bluuebunny/crossref_metadata_2025 huggingface dataset:
Who are rural China’s village clinicians?
Authors: Xue Hao , Shi Yaojiang , Medina Alexis
Published: October 2016

Purpose

The purpose of this paper is to measure the turnover (or stability in employment) of village clinicians in rural China over the past decade. The authors also want to provide quantitative evidence on the individual characteristics of the clinicians who provide health care to villagers in rural China and whether we should expect these individuals to be interested in continuing to supply quality health care in China’s villages in the coming years.

Design/methodology/approach

This paper uses data from a survey of rural China’s village clinicians conducted in five provinces, 25 counties, and 101 villages in 2005 and 2012. This paper also uses qualitative data from interviews with 31 village clinicians. Using a mixed methods approach, this study describes the turnover of village clinicians and the main factors that impact the career decisions of clinicians.

Findings

Turnover of China’s village doctors, while not trivial (about 25 percent of village doctors exited their field between 2005 and 2012), is still not overly high. Only five out of 101 villages did not have village clinicians in 2012. Of those that lost village doctors between 2005 and 2012, nearly all of them still had a village doctor in 2012 (either taken over by another local clinician or the position was taken by a newcomer). The authors find that three main sets of factors are correlated with the career decisions of village clinicians: village clinicians’ opportunity cost, the profitability of running a village clinic, and commitment to the field of medicine. In general, clinicians who left the village faced a much higher opportunity cost, had been running a clinic that was not profitable, and had fewer ties to the field of medicine. Newcomers over the same period had higher levels of education, went to higher profit clinics between 2005 and 2012, and had a stronger commitment to the field.

Originality/value

This study makes use of a data set with a large and nationally representative sample to provide a new perspective to better understand clinician turnover at village clinics, the career decisions of clinicians, and the implied trends for the quality and access to rural health care services in the future.
Online privacy and security concerns of consumers
Authors: Gurung Anil , Raja M.K.
Published: October 2016

Purpose

Privacy and security concerns of consumers have been touted as one of the hindrances to the growth of e-commerce. These concerns increase the risk perception of consumers. Understanding the consequences of privacy and security concerns and their relationship to risk perceptions may provide a solution. The relationship between privacy and security is investigated using the theory of planned behavior. The study aims to examine the relationship of trust, privacy and security concerns to the risk perception adoption of e-commerce. The results from a survey validate the model.

Design/methodology/approach

Data were collected using survey from undergraduate business students. The respondents were requested to select a specific product that they plan to purchase in the next six months. After selecting a product, the respondents were requested to report an online company that they have recently visited which offers the selected product. The respondents were requested to fill out the survey with regard to their selected online company. Time given was approximately 20 min.

Findings

The results suggest that privacy and security concerns and trust beliefs had effects on risk perception. Among these effects, trust had the largest effect followed by privacy and security concerns. Furthermore, risk perception and trust beliefs had effects on attitude. The effect of trust beliefs on attitude was larger than the effect of risk perception on attitude. Similarly, subjective norm, perceived behavioral control and attitude had a positive and direct effect on intention to be involved in e-commerce.

Research limitations/implications

The first limitation of this study is the use of student subjects. Because this study took place in an educational setting, its generalizability to the general population of consumers lacks to some degree. The second limitation of this study is mono-method bias.

Practical implications

The effect of privacy concerns on risk perception was larger than that of security concerns. Because the consumers get more experienced and sophisticated using the Web, the security concerns that they may have had at the beginning are not reflected in their risk perceptions. It is likely that they have adopted protective measures on their own to defend their privacy online. An example of such a measure would be providing false information to online companies when asked to submit personal information.

Originality/value

The major contributions of this study are developing and validating an integrative framework of e-commerce adoption at the individual level. The model includes privacy and security concerns, risk perception and trust beliefs. This study also highlighted the distinction of constructs of privacy and security concerns and showed their differential effects on other related constructs in the research model.
Why don’t UK citizens protest against privacy-invading dragnet surveillance?
Authors: Renaud Karen , Flowerday Stephen , English Rosanne , Volkamer Melanie
Published: October 2016

Purpose

The purpose of this study was to identify to identify reasons for the lack of protest against dragnet surveillance in the UK. As part of this investigation, a study was carried out to gauge the understanding of “privacy” and “confidentiality” by the well-informed.

Design/methodology/approach

To perform a best-case study, the authors identified a group of well-informed participants in terms of security. To gain insights into their privacy-related mental models, they were asked first to define the three core terms and then to identify the scenarios. Then, the participants were provided with privacy-related scenarios and were asked to demonstrate their understanding by classifying the scenarios and identifying violations.

