Zhiming Zhang , Xin Zhang , Riming Cui
Published: June 2013

Purpose

– The purpose of this paper is to measure the effects of WTO accession on the economic growth of China, and the paths of those effects.

Design/methodology/approach

– This article carries out a theoretical and empirical analysis on the effect on China's economic growth from WTO accession. First is about the theoretical analysis of the paths of those effects which WTO accession has on China's economic growth. Next is to make empirical test about the effects through dummy variable regression and cross variable analysis.

Findings

– WTO accession has a remarkable and a positive effect on China's economic growth through the following specific paths, i.e. foreign trade path, economic system reform path and FDI path. But so far entry into WTO has not positively influenced China's economic growth through technological innovation.

Originality/value

– Based on the theoretical and empirical analysis, this article puts forward relative policies and suggestions on what China should do in the future.
How does OFDI affect trade development in developing countries?
Authors: Qiang Yongchang
Published: June 2013

Purpose

– This paper aims to focus on the trade effects of outward direct investment in developing countries.

Design/methodology/approach

– To illustrate the effects, the author analyses it from the efficiency of resource utilization, technological advancement and transaction costs, respectively.

Findings

– The author concludes that OFDI has a positive effect on trade development in developing countries.

Originality/value

– Studying the interactions between FDI and trade, the traditional perspective that the investment can only lead to changes in capital endowment in a country is not perfect. These theories were mainly created and founded in developed countries and aimed only to explain their direct investment behavior. If the perspective is shifted to developing countries, it is found that the effect of FDI not only changes the supply-demand relationship of monetary capital, but also significantly influences division of labor and trade through the change in knowledge-oriented factors. Therefore, incorporating international direct investment as a new variable into contemporary international trade theories will enrich the existing theories, and also be beneficial for the development of integration theory of investment and trade.
Recycled brick masonry aggregate concrete
Authors: Cavalline Tara L. , Weggel David C.
Published: June 2013

Purpose

Reuse of construction and demolition (C&D) waste as aggregates is becoming increasingly popular for a number of environmental and economic reasons. The purpose of this paper is to explore this topic.

Design/methodology/approach

In this study, structural‐ and pavement‐grade portland cement concrete (PCC) mixtures were developed using crushed recycled brick masonry from a demolition site as a replacement for conventional coarse aggregate. Prior to developing concrete mixtures, testing was performed to determine properties of whole clay brick and tile, as well as the crushed recycled brick masonry aggregate (RBMA), and a database of material properties was developed.

Findings

Concrete mixtures exhibiting acceptable workability and other fresh concrete properties were obtained, and tests were performed to assess mechanical properties and durability performance of the hardened concrete. Results indicated that recycled brick masonry aggregate concrete (RBMAC) mixtures can exhibit mechanical properties comparable to that of structural‐ and pavement‐grade PCC containing conventional coarse aggregates.

Research limitations/implications

Results for durability performance were mixed, but additional testing to evaluate durability performance is recommended.

Practical implications

Although RBMAC has been untested in field applications, results of laboratory studies performed to date indicate that this material shows promise for use in pavement and structural applications. Future testing of RBMAC in both laboratory and field settings will allow stakeholders to gain a comfort level with its properties, identify specific potential uses, and establish guidelines that will assist in ensuring acceptable service life performance.

Originality/value

From the standpoint of sustainability, use of recycled materials as aggregates provides several advantages. Landfill space used for disposal is decreased, and existing natural aggregate sources are not as quickly depleted. Use of recycled aggregates in lieu of virgin quarried aggregates can potentially result in a lower embodied energy of the concrete, although this is often dependent on hauling costs. This particularly holds true if the methodology used to compute the embodied energy of a structure accounts for the “recovery” of energy at the end of its service life.
The designer in refurbishment projects: implications to the compatibility of design
Authors: Ali Azlan‐Shah , Au‐Yong Cheong‐Peng
Published: June 2013

Purpose

In refurbishment design, the individual designer is the one who ultimately determines the quality and performance of a project, but not his or her organization. Hence, various specific attributes are essential in the designers undertaking refurbishment projects. This directly influences the refurbishment project performance. The aims of this paper are to identify the important designer's attributes of refurbishment works and to develop prediction models for designer selection.

