bluuebunny/crossref_metadata_2025 huggingface dataset:
Re-examining manufacturing strategy from knowledge advantages
Authors: Wang Jue-Fan , Tarn David D.C.
Published: August 2017

Purpose

During this current era of the knowledge economy, knowledge activities have greatly impacted manufacturing activities, with knowledge being treated as a critical factor that creates and sustains competitive advantages. Past studies tended to relate knowledge works with organizational tasks and assumed that knowledge workers implement those tasks to achieve organizational goals. Accordingly, the purpose of this paper is to employ the perspective of task domain as the basis to clarify the impact of manufacturing task domains on the manufacturing strategy, as well as the mediating effects of knowledge advantage on such an impact.

Design/methodology/approach

The authors follow Becerra-Fernandez and Sabherwal’s (2001) task which focus/task breadth dichotomy as the basis to define market-based task domains, employs Leonard-Barton’s (1995) T-shaped skill as the theoretical base to construct knowledge advantages, i.e., knowledge depth (I-shaped skill), diversity (hyphened skill), and convergence (T-shaped skill), and uses the conventional typology to measure the manufacturing strategy (i.e. cost, quality, flexibility, and delivery). The empirical study is conducted via a questionnaire survey and selects Taiwan’s top 600 manufacturers as the population and accordingly collects 131 effective observations.

Findings

The empirical evidence indicates that firms’ priorities on cost and delivery are positively caused by the focus orientation of the tasks, while their priorities on quality and flexibility are positively caused by both focus and diversity orientations of the tasks. The results also signify that knowledge advantages perform complete mediation on the previous relationships. In more detail, knowledge depth presents mediation on focus orientation, and knowledge convergence exhibits mediating effects both on focus and breadth orientations. The statistics point out that knowledge depth has the highest impact on the manufacturing strategy, but knowledge diversity fails to significantly explain the manufacturing strategy.

Originality/value

Literature assumed that knowledge activities are task-driven issue; this study hence examines knowledge advantage based on the task domain perspective to clarify the architecture and contents of knowledge advantages.
Supply chain collaboration for ERP implementation
Authors: Li Yulong , Wu Feng , Zong Wei , Li Bo
Published: August 2017

Purpose

The purpose of this paper is to develop and empirically test a conceptual framework to analyze how inter-organizational knowledge sharing facilitates enterprise resource planning (ERP) implementation.

Design/methodology/approach

Data were collected from a 2014 survey on 283 Chinese companies. Structural equation modeling was used to test the structural model of the framework.

Findings

The results of the study indicated that organizational preparedness (in terms of internal culture, organizational structure, availability of resources, and technological capabilities), positive benefits and costs perception, and external influences (in terms of environmental uncertainty, competitive pressure, and partner readiness) would facilitate inter-organizational knowledge sharing, which in turn, would enhance ERP implementation effectiveness.

Research limitations/implications

Convenience samples from an author’s MBA classes were used in the survey, and a single respondent from each organization answering all questions for such complicated issues also posed the risk of measurement bias and inaccuracy.

Practical implications

The study provided evidences to practitioners about how organizations should collaborate with supply chain partners at a full scale in knowledge generation, maintenance, dissemination, and application in order to enhance their effectiveness on ERP implementation.

Originality/value

ERP projects are predominately observed in existing research as internal initiatives that companies take independently within their own organizational boundaries. This study represents one of the early large-scale empirical efforts to investigate ERP implementation from an inter-firm supply chain collaboration perspective. Additional contribution includes some interesting empirical evidences on the current state of ERP utilization in the Chinese market.
The role of employee empowerment in the implementation of continuous improvement
Authors: Hirzel Ann-Kathrin , Leyer Michael , Moormann Jürgen
Published: August 2017

Purpose

The purpose of this paper is to understand the role of increasing employees’ level of continuous improvement (CI) empowerment, i.e. employees’ knowledge and understanding of CI, the possibility of open communication and support from the work environment regarding CI, in the implementation of CI over time.

Design/methodology/approach

Based on the theory of structural empowerment, the authors test the research question using evidence from a case study in a European financial services provider. Data are gathered with questionnaires on a team level and cover a period of 2.5 years including 780 participants.

Findings

The findings show that after conducting a CI programme in the case, there is a significant increase in employees’ CI empowerment over time, which has a positive but time-lagged relationship with the level of CI implementation.

Research limitations/implications

Implications are that CI empowerment can be created sustainably and is an important factor in establishing CI in a company, but that it takes time until empowerment leads to changes in behaviour. However, it has to be considered that these implications are solely derived from empirical results from a single company.

Practical implications

Financial service providers should invest in establishing CI empowerment and consider a delay in realising measurable benefits in terms of the level of CI implementation.

Originality/value

This paper is the first empirical study to examine the relationship between employee CI empowerment and the implementation of CI from a longitudinal perspective.
Heavyweight extension to the UML class diagram metamodel for modeling context aware systems in ubiquitous computing
Authors: Boudjemline Haider , Touahria Mohamed , Boubetra Abdelhak , Kaabeche Hamza
Published: August 2017

Purpose

The development of context-aware applications in ubiquitous environments depends not only on the user interactions but also on several context parameters. The handling of these parameters is a fundamental problem in these systems. The key purpose of this work is to enrich the unified modeling language (UML) class diagram with new constructs to provide a universal model capable of coping with the context-awareness concerns.