Findings

Although the participants were mostly able to identify privacy and confidentiality scenarios, they experienced difficulties in articulating the actual meaning of the terms privacy, confidentiality and security.

Research limitations/implications

There were a limited number of participants, yet the findings are interesting and justify further investigation. The implications, even of this initial study, are significant in that if citizens’ privacy rights are being violated and they did not seem to know how to protest this and if indeed they had the desire to do so.

Practical implications

Had the citizens understood the meaning of privacy, and their ancient right thereto, which is enshrined in law, their response to the Snowden revelations about ongoing wide-scale surveillance might well have been more strident and insistent.

Originality/value

People in the UK, where this study was carried out, do not seem to protest the privacy invasion effected by dragnet surveillance with any verve. The authors identify a number of possible reasons for this from the literature. One possible explanation is that people do not understand privacy. Thus, this study posits that privacy is unusual in that understanding does not seem to align with the ability to articulate the rights to privacy and their disapproval of such widespread surveillance. This seems to make protests unlikely.
Spot the phish by checking the pruned URL
Authors: Volkamer Melanie , Renaud Karen , Gerber Paul
Published: October 2016

Purpose

Phishing is still a very popular and effective security threat, and it takes, on average, more than a day to detect new phish websites. Protection by purely technical means is hampered by this vulnerability window. During this window, users need to act to protect themselves. To support users in doing so, the paper aims to propose to first make users aware of the need to consult the address bar. Moreover, the authors propose to prune URL displayed in the address bar. The authors report on an evaluation of this proposal.

Design/methodology/approach

The paper opted for an online study with 411 participants, judging 16 websites – all with authentic design: half with legitimate and half with phish URLs. The authors applied four popular widely used types of URL manipulation techniques. The authors conducted a within-subject and between-subject study with participants randomly assigned to one of two groups (domain highlighting or pruning). The authors then tested both proposals using a repeated-measures multivariate analysis of variance.

Findings

The analysis shows a significant improvement in terms of phish detection after providing the hint to check the address bar. Furthermore, the analysis shows a significant improvement in terms of phish detection after the hint to check the address bar for uninitiated participants in the pruning group, as compared to those in the highlighting group.

Research limitations/implications

Because of the chosen research approach, the research results may lack generalisability. Therefore, researchers are encouraged to test the proposed propositions further.

Practical implications

This paper confirms the efficacy of URL pruning and of prompting users to consult the address bar for phish detection.

Originality/value

This paper introduces a classification for URL manipulation techniques used by phishers. We also provide evidence that drawing people’s attention to the address bar makes them more likely to spot phish websites, but does not impair their ability to identify authentic websites.
Stress-based security compliance model – an exploratory study
Authors: Pham Hiep-Cong , El-Den Jamal , Richardson Joan
Published: October 2016

Purpose

This paper aims to extend current information security compliance research by adapting “work-stress model” of the extended Job Demands-Resources model to explore how security compliance demands, organization and personal resources influence end-user security compliance. The paper proposes that security compliance burnout and security engagement as the mediating factors between security compliance demands, organizational and personal resources and individual security compliance.

Design/methodology/approach

The authors used a multi-case in-depth interview method to explore the relevance and significance of security demands, organizational resources and personal resources on security compliance at work. Seventeen participants in three organizations including a bank, a university and an oil distribution company in Vietnam were interviewed during a four-month period.

Findings

The study identified three security demands, three security resources and two aspects of personal resources that influence security compliance. The study demonstrates that the security environment factors such as security demands and resources affected compliance burden and security engagement. Personal resources could play an integral role in moderating the impact of security environment on security compliance.

Research limitations/implications

The findings presented are not generalizable to the wider population of end-users in Vietnam due to the small sample size used in the interviews. Further quantitative studies need to measure the extent of each predictor on security compliance.

Originality/value

The originality of the research stems from proposing not only stress-based but also motivating factors from the security environment on security compliance. By using qualitative approach, the study provides more insight to understand the impact of the security environments on security compliance.
Lean-team effectiveness through leader values and members’ informing
Authors: H. van Dun Desirée , Wilderom Celeste P.M.
Published: October 2016

Purpose

Although empirical tests of effective lean-team leadership are scarce, leaders are often blamed when lean work-floor initiatives fail. In the present study, a lean-team leader’s work values are assumed to affect his or her team members’ behaviors and, through them, to attain team effectiveness. Specifically, two of Schwartzet al.’s (2012) values clusters (i.e. self-transcendence and conservation) are hypothesized to be linked to team members’ degree of information and idea sharing and, in turn, to lean-team effectiveness. The paper aims to report the examination of these hypotheses.

Design/methodology/approach

Survey responses (n=429) of both leaders and members of 25 lean-teams in services and manufacturing organizations were aggregated, thereby curbing common-source bias. To test the six hypotheses, structural equation modeling was performed, with bootstrapping, linear regression analyses, and Sobel tests.

