bluuebunny/crossref_metadata_2025 huggingface dataset:
Minimal Groups Increase Young Children's Motivation and Learning on Group‐Relevant Tasks
Authors: Master Allison , Walton Gregory M.
Published: October 2012

Three experiments (N = 130) used a minimal group manipulation to show that just perceived membership in a social group boosts young children's motivation for and learning from group‐relevant tasks. In Experiment 1, 4‐year‐old children assigned to a minimal “puzzles group” persisted longer on a challenging puzzle than children identified as the “puzzles child” or children in a control condition. Experiment 2 showed that this boost in motivation occurred only when the group was associated with the task. In Experiment 3, children assigned to a minimal group associated with word learning learned more words than children assigned an analogous individual identity. The studies demonstrate that fostering shared motivations may be a powerful means by which to shape young children's academic outcomes.
Participatory Democracy, Decentralization and Local Governance: the Montreal Participatory Budget in the light of ‘Empowered Participatory Governance’
Authors: Patsias Caroline , Latendresse Anne , Bherer Laurence
Published: October 2012

The intent of this article is to reflect on the notion of empowered participatory governance in order to gain a better understanding of the institutional contexts and parameters that encourage a more participative democracy, and thereby bring to light the political mechanisms that contribute to broadening the decision‐making process. The example we consider is the Montreal Participative Budget (PB). We focus on the impact of decentralization, more specifically on the form this took as the Montreal PB was being elaborated. We examine how much decentralization circumscribes the PB process. The Montreal Participative Budget provides an illustration of the emergence of a participative level in a political context that is, on the whole, hostile to participatory decision making. We suggest that the PB in this context benefits from a new window of opportunity. The chosen example has a dual significance: it underlines the role of temporal contingencies and scales of the process of decentralization in the participative structures at the local level, and it enables us to gain a better grasp of the problem of institutional architectures in implementing participatory democracy by emphasizing the political and social realities underlying new loci for decision making.

Cette réflexion entend participer à l'agenda de recherche autour de la Empowered Participatory Governance lancé par Fung et Wright. Après avoir dressé un bilan d'analyses consacrées à différentes expériences participatives, afin de préciser les configurations institutionnelles et politiques favorables à une gouvernance plus participative, nous examinons ces résultats à l'aune du Budget Participatif du Plateau Mont‐Royal à Montréal. Notre étude s'attarde plus particulièrement sur les liens entre décentralisation et démocratie participative, soulignant la nécessité d'une analyse qui prenne en compte les rapports de force entre les acteurs au sein des systèmes de gouvernance antérieurs à l'instauration des instances participatives. Si la présence de mouvements sociaux et de partis politiques, soutenant le projet participatif, s'avère incontournable, un mouvement uniquement bottom up risque également de cantonner la portée transformatrice de la démocratie participative à sa portion congrue.
Controlling the Urban Fabric: The Complex Game of Distance and Proximity in European Upper‐Middle‐Class Residential Strategies
Authors: Andreotti Alberta , Le Galès Patrick , Fuentes Francisco Javier Moreno
Published: October 2012

This article presents an open discussion of the processes of urban secession and gentrification in contemporary European cities, arguing that intergroup social dynamics in urban spaces are generally more complex than either extreme mutual avoidance or the colonization of neighbourhoods by the wealthiest groups. We analyse the residential strategies of urban upper‐middle class managers in various European metropolitan areas through in‐depth semi‐structured interviews to argue that these groups develop complex strategies of proximity and distance in relation to other social groups. The development of these ‘partial exit’ strategies takes place through specific combinations of practices that allow groups to select the dimensions they are willing to share with other social groups, and those in which they prefer a more segregated social environment for themselves and their families. The responses of our interviewees were consistently more nuanced and complex than suggested by a simplistic theory about their drive to withdraw from society, forcing us to develop more sophisticated conceptual frameworks to account for the growing prevalence of multi‐layered identities and spheres of reference and solidarity, specific combinations of elective segregation and local involvement, and more active patterns of mobility combined with local embeddedness.
Variations of the Entrepreneurial City: Goals, roles and visions in Rotterdam's Kop van Zuid and the Glasgow Harbour Megaprojects
Authors: Doucet Brian
Published: October 2012

Both Rotterdam's Kop van Zuid and the Glasgow Harbour waterfront developments are examples of different forms of European urban entrepreneurial megaprojects. They are both situated on formerly vacant land in older industrial cities. In Rotterdam, the municipality has taken the initiative in planning and developing the megaproject, while in Glasgow, this task has been left to the private sector, with the City functioning as a facilitator. While urban entrepreneurialism and megaprojects have been discussed in academic literature for almost three decades, there are too few case studies which delve into the specific visions guiding these projects, the goals which they are meant to achieve and the positions which different actors play. The aim of this article is to analyze the relationship between these visions, goals and positions of actors in megaprojects and whether these relationships can explain how the different outcomes are produced. What we see is that in municipally‐led projects, entrepreneurial goals are more easily formed and implemented than when the public sector acts only as a facilitator to private developers. It will also argue that it is not only structural contexts which are important in determining the types of megaprojects which get built and the success which they achieve, but also the specific values, visions and goals that different stakeholders have.
Social protection to achieve sustainable inclusion: A European imperative in the current economic crisis
Authors: Euzéby Chantal
Published: October 2012

