bluuebunny/crossref_metadata_2025 huggingface dataset:
Consumer attitude towards sales promotion techniques: a multi-country study
Authors: Fam Kim-Shyan , Brito Pedro Q. , Gadekar Mahesh , Richard James E. , Jargal Ugtakh , Liu Wenchao
Published: March 2019

Purpose

The purpose of this paper is to examine and compare the influence of age, education, income, product involvement and sales promotion (SP) characteristics on consumer attitudes towards SP across eight culturally dissimilar environments.

Design/methodology/approach

A multi-country mall intercept and mail survey was conducted in Brunei, China, Hong Kong, Indonesia, Malaysia, New Zealand, Singapore and Thailand (n=4,125 respondents).

Findings

Country, education level and income significantly influence consumer attitudes towards SP. Some countries show a significant monetary value interaction effect. Consumers using delayed-reward SPT reported a significantly more positive attitude towards SP. Discounts and coupons are the two most highly ranked SP across the sampled countries.

Research limitations/implications

Limitations include the use of intercept and mail sampling. Extending the study to include additional Asian countries and other regions would benefit the understanding of cultural influences on SP.

Practical implications

Multinational marketing managers should consider three aspects of SP implementation strategy: cultural and demographic factors, interaction between delayed-reward SP and socio-demographics variables; country specific SP preferences to promote both sales and brand equity.

Originality/value

This study investigates and extends research on SP across cultures. In particular the research helps better understand the impact of demographic factors and culture on attitudes towards SP, and implementation of global promotions.
A multiple-item scale for measuring “sustainable consumption behaviour” construct
Authors: Quoquab Farzana , Mohammad Jihad , Sukari Nurain Nisa
Published: March 2019

Purpose

The purpose of this paper is to develop a reliable and valid scale with desirable psychometric properties and sufficient level of reliability and validity to measure sustainable consumption from consumer perspective.

Design/methodology/approach

In achieving this objective: the domain of the construct is specified; items are generated through qualitative interviews; the initial scale is purified, and finally it is validated. A survey yielded 1,002 complete, usable questionnaires in order to run the analysis. Data were splitted in half. First half was utilised for exploratory factor analysis (EFA) and the second half of the data were utilised to run confirmatory factor analysis (CFA). The initial pool of item was tested using EFA via SPSS version 23. The CFA was conducted using SmartPLS-3.2.7 to confirm the dimensionality of sustainable consumption behaviour (SCB) scale.

Findings

The EFA result revealed that SCB is a three-dimensional construct which is consisted of 24 items. The scale includes: quality of life; care for environmental well-being; and care for the future generation. The CFA confirmed the dimensionality, reliability and validity of the SCB scale.

Research limitations/implications

This sustainable consumption scale can be used to determine individual’s level of responsibility towards living a quality life, environment welfare, as well as responsibility towards sustainability of the future generation. It is expected that this initiative will stimulate further research on regional, cultural and demographic differences in understanding sustainable development.

Practical implications

Marketing practitioners may benefit from this scale by understanding the SCB of the socially and environmentally conscious consumers. It may eventually assist them to shape their strategies to meet the increasing demands of environmentalists.

Originality/value

The notion of sustainable consumption received significant research attention in present decade. It is regarded as one of the major catalysts of the sustainable development. However, in most cases sustainable consumption phenomenon is discussed from greater economic perspective and not much effort has been paid to consider it from consumer’s perspective. Furthermore, there is a lack of readily available scale to measure this construct in the existing literature.
Analysis of the moral mechanism to purchase counterfeit luxury goods: evidence from China
Authors: Jiang Yushi , Miao Miao , Jalees Tariq , Zaman Syed Imran
Published: March 2019

Purpose

The purpose of this paper is to extend the theory of reasoned action and the theory of planned behaviour to measure the effects of ethical and moral antecedents (e.g. integrity, moral judgement, extrinsic religiosity and intrinsic religiosity, and ethical concern) on attitudes towards counterfeit luxury products. Additionally, it also measured the effects on attitudes towards purchase intention.

Design/methodology/approach

The scope of the study is the Chinese market. The sample size for the study was 412 participants, and data were collected through established scales and measures. Structural equation modelling was used to test the developed model.

Findings

All the developed hypotheses were accepted. All the antecedents negatively affect attitudes towards counterfeit luxury products. At the same time, attitude has a positive effect on purchase intention. The results are consistent with those of earlier studies.

Research limitations/implications

Samples were gathered from just a single region in southwest China, which limits the generalisability of the discoveries. As past research in fake goods buying has done, future investigations relating to this situation in the domain of ethical reasoning should accumulate samples from other regions of China as well, as customer perception relating to profound morality and counterfeit Purchase Intention may change from region to region.

Practical implications

A few customers hold the opinion that luxury brands are lucrative because of the excessive costs of their products and therefore feel vindicated in buying counterfeits (Penz and Stottinger, 2005). Combatting this conviction requires luxury brand managers to endorse effective moral ideals and social commitment messages to prevail upon purchasers.