Findings

The positive relationship between lean-team effectiveness and leaders’ self-transcendence values, and the negative relationship between lean-team effectiveness and leaders’ conservation values were partly mediated by information sharing behavior within the team.

Research limitations/implications

Future research must compare the content of effective lean-team values and behaviors to similar non-lean teams.

Practical implications

Appoint lean-team leaders with predominantly self-transcendence rather than conservation values: to promote work-floor sharing of information and lean-team effectiveness.

Originality/value

Human factors associated with effective lean-teams were examined, thereby importing organization-behavioral insights into the operations management literature: with HRM-type implications.
Examining the impact of socialization and information sharing and the mediating effect of trust on innovation capability
Authors: Kulangara Nisha Paul , Jackson Sherry Avery , Prater Edmund
Published: October 2016

Purpose

The purpose of this paper is to investigate the interrelationship between trust, socialization, and information sharing on the buying firm’s innovation capability in the context of the buyer-supplier relationship (BSR). A nomological model is developed that examines the mediating role of relational capital (supplier trust) on the relationship between structural capital (socialization and information sharing) and innovation capability.

Design/methodology/approach

A survey was conducted on 357 US executives. Structural equation modeling was used to analyze the hypothesized relationships.

Findings

Information sharing and formal socialization activities increased the buying firm’s trust in its key supplier. However, formal socialization activities within the context of the business environment did not have a significant direct impact on buyer’s innovative capabilities; but when mediated by trust, it positively impacted innovation capabilities. Informal socialization within the context of the social environment directly impacted innovation capabilities but trust did not mediate the relationship. Information sharing impacted trust and innovation significantly and trust mediated the impact of information sharing on innovation capabilities.

Originality/value

This study defines the formal and informal aspects of socialization and investigates its impact on trust and buyer innovation capabilities. This is one of the few studies that highlights the mediating role of trust between firms to facilitate innovation capability.
Designing a performance measurement system for collaborative network
Authors: Pekkola Sanna , Ukko Juhani
Published: October 2016

Purpose

The purpose of this paper is to examine how a performance measurement system (PMS) can be designed for a collaborative network and to identify which factors affect such a design.

Design/methodology/approach

This is a single-case study of a collaborative network. The data have been collected from semi-structured interviews conducted during 2008-2009 and after the design process in 2010 and 2012, respectively.

Findings

The research results present a five-step process model for designing a PMS for a collaborative network. The findings show that a participatory development style that enhances socialisation, the positive development of a network culture and an outside facilitator all have beneficial effects on the design process.

Practical implications

The practical contribution of this study is related to knowledge about the PMS design process for a collaborative network to support its measurement-related development projects. This knowledge involves the phases of such a process as well as the various factors supporting or hindering it.

Originality/value

The study presents a PMS design process for the case network, which can be utilised in other collaborative networks in a similar context. It also highlights the most essential practical experiences related to this process.
Let’s talk about innovation
Authors: Öberg Christina
Published: October 2016

Purpose

IMP researchers have shown interest in how innovations result from interaction among companies, while, and in parallel, there has been an increased focus on open innovation (OI) during the past decade. OI depicts how companies source, spin-out, and collaborate on innovation. This paper describes and discusses whether and how IMP and OI researchers acknowledge and build on each other’s work; and whether and how ideas provided by IMP and OI, respectively, create a fit to expand the exchange of knowledge between IMP and OI.

Design/methodology/approach

The paper is based on a citation analysis focussing on whether the OI literature refers to IMP research, and whether or not the IMP literature refers to OI research. The paper also compares OI and IMP to discover potentials for knowledge exchange between them through discussing similarities, complementarities, and contradictions.

Findings

The paper points out that while IMP researchers have started to show interest in OI, OI research does not refer to IMP. As such, OI research remains more company-centric in its discussions. IMP provides tools and models to capture the OI phenomenon specifically related to collaborative OI, while OI offers interesting thought for the capture of transaction-based innovation processes and their management.

Originality/value

The paper contributes to previous research through linking together OI and IMP research. This is important for several reasons, including the ability to enhance knowledge in each domain, critically discuss and relate various research domains and their underpinnings, and expand ideas developed in one research domain to another.
Multiple manipulators path planning using double A*
Authors: Tavares Pedro , Lima José , Costa Pedro , Paulo Moreira A.
Published: October 2016

Purpose

Streamlining automated processes is currently undertaken by developing optimization methods and algorithms for robotic manipulators. This paper aims to present a new approach to improve streamlining of automatic processes. This new approach allows for multiple robotic manipulators commonly found in the industrial environment to handle different scenarios, thus providing a high-flexibility solution to automated processes.