Preventing social exclusion has become a critical issue in the European Union (EU) as a result of cutbacks in social expenditure imposed by Member States’ exploding debt. This issue sits at the intersection of employment and training policies and of reforms seeking to adapt social protection systems to the new realities of the present socio‐economic context (population ageing, family instability, massive unemployment, employment insecurity, in‐work poverty and persistent and increasing social inequality). This article will show that promoting social protection as part of a social investment approach is an excellent means of reconciling the objectives of equal opportunity over the life cycle, sustained economic performance (improved structural competitiveness) and strengthened social cohesion in the interest of collective well‐being. Particular emphasis is given to the need to promote universal and individual rights to mobility and lifelong training, which would constitute new social guarantees, offsetting requirements linked to labour market flexibility. The article also emphasizes the importance of incorporating these rights throughout the EU as part of a wider social protection floor. This would offer permanent protection against the risk of exclusion in the Union, promote the economic and social integration sought since the revised Lisbon Strategy (2003‐2005), and create confidence and hope among Europe's citizens.
Work‐related social protection for informal workers
Authors: Lund Francie
Published: October 2012

The informal workforce is growing worldwide, and changes in the global structure of employment and in places of employment mean that work is a source of hazard and ill‐health for many poorer workers. Yet informal workers do not have access to work‐related social security. They face high work‐related risks, but have little or no access to reliable formal or informal social protection. Citizen‐focused social security programmes, such as cash transfers, do not give enough attention to the needs of able‐bodied adults who work. Further, informal workplaces are not covered by the traditional discipline and practice of occupational health and safety (OHS), which is a necessary component of overall work‐related social security. In particular, poorer informal workers are ill‐placed to make use of possible preventive interventions, as they may lead to loss of income in the short term. A more inclusive approach will require changes in the institutional arrangements governingOHS, and should involve especially local authorities and informal worker organizations, who are developing influential international sectoral networks. In this regard, promising examples of negotiated and inclusiveOHSpolicy reforms are presented. The broader challenge is to develop an expandedOHSthat specifically includes informal workers as “workers”, rather than as “vulnerable citizens” who qualify only for poverty‐oriented social protection programmes, and that explicitly addresses preventive measures.
The challenges of assessing and providing compensation for mental stress under Nigeria's 2010 Employee's Compensation Act
Authors: Atilola Olayinka
Published: October 2012

Nigeria has a predominantly youthful population and limited job opportunities in the formal labour market, which makes the search for formal employment difficult and can be conducive to the growth of exploitative working conditions. As one response to address the vulnerability of Nigerian workers, the Employee's Compensation Act was passed into law in December 2010. Of note, the Act includes provisions for compensation for mental health injuries, or “mental stress”, suffered in the course of employment. The article examines the strengths and weaknesses of the provisions, in particular the premise for mental health injury claims made in the Act. The wider policy implications of the Act as regards the development of compensation for mental health injuries in sub‐Saharan Africa are discussed and suggestions for the future review of the Act offered.
Strengthening the prevention of social insecurity
Authors: Sinfield Adrian
Published: October 2012

An important contribution to preventing social insecurity can be made by strong social security programmes that promote collective as well as personal security: in particular, they act as built‐in automatic stabilizers with social and political as well as economic benefits for the whole society. By contrast, weaker systems have a destabilizing effect built in that reduces their preventive effectiveness. The ways in which social security systems can contribute to preventing social and economic insecurity have become less effective in many countries. Reasons for the relative neglect of prevention are considered together with the changes that have weakened systems' preventive elements specifically. The structural context within which social security policies have to work, particularly the quality and quantity of employment as well as the interaction with other public programmes, has of course a major effect on their ability to prevent. There is still much that can be achieved by schemes with closer attention directed to what is needed to prevent insecurity. Proposals to strengthen the preventive contribution in social security programmes are offered to promote greater debate of these issues and to restore the goal of prevention as a central objective.
Why Educational Exchange Programmes Miss Their Mark: Cross‐Border Mobility, Education and European Identity*
Authors: KUHN THERESA
Published: October 2012

Current research shows that participating in an Erasmus exchange does not strengthen European identity. However, this does not necessarily imply that transnational interactions are ineffective in fostering European identity. Rather, the Erasmus programme misses its mark by addressing university students who are already very likely to feel European. Due to a ceiling effect, their experience abroad cannot make a difference. In contrast, low‐educated individuals who might respond strongly to cross‐border mobility by adopting a European identity hardly participate in educational exchange because they leave school before these programmes take place. Analyses of Eurobarometer survey data support this hypothesis.
The EMU Debt Crisis: Early Lessons and Reforms*
Authors: BUTI MARCO , CARNOT NICOLAS
Published: October 2012