Social implications

A few customers trust that they are helping local people, such as the peddlers who offer the fakes or the producers who make these goods, suggesting in a way that a few individuals have positive attitudes towards these type of counterfeit goods sold locally. For such customers, there can be marketing messages that can show them the other side of the issue, such as the lost sales and loss caused to the organisations, which result in people becoming jobless because of their actions.

Originality/value

The primary goal of the study is to explore the relationship between the moral measurements of consumers and their attitudes and purchase intentions in the Chinese market.
Ethically minded consumer behaviour in Vietnam
Authors: Le Tri D. , Kieu Tai Anh
Published: March 2019

Purpose

Consumer ethics in Asia has attracted attention from marketing scholars and practitioners. Ethical beliefs and judgements have been predominantly investigated within this area. Recent research argues for consumer ethics to be measured in terms of behaviours rather than attitudinal judgements, due to a potential pitfall of attitudinal scales, which researchers often refer to as an attitude–behaviour gap. Accordingly, the purpose of this paper is to examine the dimensions of ethically minded consumer behaviour (EMCB) in an Asian emerging market context.

Design/methodology/approach

A survey of 316 Vietnamese consumers was conducted to investigate their ethically minded behaviours.

Findings

The SEM analyses reveal a significant impact of long-term orientation on EMCB, whereas spirituality has no impact. Collectivism, attitude to ethically minded consumption and subjective norms are found to influence the dimensions of EMCB. Age, income and job levels have effects on EMCB dimensions, but gender, surprisingly, has no effect.

Practical implications

The study can be beneficial to businesses and policy makers in Vietnam or any similar Asian markets, especially in encouraging people to engage with ethical consumption. Furthermore, it provides practitioners in Vietnam with a measurement instrument that can be used to profile and segment consumers.

Originality/value

This is among the first studies utilising and examining EMCB, especially in Vietnam where research into consumer ethics is scant. It contributes to the body of knowledge by providing a greater understanding of the impact of personal characteristics and cultural environment on consumer ethics, being measured by the EMCB scale which has taken into account the consumption choices. Furthermore, this study adds further validation to the EMCB scale.
Knowledge management and open innovation in agri-food crowdfunding
Authors: Cillo Valentina , Rialti Riccardo , Bertoldi Bernardo , Ciampi Francesco
Published: March 2019

Purpose

The purpose of this paper is to analyze the relationship between knowledge management capabilities and successful open innovation within agri-food businesses. This particular piece of research focuses on agri-food businesses which utilize crowdfunding platforms.

Design/methodology/approach

The research adopts a survey-based methodology, which is useful in enhancing the generalization of results. The final sample includes 80 cases for the analysis. The model and the hypotheses were tested through a hierarchical regression model.

Findings

This research assesses the importance of knowledge management capabilities for successful open innovation in crowdfunding for agri-food businesses. In particular, it emerged that IT-based knowledge exploitation capabilities are enablers of open innovation strategies. Additionally, it emerged that knowledge exploration capabilities can positively mediate the relationship between IT-based knowledge exploitation capabilities and open innovation in the context of agri-food businesses.

Originality/value

To the authors’ best knowledge, few researchers have explored this topic and, as such, there is a need to better conceptualize this intriguing phenomenon and to provide empirical evidence to support it.
Utilizing co-design approach to identify various stakeholders’ roles in the protection of intangible place-making heritage
Authors: Wu Haorui , Hou Chaoping
Published: March 2019

Purpose

The protection of traditional grassroots place-making knowledge and skills that comprise valuable intangible heritage has not been attracting enough attention in the field of post-disaster reconstruction and recovery. Based on the Guchengping Village’s reconstruction that followed the Lushan earthquake (Sichuan, China), the purpose of this paper is to identify the benefits of a co-design approach for post-disaster reconstruction and recovery, in order to ascertain various stakeholders’ contributions toward the protection of community-based intangible place-making heritage.

Design/methodology/approach

A qualitative method was employed to assist the professional designers in facilitating the co-design approach by bridging governments closer together with local communities. At the governmental level, focus groups and personal interviews were conducted to discover the government’s role in preserving the communities’ intangible heritage. At the community level, community-based workshops and family-based design partnerships engaged various community stakeholders to decipher their roles and contributions toward advancing the heritage age.

Findings

As the advocates of intangible heritage, all levels of government guaranteed that intangible heritage would be safeguarded in the government strategic plans. At the community level, local residents played a fundamental role as the grassroots protectors. Professional designers utilized cutting edge technologies to improve weaknesses found in the traditional knowledge and skills, by performing the protection in practice. Community-based service agencies promoted the value of heritage to address societal issues.