Design/methodology/approach

The developed system is based on a spatial discretization methodology capable of describing the surrounding environment of the robot, followed by a novel path-planning algorithm. Gazebo was the simulation engine chosen, and the robotic manipulator used was the Universal Robot 5 (UR5). The proposed system was tested using the premises of two robotic challenges: EuRoC and Amazon Picking Challenge.

Findings

The developed system was able to identify and describe the influence of each joint in the Cartesian space, and it was possible to control multiple robotic manipulators safely regardless of any obstacles in a given scene.

Practical implications

This new system was tested in both real and simulated environments, and data collected showed that this new system performed well in real-life scenarios, such as EuRoC and Amazon Picking Challenge.

Originality/value

The new proposed approach can be valuable in the robotics field with applications in various industrial scenarios, as it provides a flexible solution for multiple robotic manipulator path and motion planning.
Trace generation of friction stir welding robot for space weld joint on large thin-walled parts
Authors: Qi Ruolong , Zhou Weijia , Zhang Huijie , Zhang Wei , Yang Guangxin
Published: October 2016

Purpose

The weld joint of large thin-wall metal parts which deforms in manufacturing and clamping processes is very difficult to manufacture for its shape is different from the initial model; thus, the space normals of the part surface are uncertain.

Design/methodology/approach

In this paper, an effective method is presented to calculate cutter location points and to estimate the space normals by measuring some sparse discrete points of weld joint. First, a contact-type probe fixed in the end of friction stir welding (FSW) robot is used to measure a series of discrete points on the weld joint. Then, a space curve can be got by fitting the series of points with a quintic spline. Second, a least square plane (LSP) of the measured points is obtained by the least square method. Then, normal vectors of the plane curve, which is the projection of the space curve on the LSP, are used to estimate the space normals of the weld joint curve. After path planning, a post-processing method combing with FSW craft is elaborated.

Findings

Simulation and real experiment demonstrate that the proposed strategy, which obtains cutter locations of welding and normals without measuring the entire surface, is feasible and effective for the FSW of large thin-walled complex surface parts.

Originality/value

This paper presents a novel method which makes it possible to accurately weld the large thin-wall complex surface part by the FSW robot. The proposed method might be applied to any multi-axes FSW robot similar to the robot studied in this paper.
Managing accruals for income smoothing: empirical evidence from Pakistan
Authors: Safdar Raheel , Yan Chen
Published: October 2016

Purpose

The purpose of this paper is to investigate whether income smoothing helps to reduce volatility in reported earnings and which firms are more inclined to be engaged in income smoothing.

Design/methodology/approach

The authors used negative correlation between pre-managed earnings of a firm and its discretionary accruals (DAs) as proxy for income smoothing and the firms having more negative correlation coefficient are expected to have lower volatility in their reported earnings. The authors used Kothari et al.’s (2005) version of modified-Jones model to estimate DAs and used least squares estimations to investigate the research questions using six-year (2007-2012) sample of non-financial firms listed over Karachi Stock Exchange, Pakistan.

Findings

The authors found that firms experiencing more volatility in economic activities and smaller firms are more aggressively involved in income smoothing. Moreover, a predominant majority (72.2 per cent) of firms in the sample are involved in income smoothing through accruals manipulation. Also, the authors found that firms which are more aggressively involved in income smoothing have lesser volatility in reported earnings. Lastly, the level of DAs per se does not have any impact on income smoothing.

Research limitations/implications

The proxy used for income smoothing, though the authors consider it to be better, is not the only one used in literature and the sample is limited to Pakistan.

Originality/value

This study adds to earnings management literature by providing evidence on extensive accrual manipulation for income smoothing in Pakistan.
Cultural politics of enterprise lending and controls in closely held banks
Authors: Saliya Candauda Arachchige , Jayasinghe Kelum
Published: October 2016

Purpose

The purpose of this paper is to focus on the enterprise lending and control process in closely held banks, with special reference to Sri Lanka. It explores how those processes are being influenced by the distinctive cultural and political processes at organizational and societal levels.

Design/methodology/approach

The study relies on three cases built upon the life experiences of several employees in a closely held bank, articulating multiple sources of evidence: interviews, observations, documents, archival records, open-ended questionnaires, internet conversations and exchange of e-mails. The data analysis adopts cultural political economy theory.

Findings

The study’s findings reveal how cultural and political factors, such as egoistic motives and politics, gifts/rewards and a manipulative culture, along with exploitative and discriminatory politics at organizational and societal levels, articulate into the enterprise lending and control process (“five Cs”) in closely held banks. “Rational” enterprise lending and control processes in this context merely become a “ceremonial” practice, serving the petty interest of powerful capitalist business owners. Whereas previous studies emphasize that the criteria (five Cs) discriminate against ordinary people, as distinct from the élite, the findings of this study implicate that over and above that the criteria are set aside when it suits in order to favor or accommodate the élite.