Design/methodology/approach

The study started with the identification of an important designer's attributes through literature review followed by a questionnaire survey. A set of questionnaires was distributed to 100 selected designers who handled refurbishment projects in Malaysia.

Findings

In conclusion, the study identified six key designer's attributes in refurbishment projects. The associative test shows that to improve a refurbishment project performance, the designers need to have knowledge, enthusiasm, commitment and coordination skills. From the initial result, two prediction models were produced for the compatibility of design to an existing site.

Originality/value

By identifying the important designer's attributes, this article contributes a reference about the basic requirements that a designer should have in refurbishment projects.
Tapping into Mammon: stakeholder perspectives on developing church tourism in Dublin's Liberties
Authors: Kiely Tony
Published: June 2013

Purpose

The purpose of this paper is to explore attitudes among church administrators to church tourism, and the vexing challenge of categorizing church properties as tourist attractions for the city visitor. Furthermore, it seeks to ascertain if in the current economic climate, evidence of a collaborative inclination exists between core and peripheral supply‐stakeholders towards delivering a church tourism trail in this visitor‐rich area of Dublin city.

Design/methodology/approach

Data were gathered to coincide with the busiest period of the tourist season. Using a qualitative methodology involving a series of semi‐structured interviews, initial research concentrated on attitudes to church tourism among both church administrators and church visitors. Subsequent interviews with key informants from both core and peripheral stakeholder groups focused on their attitudes to stakeholder collaboration in the development of a localized church tourism trail.

Findings

The findings of this paper would suggest broad support among most church administrators towards tourism and contextualising church properties as heritage attractions. However, operational dissonances associated with “church ethos” and “collaborative engagement”, particularly when embedded within individual fears of being associated with an official “tourist trail” were viewed as collaborative impediments among some traditional and peripheral stakeholders.

Originality/value

As international competition for the urban tourist intensifies, this paper, in adopting a supply‐sided perspective has, through counterpointing psychological barriers to the development of a church tourism product, with the absence of collaboration champions in the area, highlighted a number of limiting factors to adding value to the visitor experience in Dublin's Liberties. Challenges abide!
The link between travel motives and activities in nature‐based tourism
Authors: Mehmetoglu Mehmet , Normann Øystein
Published: June 2013

Purpose

The essence of the demand for nature‐based tourism is an important issue seen from both an academic and practitioner's perspective. One approach to understanding it is to examine the relationship between tourists' travel motivations and activities. Therefore, the purpose of this paper is to conduct an empirical study of the links between travel motivations and travel activities within the nature‐based tourism context.

Design/methodology/approach

Performing a series of logistic regression analyses, the authors have adopted this approach to empirically investigate the travel motivations and activities (participated/planned to participate) of a sample of nature‐based tourists in Northern Norway.

Findings

The study clearly confirms the strong link between travel motivations and activities. More specifically, the study findings are moderated by the fact that “Novelty”, “Prestige”, and “Physical activity” are the main sources of motivation for participating in whale safaris, fishing and hiking respectively. Furthermore, the findings show that non‐Norwegian tourists are considerably more likely than Norwegians to participate in these nature‐based activities. Theoretical and practical implications of the study are also provided.

Research limitations/implications

The survey was conducted in a limited geographical area, and the results should accordingly be tested in several places. Analysis of other motives and activities will provide further information.

Practical implications

Knowledge about factors motivating tourists to participate (or not) in certain nature‐based activities is of value to the industry, both in marketing and providing service to the customers.

Originality/value

The paper adds useful knowledge to the relationship between nature‐based tourists' travel motivations and activities.
Examining national tourism brand image: content analysis of Lonely Planet Korea
Authors: Youn Kim Hee , Yoon Ji‐Hwan
Published: June 2013

Purpose

The purpose of this paper is to analyze the Korea tourism brand image in a popular tour guidebook, Lonely Planet Korea and to provide an objective insight for examining destination image.

