bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimating productivity using simulation
Authors: Rustom R.N. , Yahia A.
Published: April 2007

Purpose

Recently, there has been increased interest in the use of simulation for real‐time planning, scheduling, control of construction projects and obtaining optimum productivity. The purpose of this case study is to demonstrate the use of simulation as an effective tool for estimating production rates in an attempt to prepare optimal time schedules.

Design/methodology/approach

Gaza Beach‐Camp Shore Protection Project was taken as a case study. The case study is used to demonstrate how to estimate effectively the production rates of labour and equipment during the implementation of the project activities and to estimate the duration of the project using process simulation. The model simulates the construction of 1,600 m of gabions divided into 32 identical stations. Probabilistic distribution functions were used to fit the time functions for each process and sub‐process based on 100 replications.

Findings

The simulation output generated three probabilistic values for completing each activity upon which the overall project completion time is determined. The resources utilizations for all processes were also generated and used in the determination of the average production rates.

Originality/value

The computation of productivity based on effective resources utilization has been demonstrated to give better results than estimating productivity based on aggregate resources assignments.
Application of line‐of‐balance and 4D CAD for lean planning
Authors: Björnfot A. , Jongeling R.
Published: April 2007

Purpose

The purpose of this paper is to suggest the application of the line‐of‐balance (LoB) scheduling technique in combination with a 4D CAD workspace model as a method to improve the management of the flow of resources through locations in construction projects, defined as work flow. Current scheduling methods fail to consistently manage work flow, which can disrupt the construction process, leading to waste such as conflicts in time and space by construction crews.

Design/methodology/approach

LoB and 4D CAD are applied to a case study of multi‐story timber housing project involving the construction of 95 apartments in five six‐storey buildings. Based on the case study results, the benefits and limitations of the combined use of both methods are discussed.

Findings

The majority of the problems experienced during the actual construction process quickly become evident from an analysis of a relatively simple LoB diagram. Furthermore, the 4D CAD workspace model provides additional insights in the scheduling of construction activities, such as workspace availability, the spatial context of workspaces and partial overlap of workspaces.

Practical implications

Virtual design and construction methods based on principles from lean construction can contribute significantly to the value of the product and the elimination of waste in any construction project.

Originality/value

The paper refers to the guiding principles from lean construction in relation to virtual design and construction methods, such as simulations with 4D CAD. Additional research and studies of practical applications are suggested to facilitate the combination of principles from lean construction with virtual design and construction methods.
Integrated collaborative design
Authors: Austin Simon A. , Thorpe Anthony , Root David , Thomson Derek , Hammond Jamie
Published: April 2007

Purpose

The purpose of this paper is to describe an approach to managing the supply chain from the perspective of design which the paper refers to as integrated collaborative design (ICD).

Design/methodology/approach

Building on a substantial program of research using a range of methodologies previously reported, the concept of a design chain is described the argument is made that the industry needs to center the development of integrated teams (as proposed in accelerating change) around collaborative working of all parties involved in the design process.

Findings

The research recognizes that the construction sector is too often focused on the short‐term objectives of projects, rather than long‐term business strategy and organizational relationships. The ICD approach involves three steps: identifying tasks (process management); allocating roles (as part of supply chain management); and focusing design solutions to deliver value.

Originality/value

The paper outlines the principles and approach to ICD and provides a strategic overview within which various techniques and practices can be utilized to integrate organizations and more effectively manage the design process.
How do a company's information technology competences influence its ability to innovate?
Authors: Gordon Steven R. , Tarafdar Monideepa
Published: April 2007

Purpose

The purpose of this paper is to describe research that explores how an organization's information technology (IT) competences influence its ability to innovate.

Design/methodology/approach

This paper draws on prior research to describe stages of the innovation process and to identify several IT competences that have been linked to innovation success. Then, examining innovation at three case study sites, it demonstrates how IT competences can influence the success of innovation at various stages of the innovation process.

Findings

The paper finds that IT competences in information and knowledge management, project management, collaboration and communication, and business involvement are likely to improve an organization's ability to innovate.

Research limitations/implications

The research in this paper is exploratory. The small number of cases limits one's ability to claim that the IT competences one has identified always affect innovation.