Originality/value

The paper provides a “qualitative inquiry” on how cultural politics at organizational and societal-level effect on enterprise lending and control process within closely held banks in less developed countries (LDCs). The previous studies on bank lending and control used either large-scale surveys or alternatively devoted their interest toward the role and impact of accounting in World Bank and IMF-led lending schemes and policies, particularly in LDCs.
Supporting imprisoned women who self-harm: exploring prison staff strategies
Authors: Walker Tammi , Shaw Jenny , Hamilton Lea , Turpin Clive , Reid Catherine , Abel Kathryn
Published: October 2016

Purpose

The purpose of this paper is to explore the experiences of prison staff working with imprisoned women who self-harm in English prisons. In this small-scale study, 14 prison staff in three English prisons were interviewed to examine the strategies currently used by them to support imprisoned women who self-harm.

Design/methodology/approach

Thematic analysis (Braun and Clarke, 2006) was used to identify three key themes: “developing a relationship”, “self-help strategies” and “relational interventions”.

Findings

Many staff expressed some dissatisfaction in the techniques available to support the women, and felt their utility can be restricted by the prison regime.

Research limitations/implications

This study suggests that there is currently a deficit in the provision of training and support for prison staff, who are expected to fulfil a dual role as both custodian and carer of imprisoned women. Further research into prison staff’s perception of the training currently available could highlight gaps between current theory and practice in the management of self-harm and thus indicate content for future training programmes. Research exploring the impact of working with imprisoned women who self-harm is suggested to identify strategies for supporting staff. It must be acknowledged that this is a small-scale qualitative study and the findings are from only three prisons and may not apply to staff in other settings.

Originality/value

Currently few studies have focussed on the perspective of prison staff. This study is one of very few studies which focusses on the techniques and resources available to support the women, from the perspective of the prison staff.
CSR approaches of MNEs in developing countries
Authors: Mukherjee Kajari
Published: October 2016

Purpose

This paper aims to discuss how multinational enterprises (MNEs) can approach corporate social responsibility (CSR) in developing countries. Such countries face challenges of low social development, income differences and weak institutional framework. The society is also characterized by greater power distance and in-group collectivism. Managers of MNEs operating in developing countries have to find ways and means to deliver CSR which is in sync with the atypical socio-cultural-political-demographical needs of the country. They cannot just concentrate on strategic CSR to create positive externalities; rather, they have to provide generic social benefits to local communities.

Design/methodology/approach

The paper examines select literature to suggest six propositions regarding CSR approaches that can be adopted by MNEs.

Findings

Managers of MNEs will concentrate on those stakeholders who have power to punish or reward, and, apart from shareholders, these are likely to be local communities. Hypernorms operating in background will be linked to emergence of macro-social contract of societal expectation to provide some support to local community, whose specific forms will be community-specific microsocial contracts. These will aim at providing generic social goods to local community, through a variety of transactional and calculative activities, high on tokenism.

Research limitations/implications

This is a conceptual work. Empirical study is not done.

Originality/value

The mainstream CSR agenda is largely driven by concerns and priorities of developed countries. It aims at universalizing a set of conditions that do not exist in developing countries, and ignores the local realities and priorities. The paper fills a gap in explaining why the concept of global CSR has its limitations, and MNEs have to concentrate on alleviating local demands.
Poly(ADP‐ribose) polymerase 1 deficiency increases nitric oxide production and attenuates aortic atherogenesis through downregulation of arginase II
Authors: Wei Shu‐jian , Cheng Lin , Liang Er‐shun , Wang Qi , Zhou Sheng‐nan , Xu Hao , Hui Long‐hua , Ge Zhi‐ming , Zhang Ming‐xiang
Published: October 2016