Originality/value

The co-design approach offered a new method of intangible heritage protection in post-disaster reconstruction and recovery by engaging different stakeholders, in order to effectively transfer the governmental strategic plans into community-based action plans, and in turn, enabled the grassroots voice to inform the government policies.
Numerical simulation of water hammer in multi-level intake hydropower station considering the impact of intake
Authors: Ding Yuan , Li TongChun , Zhao LanHao , Zhou MinZhe , Lin ChaoNing
Published: March 2019

Purpose

Multi-level intake structures are used to take the surface water of reservoirs. The changed boundary conditions will certainly make the water hammer phenomenon more complicated. This paper aims to find out the influence and law of the water hammer pressure after setting the stop log gates.

Design/methodology/approach

The authors use the computational fluid dynamics method with the adaptive grid technology to stimulate the water hammer phenomenon of the multi-level intake hydropower station. In the analysis, we set several different heights of stop log gates and two representative times in the starting up and shutdown processes to reflect the impact of multi-level intake structures.

Findings

The authors find that the setting of the stop log gates will reduce the pressure during the normal operation and will increase the period and amplitude of the water hammer wave, but will not necessarily increase the maximum water hammer pressure during the shutdown process. The relationship between the height of the stop log gates and the amplitude of the water hammer wave is affected by the shutdown time. After setting stop log gates, the depression depth and wave height of the water level in front of the dam increase when the load changes.

Originality/value

The authors study in this paper the water pressure of the multi-level intake hydropower station that has never been studied before and obtain some laws.
The link between perceptions of fairness, job training opportunity and at-will employees’ work attitudes
Authors: Hur Hyunkang , Ha Hyesong
Published: March 2019

Purpose

This study aims to investigate the relationship between three organizational practices (distributive justice, procedural justice and potential growth opportunity) and at-will employees’ work attitudes (job satisfaction and affective organizational commitment).

Design/methodology/approach

The data for the analysis are derived from the 2000 GeorgiaGain Survey. Multinomial logit model is used to examine the relationship of three organizational practices to reduce job insecurity and to promote at-will employees’ work attitudes.

Findings

This study demonstrated that at-will employees responded positively with job satisfaction or affective organizational commitment if they perceived a strong perception of organizational practices fairly and properly, in the form of providing distributive justice (affective organizational commitment), procedural justice (job satisfaction and affective organizational commitment) and offering career development opportunity (affective organizational commitment).

Originality/value

By using a unique data set of US public employees who felt limited job security protection through at-will employment policy reform, this study has enhanced our understanding of how at-will employee group in US state government would respond to different organizational practices which is currently limited.
Job quality dynamic in Benin
Authors: Kponou Kenneth , Fomba Kamga Benjamin
Published: March 2019

Purpose

The purpose of this paper is to analyze the job quality in Benin between 2007 and 2011. To do this, the study constructed a multidimensional measure of job quality and identified the determinants of the quality of the job. The measure adopted by the authors includes four dimensions: wages; extra-wage benefits and regularity of employment; conditions and career opportunities; and, finally, social security. Two methods, including the construction of measure of job quality and the estimation of determinants of the job quality index, were used to test the robustness of the effects. The results show that the quality of job improved slightly between 2007 and 2011 and that factors such as experience, the type of contract, the level of education, the formal character of the company and the work hours explain the job quality of workers in Benin.

Design/methodology/approach

The measure adopted by the authors includes four dimensions: wages; extra-wage benefits and regularity of employment; conditions and career opportunities; and, finally, social security. Two methods, including the construction of measure of job quality and the estimation of determinants of the job quality index, were used to test the robustness of the effects.

Findings

The results show that the quality of job improved slightly between 2007 and 2011 and that factors such as experience, the type of contract, the level of education, the formal character of the company and the work hours explain the job quality of workers in Benin.

Originality/value

The contribution of this study lies in its analytical approach and in the fact that it reinforces the knowledge that exists on this theme, which is still little studied in African countries.
Apparel-based deep learning system design for apparel style recommendation
Authors: Guan Congying , Qin Shengfeng , Long Yang
Published: March 2019

Purpose

The big challenge in apparel recommendation system research is not the exploration of machine learning technologies in fashion, but to really understand clothes, fashion and people, and know what to learn. The purpose of this paper is to explore an advanced apparel style learning and recommendation system that can recognise deep design-associated features of clothes and learn the connotative meanings conveyed by these features relating to style and the body so that it can make recommendations as a skilled human expert.

Design/methodology/approach

This study first proposes a type of new clothes style training data. Second, it designs three intelligent apparel-learning models based on newly proposed training data including ATTRIBUTE, MEANING and the raw image data, and compares the models’ performances in order to identify the best learning model. For deep learning, two models are introduced to train the prediction model, one is a convolutional neural network joint with the baseline classifier support vector machine and the other is with a newly proposed classifier later kernel fusion.

Findings

The results show that the most accurate model (with average prediction rate of 88.1 per cent) is the third model that is designed with two steps, one is to predict apparel ATTRIBUTEs through the apparel images, and the other is to further predict apparel MEANINGs based on predicted ATTRIBUTEs. The results indicate that adding the proposed ATTRIBUTE data that captures the deep features of clothes design does improve the model performances (e.g. from 73.5 per cent, Model B to 86 per cent, Model C), and the new concept of apparel recommendation based on style meanings is technically applicable.