The economic and financial crisis and its aftermath have put economic and monetary union (EMU) to the test and exposed gaps in its initial policy architecture. Collective rules of fiscal discipline have proven difficult fully to enforce and excessive public indebtedness has been confirmed as a potential source of systemic instability. Broader economic and financial imbalances have also been shown to carry important risks for individual Member States' and area‐wide stability. Recent governance reforms have sought to address these shortcomings. In particular, the so‐called ‘Six‐Pack’ has brought changes strengthening the ability to prevent and correct economic and fiscal imbalances in the future. With the crisis not terminated, however, the debate over optimal policy arrangements continues and additional governance reforms have been put forward. This article reviews some lessons drawn from the crisis episode for the economic and budgetary framework of EMU and describes the governance reforms that have been undertaken as part of the comprehensive solution needed to underpin the single currency.
The Interplay of Economic Reforms and Monetary Policy: The Case of the Eurozone*
Authors: DRUDI FRANCESCO , DURRÉ ALAIN , MONGELLI FRANCESCO PAOLO
Published: October 2012

The world has been struck by a mutating systemic financial crisis that is unprecedented in terms of financial losses and fiscal costs, geographic reach, and speed and synchronization. The crisis from August 2007 to date can be divided into three main phases: the financial turmoil from August 2007 to the collapse of Lehman Brothers; the global financial crisis from September 2008 until spring 2010; and the eurozone sovereign debt crisis from spring 2010 to the current period. While each phase has brought significant challenges, the current sovereign debt crisis has been the most critical stage for the eurozone. It has brought unprecedented challenges for the monetary union and triggered extraordinary adjustments in both monetary policy and institutional arrangements at the eurozone level. The purpose of this article is to outline the features of each crisis phase, to describe the actions taken by the European Central Bank (ECB) during each phase and to explain the rationale for such measures. It also discusses the need to strengthen further the economic union in order to guarantee the sustainability of the monetary union of the eurozone. In this respect, it is argued that the recent institutional adjustments made at the European Union level would have been necessary independently of the financial crisis.
The Politics of ‘Norm Diffusion’ in Turkish European Union Accession Negotiations: Why It was Rational for an Islamist Party to be ‘Pro‐European’ and a Secularist Party to be ‘Anti‐European’*
Authors: BAUDNER JOERG
Published: October 2012

The article will suggest a bottom‐up approach to analyzing the impact of European Union (EU) conditionality on candidate countries. If requiring comprehensive reforms, EU accession negotiations offer domestic actors a legitimacy standard, external constraints and a focal point for electoral coalitions as resources in the domestic political arena. The Turkish case serves as a hypothesis‐generating case study suggesting that domestic actors who are disadvantaged in domestic resources in these dimensions embrace EU accession, whereas domestic actors who feel threatened in their domestic resources adopt an opposite strategy. It will be demonstrated that the two major Turkish political parties adopted a cost–benefit calculus in their position towards EU accession. The Turkish case is particularly intriguing because the positions adopted by the Justice and Development Party (AKP) and the Republican People's Party (CHP), respectively, have been counter‐intuitive, and in fact both parties have drastically reversed earlier positions towards EU accession and done so in disregard of the preferences of their core electorate.
Nurses’ experiences of managing sick‐listing issues in telephone advisory services at primary health care centres
Authors: Lännerström Linda , Wallman Thorne , Söderbäck Maja
Published: October 2012

Introduction

Over the last decade, Swedish health care has focused on improving the management of sick‐listing issues. At primary healthcare centres, sick listing is mainly dealt with by the patient's physician but when patients have requests related to sick listing and contact the telephone advisory service, nurses will be involved. The aim of this study was to describe nurses’ experiences of managing sick‐listing issues in telephone advisory services in a primary healthcare setting.

Methods

The study was a qualitative focus group study. Data collection was conducted in three focus group conversations in a county in central Sweden in 2009. The conversations were recorded, transcribed and analysed using qualitative content analysis. The study included fourteen nurses, purposively sampled as having current experience of telephone advisory services at primary healthcare centres.

Findings

The management of sick‐listing issues was described by the nurses as Nurses Actions that were affected by Enabling conditions and Obstructing conditions. The Nurses’ Actions included making an assessment for appropriate action, making an appointment and/or giving information and guidance to the patient and/or monitoring patient's rights. Enabling conditions included documentation, routines, supportive cooperation and training in insurance medicine. The obstructing conditions were related to patients’ expectations, cooperation with other professionals, lack of training and the nurses’ professional role.