Design/methodology/approach

To achieve this goal, this study used content analysis to analyze the Korea tourism brand image.

Findings

Overall, 200,435 words were selected. The frequency of words was highly related to transportation and famous attractions. Moreover, to evaluate the value of the Korea tourism brand image, only adjectives in context were extracted. In total, 2,716 adjectives in each category were examined. The Korea tourism brand image was positive in that “good” adjectives were the most frequently selected. Furthermore, value properties based on The Lasswell Value Dictionary were examined. The value of words also supported the results of the content analysis of adjectives. The results of correspondence analysis found that the “outdoor” category was separately positioned with “old” adjectives.

Practical implications

Based on the results of content analysis by category, selected adjectives reflected current Korean tourism and hospitality problems.

Originality/value

The paper suggests implications that can be used to improve the Korea tourism brand image.
Arbiters of Waste: Date Labels, the Consumer and Knowing Good, Safe Food
Authors: Milne Richard
Published: June 2013

The importance of date labelling in informing both retailers and consumers how long a food will remain edible, safe and of sufficient quality makes it a prime site for the identification of, and intervention in, food waste. This paper examines the historical and spatial evolution of the date labelling system in the UK. The paper shows how reforms to date marking have occurred in response to shifting concerns about food quality, safety and latterly waste. It distinguishes four periods during which labels moved from an internal stock control mechanism to a consumer protection mechanism, a food safety device and recently emerged as a key element in the fight against food waste. Contributing to recent sociological studies of food labelling, the paper charts changing understandings of the role of the label in mediating between consumers, the food industry and regulators. It shows how regulatory objects such as date labels materialize societal concerns about food and situates contemporary efforts to reform date labelling in relation to prior articulations of consumer, government and industry interests.
Eating from the Bin: Salmon Heads, Waste and the Markets That Make Them
Authors: Coles Benjamin , Hallett Lucius
Published: June 2013

Recent scholarship in the social sciences has begun to question the cultural contingencies that demarcate waste from ‘stuff worth keeping’ (Watson and Meah, this volume). This scholarship has problematized linear discourses of production, consumption and disposal, and interrogated the relationships between objects, commodities and value but has yet to investigate the ways in which place and place-making are complicit in constituting these relationships. This paper explores where and how the lines between foodstuff and food waste are drawn, as well as the role of place and processes of place-making in contesting and reproducing them. Focusing on salmon heads and salmon, this paper examines not only how food becomes waste, but also on the issue of how waste becomes food. Specifically, we analyse the geographical processes through which salmon heads are valued as foodstuffs in some places but waste in others. We argue further that these valuations extend beyond the place of one market to encompass an assembled geography of markets. Further, we suggest that by tracing out the geographies of salmon heads and salmon – and the markets where each can be found – we can better articulate where as well as how it is that waste can become food. Ultimately, we argue that questions of food and waste are not just questions of materiality, but questions of the ways in which the material intersects relations of place, place-making and geography. Salmon heads, we argue, become a matter of geography.
The physicochemical, microbiological, organoleptic properties and antioxidant activities of functional cream cheeses fortified with lutein
Authors: Tokuşoğlu Özlem
Published: June 2013

Functional cream cheeses were manufactured with 0, 0.5, 0.75, 1.5 and 3.0 mg lutein/100 g serving. Cheeses were monitored at 0, 1, 3, 5 and 7 weeks of storage. The pH value of an average of 5.5 provides softness and strong taste for the product. Descriptive sensory properties of lutein‐fortified cream cheeses contained milky, buttery, salty and whey flavours. Cheese flavour was not affected by the differences in lutein levels. HPLC detection showed that lutein remained as stabile throughout about 6 weeks of storage. Physicochemical, microbiological and organoleptic data showed that 1.5 mg of fortification has preferred overall quality, and the best shelf life was recorded at week 3 of storage (P < 0.05).
New insights on the pathomechanisms of inflammatory bowel disease
Authors: Abdullah Murdani , Syam Ari Fahrial , Simadibrata Marcellus , Gunawan Jeffri , Makmun Dadang , Rani Abdul Aziz
Published: June 2013