Originality/value

The apparel data and the design of three training models are originally introduced in this study. The proposed methodology can evaluate the pros and cons of different clothes feature extraction approaches through either images or design attributes and balance different machine learning technologies between the latest CNN and traditional SVM.
Increasing wine sales through customised wine service training – a quasi-experiment
Authors: Brain Arthur Donald
Published: March 2019

Purpose

The selling of wines is usually performed by a sommelier in the context of an upmarket restaurant. However, many restaurants cannot afford to employ a sommelier and must rely on the food and beverage service personnel to assist customers with the selection of wine. The food and beverage service personnel are generally not qualified to do this. Restaurants usually do not provide training with regard to wine knowledge, wine service skills and wine selling skills. The purpose of this paper was to establish whether wine service training had an influence on the wine sales of a restaurant.

Design/methodology/approach

A quasi-experimental research design used two restaurants from the same franchise. One restaurant was the control group while the other was the experimental group. Wine sales were monitored and recorded for a period of three months, the second month being used for the training intervention of the experimental group.

Findings

Although the results were not statistically significant, the results indicated that wine service training increased the wine sales in the restaurant of the experimental group.

Originality/value

This study contributes to the literature in the South African hospitality sector and establishes that wine service training is a necessity for wine sales to explore further in the restaurant industry.
Applicability of the DUNDRUM-1 in a forensic Belgium setting
Authors: Habets Petra , Jeandarme Inge , Kennedy Harry G.
Published: March 2019

Purpose

Criteria to determine in which level of security forensic patients should receive treatment are currently non-existent in Belgium. Research regarding the assessment of security level is minimal and few instruments are available. The DUNDRUM toolkit is a structured clinical judgement instrument that can be used to provide support when determining security level. The purpose of this paper is to investigate the applicability and validity of the DUNDRUM-1 in Flanders.

Design/methodology/approach

The DUNDRUM-1 was scored for 50 male patients admitted at the forensic units in the public psychiatric hospital Rekem. Some files were rated by three researchers who were blind to participants’ security status, resulting in 33 double measurements.

Findings

Almost all files (96 per cent) contained enough information to score the DUNDRUM-1. Average DUNDRUM-1 final judgement scores were concordant with a medium security profile. No difference was found between the current security levels and the DUNDRUM-1 final judgement scores. Inter-rater reliability was excellent for the DUNDRUM-1 final judgement scores. On item level, all items had excellent to good inter-rater reliability with the exception of one item institutional behaviour which had an average inter-rater reliability.

Practical implications

The DUNDRUM-1 can be a useful tool in Flemish forensic settings. It has good psychometric properties. More research is needed to investigate the relationship between DUNDRUM-1 scores and security level decisions by the courts.

Originality/value

This is the first study that investigated the applicability of the DUNDRUM-1 in a Belgian setting, also a relative large number of repeated measurements were available to investigate the inter-rater reliability of the DUNDRUM-1.
A fuzzy optimization method for octet-truss lattices
Authors: Yang Yunhui , Zhao Libin , Qi Dexuan , Shan Meijuan , Zhang Jianyu
Published: March 2019

Purpose

This paper aims to present a multiscale fuzzy optimization (FO) method to optimize both the density distribution and macrotopology of a uniform octet-truss lattice structure.

Design/methodology/approach

The design formulae for the strut radii are presented based on the effective mechanical properties obtained from the representative volume element. The proposed basic lattice material is applied in a normalization process to determine the material model with penalization. The solid isotropic material with penalization (SIMP) method is extended to solve the minimum compliance problem using the optimality criteria. The evolutionary deletion process is proposed to delete elements corresponding to thin-strut unit cells and to obtain the optimal macrotopology.

Findings

Both numerical cases indicate that the FO results significantly improved in structural performance compared with the results of the conventional SIMP. The deleting threshold controls the macrotopology of the graded-density lattice structures with negligible effects on the mechanical properties.

Originality/value

This paper presents one of the first multiscale optimization methods to optimize both the relative density and macrotopology of uniform octet-truss lattices. The material model and corresponding optimality criteria of octet-truss lattices are proposed and implemented in the optimization.
Performance of generation time approximations for extinction risk assessments
Authors: Staerk Johanna , Conde Dalia A. , Ronget Victor , Lemaitre Jean‐François , Gaillard Jean‐Michel , Colchero Fernando
Published: March 2019

Generation time is a fundamental component of extinction risk assessments for the International Union for Conservation of Nature’s Red List of Threatened Species. The calculation of generation time requires age‐specific data on survival and fecundity rates and knowledge of population growth rates. These data are generally lacking for threatened species, so approximations including only partial demographic information need to be used. This leads to potential errors in generation time estimates.