Conclusion

The nurses experienced stress and difficulties related to being gatekeepers and related to the act of balancing different demands from patients, co‐workers and the organisation. This in combination with the lack of training caused the nurses to state that they did not want responsibility for managing sick‐listing issues. Sufficient documentation, education, routines, support of and discussions with other professionals at the primary healthcare centre could be ways of improving nurses’ and other professionals’ management of sick‐listing issues.
A branch‐and‐bound algorithm for scheduling of new product development projects
Authors: Ranjbar Mohammad
Published: October 2012

In this paper, we consider scheduling problem in a new product development project. Each research and development project consists of a set of activities in which each activity may be executed in several ways. Each way of execution of an activity is a different technology, called an alternative technology, which may fail due to technical risks. In this work, we focus on alternative technologies for scheduling activities to maximize the expected net present value. We assume that the activity payoff is obtained as soon as any single technology is completed successfully. Therefore, we analyze the problem and develop a two‐phase solution procedure, consisting of a branch‐and‐bound algorithm and a recursive search procedure. The efficiency of the proposed algorithm has been evaluated on a set of randomly generated test instances.
Understanding Landscape Stewardship – Lessons to be Learned from Public Service Economics
Authors: Penker Marianne , Enengel Barbara , Mann Carsten , Aznar Olivier
Published: October 2012

We argue that public service economics provides a new perspective on landscape stewardship by explaining it as human‐to‐human transfer of partial property rights. These mutually linked exchanges involve rights to use, to access, or to control and allocate land, labour, skills or information. From the perspective of public service economics, we identify the actors involved in landscape stewardship and distinguish entrepreneurial strategies for service provision based on resource orientation, user orientation or competiveness orientation. The difficulties in evaluating the quality of services in general and landscape stewardship in particular result in substantial uncertainty. Three types of contracts that cope differently with this uncertainty can be distinguished: contracts focusing on the technical process, on the intended outcome or on the choice of suppliers based on trust and features of their performance potential. We conclude that a service economics perspective can add to the understanding of landscape stewardship. Due to the fact that ‘public service’ is already a well‐known and broadly acknowledged concept in society, public service economics could possibly provide more rapid progress towards a better co‐ordination of supply and demand for landscape qualities than other more novel concepts.
The Role of Risk Mitigation in Production Efficiency: A Case Study of Potato Cultivation in the Bolivian Andes
Authors: Larochelle Catherine , Alwang Jeffrey
Published: October 2012

Using a stochastic production frontier to model potato production in Bolivia, we quantify the costs of environmental and activity diversification (AD) in the form of efficiency losses and yield forgone. We find that efficiency decreases with the number of fields in a geographical cluster, distance between the dwelling and a particular field, discontinuity between fields, and off‐farm income. However, environmental diversification (ED) is more detrimental than AD. Using spatial analysis of field and household efficiency measures, we assess production vulnerability to climatic shocks and the potential of ED in mitigating shocks. We find important spatial clusters of low and high efficiencies at the field level suggesting that climatic shocks influence efficiency measures. Household‐level efficiency measures exhibit random spatial patterns suggesting that on average households can mitigate the adverse effects of shocks through ED.
Incidence of hepatitis C virus infection in patients on hemodialysis: A systematic review and meta‐analysis
Authors: Su Yingying , Norris Jessie L. , Zang Chunpeng , Peng Zhihang , Wang Ning
Published: October 2012

Hepatitis C virus infection is a perennial concern for hemodialysis units because the prevalence of hepatitis C is significantly higher there than in the general population. Through a systematic review and meta‐analysis, we aim to assess the incidence rate of hepatitis C virus infection in hemodialysis units and explore its potential risk factors. Five electronic databases were used to search articles from 1990 to 2012, including PubMed, Embase, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Wanfang. A random‐effects analysis was used to estimate the overall incidence rate of hepatitis C virus infection. A subgroup analysis and meta‐regression analysis were conducted to explore factors associated with heterogeneity between studies. Twenty‐two eligible articles were found, including 23 incidence rate estimates. The overall incidence rate of hepatitis C virus infection was 1.47 per 100 patient‐years (95% confidence interval [CI] 1.14 to 1.80). In the subgroup analysis, the pooled incidence rate was 4.44 (CI 2.65, 6.23) per 100 patient‐years in the developing world and 0.99 (CI 0.66, 1.29) per 100 patient‐years in the developed world. [Correction added on 2 November 2012, after first online publication: Pooled incidence rate in the developed world has been changed.] In addition, in hemodialysis units with higher prevalence, the incidence rate of hepatitis C virus infection also tended to be higher. Meta‐regression analysis showed that the country's development level and initial HCV prevalence combined could explain 67.91% of the observed heterogeneity. The incidence rate of hepatitis C virus infection among patients on hemodialysis was significantly high. Efforts should be taken to control hepatitis C virus infection in hemodialysis units, especially in developing countries.
Recruitment Practices and the Politics of Inclusion in Cancer Clinical Trials
Authors: Joseph Galen , Dohan Daniel
Published: October 2012