Design/methodology/approach

The authors provide a review of existing context handling approaches. Afterward, they relied on the UML extensibility mechanisms to propose a heavyweight extension for the UML class diagram. This generic approach allows describing the different context parameters since the modeling phase.

Findings

Existing solutions for context handling apply the contextual constraints on finished applications or tend to be dependent on a specific development process. This paper presents a solution based on UML, which allows dealing with context since the modeling phase, and independently of development processes. This proposal is implemented as an eclipse editor and illustrated through a case study in the healthcare field.

Originality/value

This paper addresses the problem of context handling, and it presents a review of the foremost existing solutions. The paper also presents a heavyweight extension for the UML class diagram, which consists in enriching it with additional constructs, capable of monitoring how applications are linked to context parameters and how the values of these parameters may affect the application behavior.
A survey and comparative analysis of the various routing protocols of Internet of Things
Authors: Agnihotri Shailja , Ramkumar K.R.
Published: August 2017

Purpose

The purpose of this paper is to provide insight into various swarm intelligence-based routing protocols for Internet of Things (IoT), which are currently available for the Mobile Ad-hoc networks (MANETs) and wireless sensor networks (WSNs). There are several issues which are limiting the growth of IoT. These include privacy, security, reliability, link failures, routing, heterogeneity, etc. The routing issues of MANETs and WSNs impose almost the same requirements for IoT routing mechanism. The recent work of worldwide researchers is focused on this area.

Design/methodology/approach

The paper provides the literature review for various standard routing protocols. The different comparative analysis of the routing protocols is done. The paper surveys various routing protocols available for the seamless connectivity of things in IoT. Various features, advantages and challenges of the said protocols are discussed. The protocols are based on the principles of swarm intelligence. Swarm intelligence is applied to achieve optimality and efficiency in solving the complex, multi-hop and dynamic requirements of the wireless networks. The application of the ant colony optimization technique tries to provide answers to many routing issues.

Findings

Using the swarm intelligence and ant colony optimization principles, it has been seen that the protocols’ efficiency definitely increases and also provides more scope for the development of more robust, reliable and efficient routing protocols for the IoT.

Research limitations/implications

The existing protocols do not solve all reliability issues and efficient routing is still not achieved completely. As of now no techniques or protocols are efficient enough to cover all the issues and provide the solution. There is a need to develop new protocols for the communication which will cater to all these needs. Efficient and scalable routing protocols adaptable to different scenarios and network size variation capable to find optimal routes are required.

Practical implications

The various routing protocols are discussed and there is also an introduction to new parameters which can strengthen the protocols. This can lead to encouragement of readers, as well as researchers, to analyze and develop new routing algorithms.

Social implications

The paper provides better understanding of the various routing protocols and provides better comparative analysis for the use of swarm-based research methodology in the development of routing algorithms exclusively for the IoT.

Originality/value

This is a review paper which discusses the various routing protocols available for MANETs and WSNs and provides the groundwork for the development of new intelligent routing protocols for IoT.
Medicine, madness and murderers: the context of English forensic psychiatric hospitals
Authors: McDonald Ruth , Furtado Vivek , Völlm Birgit
Published: August 2017

Purpose

The purpose of this paper is to add to the understanding of context by shedding light on the relationship between context and organisational actors’ abilities to resolve ongoing challenges.

Design/methodology/approach

The authors used qualitative data collection (interviews and focus groups with staff and site visits to English forensic psychiatry hospitals) and the analysis was informed by Lefebvre’s writings on space.

Findings

Responses to ongoing challenges were both constrained and facilitated by the context, which was negotiated and co-produced by the actors involved. Various (i.e. societal and professional) dimensions of context interacted to create tensions, which resulted in changes in service configuration. These changes were reconciled, to some extent, via discourse. Despite some resolution, the co-production of context preserved contradictions which mean that ongoing challenges were modified, but not resolved entirely.

Originality/value

The paper highlights the importance of viewing context as co-produced in a continuous manner. This helps us to delineate and understand its dynamic nature and its relationship with the everyday actions and beliefs of the organisational actors concerned.
Bringing humanity into view: action research with Qatar’s ambulance service
Authors: Coleman Gill , Wiggins Liz
Published: August 2017

Purpose

The purpose of this paper is to argue for the widening of attention in healthcare improvement efforts, to include an awareness of the humanity of people who work in the sector and an appreciation of the part human connection plays in engagement around good quality work. Theoretical frameworks and research approaches which draw on action-based, interpretive and systemic thinking are proposed, as a complement to current practices.

Design/methodology/approach

The paper describes the early stages of an action research (AR) project, which used the appreciative inquiry “4D” framework to conduct participative inquiry in Hamad Medical Corporation’s ambulance service in Qatar, in which staff became co-researchers.