Poly (ADP‐ribose) polymerase (PARP) plays an important role in endothelial dysfunction, leading to atherogenesis and vascular‐related diseases. However, whether PARP regulates nitric oxide (NO), a key regulator of endothelial function, is unclear so far. We investigated whether inhibition of PARP‐1, the most abundant PARP isoform, prevents atherogenesis by regulating NO production and tried to elucidate the possible mechanisms involved in this phenomenon. In apolipoprotein E‐deficient (apoE−/−) mice fed a high‐cholesterol diet for 12 weeks, PARP‐1 inhibition via treatment with 3,4‐dihydro‐54‐(1‐piperindinyl) butoxy‐1(2H)‐isoquinoline (DPQ) or PARP‐1 gene knockout reduced aortic atherosclerotic plaque areas (49% and 46%, respectively). Both the groups showed restored NO production in mouse aortas with reduced arginase II (Arg II) expression compared to that in the controls. In mouse peritoneal macrophages and aortic endothelial cells (MAECs), PARP‐1 knockout resulted in lowered Arg II expression. Moreover, phosphorylation of endothelial NO synthase (eNOS) was preserved in the aortas and MAECs when PARP‐1 was inhibited. Reduced NO production in vitro due to PARP‐1 deficiency could be restored by treating the MAECs with oxidized low‐density lipoprotein treatment, but this effect could not be achieved with peritoneal macrophages, which was likely due to a reduction in the expression of induced NOS expression. Our findings indicate that PARP‐1 inhibition may attenuate atherogenesis by restoring NO production in endothelial cells and thus by reducing Arg II expression and consequently arginase the activity.
What can a government do? Government issue ownership and real‐world problems
Authors: SEEBERG HENRIK BECH
Published: October 2016

Despite major interest in issue ownership, what shapes it remains a puzzle. In his pioneering work on issue ownership, John Petrocik emphasises the importance of a party's performance. Recent research acknowledges this by pointing to the role of real‐world problems and incumbency for issue ownership. However, if performance truly matters, it should be difficult to understand the impact of such problems without taking into account the government's response to it. Based on novel data on issue ownership, policy development and government attention across five issues in nine countries over time, the analysis shows that the government's issue‐handling reputation is associated with the policy development, and the government's attention to the problem is important for this association. This is especially true for parties with no history of issue ownership on the issue and if the government is a coalition or in minority.
Emergency Department Telemedicine Is Used for More Severely Injured Rural Trauma Patients, but Does Not Decrease Transfer: A Cohort Study
Authors: Mohr Nicholas M. , Harland Karisa K. , Chrischilles Elizabeth A. , Bell Amanda , Shane Dan M. , Ward Marcia M.
Published: October 2016

Objectives

Traumatic injury is a leading cause of death in the United States, and rural populations are at increased risk of injury and death. Rural residents have limited access to trauma care, and telemedicine has been proposed as one strategy to improve the provision of trauma care locally. The objective of this study was to describe patient‐level factors associated with telemedicine consultation in North Dakota critical‐access hospital (CAH) emergency departments (EDs) and to measure the association between telemedicine consultation and interhospital transfer.

Methods

Observational cohort study of all adult (age ≥ 18 years) trauma patients treated in North Dakota CAH EDs with an active telemedicine subscription between 2008 and 2014. Trauma cases were identified from the North Dakota Trauma Registry, and telemedicine‐enabled care was determined using a probabilistic linking algorithm with the call records of the predominant telemedicine network in North Dakota. Multivariable generalized estimating equations were used to identify factors associated with telemedicine consultation and to measure the association between telemedicine consultation and interhospital transfer, adjusting for patient, injury, and hospital factors.

Results

Of the 9,281 North Dakota trauma patients seen in CAHs, 2,837 were treated in an ED with an active telemedicine subscription. Telemedicine was consulted for 11% of all trauma patients in telemedicine‐capable EDs. Factors associated with telemedicine consultation included higher Injury Severity Score, penetrating injuries, burns, hypotension, tachycardia, and ambulance transport. Adjusting for severity of illness, injury mechanism, and type of injury, telemedicine use was not associated with interhospital transfer (adjusted odds ratio = 1.28, 95% confidence interval = 0.94 to 1.75).

Conclusion

Emergency department–based telemedicine consultation is requested for the most severely injured rural trauma patients, especially with those with penetrating trauma, burns, and abnormal presenting vital signs. Telemedicine consultation was not independently associated with increased probability of transfer. Future work should evaluate how telemedicine impacts the timeliness of care and specific care interventions.
Resuscitation orders in acute hospitals: A point prevalence study
Authors: Mills Amber , Walker Anne , Levinson Michele , Hutchinson Alison M , Stephenson Gemma , Gellie Anthea , Heriot George , Newnham Harvey , Robertson Megan
Published: October 2016

Objective

To determine the prevalence of resuscitation orders and Advance Care Plans, and the relationship with Medical Emergency Team (MET) calls.

Methods

A point prevalence review of patient records at five Victorian hospital services.

Results

One thousand nine hundred and thirty‐four patient records were reviewed, and 230 resuscitation orders and 15 Advance Care Plans found. Significantly, more resuscitation orders were found at public hospitals. Patients admitted to private hospitals were older, with shorter admissions. A further 24 orders were written following MET calls for 97 patients. Only 16% of patients aged 80+ years had a resuscitation order written within 24 hours of admission.