Since the U.S. National Institutes of Health (NIH) Revitalization Act of 1993, researchers with federal funding have been required to include “minorities and women” in their clinical trials, and inclusion in research has come to be seen as an important strategy for reducing health disparities. On the basis of ethnographic research in oncology clinics in an academic medical center and a public hospital over a period of two years, this article examines how the NIH inclusion mandate is playing out in the context of oncology clinical trials. We argue that although individual patients are recruited to particular trials by individual providers, recruitment processes are shaped by the structural inequities in the U.S. health care system that create differential access to medical facilities with different and unequal research infrastructures. Given the heterogeneity of clinical trials, research infrastructures, and the U.S. health care system, the meanings of inclusion in research are multiple, and inclusion by itself does not ensure equity.
“They Just Happened”: The Curious Case of the Unplanned Baby, Italian Low Fertility, and the “End” of Rationality
Authors: Krause Elizabeth L.
Published: October 2012

Even in a country with super‐low fertility rates, at least one‐quarter of all babies are unplanned. The finding puzzles policymakers. This article uses Italy's “curious case” as a jumping‐off point to expose assumptions about rationality. It offers a model to dismantle the “conceit” of rationality, drawing on Max Weber's classic critique and Emily Martin's contemporary appraisal. It asks: (1) How do assumptions about rationality related to sexuality and reproduction manifest? (2) How do qualitative data challenge rationalist assumptions? and (3) How are cultural logics expressed and what do they reveal about the “problem” of low fertility? Methodologically, the article offers an innovative approach, juxtaposing ethnographic data derived from the author's fieldwork with startling findings from Italian researchers’ multicity project. The analysis exposes the rationality trope as a technique of governance in a context in which policymakers yearn for social cohesion and population politics intensify around birthing, immigration, and aging.
Geography, environment, and spatial turnover of species in China's grasslands
Authors: Tang Zhiyao , Fang Jingyun , Chi Xiulian , Yang Yuanhe , Ma Wenhong , Mohhamot Anwar , Guo Zhaodi , Liu Yining , Gaston Kevin J.
Published: October 2012

Environment and spatial processes are key factors in shaping species composition in a community. These two factors make competing predictions concerning the decay of species composition similarity with environmental divergence and geographic distance. Unfortunately, these can be difficult to test independently because changes in environment are commonly well correlated with geographic distance. However, an opportunity is provided by exploiting marked regional differences in the spatial structure of the environment. In this study, we test the predictions of environment filtering and dispersal in explaining species turnover using > 300 study sites spanning ˜4000 km, across three major grasslands in China in which the environment is spatially structured to different degrees. We find that species composition similarity decayed with environmental divergence in the same way in all three regions, and even across biogeographic regions between which dispersal barriers are evident; in contrast, the decay of species composition similarity with geographic distance depended largely on the spatial structure of the environment. We conclude that, at the scale of study, environmental filtering rather than spatial processes best explains patterns of species turnover in China's grasslands.
Specific immunotherapy with allergens: an important tool in the treatment of the allergic diseases
Authors: Zuberbier Torsten , Canonica Giorgio Walter , da Silva Barbara
Published: October 2012

Immunotherapy was introduced 100 years ago and still is the only treatment that modifies the course of allergic diseases. The success of its use depends on correct indications, use of standardized extracts and monitoring the therapeutic response.
Evaluation of a blended learning model in geriatric medicine: A successful learning experience for medical students
Authors: Duque Gustavo , Demontiero Oddom , Whereat Sarah , Gunawardene Piumali , Leung Oliver , Webster Peter , Sardinha Luis , Boersma Derek , Sharma Anita
Published: October 2012

Background

Despite the increasingly ageing population, teaching geriatric medicine at medical schools is a challenge due to the particularities of this subspecialty and the lack of student interest in this subject.

Methods

We assessed a blended system that combines e‐learning and person‐to‐person interaction. Our program offered the students a hands‐on learning experience based on self‐reflection, access to technology, interactive learning, frequent interaction with the multidisciplinary team, more exposure to patients, and regular feedback.

Results

Our results indicate that the students appreciate this system as a rich and effective learning experience demonstrated by their positive feedback and by their significant improvement in knowledge assessed at the end of their rotation.

Conclusion

Implementing an interactive blended system is a beneficial approach to teaching geriatric medicine in medical schools and to motivating medical students' interest in this important medical subspecialty.
Self‐reported hearing, vision and quality of life: Older people in New Zealand
Authors: Zhang Shiran , Moyes Simon , McLean Chris , Searchfield Grant , Welch David , Jacobs Robert , Kerse Ngaire
Published: October 2012

Aim

To establish associations between sensory‐related disability and quality of life (QOL).

Methods

A total of 3817 people aged 75 years and older, including 173 Māori aged 61 years and older, were surveyed. Measures included: sociodemographic and health factors; World Health Organization quality of life (WHOQOL)‐BREF for QOL; and self‐rated hearing‐ and vision‐related disability.