Findings

The co-researchers were highly motivated to work with improvement goals as a result of their participation in the AR. They, and their managers, saw each other and the work in new ways and discovered that they had much to offer.

Research limitations/implications

This was a small-scale pilot project, from which findings must be considered tentative. The challenges of establishing good collaboration across language, culture and organisational divides are considerable.

Practical implications

Appreciative and action-oriented inquiry methods can serve not only to find things out, but also to highlight and give value to aspects of humanity in the workplace that are routinely left invisible in formal processes. This, in turn, can help with quality improvement.

Originality/value

This paper is a challenge to the orthodox way of viewing healthcare organisations, and improvement processes within them, as reliant on control rather than empowerment. An alternative is to actively include the agency, sense-making capacity and humanity of those involved.
The significance of unforeseen events in organisational ethnographic inquiry
Authors: Green Trevor , Swailes Stephen , Handley Janet
Published: August 2017

Purpose

The purpose of this paper is to emphasise the importance for the practicing ethnographer of responding to unforeseen events that occur during periods of data collection.

Design/methodology/approach

An analysis of four unforeseen events occurring during prolonged periods of study amongst workplace cleaners is undertaken and the changes in researcher acceptance resulting from the outcomes of these events are reported.

Findings

This paper shows how awareness of the possible incidence of unforeseen events and the ability to carefully yet spontaneously manage the ethnographer’s reaction to them can substantially influence the degree of acceptance achieved by the observer within the group under study.

Originality/value

Though the need for an ethnographer to get close to the participants in a study is well documented, detailed examples as described in this paper are rare. The documentation of the nature and effects of such episodes and how they unfold serve to enhance the credibility of the research.
“Confucian management” or a confused and epistemologically questionable view on Chinese management?
Authors: Friend Anthony
Published: August 2017

Purpose

In the wake of the ongoing financial crisis, US managerialism has been denounced as a professional caste that has slowly served to erode the competitiveness of the US economy. In light of this, there is an increasing search for possible alternatives to US managerialism, with some authorities putting forward that one enviable alternative is “Confucian management”, which they claim is a means of organising in Chinese institutions that gets things done by pulling on the rich heritage of Ancient Chinese philosophy. The purpose of this paper is to interrogate “Confucian management”.

Design/methodology/approach

This paper questions the common view of “Confucian management” through an ethnography of Baiyun University (a pseudonym) in South China, where the author worked as a “foreign” English lecturer for one academic year, and in order to do this the author draws on participant-observation and semi-structured interviews. Ethnography has long been associated with colonialism and has more recently been connected with post-colonialism, so in an attempt to decolonise the methodology, the author analyses the generated research data through a Chinese sensitive cultural framework.

Findings

This paper argues that “Confucian management” offers a confused and epistemologically questionable view on Chinese management. It points to some of the limitations of management and organisation studies brought about by claims being made without sufficient empirical evidence.

Research limitations/implications

The focus is on “Confucian management” at Baiyun University so findings are specific to this empirical research site. It is also acknowledged that universities have a divergent form of management to other institutions. The paper’s intent is ideographic rather than nomothetic; therefore, no claims to generalisation are made.

Originality/value

The paper makes three substantive contributions. First, the empirical contribution is an ethnographic description of “Confucian management” at Baiyun University. Second, the methodological contribution attempts to decolonise methodology by analysing the generated research data through a Chinese sensitive cultural framework. Third, the epistemological contribution queries to what extent “Confucian management” as an idea that is enunciated from the Global North is able to effectively speak about a practice that is supposedly performed in the Global South.
Investor sentiment and US presidential elections
Authors: Colón-De-Armas Carlos , Rodriguez Javier , Romero Herminio
Published: August 2017

Purpose

The purpose of this paper is to examine the shifts in investor sentiment around the last seven US presidential elections (1988 through 2012).

Design/methodology/approach

Investor sentiment is measured by changes in closed-end funds discounts, and the results are corroborated with three robustness tests, including an alternate measure of investor sentiment obtained from the survey conducted by the American Association of Individual Investors.

Findings

Closed­end funds discounts are significantly diminished from two weeks before a US presidential election to a week before the election, and persist until the week after the election, suggesting an increase in investors’ optimism during that period, particularly when a Democrat is elected president. More than the particular party prevailing, however, investors appear to be more interested in avoiding the entrenchment of power since the results suggest that they become optimistic when a change in the ruling party takes place, but become pessimistic when there is power continuity in the White House. The increase in investor optimism that is observed around the time of US presidential elections is not replicated during non-election years, which seems to corroborate that the elections are indeed driving the results.

Originality/value

This paper is the first to formally examine the relation between investor sentiment and US presidential elections using closed-end funds discounts as the measure for sentiment.
Does ticker fluency matter?
Authors: Peterburgsky Stanley
Published: August 2017

Purpose

The purpose of this paper is to investigate whether investors prefer stocks with more linguistically fluent tickers (MAK, SOM) to those with less linguistically fluent tickers (WQH, JZU) in an experimental setting.