Practical implications

The paper shows that organizations that want to be innovative should cultivate the identified IT competences.

Originality/value

For researchers, the paper proposes a model relating an organization's ability to innovate to its IT competences. For managers, it identifies it competences that should be cultivated to support the process of innovation.
Investigating the internet's impact on interfirm relations
Authors: Sigala Marianna
Published: April 2007

Purpose

The purpose of the paper is to show that research on the internet's impact on B2B inter‐firm relations is limited, while findings are anecdotal and sometimes contradictory. This study investigates inter‐firm relations amongst Business Travel Management (BTM) firms and their clients by examining the impact of online BTM solutions on the creation and reinforcement of relational bonds.

Design/methodology/approach

The paper shows that two major approaches were combined for examining inter‐firm relations: economic (transaction costs economics) and socio‐psychological (social exchange; inter‐organisation; and industrial network) theories. A model illustrating the interrelations amongst the use of online BTM solutions, two structural (communication, dependence) and two social bonds (trust, satisfaction) was proposed for investigating the impact of online BTM solutions on BTM‐clients relations. Data were gathered from a convenience sample of BTM managers in the UK, Greece, and Cyprus and 194 usable responses were analysed using structural equation modelling.

Findings

The paper finds that the impact of online BTM solutions on trust, satisfaction and dependence was not confirmed. However, the hypotheses reflecting the interactions between structural and social bonds were supported, which confirmed the mediating impact of internet‐enabled communication on fostering inter‐firm relations.

Research limitations/implications

In this paper the sample is convenient, while data are gathered only from the buyer‐traveller perspective. Larger scale, cross‐industry studies that also combine buyers' and sellers' perspectives are required.

Practical implications

The paper shows that the internet's ability to foster relational bonds was found to be dependent on its exploitation for enhancing inter‐firm communications. When using the internet for enhancing clients' relations and satisfaction, firms should exploit the internet's communication tools and identify clients' information needs for customising the communications' content.

Originality/value

The paper sees that the internet's impact on forming relational bonds and building B2B relations in the BTM context has not been previously researched.
Pacific Voices: educational technologies for literacy learning
Authors: Skouge James , Boisvert Precille , Rao Kavita
Published: April 2007

Purpose

To describe how literacy‐learning strategies and educational technology were integrated in Pacific island classrooms.

Design/methodology/approach

The paper discusses the unique context and setting of a five‐year initiative that introduced educational technologies to classrooms in the Northern Pacific islands. Several of the literacy strategies that were most valued by the Pacific educators, particularly the creative uses of audio and video technologies in classroom contexts, are highlighted in the paper.

Findings

Provides detailed information on how educators can implement similar projects in multicultural settings.

Practical implications

The paper provides strategies and information for educators who work with culturally diverse and indigenous populations and highlights how cultural wisdom and knowledge can be melded with new technologies.

Originality/value

This paper discusses how technology transfer and training can be done in culturally‐appropriate and relevant ways.
Behind the Australian wine industry's success: does environment matter?
Authors: Jordan Rohan , Zidda Pietro , Lockshin Larry
Published: April 2007

Purpose

The success of the Australian wine industry is well documented. However, there have been few comparative studies of the reasons for this success as compared to Australia's main competitors. Most of the anecdotal evidence and trade publications focus on “value for money” and fruit‐driven wines, without looking at how the Australian wine businesses operate. The purpose of this paper is to investigate the external environment in France and Australia as one of the drivers for Australian wine sector success.

Design/methodology/approach

In‐depth interviews with two French and two Australian wineries and a review of the literature led to a series of hypotheses about the role of market orientation, strategic orientation, innovative and entrepreneurial environment orientation, constraining legislation, industry infrastructure usage, industry plan support, and interorganizational collaboration as factors differentiating the two countries. An online survey of wineries in the two countries resulted in a sample of 82 French and 63 Australian responses. An analysis of variance revealed significant differences between Australian wineries as compared to the French.

Findings

Australian wineries rated themselves higher in market orientation, growth strategy, export proactiveness, perceived innovative environment, perceived entrepreneurial environment, more interorganizational collaboration, and less perceived constraining legislation.