Results

Hearing disability was reported by 866 (51%) men and 736 (36%) women. A total of 974 (26% of all, 61% of hearing disabled) used hearing aids. A total of 513 (30%) men and 618 (30%) women reported vision disability. Vision and hearing disability were both independently associated with lower QOL, with hearing difficulty affecting physical and social domains more, and the environmental domain least. Vision difficulty impacted the environmental domain most and the social domain least. QOL impact was higher for those with both hearing and visual disability (631, 17%).

Conclusions

Hearing and vision disability are associated with poorer QOL.
Prevalence of physical activity behaviour in older people: Findings from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project and Australian national survey data
Authors: Sims Jane , Birrell Carole L , Hunt Susan , Browning Colette , Burns Richard A , Mitchell Paul
Published: October 2012

Aim

Many older people lead sedentary lives. National Health Survey physical activity prevalence data provide limited coverage of the ‘old old’ (≥75 years).

Method

The Dynamic Analyses to Optimise Ageing (DYNOPTA) project's dataset provided physical activity data for 13 420 participants. Physical activity (walking, moderate‐ and vigorous‐intensity activities in the previous week) was measured. Data were weighted and prevalence was calculated.

Results

The frequency of walking in DYNOPTA was similar to that in the national sample. Walking remained relatively stable until a decline among persons aged 80 years and over; moderate and vigorous activity declined in all but a minority of persons aged 70 years and over. Although DYNOPTA participants reported more physical activity than those in the contemporary national survey, the rates of sedentary behaviour were high.

Conclusion

We require more information about the ‘oldest old’ (85+ years). There is great scope for increasing physical activity, even walking, among older people.
Management of women with postmenopausal bleeding: evidence‐based review
Authors: Bakour Shagaf H , Timmermans Anne , Mol Ben Willem , Khan Khalid S
Published: October 2012

Key content

Patients with postmenopausal bleeding (PMB) have a 10–15% chance of having endometrial carcinoma; they should therefore be seen within 2 weeks of referral. Cervical and vulval cancers remain important components of the differential diagnosis and can only be assessed by clinical examination.

There are well‐developed and evidence‐based strategies on how best to investigate women with PMB. These strategies are formulated in several guidelines.

Learning objectives

To understand that the completion of investigations of patients with PMB should include test performance and patient characteristics.

To be able to evaluate the various investigations for women with PMB.

To be able to describe the appropriate management of women with PMB on tamoxifen, and unscheduled PMB in women undergoing hormone replacement therapy.

Ethical issues

Incidental finding of thickened endometrium on transvaginal sonography (TVS) in asymptomatic individuals carries a management dilemma.

Approach to benign pathology: should subsequent evaluation for benign abnormalities be performed after malignancy has been ruled out?

Ongoing work and technology development will evolve our strategy in managing PMB.
An update on the diagnosis and management of ovarian torsion
Authors: Damigos Emmanuel , Johns Jemma , Ross Jackie
Published: October 2012

Key content

Torsion of the ovary, tube or both is estimated to be responsible for only a small number of all gynaecological emergencies, but is a common diagnostic challenge in the emergency setting.

Diagnosis can be difficult and is mainly based on clinical symptoms and imaging techniques such as ultrasound and MRI.

A normal ultrasound scan does not exclude adnexal torsion and the decision to operate should be made on clinical grounds if symptoms are severe.

Treatment is traditionally surgical removal of the ovary or adnexum, however, there is increasing evidence for conservative surgery, such as de‐torsion and oophoropexy, particularly in younger women.

This article provides an overview of the symptomatology, ultrasound diagnosis and classification, as well as treatment options for ovarian torsion.

Learning objectives

To understand the clinical presentation and ultrasound characteristics associated with ovarian torsion.

To review the literature on the available surgical options.

Ethical issues

Oophorectomy is commonly performed for adnexal torsion with a possible negative impact on fertility in women of reproductive age. De‐torsion is a more conservative surgical approach that should be considered in all younger women with ovarian torsion.
Maternal serum analytes as markers of adverse obstetric outcome
Authors: Lakhi Nisha , Govind Abha , Moretti Michael , Jones Johannes
Published: October 2012

Key content

Screening for Down syndrome is available in the first or second trimester.

In the absence of aneuploidy and structural anomalies, abnormal maternal serum levels of first and second trimester markers are associated with adverse obstetric outcome.

As the number of markers increases and their value becomes more extreme the likelihood of adverse obstetric outcome increases.

Although many of the associations between maternal serum markers for adverse maternity outcome are statistically significant, the positive predictive value for individual outcomes are too low for them to be clinically useful as screening tests.

Potential management strategies for care of women with abnormal serum markers are yet to be established.

Pregnancies complicated by pre‐eclampsia, fetal growth restriction, pre‐term delivery, fetal demise and spontaneous miscarriage have been associated with abnormal deviations in either one or several components of these markers.

Learning objectives

To review the relationship between abnormal first and second trimester maternal markers and adverse obstetric outcomes.

Ethical issues

Despite evidence of increased pregnancy complications with unexplained abnormal quadruple screen, the optimal method to manage them is unclear.