Pathogenesis of inflammatory bowel disease (IBD) remains an enigma on whether germs, genes or a combination of these two with excessive immune responses to gut‐associated bacteria explicates its pathomechanisms. The incidence of IBD is 0.76747 per 100 000 in Central Indonesia, as shown in the Project Indonesian IBD ACCESS 2012 progress report. This result, together with other epidemiological studies in Asia, may conclusively reflect increased rates of the disease, while its pathogenesis still undoubtedly obscured. However, knowledge of the pathophysiology of IBD is rapidly growing, abreast with new developments. A series of recent updates in core pathomechanisms such as bacterial, endoplasmic reticulum stress, new immune cell populations, T‐cell differentiation and function, mucosal immune defenses and oxidative stress are relevant pathomechanism keypoints in IBD.
Hospital Admissions for Alcohol Use Disorders Before, During, and After Pregnancy: A Study Based on Linked Population Data in New South Wales, Australia
Authors: Xu Fenglian , Bonello Michelle , Burns Lucy , Austin Marie‐Paule , Li Zhuoyang , Sullivan Elizabeth
Published: June 2013

Background

Alcohol use disorders (AUD) during pregnancy can have profound lifelong effects on the baby, including fetal alcohol spectrum disorders (FASD). Hospital admission for AUD during pregnancy provides an opportunity for intervention. Characterization of women along the AUD spectrum during pregnancy aids the development of prevention strategies, policy, and clinical management guidelines aimed at this population. This study describes the hospital admission levels for AUD between the sixth month before pregnancy and the first year after birth and explores risk factors associated with the hospital admissions.

Methods

This study was based on linked population data between 2002 and 2005 using the New South Wales (NSW) Midwives Data Collection (MDC) and the NSW Admitted Patients Data Collection (APDC), Australia. The study subjects included primiparous mothers who were admitted to hospital in the period from the sixth month before pregnancy to 1 year after birth with at least 1 of the following diagnoses (ICD‐10‐AM): mental and behavioral disorders due to the use of alcohol (MBDA) (F10.0–10.9); toxic effects of alcohol (T51.0–51.9); maternal care for suspected damage to fetus from alcohol (O35.4); or alcohol rehabilitation (Z50.2).

Results

A total of 175 new mothers had 287 hospital admissions with the principal or stay AUD diagnoses during the study period in NSW. Of the 287 admissions, 181 admissions (63.07%) were reported for an alcohol‐related disorder as the principal diagnosis. The hospital admission rate for AUD was 1.76/1,000 person‐years (PY) (95% CI: 1.45 to 2.07) during the 6 months prepregnancy. The rate decreased to 0.49/1,000 PY (95% CI: 0.36 to 0.63) during pregnancy and to 0.82/1,000 PY (95% CI: 0.67 to 0.97) in the first year after birth. Women who smoked during pregnancy, lived in a remote area and were younger than 25 years, were more likely to be admitted to hospital with AUD diagnoses. Women in the middle disadvantaged quintile and born in other countries were less likely to be admitted to hospital with AUD diagnoses.

Conclusions

Hospital admission for AUD decreased significantly in pregnancy and the first year postpartum compared to the prepregnancy period.
A randomised comparison of lidocaine 2% gel and proparacaine 0.5% eye drops in paediatric squint surgery
Authors: Sinha R. , Chandralekha  , Batra M. , Ray B. R. , Mohan V. K. , Saxena R.
Published: June 2013