To quantify the magnitude of potential errors in generation time estimates, we compared seven approximations with exact generation time measures, calculated either from complete life tables available for 58 mammalian species or from simulated data. We tested the influence of these errors on conservation assessments conducting mock assessments for ten species. We also tested the commonly used prediction of generation time based on the allometric relationship with body mass using phylogenetic generalized least squares.

Root mean square errors were largest in measures assuming constant fecundity with age, some of which are currently used in Red List assessments. We found that the measure of generation time that only ignores population growth rates performed relatively well, but tended to underestimate the generation time for decreasing populations, and over‐estimate it for increasing populations.

In the mock assessment, we found that we underestimated the threat level in 10% to 90% of the species depending on the generation time approximation we used.

The predictive metric of generation time based on body mass is inaccurate. We propose an alternative predictive metric based on body mass, age at first reproduction, and reproductive life span.

Synthesis and applications. Our results demonstrate potential errors that occur when estimating generation time in the absence of key demographic information. We offer practical recommendations for extinction risk assessments including more rigorous mathematical formulations of generation time, such as the measure of generation time that includes population growth rates and the appropriate age‐specific vital rates. Furthermore, we recommend alerting risk assessors of the uncertainties in proxy measures, such as the underestimation of generation time resulting from the assumption of constant fecundity in future Red List assessments.
Postcards from the Edge? Setting the Suburban Scene
Authors: Huq Rupa
Published: March 2019

This introduction highlights four themes about the politics of suburbia which are developed in the collection. First, what constitutes suburbia is multiple and constantly changing. This is reflected in diverse and evolving architectures and economic conditions. Second, the idea of the suburb as synonymous with the pinnacle of betterment is taking a battering as suburbs are now looking the worse for wear. ‘Just about managing’ families and the ‘squeezed middle’ are to be found in the suburbs. Third, in post‐2016 Britain, Brexit is the new political fault‐line where regional variations manifest themselves, and this is reflected in distinctive suburban politics, producing strange bedfellows spanning Surrey and Sunderland. Fourth, voting patterns reflect the dynamism of the modern suburb. The social and physical environment of the suburb may shape attitudes to some extent, but incomers have brought their politics with them.
The analyst as a citizen in the world
Authors: Singer Thomas
Published: March 2019

Beginning with a ‘big dream’ from almost fifty years ago, this paper tracks movement back and forth from an inner/individual adaptation to life to outer/collective adaptations through various stages of a life's journey. The rhythm between more inner orientation at one stage gives way to more outer adaptation at another stage and vice versa. This same movement can be paralleled by an exclusive emphasis on analysis at one stage and more of a mixture of analysis and activism at another stage. At the heart of this narrative is the realization that an inner big dream of decades before, symbolised both an inner path of developing a relationship with life‐promoting energies and an outer path represented by facilitating others’ discovery and participation in those energies. The dream therefore anticipated a more activist future of connecting inner and outer, individual and collective in various professional projects. This has resulted in occasional glimpses of the fact that the ‘spirit of the depths’ and ‘the spirit of the times’ can have a common meeting ground.
The incremental cost of infections associated with multidrug‐resistant organisms in the inpatient hospital setting—A national estimate
Authors: Johnston Kenton J. , Thorpe Kenneth E. , Jacob Jesse T. , Murphy David J.
Published: March 2019

Objective

To estimate the cost of infections associated with multidrug‐resistant organisms (MDROs) during inpatient hospitalization in the United States.

Data Sources/Study Setting

2014 National Inpatient Sample.

Study Design

Multivariable regression models assessed the incremental effect of MDROs on the cost of hospitalization and hospital length of stay among patients with bacterial infections.

Data Collection/Extraction Methods

We retrospectively identified 6 385 258 inpatient stays for patients with bacterial infection.

Principal Findings

The national incidence rate of inpatient stays with bacterial infection is 20.1 percent. At least 10.8 percent of such stays—and as many as 16.9 percent if we account for undercoded infections—show evidence of one or more MDROs. MRSA, C. difficile, infection with another MDRO, and the presence of more than one MDRO are associated with $1718 (95% CI, $1609‐$1826), $4617 (95% CI, $4407‐$4827), $2302 (95% CI, $2044‐$2560), and $3570 (95% CI, $3019‐$4122) in additional costs per stay, respectively. The national cost of infections associated with MDROs is at least $2.39 billion (95% CI, $2.25‐$2.52 billion) and as high as $3.38 billion (95% CI, $3.13‐$3.62 billion) if we account for undercoded infections.