Practical implications

These results not only provide some basis for Australia's success in wine exporting, but also add to the literature on the effect of the external environment on business performance.

Originality value

Wine exporting countries can use the results to help shape policy for creating a more conducive environment for exporting wine.
The Nez Perce leadership council
Authors: Humphreys John , Ingram Kendra , Kernek Courtney , Sadler Theresa
Published: April 2007

Purpose

This paper aims to show how industrial thinking has led to a myopic focus on individual leadership styles to the potential detriment of a broader understanding of leadership. Also, to present the Nez Perce leadership council as an exemplar of post‐industrial leadership. Finally, to demonstrate that a historical approach can be used effectively to elucidate such constructs.

Design/methodology/approach

A historical examination of the popular portrayal versus the actual functioning of the non‐treaty Nez Perce leadership council during the conflict of 1877.

Findings

Although Chief Joseph has often been considered the supreme leader of the Nez Perce during the conflict period (industrial view), the group was actually led by a leadership council, which functioned in the manner described by Rost and Smith as post‐industrial leadership.

Research limitations/implications

Although the paper illuminates Rost and Smith's model, it does not attempt to assess the effectiveness of post‐industrial leadership, as the successes and failures of the Nez Perce during the conflict period could be attributed to other variables beyond the authors' scope. It is to be hoped, however, that future researchers will continue the debate concerning leadership and its peripheral elements.

Practical implications

It is suggested that contemporary organizational leaders should be focused on leadership beyond style and might consider the post‐industrial model for mutually satisfying influence, particularly with the team‐based and flattened structures common to the modern firm.

Originality/value

The use of a historical example and method to exemplify the contemporary model of post‐industrial leadership. Further, to demonstrate how industrial thinking has encouraged many to focus on the periphery of leadership.
The golden age: service management on transatlantic ocean liners
Authors: Coye Ray W. , Murphy Patrick J.
Published: April 2007

Purpose

The paper seeks to explore lessons in service delivery from an industry that no longer exists. The transatlantic passenger liner dramatizes some of the most unique challenges of service delivery. The ship itself was a delivery mechanism completely separated from support services. Customers were essentially contained for extended periods. Whereas all customers received the same core transportation service, peripheral services varied substantially by service class.

Design/methodology/approach

Description of the historical context is followed by examinations of passenger and service provider perspectives to illustrate services expected and delivered. Primary and secondary source material is used to exemplify service management challenges.

Findings

Socioeconomic and technological factors played major roles in delivery system design decisions. With stable and loyal workforces and well designed delivery systems, ocean liners were able to deliver service successfully to customer classes with widely varying expectations.

Practical implications

Service management on ocean liners occupied a range of levels and intensity not found in current organizational contexts. The context provides modern practitioners pure consideration of complexities and service management implications.

Originality/value

The novel and isolated organizational aspects of transatlantic ocean liners is unique among organizations. Examination of service management in this context provides information of original value not available from examination of other kinds of organizations.
Managing building projects in ancient China
Authors: Sui Pheng Low
Published: April 2007

Purpose

The Chinese civilization is an important part of the history of mankind. The purpose of this paper is to show that there are project management lessons to be learned from Chinese history, including that relating to the management of the building process in ancient China.

Design/methodology/approach

Through a review of the literature, this paper discusses the key management and economic practices in the building process of ancient China and highlights these practices from an important document, the Yingzao Fashi or (“Treatise on Architectural Methods”), that was compared with the modern‐day project management framework.

Findings

This paper explains the official systems instituted for public projects; the management of labour, design and planning of construction works; quantity surveying practices; the use, control and recycling of building materials; and inspection of building elements in ancient China.

Practical implications

The study suggests that lessons in the principles of construction project management in ancient China bear many similarities with the nine areas of modern‐day project management body of knowledge relating to integration, scope, time, cost, quality, human resource, communications, risk, and procurement management. An area for future research would be to compare the Yingzao Fashi with modern‐day codes of practice for building works to determine which of its “ancient” provisions relating to quality management are still relevant today.