Conclusion

Fewer resuscitation orders were written at admission for older adults than might be expected if goals of care and resuscitation outcome are considered. MET continue to have a prominent role in end‐of‐life care. Consideration and documentation about treatment plans are needed early in an admission to avoid burdensome and futile resuscitation events.
Potentially preventable deaths in the Victorian Audit of Surgical Mortality
Authors: Chen Andrew , Retegan Claudia , Vinluan Jessele , Beiles Charles Barry
Published: October 2016

Background

The Victorian Audit of Surgical Mortality (VASM) seeks to peer‐review all deaths associated with surgical care. This study aimed to examine the mortalities that were determined by the assessor to be potentially preventable, and identify the clinical factors associated with these cases. The assessment of preventability of death and its relationship to management issues at different stages of the admission episode, as opposed to whether the management issue(s) alone were preventable have not been reported previously.

Methods

Mortality data from the VASM audit since 2007 that completed the peer‐review process were retrospectively analysed. Mortalities identified as being preventable were assessed to determine any treatment errors.

Results

A total of 6155 deaths were assessed. Of these, 14.6% (896/6155) were considered to be potentially preventable. Where a second‐line assessment was requested (1113/6155, 17.5% cases), 48.3% of these deaths were considered potentially preventable. Elective patient deaths were more likely to be potentially preventable (P < 0.001), especially in public patients. Lack of timely involvement of senior staff, inappropriate treatment delay and failure of problem recognition were factors most frequently associated with potentially preventable mortality.

Conclusion

Overall assessment of the preventability of death is unique to VASM. This allows an additional level of analysis to be applied to the circumstances surrounding each mortality and correlation of preventability of death with clinical management issues provides important feedback to surgeons and health‐care providers to further improve the safety and quality of care.
Regeneration dynamics of woody vegetation in a Mediterranean landscape under different disturbance‐based management treatments
Authors: Bashan Danielle , Bar‐Massada Avi
Published: October 2016

Question

Mediterranean landscapes have been affected for millennia by agro‐pastoral disturbances such as grazing and vegetation clearing. Increased levels of fine‐scale habitat heterogeneity that resulted from these disturbances contribute to reduced wildfire risk and increased species diversity. Disturbance‐based management tools utilize disturbances in order to promote biodiversity and reduce fire risk, but are complicated to apply effectively due to the natural regeneration ability of many woody species following disturbances. Therefore, their successful application requires a better understanding of woody regeneration dynamics. Here, we asked how disturbance‐based management treatments affected the spatiotemporal dynamics of woody vegetation across 11 yrs in a Mediterranean landscape.

Location

Ramat HaNadiv LTER, northern Israel.

Methods

We analysed vegetation dynamics in a field experiment comprising five treatments: cattle grazing, goat grazing, shrub clearing, shrub clearing followed by goat grazing and undisturbed control. We used image analysis of high‐resolution aerial photographs to map woody patches in our study plots. We then quantified the spatial pattern of woody vegetation using multiple landscape indices, and conducted a comparative analysis of woody regeneration rates under different management treatments.

Results

Cattle grazing did not inhibit woody regeneration, as regeneration rates were similar to those found in undisturbed control plots. Shrub clearing led to rapid woody regeneration (7% yr−1), while a combination of shrub clearing and intense goat grazing halted woody regeneration completely. Finally, intense goat grazing not only prevented woody regeneration but led to significant decline in woody cover (1% yr−1).

Conclusions

Our results highlight the rapid regenerative response of woody vegetation to severe disturbances, and the growth rates we found can serve as guidelines for long‐term management regimes aimed at maintaining low woody cover and biomass in fuel breaks and buffer zones.
The peptide Phα1β, from spider venom, acts as a TRPA1 channel antagonist with antinociceptive effects in mice
Authors: Tonello Raquel , Fusi Camilla , Materazzi Serena , Marone Ilaria M , De Logu Francesco , Benemei Silvia , Gonçalves Muryel C , Coppi Elisabetta , Castro‐Junior Celio J , Gomez Marcus Vinicius , Geppetti Pierangelo , Ferreira Juliano , Nassini Romina
Published: October 2016

Background and Purpose

Peptides from venomous animals have long been important for understanding pain mechanisms and for the discovery of pain treatments. Here, we hypothesized that Phα1β, a peptide from the venom of the armed spider Phoneutria nigriventer, produces analgesia by blocking the TRPA1 channel.

Experimental Approach

Cultured rat dorsal root ganglion (DRG) neurons, human fetal lung fibroblasts (IMR90) or HEK293 cells expressing the human TRPA1 (hTRPA1‐HEK293), human TRPV1 (hTRPV1‐HEK293) or human TRPV4 channels (hTRPV4‐HEK293), were used for calcium imaging and electrophysiology. Nociceptive responses induced by TRPA1, TRPV1 or TRPV4 agonists or by bortezomib were investigated in mice.