Conclusions

Infections associated with MDROs result in a substantial cost burden to the US health care system.
Lactic Acid Fermentation of Edible Mushrooms: Tradition, Technology, Current State of Research: A Review
Authors: Jabłońska‐Ryś Ewa , Skrzypczak Katarzyna , Sławińska Aneta , Radzki Wojciech , Gustaw Waldemar
Published: March 2019

Pickling is one of the methods for preserving food. However, this term may refer to both types of products, that is, to those subjected to lactic acid fermentation and to marinated ones (acidified) that are usually produced by the addition of acetic acid. Various raw materials are subjected to lactic acid fermentation (vegetable and animal origin), which yields food products with high nutritional and dietary value. In many regions of the world, the process of lactic fermentation is also traditionally used to preserve fruiting bodies of edible mushrooms. Mushrooms are appreciated for their organoleptic qualities as well as the presence of many different bioactive substances exhibiting healing and health‐promoting properties. This article reviews the literature related to the use of lactic fermentation in the process of mushroom preservation. Particular attention has been paid to the aspects of the technological process and its impact on the quality and suitability of the final products. Moreover, research results concerning the influence of lactic fermentation on chemical and physical changes in fruiting bodies of edible fungi are also presented.
Effective triage in the Pacific region: The development and implementation of the Solomon Islands Triage Scale
Authors: Wanefalea Lynne E , Mitchell Rob , Sale Trina , Sanau Elizabeth , Phillips Georgina A
Published: March 2019

Objective

The ED at the National Referral Hospital in Honiara, Solomon Islands, receives approximately 50 000 patients per year. A 2014 review of ED functioning identified deficiencies in triage processes. Placement of Australian volunteer advisors provided an opportunity to develop and implement a purpose‐designed triage system.

Methods

Action research methodology and the ‘plan, act, observe, reflect’ cycle was employed, leading to the development of a three‐tier triage system based on the South African Triage Scale. ED patient flow and data management processes were simultaneously updated, and staff were trained in the new system. After a pilot period, the Solomon Islands Triage Scale was implemented in August 2017. Evaluation after 3 months of operation included predictive validity (using admission and case fatality rates as surrogate markers of urgency) and reliability (based on inter‐rater agreement at retrospective chart review by an independent nurse).

Results

In the period 1 August to 31 October, there were 10 905 presentations, of which 97.1% were allocated a triage category (1% category 1, 21.3% category 2 and the remainder category 3). Admission rates correlated closely with triage category (P < 0.01). The case fatality rate was 22.1% for category 1 patients, 0.09% for category 2 and 0.01% for category 3 (P < 0.01). An audit of 96 records conducted in October 2017 revealed 88.4% agreement for triage category allocation.

Conclusion

Solomon Islands Triage Scale is the first three‐tier triage scale to be implemented in the Pacific region and appears to have adequate validity and reliability. The partnership between Australian volunteers and local clinicians is a positive example of capacity development and represents a model that could be implemented in other resource‐limited settings.
The Painted Chamber at Westminster and the Openings of Parliament, 1399–1484*
Authors: Caddick Jennifer
Published: March 2019

The aim of this article is to investigate the use of the Painted Chamber in the Palace of Westminster as a parliamentary space in the 15th century, focusing on 41 openings of parliament held there between 1399 and 1484. It will examine the history and images of the Painted Chamber and the procedures of the opening of parliament through a combination of historical, art historical, and archaeological sources, scholarship and methodologies. It will argue that the Painted Chamber and the openings of parliament therein were tools used by the crown to establish a dynamic between itself and the Commons in which the crown claimed its right to authority but also encouraged a political dialogue. Furthermore, it will argue that this need for dialogue was a response to the growing political influence of the Commons.
The Elizabethan House of Commons and St Stephen's Chapel Westminster
Authors: Cooper J.P.D.
Published: March 2019

This essay explores the significance of the Elizabethan house of commons meeting in a converted royal chapel within the Palace of Westminster. In 1548 the dissolved collegiate chapel of St Stephen at Westminster was given over to the exclusive use of the Commons, providing MPs with a dedicated meeting space for the first time. Although a great deal has been written about Elizabethan parliaments, little attention has been paid to the physical spaces within which MPs gathered, debated and legislated. Drawing on parliamentary diaries and exchequer records and informed by digital reconstructions of the Commons chamber modelled by the St Stephen's Chapel project at the University of York, this essay argues for the enduring influence of the architecture and decoration of the medieval chapel on the procedure, culture, ritual, and self‐awareness of the Elizabethan house of commons. Famously likened to a theatre by the MP and writer on parliamentary procedure, John Hooker, the Commons chamber is analysed as a space in which parliamentary speeches were performed and disrupted. The sound of debate is contrasted with other kinds of noise including scoffing and laughter, disruptive coughing, and prayers led by the clerk and the Speaker of the Commons. The iconography of the chamber, including the royal arms above the Speaker's chair and the mace carried by the serjeant‐at‐arms, is interpreted as enabling a culture of counsel and debate as much as an assertion of monarchical power. Evidence is also presented for the Commons chamber as a site of political memory.
‘A Sense of Crowd and Urgency’? Atmosphere and Inconvenience in the Chamber of the Old House of Commons
Authors: Seaward Paul
Published: March 2019