Originality/value

It was found that much emphasis was placed by the ancient Chinese on the quality aspects of prominent building projects. This is one facet from which modern‐day project managers and clients can draw lessons.
Crystal structure of the human ephrin‐A5 ectodomain
Authors: Nikolov Dimitar , Li Chen , Lackmann Martin , Jeffrey Philip , Himanen Juha
Published: March 2007

The Eph receptors, the largest subfamily of receptor tyrosine kinases, and their ephrin ligands are important mediators of cell–cell communication regulating cell attachment, pathfinding, and mobility in the nervous and cardiovascular systems. Recent structural studies have revealed unique molecular features that explain many of the biochemical and signaling properties of Ephs and ephrins. Nevertheless, open questions remain, including understanding the precise molecular mechanism underlining their binding‐partner preferences and subclass specificity. In this study, we have determined and present the crystal structure of the extracellular domain of ephrin‐A5—the first structure of an unbound A‐class ephrin. The structure, determined at 2.1 Å resolution, is a variation of the Greek key β‐barrel folding topology, containing eight β‐strands, and stabilized by two disulphide bonds. Overall, ephrin‐A5 is structurally very similar to ephrin‐B1 and ephrin‐B2 but, unlike ephrin‐B2, it does not show dimerization either in solution or in the crystals. Comparing free ephrin‐A5 to the previously published structure of EphB2‐bound ephrin‐A5 reveals that significant conformational changes occur only around the G–H ephrin loop that upon binding bends toward the receptor. Interestingly, the G–H loop undergoes a very similar conformational rearrangement in ephrin‐B2 upon receptor binding. The results of this study further emphasize the importance of the G–H loop for receptor recognition and selectivity, and could serve as a starting point for the development of structure‐based Eph antagonists.
Crystal structure of the MAP kinase binding domain and the catalytic domain of human MKP5
Authors: Tao Xiao , Tong Liang
Published: March 2007

MAP kinase phosphatases (MKPs) have crucial roles in regulating the signaling activity of MAP kinases and are potential targets for drug discovery against human diseases. These enzymes contain a catalytic domain (CD) as well as a binding domain (BD) that help recognize the target MAP kinase. We report here the crystal structures at up to 2.2 Å resolution of the BD and CD of human MKP5 and compare them to the known structures from other MKPs. Dramatic structural differences are observed between the BD of MKP5 and that of MKP3 determined previously by NMR. In particular, the cluster of positively charged residues that is important for MAP kinase binding is located in completely different positions in the two structures, with a distance of 25 Å between them. Moreover, this cluster is α‐helical in MKP5, while it forms a loop followed by a β‐strand in MKP3. These large structural differences could be associated with the distinct substrate preferences of these phosphatases, but further studies are needed to confirm this. The CD of MKP5 is observed in an active conformation, and two loops in the active site have backbone shifts of up to 5 Å relative to the inactive CDs from other MKPs.
Percutaneous application of peptidoglycan from Staphylococcus aureus induces eosinophil infiltration in mouse skin
Authors: Matsui K. , Wirotesangthong M. , Nishikawa A.
Published: April 2007

Background
Atopic dermatitis (AD) is a chronic inflammatory skin disease with immunopathologic features that vary depending on the duration of the lesion. The lesioned skin of AD patients shows an increased number of inflammatory cells such as eosinophils, mast cells and mononuclear cells in the dermis and superficial Staphylococcus aureus colonization.

Objective
The purpose of this study was to determine the effects of peptidoglycan (PEG) from S. aureus on eosinophil induction in murine skin.

Methods
PEG was applied to the barrier‐disrupted abdominal skin of mice every 5 days. Twenty days later, the number of eosinophils in the abdominal skin was counted. The cytokine response in the skin was investigated by RT‐PCR and immunohistological analysis. The regulated‐upon activation in normal T cells expressed and secreted (RANTES) production from cultured epidermal cells was measured by ELISA.

Results
The skin of mice treated with PEG showed a significantly increased number of eosinophils compared with that of mice treated with vehicle alone. In addition, application of PEG to the abdominal skin of mice increased the expression of mRNA for RANTES, but not that of mRNA for eotaxin, eotaxin‐2 and monocyte chemotactic protein‐3 in the skin. Immunohistologic analysis demonstrated that the levels of RANTES transcripts corresponded with those of protein synthesis in the epidermis. In vitro experiments using epidermal Langerhans cells (LCs) and keratinocytes (KCs) showed that RANTES production was induced by LCs but not by KCs stimulated with PEG. Furthermore, an intraperitoneal injection of anti‐RANTES antibody neutralized the induction of eosinophils in the skin.