The cost of screening and emotional anxiety caused to patients must be outweighed by the benefits of early detection and the ability to reduce the overall risk.

It is a great dilemma for obstetricians on how to proceed when confronted with an unexplained abnormal serum screen.
Obstetric pelvic floor and anal sphincter injuries
Authors: Lone Farah , Sultan Abdul , Thakar Ranee
Published: October 2012

Key content

Vaginal delivery, especially the first, contributes to the development of pelvic organ prolapse, and urinary and anal incontinence.

Although the effects of childbirth on the pelvic floor are commonly reported within 12 months of delivery, the peak presentation of symptoms occur some 2–3 decades later.

Vaginal childbirth, advancing maternal age and increasing body mass index are the most consistent risk factors.

Diagnosis of obstetric anal sphincter trauma can be improved by training and thereby minimising the risk of anal incontinence.

Further research, using pelvic floor imaging, may improve our understanding of the nature of pelvic floor and anal sphincter injuries.

Learning objectives

To review the effect of childbirth on pelvic organ function.

To identify and appropriately manage anal sphincter injuries following childbirth.

Ethical issues

There are inadequate long‐term data from well‐conducted longitudinal studies to make definitive recommendations in many aspects of pelvic organ dysfunction.
The effect of bacterial challenge on ferritin regulation in the yellow fever mosquito, Aedes aegypti
Authors: Geiser Dawn L. , Zhou Guoli , Mayo Jonathan J. , Winzerling Joy J.
Published: October 2012

Secreted ferritin is the major iron storage and transport protein in insects. Here, we characterize the message and protein expression profiles of yellow fever mosquito (Aedes aegypti) ferritin heavy chain homologue (HCH) and light chain homologue (LCH) subunits in response to iron and bacterial challenge. In vivo experiments demonstrated tissue‐specific regulation of HCH and LCH expression over time post‐blood meal (PBM). Transcriptional regulation of HCH and LCH was treatment specific, with differences in regulation for naïve versus mosquitoes challenged with heat‐killed bacteria (HKB). Translational regulation by iron regulatory protein (IRP) binding activity for the iron‐responsive element (IRE) was tissue‐specific and time‐dependent PBM. However, mosquitoes challenged with HKB showed little change in IRP/IRE binding activity compared to naïve animals. The changes in ferritin regulation and expression in vivo were confirmed with in vitro studies. We challenged mosquitoes with HKB followed by a blood meal to determine the effects on ferritin expression, and demonstrate a synergistic, time‐dependent regulation of expression for HCH and LCH.
An Attribution Approach to Consumer Evaluations in Logistics Customer Service Failure Situations
Authors: Oflaç Bengü S. , Sullivan Ursula Y. , Baltacioğlu Tunçdan
Published: October 2012

The primary goal of this study is to investigate the roles of expectations and purchase criticality on consumers' brand perceptions and attribution behaviors in service delivery failures. The provision of logistics services is often a crucial point in supply chain management that can influence brand perceptions of customers. Indeed, the level and the quality of customer service provided may determine whether the organization will retain existing customers or even attract new ones. As a consequence, a failure in logistics customer service and its effect on overall perceptions of a brand should not be underestimated. Furthermore, the involvement of a third‐party logistics (3PL) company in this failure situation can create considerable shifts in the responses of consumers, especially in the attribution behavior for cause of failure. By applying scenario‐based experiments, this study demonstrates the dynamics by which customer expectations, purchase criticality and 3PL companies affect consumer brand perceptions and attributions. The results suggest the presence of two expectation‐based buffering effects in delivery failures. The first buffering effect is revealed in overall brand evaluation and repurchase intention, while the second buffering effect is observed in consumer brand attribution. The findings indicate that higher expectations may protect the brand and cause more attribution to the third‐party service provider. Additionally, it is shown that criticality of the purchase has crucial impacts on brand evaluations and attributions.
Service Supply Chains: Introducing the Special Topic Forum
Authors: Sampson Scott E. , Spring Martin
Published: October 2012

This article introduces the Special Topic Forum (STF) on Service Supply Chains (SSC). A fundamental purpose of the STF is to more clearly define the field of SSC research and to provide conceptual foundations, as well as empirical observations. A review of SSC literature shows three perspectives of SSC research that correspond to the source‐make‐deliver processes from the well‐known supply chain operations reference (SCOR) model. The STF contains articles that assume each of the three SSC perspectives: sourcing of services, making services, and services involved in product delivery. A fourth paper introduces a newer perspective in which the customer is the center of a network of interrelated service providers. This STF can serve as a springboard for future SSC research.
Customer Roles in Service Supply Chains and Opportunities for Innovation
Authors: Sampson Scott E. , Spring Martin
Published: October 2012