The house of commons before the 1834 fire that destroyed it was small, poky, and uncomfortable. Its effects on the health, audibility, and behaviour of its members were frequently a cause of complaint, and informed the consideration by two select committees in 1831 and 1833 of what could be done to replace the chamber. This article examines the background to the appointment of the committees, and what their discussions reveal about the unsatisfactory nature of the chamber. It considers why there failed to be a consensus on altering the chamber before its destruction.
Parliament as Viewed Through a Woman's Eyes: Gender and Space in the 19th‐Century Commons
Authors: Richardson Sarah
Published: March 2019

The 19th‐century house of commons is traditionally viewed as a masculine space overlooking the presence of female tourists, waitresses, housekeepers, servants, spectators, and residents. This essay demonstrates that, even when formally excluded from the Commons, women were determined to colonize spaces to witness debates. In the pre‐1834 Commons they created their own observation gallery in an attic high above the chamber, peeping through a light fitting to listen to parliamentary sessions. After 1834, they were accommodated in their own galleries in the temporary and new house of commons, growing increasingly assertive and protective of their rights to attend debates and participate in parliamentary political culture. Far from being exclusively male, parliament was increasingly viewed through women's eyes.
Control of Autochthonous Spoilage Lactic Acid Bacteria in Apple and Orange Juices by Sensorially Accepted Doses of Citrus Spp. Essential Oils Combined with Mild Heat Treatments
Authors: de Souza Pedrosa Geany Targino , de Carvalho Rayssa Julliane , Berdejo Daniel , de Souza Evandro Leite , Pagán Rafael , Magnani Marciane
Published: March 2019

This study assessed the compromised acceptance threshold (CAT) and rejection threshold (RT) of Citrus lemon (CLEO) and Citrus reticulata essential oil (CREO) in apple and orange juices. The efficacy of CLEO and CREO concentrations below the RT were evaluated alone and combined with mild heat treatment (MHT) (54 °C, up to 12 min) to inactivate the autochthonous spoilage bacteria Lactobacillus brevis, Lactobacillus plantarum, and Leuconostoc mesenteroides in apple and orange juices. The CAT of CLEO and CREO varied from 0.15 to 0.17 μL/mL in orange and apple juices. The RT of CLEO was approximately 0.58 μL/mL in apple and orange juices, and the RT of CREO was 0.68 μL/mL in both juices. When CLEO and CREO were assayed alone, the highest concentration (0.50 μL/mL) decreased counts of all strains approximately 2 log10 CFU/mL after 12 min of exposure to 54 °C. All concentrations of CLEO or CREO in combination with MHT acted synergistically against L. brevis, L. plantarum, and L. mesenteroides. Decreases in counts varied with the strain, CLEO and CREO concentrations, juice type, and exposure time to the combined treatment. CREO was more effective than CLEO in combination with MHT against the strains in apple and orange juices. Effective combinations of CLEO or CREO with MHT to control the autochthonous spoilage bacteria did not compromise the quality parameters (°Brix, pH, and titratable acidity) that characterize unsweetened juices. These results indicate CLEO or CREO at concentrations below the sensory RT in combination with MHT as a feasible technology to control autochthonous spoilage bacteria in fresh fruit juices.

Practical Application

The present study provides novel information concerning the efficacy of sensorially accepted doses of CLEO and CREO combined with MHT against autochthonous spoilers in fruit juice. The valuable synergistic effects that can be observed when combining CLEO and CREO with MHT reveal a feasible preservation technology and alternative to traditional treatments that are successful because they help reduce treatment intensity, thereby avoiding adverse effects on the sensory, physicochemical, and nutritional properties of these products.
Dismantling the bacterial virulence program
Authors: Alford Morgan A. , Pletzer Daniel , Hancock Robert E.W.
Published: March 2019

In the face of rising antimicrobial resistance, there is an urgent need for the development of efficient and effective anti‐infective compounds. Adaptive resistance, a reversible bacterial phenotype characterized by the ability to surmount antibiotic challenge without mutation, is triggered to cope in situ with several stressors and is very common clinically. Thus, it is important to target stress‐response effectors that contribute to in vivo adaptations and associated lifestyles such as biofilm formation. Interfering with these proteins should provide a means of dismantling bacterial virulence for treating infectious diseases, in combination with conventional antibiotics.
Do subsidies cause a less competitive milk market in China?
Authors: Chen Yuquan , Yu Xiaohua
Published: March 2019

After 2008, China dairy industry has experienced a consolidation supported by the government mainly for the reason of food safety. Subsidies are one of the tools to shape a concentrated market with goals of reducing regulation cost and accomplishing quality control. This gives a serious concern that subsidies would generate a less competitive dairy industry. We construct a parametric model and use the firm‐level panel data, specifically the top eight dairy firms, to test if government subsidies strengthen the market power in the dairy industry. Our empirical results indicate government subsidies have a negative impact on the Lerner index for the top privately owned firms, but no significant effect on state‐controlled ones after controlling for advertising, time trend, and proprietorship. It is possible that the subsidies give more room for private firms to increase the scale or suppress the price, which eventually reduces the market power and benefits dairy customers in the downstream.
Systematic review with meta‐analysis: risk of post‐operative complications associated with pre‐operative exposure to anti‐tumour necrosis factor agents for Crohn’s disease
Authors: Lin Yang‐Sheng , Cheng Sheng‐Wei , Wang Yuan‐Hung , Chen Kee‐Hsin , Fang Ching‐Ju , Chen Chiehfeng
Published: March 2019

Background

Post‐operative complications after anti‐tumour necrosis agent treatment for Crohn's disease (CD) have been analysed with conflicting results.