We conducted a randomised trial comparing lidocaine 2% gel with proparacaine 0.5% eye drops in children having elective squint surgery. One hundred and forty children aged between 3 and 14 years were recruited. The requirement for intra‐operative fentanyl and postoperative ibuprofen was significantly less in the lidocaine group compared with the proparacaine group (1 (1.7%) vs 12 (18.5%), p = 0.002 and 16 (27.6%) 38 (58.5%), p = 0.001, respectively). The incidence of postoperative nausea and vomiting was significantly less in the lidocaine group compared with the proparacaine group (6 (10.3%) vs 16 (24.6%), p = 0.04). There were no differences between the groups in terms of incidence and severity of the oculocardiac reflex. We conclude that, compared with proparacaine 0.5% eye drops, a single application of lidocaine 2% gel improves peri‐operative analgesia and reduces the incidence of postoperative nausea and vomiting in elective paediatric squint surgery.
Developmentalities and Donor–NGO Relations: Contesting Foreign Aid Policies in New Zealand/Aotearoa
Authors: McGregor Andrew , Challies Edward , Overton John , Sentes Lee
Published: June 2013

In this paper we draw on the concept of governmentality to examine the relationships between donors and northern non‐governmental organisations (NGOs) during moments of policy change. Our case study comes from New Zealand/Aotearoa where a change in government has seen aid policy shift from poverty alleviation to sustainable economic development. We detail three mechanisms through which the government sought to normalise this change: changes in language and fields of visibility; institutional reform; and funding delays and cuts. Far from being complete, however, we also trace how some NGOs contested the new agenda through engaging in the practice of politics and how, at least temporarily, new more politicised development subjectivities were created. While our study raises awkward questions about the autonomy of NGOs within current funding environments, we also emphasise the productive possibilities and openings that emerge as one set of development ideas and techniques, or developmentalities, shifts to another.
Obese women's reasons for not attending a weight management service during pregnancy
Authors: Olander Ellinor K. , Atkinson Lou
Published: June 2013

Evaluations of services targeting obese women's gestational weight gain often report low uptake. Thus it is important to elicit the reasons why obese pregnant women decline to participate in these services and to identify their barriers to participation. Sixteen obese pregnant and postnatal women were interviewed regarding their reasons for declining a group‐based service targeting their gestational weight gain. All interviews were recorded, transcribed verbatim and analyzed thematically. Both pragmatic and motivational barriers were identified. The most common practical reasons for not attending the service were its inconvenient location and time, and feeling unable to attend due to work commitments. Pregnancy‐specific barriers included decreased mobility and feeling unwell. Motivational barriers included lack of interest and not wanting to focus on one's weight in pregnancy. These findings highlight issues that need to be taken into consideration when designing group‐based weight management services for this population.
Adherence, persistence and switch rates for anticholinergic drugs used for overactive bladder in women: data from the Norwegian Prescription Database
Authors: Mauseth Siri A. , Skurtveit Svetlana , Spigset Olav
Published: June 2013

Objective

To investigate the pattern of use of anticholinergic drugs for overactive bladder among women in Norway with regard to persistence, adherence and switch rates.

Design

Observational study.

Setting and sample

Data from the Norwegian Prescription Database on prescriptions for tolterodine, solifenacin, darifenacin and fesoterodine filled in Norwegian pharmacies from 1 January 2004 to 31 December 2010.

Methods and main outcome measures

Data from the database were analysed at an individual level, and drug persistence, discontinuation rates and switch rates during a follow‐up period of 365 days after the first prescription were calculated.

Results

Overall 1‐year persistence for new users was 38.0%. Within the same period, a total of 10.3% switched from the index drug to another drug in the same group, whereas 51.7% discontinued without switching. Users of solifenacin and tolterodine were somewhat more persistent than users of darifenacin and fesoterodine. Persistence was lowest (20.9%) in the age group 18–39 years, increased with age and was highest in the age groups 70–79 years and 80 years and above (43.5 and 43.3%, respectively). In total, 31.9% filled only one prescription of the drug and, of these, only one of four women switched to another drug. The proportion who were adherent during treatment was 60.4%.