Design/methodology/approach

The author conducts an experiment in which a choice of two hypothetical investments with linguistically fluent and non-fluent tickers is presented to survey participants, who are asked to choose the preferred investment (or indicate that they are indifferent between the investments).

Findings

Consistent with investor rationality, survey results indicate that, for both riskless and risky investments, individuals do not exhibit differential preferences for stocks with pronounceable vs unpronounceable tickers. Additionally, individuals are not willing to pay more for former vs latter stocks.

Originality/value

A potential implication is that corporate boards should not attribute high importance to ticker fluency.
Cumulative stress restricts niche filling potential of habitat‐forming kelps in a future climate
Authors: King Nathan G. , Wilcockson David C. , Webster Richard , Smale Dan A. , Hoelters Laura S. , Moore Pippa J.
Published: August 2017

Climate change is driving range contractions and local population extinctions across the globe. When this affects ecosystem engineers the vacant niches left behind are likely to alter the wider ecosystem unless a similar species can fulfil them.

Here, we explore the stress physiology of two coexisting kelps undergoing opposing range shifts in the Northeast Atlantic and discuss what differences in stress physiology may mean for future niche filling.

We used chlorophyll florescence (Fv/Fm) and differentiation of the heat shock response (HSR) to determine the capacity of the expanding kelp, Laminaria ochroleuca, to move into the higher shore position of the retreating kelp,Laminaria digitata. We applied both single and consecutive exposures to immersed and emersed high and low temperature treatments, replicating low tide exposures experienced in summer and winter.

No interspecific differences in HSR were observed which was surprising given the species’ different biogeographic distributions. However, chlorophyll florescence revealed clear differences between species withL. ochroleucabetter equipped to tolerate high immersed temperatures but showed little capacity to tolerate frosts or high emersion temperatures.

Many patterns observed were only apparent after consecutive exposures. Such cumulative effects have largely been overlooked in tolerance experiments on intertidal organisms despite being more representative of the stress experienced in natural habitats. We therefore suggest future experiments incorporate consecutive stress into their design.

Climate change is predicted to result in fewer ground frosts and increased summer temperatures. Therefore,L. ochroleucamay be released from its summer cold limit in winter but still be prevented from moving up the shore due to desiccation in the summer.Laminaria ochroleucawill, however, likely be able to move into tidal pools. Therefore, only partial niche filling byL. ochroleucawill be possible in this system as climate change advances.

Aplain language summaryis available for this article.
Why are some plant–pollinator networks more nested than others?
Authors: Song Chuliang , Rohr Rudolf P. , Saavedra Serguei
Published: August 2017

Empirical studies have found that the mutualistic interactions forming the structure of plant–pollinator networks are typically more nested than expected by chance alone. Additionally, theoretical studies have shown a positive association between the nested structure of mutualistic networks and community persistence. Yet, it has been shown that some plant–pollinator networks may be more nested than others, raising the interesting question of which factors are responsible for such enhanced nested structure.

It has been argued that ordered network structures may increase the persistence of ecological communities under less predictable environments. This suggests that nested structures of plant–pollinator networks could be more advantageous under highly seasonal environments. While several studies have investigated the link between nestedness and various environmental variables, unfortunately, there has been no unified answer to validate these predictions. Here, we move from the problem of describing network structures to the problem of comparing network structures. We develop comparative statistics, and apply them to investigate the association between the nested structure of 59 plant–pollinator networks and the temperature seasonality present in their locations.

We demonstrate that higher levels of nestedness are associated with a higher temperature seasonality. We show that the previous lack of agreement came from an extended practice of using standardized measures of nestedness that cannot be compared across different networks.

Importantly, our observations complement theory showing that more nested network structures can increase the range of environmental conditions compatible with species coexistence in mutualistic systems, also known as structural stability. This increase in nestedness should be more advantageous and occur more often in locations subject to random environmental perturbations, which could be driven by highly changing or seasonal environments. This synthesis of theory and observations could prove relevant for a better understanding of the ecological processes driving the assembly and persistence of ecological communities.
Ain't Talkin' ‘Bout Gentrification: The Erasure of Alternative Idioms of Displacement Resulting from Anglo‐American Academic Hegemony
Authors: Smart Alan , Smart Josephine
Published: August 2017

The concept of gentrification has become stretched, both conceptually and geographically, in ways that both erode its utility and displace alternative ways of understanding the displacement of lower‐income people by urban transformation. Among the negative consequences that we consider is that the resulting pressure to reframe analysis in terms of gentrification reinforces Anglo‐American academic hegemony and increases the difficulty of introducing more appropriate theoretical approaches from scholars in, and of, the global South. We draw on the anthropological concepts of emic and etic analysis to illustrate the dangers of such erasure and displacement of alternative frames of understanding. At the same time, the theoretical extension of the concept of gentrification to replace alternative ways of thinking about the displacement of lower income populations, such as ‘urban renewal’, has reduced the analytical utility of gentrification itself by confusing different mechanisms by which this is achieved. We illustrate the problems through consideration of the sustained tradition of work on displacement in Hong Kong using other conceptual frames. We encourage greater openness to alternative critical traditions that offer insights into the dislocation of poorer urban populations.
Institutionalization of ‘The Property Mind’
Authors: Haila Anne
Published: August 2017