Aim

To assess the effects of pre‐operative anti‐tumour necrosis factor (TNF) therapy on post‐operative complications within 30 days post‐operatively in patients with CD undergoing abdominal surgery.

Methods

Systematic review with meta‐analysis was performed on articles found in MEDLINE, Embase, Cochrane Library, Scopus, and the International Clinical Trials Registry Platform until September 2018.

Results

Twenty studies (7115 patients) were included. Without confounder adjustment, pre‐operative anti‐TNF therapy in patients with CD undergoing abdominal surgery was associated with increased rates of infectious complications (unadjusted odds ratio, OR, 1.49; 95% CI, 1.08‐2.06). After confounder adjustment, Pre‐operative anti‐TNF therapy was significantly associated with both increased rates of total and infectious complications (adjusted OR, 1.53 and 2.09; 95% CI, 1.11‐2.09 and 1.19‐3.65, respectively). After subgroup analyses, the association between anti‐TNF agents and total complications was significant in high incidence countries (adjusted OR, 1.86; 95% CI, 1.43‐2.42) but not in low incidence countries (adjusted OR, 0.77; 95% CI, 0.48‐1.25).

Conclusions

Exposure to anti‐TNF agents is an independent risk factor for post‐operative infectious complications in patients with CD, especially in countries with a high incidence of Crohn's disease. We suggest postponing elective surgery or carefully monitoring these patients post‐operatively.
Public reason in justifications of conscientious objection in health care
Authors: McConnell Doug , Card Robert F.
Published: March 2019

Current mainstream approaches to conscientious objection either uphold the standards of public health care by preventing objections or protect the consciences of health‐care professionals by accommodating objections. Public justification approaches are a compromise position that accommodate conscientious objections only when objectors can publicly justify the grounds of their objections. Public justification approaches require objectors and assessors to speak a common normative language and to this end it has been suggested that objectors should be required to cast their objection in terms of public reason. We provide critical support for such a public reason condition and argue that it would be neither too demanding nor too permissive. We also respond to objections that it unfairly favours secular over religious objectors and that public reasons cannot be held with the kind of sincerity thought to characterize conscientious objections.
PET‐adapted therapy after three cycles of ABVD for all stages of Hodgkin lymphoma: results of the GATLA LH‐05 trial
Authors: Pavlovsky Astrid , Fernandez Isolda , Kurgansky Nicolas , Prates Virginia , Zoppegno Lucia , Negri Pedro , Milone Gustavo , Cerutti Ider , Zabaljauregui Soledad , Mariano Romina , Grecco Horacio F. , Basquiera Ana L. , Saba Silvia , Rudoy Silvia , Sackmann Federico , Castano Vanesa , Remaggi Guillermina , Cabrejo Maria , Roveri Eriberto , Casale Maria F. , Cabane Vanina , Taus Rossana , Venturini Claudia , Sakamoto Francisco , Varela Ana I. , Riddick Maximiliano , Pavlovsky Santiago ,   the Grupo Argentino de tratamiento de Leucemia Aguda (GATLA), Argentina
Published: March 2019

The role of Ann Arbor staging in determining treatment intensity after achieving a negative positron emission tomography (PET) has not been established in classical Hodgkin lymphoma (cHL). Patients with stage I–IV cHL, received three cycles of ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) and an interim PET scan (PET3). PET3‐negative patients received no further therapy. PET3‐positive patients received three additional cycles of ABVD plus involved‐field radiation therapy or salvage chemotherapy, if refractory to ABVD, and were re‐evaluated by PET scan (PET6). Study endpoints were 3‐year progression‐free survival (PFS) and overall survival (OS) rates. Two hundred and thirty‐nine patients with early‐stage and 138 with advanced‐stage were evaluable. Overall, 260 patients (70%) were PET3‐negative and had higher 3‐year PFS (90% vs. 65%; P < 0·0001) and OS (98% vs. 92%; P = 0·007) rates than PET3‐positive patients. All PET3‐negative patients, regardless of disease stage at diagnosis, achieved similarly good PFS (90–91%; P = 0·76) and OS (97–99%). The only independent prognostic factor for PFS was PET3‐negativity (Hazard ratio 3·8; 95% confidence interval 2·4–6·3; P < 0·0001). This study suggests that cHL patients who achieve a negative PET3 following ABVD have an excellent outcome, regardless of stage at diagnosis. An appropriately powered, phase III trial will be necessary to confirm these findings.