Conclusions

The discontinuation rate for anticholinergic drugs for overactive bladder in women is high. The reasons why patients stop using them remain obscure but could be related both to a limited clinical effect and an unacceptable adverse effect burden.
Accountants as Emotional Wellbeing Counsellors in Rural Areas
Authors: Carter Amanda J. , Burritt Roger L. , Pisaniello John D.
Published: June 2013

The role of accountants in dealing with the social, emotional and stress‐related problems of their clients is explored using semi‐structured interviews with owner‐accountants and regional development workers. Findings indicate the importance to rural communities and the related public of accountants acting as ‘emotional wellbeing counsellors’; a role they are pressured to accept by their clients and community, and for which they are neither formally educated nor trained. Implications are drawn for effective counselling preparation of accounting graduates and practising accountants by educators and professional associations.
Influence of nutritional deficiency on prognosis of renal cell carcinoma (RCC)
Authors: Ko Kyungtae , Park Young H. , Lee Jeong W. , Ku Ja H. , Kwak Cheol , Kim Hyeon H.
Published: June 2013

Objective

To evaluate the prognosis of patients with renal cell carcinoma (RCC) by nutritional status defined by body mass index (BMI), serum albumin and cholesterol.

Patients and Methods

This study retrospectively enrolled 1437 patients who underwent radical nephrectomy (932) or partial nephrectomy (505) for RCC.

We assigned nutritional status according to the presence of none or one nutritional risk factor (control group) and two or all three of the following nutritional risk factors (nutritional deficiency group).

The nutritional factors and thresholds were preoperative albumin level (<3.5 g/dL), preoperative cholesterol level (<220 mg/dL), and preoperative BMI (<23 kg/m2)

Results

The patients' mean (sd) age was 55.23 (12.41) years and BMI was 24.36 (3.17) kg/m2. The mean (sd) serum cholesterol level was 180.07 (38.24) mg/dL, and the albumin level was 4.2 (0.45) g/dL.

In all, 141 (9.8%) patients had none of the nutritional deficiency criteria, 802 (55.8%) had one, 429 (29.9%) had two, and 65 (4.5%) had all three.

Clinicopathological variables, i.e. female gender, high tumour stage, positive lymph node metastasis, positive distant metastasis, high nuclear grade and non‐clear cell type histopathology were associated with the nutritional deficiency group.

In multivariate Cox analysis, nutritional deficiency was an independent predictor for RCC recurrence (hazard ratio [HR] 1.39, 95% confidence interval [CI] 1.05–1.83, P = 0.020) and RCC‐related mortality (HR 2.06, 95% CI 1.39–3.03, P < 0.001).

Conclusion

Nutritional deficiency defined by BMI, serum albumin and cholesterol is an important factor that predicts postoperative prognosis of patients with RCC who have undergone radical or partial nephrectomy.
Renal tumour nephrometry score does not correlate with the risk of radiofrequency ablation complications
Authors: Seideman Casey A. , Gahan Jeffrey , Weaver Matthew , Olweny Ephrem O. , Richter Michael , Chan Danny , Cadeddu Jeffrey A.
Published: June 2013

Objectives

To assess whether the R.E.N.A.L. nephrometry score (consists of [R]adius [tumour size as maximal diameter], [E]xophytic/endophytic properties of the tumour, [N]earness of tumour deepest portion to the collecting system or sinus, [A]nterior [a]/posterior [p] descriptor and the [L]ocation relative to the polar line) is associated with complication risk in patients that have radiofrequency ablation (RFA) for small renal masses (SRMs).

To evaluate a standardised system for predicting complication risks which has not been studied.

Patients and Methods

We reviewed the records of all patients who underwent RFA at our institution between May 2001 and May 2011.

RFA was performed using a temperature‐based system and a 25‐G nine‐tine array needle probe. Patients with preoperative imaging available for R.E.N.A.L. nephrometry scoring were included.

R.E.N.A.L. composite scores, tertile stratification and preoperative patient characteristics were analysed for significance in relation to complications.

Complications were defined using the Clavien‐Dindo classification system.