This essay discusses the idea of ‘the culture of property’ and whether it combines the economic and cultural explanations of gentrification. To explore the idea of a culture of property in the case of Singapore, it examines both what motivates Singaporeans to invest in real estate (e.g. nostalgic feelings, duty, guilt, moral economy, face, filial piety towards ancestors and a way to remember their origins as reasons for investing in properties in China), and the institutions in the property state of Singapore (e.g. the possibility of owning and selling public housing, collective sales legislation that encourages collective profitmaking and the pension system) that increase Singaporeans' appetite for property and make them watchers of the property market. Lastly, the essay discusses the consciousness of evictions and of class differences and notes the random and unfair nature of the property market. It ends with a call for further research on real estate and property development, and their role in increasing urban inequality.
Motives of corporate political donations: industry regulation, subjective judgement and the origins of pragmatic and ideological corporations
Authors: Harrigan Nicholas M.
Published: August 2017

What motivates corporate political action? Are corporations motivated by their own narrow economic self‐interest; are they committed to pursuing larger class interests; or are corporations instruments for status groups to pursue their own agendas? Sociologists have been divided over this question for much of the last century. This paper introduces a novel case – that of Australia – and an extensive dataset of over 1,500 corporations and 7,500 directors. The paper attempts to understand the motives of corporate political action by examining patterns of corporate political donations. Using statistical modelling, supported by qualitative evidence, the paper argues that, in the Australian case, corporate political action is largely motivated by the narrow economic self‐interest of individual corporations. Firms’ interests are, consistent with regulatory environment theory, defined by the nature of government regulation in their industry: those in highly regulated industries (such as banking) and those dependent on government support (such as defence) tend to adopt a strategy of hedging their political support, and make bipartisan donations (to both major parties). In contrast, firms facing hostile regulation (such as timber or mining), and those without strong dependence on state support (such as small companies) tend to adopt a strategy of conservative partisanship, and make conservative‐only donations. This paper argues that regulatory environment theory needs to be modified to incorporate greater emphasis on the subjective political judgements of corporations facing hostile regulation: a corporation's adoption of conservative partisanship or hedging is not just a product of the objective regulation they face, but also whether corporate leaders judge such regulation as politically inevitable or something that can be resisted. Such a judgement is highly subjective, introducing a dynamic and unpredictable dimension to corporate political action.
Estimation of Population Average Treatment Effects in the FIRST Trial: Application of a Propensity Score‐Based Stratification Approach
Authors: Chung Jeanette W. , Bilimoria Karl Y. , Stulberg Jonah J. , Quinn Christopher M. , Hedges Larry V.
Published: August 2017

Objective/Study Question

To estimate and compare sample average treatment effects (SATE) and population average treatment effects (PATE) of a resident duty hour policy change on patient and resident outcomes using data from the Flexibility in Duty Hour Requirements for Surgical Trainees Trial (“FIRST Trial”).

Data Sources/Study Setting

Secondary data from the National Surgical Quality Improvement Program and the FIRST Trial (2014–2015).

Study Design

The FIRST Trial was a cluster‐randomized pragmatic noninferiority trial designed to evaluate the effects of a resident work hour policy change to permit greater flexibility in scheduling on patient and resident outcomes. We estimated hierarchical logistic regression models to estimate the SATE of a policy change on outcomes within an intent‐to‐treat framework. Propensity score‐based poststratification was used to estimate PATE.

Data Collection/Extraction Methods

This study was a secondary analysis of previously collected data.

Principal Findings

Although SATE estimates suggested noninferiority of outcomes under flexible duty hour policy versus standard policy, the noninferiority of a policy change was inconclusively noninferior based on PATE estimates due to imprecision.

Conclusions

Propensity score‐based poststratification can be valuable tools to address trial generalizability but may yield imprecise estimates of PATE when sparse strata exist.
Psychometric Testing of INTEGRARE, an Instrument for the Assesment of Pressure Ulcer Risk in Inpatients
Authors: Porcel‐Gálvez Ana María , Romero‐Castillo Rocío , Fernández‐García Elena , Barrientos‐Trigo Sergio
Published: August 2017

PURPOSE

The aim of this study is to evaluate the psychometric properties of INTEGRARE, an instrument based on Nursing Outcome Classification.

METHOD

A multicenter, cross‐sectional, methodological design was used.

FINDINGS

The study included 3,835 patients. Internal consistency α = 0.86. Confirmatory factor analysis demonstrated the unidimensionality of the scale, indicating a good model fit (CMIN/DF = 4; GFI, CFI, NFI, IFI = 0.999; RMSEA = 0.028).

CONCLUSIONS

INTEGRARE is a valid and reliable instrument with high sensitivity, specificity, and diagnostic accuracy in measuring pressure ulcer (PU) risk in inpatients.