This article conceptualizes service supply chains according to the Unified Service Theory, which defines services as bidirectional supply chains that have customers both providing resources to and receiving resources from service providers. We establish how eight traditional roles in manufacturing supply chains are assumed by customers in service supply chains. Those service–customer roles include component supplier, labor, design engineer, production manager, product, quality assurance, inventory, and competitor. We describe how these eight roles are manifested in both business‐to‐consumer and business‐to‐business service contexts. We confirm the distinctiveness of these eight customer roles through an initial empirical study and show how the roles are manifested across different types of services. We then demonstrate how these distinctive customer roles can form the basis for service supply chain innovation.
Storm Tide Recurrence Intervals – A Statistical Approach Using Beach Ridge Plains in Northern Australia
Authors: NOTT JONATHAN
Published: October 2012

The marine inundation generated by Tropical Cyclone Yasi, north Queensland, February 2011, flooded at least 130 beachfront homes and many commercial businesses, becoming the most substantial marine inundation impact in Australia's modern history. As a consequence, guidelines for building in storm tide impact areas have been developed and discussions are beginning on whether Australia needs a national standard for buildings impacted by these events. Central to this will be determining which areas of coastal land need to be subjected to the standard, and this will likely be based upon the magnitude of a particular return interval event. The veracity of the current method for determining these return intervals is difficult to determine as there has been no objective way to assess the accuracy of this approach. One such method is developed here – applying extreme value theory statistics to millennial scale sedimentary records of tropical cyclone marine inundations. The approach is applied to a 5000‐year‐long beach ridge record of tropical cyclone inundations near Tully Heads and the results suggest that the inundation generated by Tropical Cyclone Yasi here had a return interval of approximately 1000 years. This is a substantially lower figure than the approximately 5000‐year return interval suggested by the currently accepted approach. Irrespective of which method is more accurate, the marine inundation generated by Yasi was a very rare event and one that may become more common under a future altered climate.
The use of respiratory‐correlated four‐dimensional CT where kidney motion has the potential to impact upon the radiotherapy planning process
Authors: Gawthrop Janet B , Gill Suki
Published: October 2012

Purpose

Four‐dimensional CT (4D‐CT) image data can be sorted into bins of each 10% of the respiratory cycle. From these data, an averaged scan (AS) and a maximum intensity projection (MIP) are derived. While sorting based on the respiratory cycle applies to lung tumours, the use of 4D‐CT for the kidney has not been analysed.

Methods

Both kidneys from five patients were contoured from every phase of the 4D‐CT, MIP and AS (in total 116 kidneys were contoured). For each patient, the kidney volumes on the AS and calculated mathematical average (CMA) from individual phases were compared. The kidney volumes on the MIP and Boolean expansion of all phases were compared. The maximum excursions of the superior and inferior poles of the kidneys were measured in the craniocaudal and anterior–posterior (AP) directions. Mid‐kidney excursion was measured in the AP and medial–lateral directions.

Results

Mean difference between CMA and AS was −0.91 cm3 (range −8.04 to 5.07 cm3). Mean difference between Boolean and MIP was 18.92 cm3 (range −2.24 to 44.34 cm3). Mean maximum displacement of mid‐kidney was 0.28 cm anteriorly (range 0 to 1.0 cm), 0.22 cm posteriorly (range 0.1 to 0.4 cm), 0.28 cm medially (range 0.1 to 0.5 cm) and 0.27 cm laterally (range 0.1 to 0.5 cm). Mean maximum excursion of superior pole was 0.31 cm anteriorly (range 0.2 to 0.5 cm), 0.29 cm posteriorly (range 0.2 to 0.5 cm) and 1.23 cm craniocaudally (range of 0.6 to 2.7 cm). Mean maximum excursion of inferior pole was 0.52 cm anteriorly (range 0.2 to 0.9 cm), 0.23 cm posteriorly (range 0.1 to 0.4 cm) and 0.67 cm craniocaudally (range of 0.3 to 1.8 cm).

Conclusion

The current study using 4D‐CT has shown that the derived MIP is a good surrogate for the evaluation of three‐dimensional kidney displacement, and that the volume of the AS is not largely different from the average volume for individual phases. The 4D‐CT is useful for the creation of individual patient internal target volume or planning organ at risk volume when kidney motion impacts on radiotherapy planning.
Suicide Attempt Risk in Youths: Utility of the Harkavy–Asnis Suicide Scale for Monitoring Risk Levels
Authors: Asarnow Joan , McArthur David , Hughes Jennifer , Barbery Veronica , Berk Michele
Published: October 2012

The Harkavy–Asnis Suicide Scale (HASS), one of the few self‐report scales assessing suicidal behavior was evaluated and ideation, was evaluated and predictors of suicide attempts (SAs) were identified with the goal of developing a model that clinicians can use for monitoring SA risk. Participants were 131 pediatric emergency department (ED) patients with suicidal behavior. The HASS and Diagnostic Interview Schedule for Children (DISC‐IV) were administered approximately 2 months after ED presentation. When compared with DISC‐IV ratings, sensitivity of the HASS SA items was excellent (100%), and overall classification accuracy was 72%. SA planning was the strongest predictor of SAs.