Results

In all, 199 patients had preoperative R.E.N.A.L. nephrometry scores available; 170 underwent percutaneous RFA and 29 laparoscopic RFA.

The mean (range) American Society of Anesthesiologists (ASA) score was 2.6 (1–4). The mean (range) tumour size was 2.4 (0.7–5.4) cm.

Overall, 14 complications were identified; 10 minor (Clavien I–II) and four major (Clavien III–IV). There was no significant association between complications and R.E.N.A.L. nephrometry score, R.E.N.A.L. nephrometry tertiles, tumour diameter, tumour location or ASA score (P > 0.05).

Conclusion

R.E.N.A.L. nephrometry scoring fails to predict complications of RFA for SRMs when using a temperature‐based nine‐tine array probe.
Trends in renal function after radical nephrectomy: a multicentre analysis
Authors: Chung Jae S. , Son Nak H. , Byun Seok‐Soo , Lee Sang E. , Hong Sung K. , Jeong Chang W. , Lee Sang C. , Chae Dong‐Wan , Choi Won S. , Park Yong H. , Hong Sung H. , Kim Yong J. , Kang Seok H.
Published: June 2013

Objective

To evaluate serial changes in renal function by investigating various clinical factors after radical nephrectomy (RN).

Patients and Methods

The study population consisted of 2068 consecutive patients who were treated at multiple institutions by RN for renal cortical tumour without metastasis between 1999 and 2011.

We measured the serial change in estimated glomerular filtration rate (eGFR) and clinical factors during a 60‐month follow‐up period.

The changes in eGFR over time were analysed according to baseline eGFR (eGFR ≥60 and 15–59 mL/min/1.73m2) using a linear mixed model.

The independent prognostic value of various clinical factors on the increase in eGFR was ascertained by multivariate mixed regression model.

Results

Overall, there was a subsequent restoration of renal function over the 60 months.

The slope for the relationship between the eGFR and the time since RN was 0.082 (95% confidence interval [CI] 0.039–0.104; P < 0.001) and 0.053 (95% CI 0.006–0.100; P = 0.038) in each baseline group, indicating that each month after RN was associated with an increase in eGFR of 0.082 and 0.053 mL/min/1.73m2, respectively.

When we analysed renal function based on various factors, postoperative eGFR of patients with diabetes mellitus, old age (≥70 years) or a preoperative eGFR of <30 mL/min/1.73 m2, was decreased or maintained at a certain level without any improvement in renal function.

Preoperative predictors of an increase in eGFR after RN were young age, no DM, no hypertension, a preoperative eGFR of ≥30 mL/min/1.73m2 and time after surgery (≥36 months).

Conclusions

Renal function recovered continuously during the 60‐month follow‐up period after RN.

However, the trends in functional recovery change were different according to various clinical factors and such information should be discussed with patients when being counselled about their treatment for renal cell carcinoma (RCC).
Yonsei nomogram to predict lymph node invasion in Asian men with prostate cancer during robotic era
Authors: Kim Kwang Hyun , Lim Sey Kiat , Kim Ha Yan , Han Woong Kyu , Choi Young Deuk , Chung Byung Ha , Hong Sung Joon , Rha Koon Ho
Published: June 2013

Objective

To develop a novel nomogram to predict lymph node invasion (LNI) in Asian men undergoing radical prostatectomy (RP) and pelvic LN dissection (PLND) for localised prostate cancer.

Patients and Methods

The patient cohort included 541 patients who underwent robot‐assisted RP and PLND by a single surgeon between January 2008 and December 2011.

Patients with dissection of <10 LNs, prostate‐specific antigen (PSA) levels of >50 ng/mL, incomplete biopsy data, and treatment with neoadjuvant therapy were excluded.

Results

The median (interquartile range) number of LNs removed was 17 (14–22) and 45 patients (8.3%) had LN metastases.

On multivariate logistic regression analysis, PSA level, clinical stage and Gleason score were independent predictors of LNI.

The bootstrap corrected area under curve of the model incorporating PSA level, clinical stage, and biopsy Gleason score was 0.883.