IMPLICATIONS FOR NURSING PRACTICE

This instrument allows us to know the effectiveness of nursing interventions, providing evidence for the validation of the diagnosis Risk for pressure ulcer (00249) as well as on health outcomes, due to the fact that PUs are nursing‐sensitive outcomes.

OBJETIVO

Evaluar las propiedades psicométricas de INTEGRARE, un instrumento basado en la Clasificación de Resultados de Enfermería.

MÉTODO

Se optó por un diseño transversal multicéntrico.

RESULTADOS

El estudio incluyó a 3,835 pacientes. Consistencia interna α = 0.86. El análisis factorial confirmatorio demostró la unidimensionalidad de la escala, indicando un buen ajuste del modelo (CMIN/DF = 4; GFI, CFI, NFI, IFI = 0.999; RMSEA = 0.028).

CONCLUSIONES

INTEGRARE es un instrumento válido y fiable con alta sensibilidad, especificidad y precisión diagnóstica en la medición de riesgo de úlcera por presión (UPP) en pacientes hospitalizados. IMPLICACIONES PARA LA PRÁCTICA ENFERMERA: Este instrumento nos permite conocer la efectividad de las intervenciones enfermeras, aportando evidencia para la validación del diagnóstico Riesgo de úlcera por presión (00249), así como sobre los resultados de salud, debido a que las UPP son resultados sensibles a la práctica enfermera.
National surgical mortality audit may be associated with reduced mortality after emergency admission
Authors: Kiermeier Andreas , Babidge Wendy J. , McCulloch Glenn A. J. , Maddern Guy J. , Watters David A. , Aitken R. James
Published: August 2017

Background

The Western Australian Audit of Surgical Mortality was established in 2002. A 10‐year analysis suggested it was the primary driver in the subsequent fall in surgeon‐related mortality. Between 2004 and 2010 the Royal Australasian College of Surgeons established mortality audits in other states. The aim of this study was to examine national data from the Australian Institute of Health and Welfare (AIHW) to determine if a similar fall in mortality was observed across Australia.

Method

The AIHW collects procedure and outcome data for all surgical admissions. AIHW data from 2005/2006 to 2012/2013 was used to assess changes in surgical mortality.

Results

Over the 8 years surgical admissions increased by 23%, while mortality fell by 18% and the mortality per admission fell by 33% (P < 0.0001). A similar decrease was seen in all regions. The mortality reduction was overwhelmingly observed in elderly patients admitted as an emergency.

Conclusion

The commencement of this nation‐wide mortality audit was associated with a sharp decline in perioperative mortality. In the absence of any influences from other changes in clinical governance or new quality programmes it is probable it had a causal effect. The reduced mortality was most evident in high‐risk patients. This study adds to the evidence that national audits are associated with improved outcomes.
Propensity score method for analyzing the effect of labor induction in prolonged pregnancy
Authors: Pyykönen Aura , Tapper Anna‐Maija , Gissler Mika , Haukka Jari , Petäjä Jari , Lehtonen Lasse
Published: August 2017

Introduction

There is an ongoing debate on the optimal time of labor induction to reduce the risks associated with prolonged pregnancy.

Material and methods

Registry‐based study of 212 716 term, singleton cephalic deliveries between 2006 and 2012 in Finland comparing the outcomes of labor induction with those of expectant management in five, three‐day gestational age periods between 40 and 42 weeks (group 1: 40+0–40+2; group 2: 40+3–40+5; group 3: 40+6–41+1; group 4: 41+2–41+4; group 5: 41+5–42+0). Using Poisson regression, induced deliveries in each of the gestational age periods were compared with all ongoing pregnancies. Propensity score matching was applied to reduce confounding by indication.

Results

In the gestational age groups 1 and 2, labor induction significantly decreased the risk of meconium aspiration syndrome [relative risk (RR) 0.40, 95% confidence interval (CI) 0.18–0.91 (group 1), RR 0.44, 95% CI 0.21–0.91 (group 2)] but increased the risk for prolonged hospitalization of a neonate [RR 1.30, 95% CI 1.10‐1.54 (group 1) and RR 1.23, 95% CI 1.03–1.47 (group 2)]. In groups 3 and 4, labor induction significantly increased the risk for emergency cesarean section [RR 1.17, 95% CI 1.06–1.28 (group 3) and RR 1.19, 95% CI 1.09–1.29 (group 4)] but still reduced the risk for meconium aspiration syndrome. In group 5, labor induction did not affect the risk for any of the studied outcomes (operative delivery, obstetric trauma, neonatal mortality, respirator treatment, Apgar <7).