Key Results

Phα1β selectively inhibited calcium responses and currents evoked by the TRPA1 agonist, allyl isothiocyanate (AITC), on hTRPA1‐HEK293, IMR90 fibroblasts and DRG neurons. Phα1β did not affect calcium responses evoked by selective TRPV1 (capsaicin) or TRPV4 (GSK 1016790A) agonists on the various cell types. Intrathecal (i.t.) and intraplantar (i.pl.) administration of low doses of Phα1β (up to 300 pmol per paw) attenuated acute nociception and mechanical and cold hyperalgesia evoked by AITC (i.t. or i.pl.), without affecting responses produced by capsaicin or hypotonic solution. Notably, Phα1β abated the TRPA1‐dependent neuropathic pain‐like responses induced by bortezomib. In vitro and in vivo inhibition of TRPA1 by Phα1β was reproduced by a recombinant form of the peptide, CTK 01512‐2.

Conclusions and Implications

Phα1β and CTK 01512–2 selectively target TRPA1, but not other TRP channels. This specific action underlines the potential of Phα1β and CTK 01512‐2 for pain treatment.
Gender Attitudes in Early Childhood: Behavioral Consequences and Cognitive Antecedents
Authors: Halim May Ling D. , Ruble Diane N. , Tamis‐LeMonda Catherine S. , Shrout Patrick E. , Amodio David M.
Published: October 2016

This study examined factors that predicted children's gender intergroup attitudes at age 5 and the implications of these attitudes for intergroup behavior. Ethnically diverse children from low‐income backgrounds (N = 246; Mexican‐, Chinese‐, Dominican‐, and African American) were assessed at ages 4 and 5. On average, children reported positive same‐gender and negative other‐gender attitudes. Positive same‐gender attitudes were associated with knowledge of gender stereotypes. In contrast, positive other‐gender attitudes were associated with flexibility in gender cognitions (stereotype flexibility, gender consistency). Other‐gender attitudes predicted gender‐biased behavior. These patterns were observed in all ethnic groups. These findings suggest that early learning about gender categories shape young children's gender attitudes and that these gender attitudes already have consequences for children's intergroup behavior at age 5.
Carving Metacognition at Its Joints: Protracted Development of Component Processes
Authors: O'Leary Allison P. , Sloutsky Vladimir M.
Published: October 2016

Two experiments investigated the development of metacognitive monitoring and control, and conditions under which children engage these processes. In Experiment 1, 5‐year‐olds (N = 30) and 7‐year‐olds (N = 30), unlike adults (N = 30), showed little evidence of either monitoring or control. In Experiment 2, 5‐year‐olds (N = 90) were given performance feedback (aimed at improving monitoring), instruction to follow a particular strategy (aimed at improving control), or both. Across conditions, feedback improved children's monitoring, and instruction improved both monitoring and control. Thus, children's poor metacognitive performance likely reflects a difficulty engaging the component processes spontaneously rather than a lack of metacognitive ability. These findings also suggest that the component processes are distinct, with both undergoing protracted development.
Hearing aid fitting for visual and hearing impaired patients with Usher syndrome type IIa
Authors: Hartel B.P. , Agterberg M.J.H. , Snik A.F. , Kunst H.P.M. , van Opstal A.J. , Bosman A.J. , Pennings R.J.E.
Published: October 2016

Objectives

Usher syndrome is the leading cause of hereditary deaf‐blindness. Most patients with Usher syndrome type IIa start using hearing aids from a young age. A serious complaint refers to interference between sound localisation abilities and adaptive sound processing (compression), as present in today's hearing aids. The aim of this study was to investigate the effect of advanced signal processing on binaural hearing, including sound localisation.

Design and participants

In this prospective study, patients were fitted with hearing aids with a nonlinear (compression) and linear amplification programs. Data logging was used to objectively evaluate the use of either program. Performance was evaluated with a speech‐in‐noise test, a sound localisation test and two questionnaires focussing on self‐reported benefit.

Results

Data logging confirmed that the reported use of hearing aids was high. The linear program was used significantly more often (average use: 77%) than the nonlinear program (average use: 17%). The results for speech intelligibility in noise and sound localisation did not show a significant difference between type of amplification. However, the self‐reported outcomes showed higher scores on ‘ease of communication’ and overall benefit, and significant lower scores on disability for the new hearing aids when compared to their previous hearing aids with compression amplification.

Conclusions

Patients with Usher syndrome type IIa prefer a linear amplification over nonlinear amplification when fitted with novel hearing aids. Apart from a significantly higher logged use, no difference in speech in noise and sound localisation was observed between linear and nonlinear amplification with the currently used tests. Further research is needed to evaluate the reasons behind the preference for the linear settings.