With a cutoff value of 4%, PLND could be omitted in 326 patients (60.2%), missing only two patients (4.4%) with LNI. The sensitivity, specificity, positive predictive value and negative predictive value were 95.6%, 65.3%, 20.0% and 99.4%, respectively.

Conclusions

We report a nomogram to predict LNI in Asian men with prostate cancer. The model demonstrated high accuracy and could be used for counselling patients and the selection of candidates for PLND.
Indications, results and safety profile of transperineal sector biopsies (TPSB) of the prostate: a single centre experience of 634 cases
Authors: Vyas Lona , Acher Peter , Kinsella Janette , Challacombe Ben , Chang Richard T.M. , Sturch Paul , Cahill Declan , Chandra Ashish , Popert Richard
Published: June 2013

Objective

To describe a protocol for transperineal sector biopsies (TPSB) of the prostate and present the clinical experience of this technique in a UK population.

Patients and Methods

A retrospective review of a single‐centre experience of TPSB approach was undertaken that preferentially, but not exclusively, targeted the peripheral zone of the prostate with 24–38 cores using a ‘sector plan’. Procedures were carried out under general anaesthetic in most patients.

Between January 2007 and August 2011, 634 consecutive patients underwent TPSB for the following indications: prior negative transrectal biopsy (TRB; 174 men); primary biopsy in men at risk of sepsis (153); further evaluation after low‐risk disease diagnosed based on a 12‐core TRB (307).

Results

Prostate cancer was found in 36% of men after a negative TRB; 17% of these had disease solely in anterior sectors.

As a primary diagnostic strategy, prostate cancer was diagnosed in 54% of men (median PSA level was 7.4 ng/mL).

Of men with Gleason 3+3 disease on TRB, 29% were upgraded and went on to have radical treatment.

Postoperative urinary retention occurred in 11 (1.7%) men, two secondary to clots. Per‐urethral bleeding requiring hospital stay occurred in two men. There were no cases of urosepsis.

Conclusions

TPSB of the prostate has a role in defining disease previously missed or under‐diagnosed by TRB. The procedure has low morbidity.
Benefit in regionalisation of care for patients treated with radical cystectomy: a nationwide inpatient sample analysis
Authors: Ravi Praful , Bianchi Marco , Hansen Jens , Trinh Quoc‐Dien , Tian Zhe , Meskawi Malek , Abdollah Firas , Briganti Alberto , Shariat Shahrokh F. , Perrotte Paul , Montorsi Francesco , Karakiewicz Pierre I. , Sun Maxine
Published: June 2013

Objective

To quantify in absolute terms the potential benefit of regionalisation of care from low‐ to high‐volume hospitals.

Patients and Methods

Patients with a primary diagnosis of bladder cancer treated with radical cystectomy (RC) were identified within the Nationwide Inpatient Sample, a retrospective observational population‐based cohort of the USA, between 1998 and 2009.

Intraoperative and postoperative complications, blood transfusions, prolonged length of stay, and in‐hospital mortality rates represented the outcomes of interest.

Potentially avoidable outcomes were calculated by subtracting predicted rates (i.e. estimated outcomes if care was delivered at a high‐volume hospital) from observed rates (i.e. actual observed outcomes after care delivered at a low‐volume hospital).

Multivariable logistic regression models and number needed to treat were generated.

Results

Patients treated at high‐volume hospitals had lower odds of complications during hospitalisation than those treated in low‐volume hospitals.

Potentially avoidable intraoperative complications, postoperative complications, blood transfusions, prolonged hospitalisation, and in‐hospital mortality rates were 0.6, 7.4, 2.8, 9.4, and 2.0%, respectively.

This corresponds to a number needed to redirect from low‐ to high‐volume hospitals in order to avoid one adverse event of 166, 14, 36, 11 and 50, respectively.

Conclusion

This is the first report to quantify the potential benefit of regionalisation of RC for muscle‐invasive bladder cancer to high‐volume hospitals.