Conclusions

Propensity score matching is a novel approach to studying the effect of labor induction. It highlighted the conflicting maternal and neonatal risks and benefits of the intervention, and supported expectant management as a valid option, at least until close to 42 weeks.
The Pharmacogenetics of Metformin in Women with Polycystic Ovary Syndrome: A Randomized Trial
Authors: Pedersen Andreas J. T. , Stage Tore Bjerregaard , Glintborg Dorte , Andersen Marianne , Christensen Mette Marie Hougaard
Published: August 2017

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age. PCOS is associated with obesity, dyslipidaemia and insulin resistance, and metformin treatment may improve such metabolic features. The effect of genetic variants in key metformin transporters, their transcriptional regulators or in metformin target genes on metformin response in women with PCOS is unclear. Associations between pharmacodynamic responses to metformin (changes in weight, lipid profile, insulin sensitivity evaluated by oral glucose tolerance testing) and polymorphisms in OCT1 (rs12208357 and rs72552763), HNF1A (rs1169288 and rs2464196), MATE1 (rs2289669 and rs2252281), MATE2‐K (rs12943590) and ATM (rs11212617) were studied in 40 women with PCOS randomized to 12 months of treatment with metformin 1000 mg twice daily ± oral contraceptive pills (150 μg desogestrel + 30 μg ethinylestradiol). In the entire study population, treatment was associated with reduced weight (median weight change −2.4 kg, 25th–75th percentile −5.2 to 0.3 kg, p < 0.001) and increased triglycerides (0.2 mmol/L (0.0–0.6 mmol/L), p < 0.01) without significant changes in other lipid parameters or insulin sensitivity (insulinAUC, glucoseAUC during OGTT). None of the evaluated polymorphisms significantly affected any treatment outcome. In conclusion, the genetic variants investigated were not crucial for the clinical response to metformin in PCOS.
Analysis of survival for patients with chronic kidney disease primarily related to renal cancer surgery
Authors: Wu Jitao , Suk‐Ouichai Chalairat , Dong Wen , Antonio Elvis Caraballo , Derweesh Ithaar H. , Lane Brian R. , Demirjian Sevag , Li Jianbo , Campbell Steven C.
Published: August 2017

Objectives

To evaluate predictors of long‐term survival for patients with chronic kidney disease primarily due to surgery (CKD‐S). Patients with CKD‐S have generally good survival that approximates patients who do not have CKD even after renal cancer surgery (RCS), yet there may be heterogeneity within this cohort.

Patients and Methods

From 1997 to 2008, 4 246 patients underwent RCS at our centre. The median (interquartile range [IQR]) follow‐up was 9.4 (7.3–11.0) years. New baseline glomerular filtration rate (GFR) was defined as highest GFR between nadir and 6 weeks after RCS. We retrospectively evaluated three cohorts: no‐CKD (new baseline GFR of ≥60 mL/min/1.73 m2); CKD‐S (new baseline GFR of <60 mL/min/1.73 m2 but preoperative GFR of ≥60 mL/min/1.73 m2); and CKD due to medical aetiologies who then require RCS (CKD‐M/S, preoperative and new baseline GFR both <60 mL/min/1.73 m2). Analysis focused primarily on non‐renal cancer‐related survival (NRCRS) for the CKD‐S cohort. Kaplan–Meier analysis assessed the longitudinal impact of new baseline GFR (45–60 mL/min/1.73 m2 vs <45 mL/min/1.73 m2) and Cox regression evaluated relative impact of preoperative GFR, new baseline GFR, and relevant demographics/comorbidities.

Results

Of the 4 246 patients who underwent RCS, 931 had CKD‐S and 1 113 had CKD‐M/S, whilst 2 202 had no‐CKD even after RCS. Partial/radical nephrectomy (PN/RN) was performed in 54%/46% of the patients, respectively. For CKD‐S, 641 patients had a new baseline GFR of 45–60 mL/min/1.73 m2 and 290 had a new baseline GFR of <45 mL/min/1.73 m2. Kaplan–Meier analysis showed significantly reduced NRCRS for patients with CKD‐S with a GFR of <45 mL/min/1.73 m2 compared to those with no‐CKD or CKD‐S with a GFR of 45–60 mL/min/1.73 m2 (both P ≤ 0.004), and competing risk analysis confirmed this (P < 0.001). Age, gender, heart disease, and new baseline GFR were all associated independently with NRCRS for patients with CKD‐S (all P ≤ 0.02).

Conclusion

Our data suggest that CKD‐S is heterogeneous, and patients with a reduced new baseline GFR have compromised survival, particularly if <45 mL/min/1.73 m2. Our findings may have implications regarding choice of PN/RN in patients at risk of developing CKD‐S.
Tree functional diversity affects litter decomposition and arthropod community composition in a tropical forest
Authors: Laird‐Hopkins Benita C. , Bréchet Laëtitia M. , Trujillo Biancolini C. , Sayer Emma J.
Published: August 2017

Disturbance can alter tree species and functional diversity in tropical forests, which in turn could affect carbon and nutrient cycling via the decomposition of plant litter. However, the influence of tropical tree diversity on forest floor organisms and the processes they mediate are far from clear. We investigated the influence of different litter mixtures on arthropod communities and decomposition processes in a 60‐year‐old lowland tropical forest in Panama, Central America. We used litter mixtures representing pioneer and old growth tree species in experimental mesocosms to assess the links between litter types, decomposition rates, and litter arthropod communities. Overall, pioneer species litter decomposed most rapidly and old growth species litter decomposed the slowest but there were clear non‐additive effects of litter mixtures containing both functional groups. We observed distinct arthropod communities in different litter mixtures at 6 mo, with greater arthropod diversity and abundance in litter from old growth forest species. By comparing the decay of different litter mixtures in mesocosms and conventional litterbags, we demonstrated that our mesocosms represent an effective approach to link studies of litter decomposition and arthropod communities. Our results indicate that changes in the functional diversity of litter could have wider implications for arthropod communities and ecosystem functioning in tropical forests.
Catching the ‘big fish’: The (ab)use of corruption‐related prosecutions across sub‐Saharan Africa
Authors: Mills Linnea Cecilia
Published: August 2017

This analysis concerns the use of punitive actions to curb corruption. Propositions from the literature on corruption state that by prosecuting offenders for corruption‐related crimes and thus ending impunity, particularly among high‐level political figures (‘big fish’), a political culture of less corruption will evolve. This, however, hinges on there being no impunity and politicization of prosecutions. This study empirically assesses whether this condition holds in the sub‐Saharan African political context. A unique database on corruption‐related prosecutions at the level of ministers across Africa was compiled and patterns were found that suggest that prosecutions are indeed politicized and serve as a way to eliminate political rivals. These findings are a warning in the face of the international community's overly technical and apolitical approach to anti‐corruption in sub‐Saharan Africa.
Converging in divergent ways
Authors: Dautović Ernest , Orszaghova Lucia , Schudel Willem
Published: August 2017

This paper focuses on intra‐industry trade (IIT) between Central, Eastern and South‐Eastern European (CESEE) countries and the EU‐15. It assesses the determinants of intra‐industry trade by combining a detailed product‐level (HS‐6) trade‐flow database with country‐level structural, monetary and institutional variables. Estimates are obtained with System‐GMM and dynamic fractional response models. Our results suggest that structural factors driving IIT differ in the region, notably perceptions of corruption and the distance in the stock of physical capital from the EU‐15. On the other hand, nominal variables such as the competitiveness of corporate taxation and the flexibility of exchange rate regimes contribute to the increase in intra‐industry trade in the whole region.
Preliminary report: Measurement of apixaban and rivaroxaban in plasma from bleeding patients
Authors: Jensen Kathrine O. F. , Hansen Svend H. , Goetze Jens P. , Jesting Amalie , Stensballe Jakob , Hansen Henrik
Published: August 2017

Objectives

The direct oral anticoagulants (DOACs), apixaban and rivaroxaban, are used for anticoagulation treatment. Although biochemical monitoring is not required, severe bleedings caused by DOAC have been reported. We therefore evaluated the chromogenic assay Biophen DiXaI® (Biophen) using plasma from non‐bleeding patients in treatment with DOAC and on spiked plasma from patients with ongoing bleeding.

Methods

The Biophen method was compared with an in‐house reference method; liquid chromatography‐tandem mass spectrometry (LC‐MS/MS) using plasma spiked with the compounds ranging from 20 to 1500 μg/L. Furthermore, the methods were compared using plasma from non‐bleeding patients in treatment with DOAC (n = 106). In addition, plasma was collected from patients not treated with DOAC, but with ongoing bleeding and tested in spiking experiments (n = 14).

Results

Analysis of plasma from 106 patients receiving rivaroxaban (n = 91) or apixaban (n = 15) showed agreement and correlation between the methods. Measurement in spiked plasma from patients with active bleeding, however, revealed a 26% overestimation by the assay.

Conclusions

Our findings show that Biophen is suitable for measuring apixaban and rivaroxaban concentrations in plasma. However, our results in patients with active bleeding show an overestimation of 26%. This should be taken into account when assessing possible intoxication with apixaban and rivaroxaban in patients presenting with bleeding.
A post‐mortem study on the prevalence of peripheral dental caries in Scottish horses
Authors: Lee L. , Reardon R. J. M. , Dixon P. M.
Published: August 2017

Peripheral caries (PC) is an increasingly recognised equine dental disorder with unknown predisposing factors that differs from the well described maxillary cheek teeth infundibular caries. Advanced PC can lead to premature wear and fracture of cheek teeth and thus is of welfare importance. Recent studies have shown large variation in the prevalence of PC in different European countries, with a trend towards a greatly increasing prevalence. One hundred and one equine heads sourced from a Scottish rendering plant were examined for the presence and grade of PC using the modified Honma equine dental caries grading system. The presence of cheek teeth calculus, diastemata and fractures was also recorded. Peripheral caries was present in 91% of horses; only affected the cheek teeth and was predominantly (72.6%) Grade 1 Class 1 (localised pitting lesions only affecting cementum). The caudal three cheek teeth were more commonly affected (74.7% prevalence) as compared to the rostral three cheek teeth (32.1% prevalence). The palatal aspect of maxillary and the buccal aspect of mandibular cheek teeth were significantly (245% and 170%, respectively) more commonly affected by PC than the opposite sides. Female horses were more commonly affected than males. Because post‐mortem examination allows the most detailed oral examination to be performed, this may partly explain the higher PC prevalence found in the current, as compared to previous studies, in addition to the particular population examined in this study.