Conclusion
These results suggest that PEG may have an ability to induce eosinophil infiltration in the skin through RANTES production by LCs, and would explain the role of S. aureus colonization in AD patients.
Association and functional relevance of E237G, a polymorphism of the high‐affinity immunoglobulin E‐receptor β chain gene, to airway hyper‐responsiveness
Authors: Kim Y.‐K. , Park H.‐W. , Yang J.‐S. , Oh S.‐Y. , Chang Y.‐S. , Shin E.‐S. , Lee J.‐E. , Kim S. , Gho Y. S. , Cho S.‐H. , Min K.‐U. , Kim Y.‐Y.
Published: April 2007

Background
The hyper‐sensitivity reaction of IgE, with its high‐affinity receptors (FcɛRI), is central to the phenomenon of atopic diseases.

Objective
To evaluate the genetic effects of non‐synonymous single‐nucleotide polymorphisms (SNPs) of FcɛRI on intermediate phenotypes of asthma, i.e. atopy and airway hyper‐responsiveness (AHR), in the Korean general population.

Subjects and methods
Atopy and AHR were evaluated in a cohort of 2055 subjects, aged 10–18 years, using skin prick tests (SPTs) for common aeroallergens and total serum IgE and methacholine bronchial provocation tests. All FcɛRI‐α, FcɛRI‐β, and FcɛRI‐γ gene exons of 24 healthy subjects were sequenced to locate informative non‐synonymous SNPs (minor allele frequency >2%). Informative SNPs were then scored, using the high‐throughput single base extension method. Relative risk (RR) was determined by multiple logistic regression analysis, after adjusting for confounding factors. The functional relevance of non‐synonymous SNPs was analysed using the sorting intolerant from tolerant (SIFT) program.

Results
The SNP search found only one informative non‐synonymous SNP in FcɛRI‐β: E237G (minor allele frequency=0.21). The positive rate of AHR was lower among subjects with the 237*E allele than among those with 237*G [RR (95% confidence interval)=0.41 (0.19–0.89); P=0.01]. However, the E237G substitution was not associated with either a positive SPT response or total serum IgE levels. Sequence evolution analysis predicted that the E237G variation is an intolerant amino acid substitution, with functional importance.

Conclusion
In the Korean general population, AHR is significantly associated with the E237G polymorphism of FcɛRI‐β, which results in an intolerant amino acid substitution.
Influence of plant lipids on immune responses in mice to the major Brazil nut allergen Ber e 1
Authors: Dearman R. J. , Alcocer M. J. C. , Kimber I.
Published: April 2007

Background
Lipids, particularly bacterial lipopolysaccharide, can impact on immune responses to proteins, with low doses enhancing type 2 responses.

Objective
We have examined the influence of natural plant lipid extracts on antibody responses provoked in mice by recombinant Ber e 1, the major allergen in Brazil nuts.

Methods
BALB/c strain mice were immunized (by intraperitoneal injection) with natural or recombinant Ber e l produced in Pichia pastoris and admixed with various lipid fractions isolated from Brazil nuts. Serum samples were analysed for specific IgE antibody by homologous passive cutaneous anaphylaxis assay and for IgG by enzyme‐linked immunosorbant assay.

Results
Exposure to recombinant (lipid‐free) Ber e 1 alone failed to induce detectable IgG or IgE antibody. Co‐administration of the total lipid fraction (with reduced triglyceride levels), sterol‐rich, or polar lipid fractions, resulted in marked adjuvant effects on IgG and IgE. However, the β‐sitosterol and glycolipid‐rich fractions were associated with only low‐level IgG antibody, and had little impact on IgE antibody production. Natural Ber e 1 containing endogenous lipids also provoked IgG and IgE antibody responses. Identical IgE and IgG antibody responses were detected regardless of whether natural or recombinant Ber e 1 was used as substrates for analyses.

Conclusion
Endogenous Brazil nut lipids are required for the induction of optimal antibody responses to Ber e 1 in the BALB/c strain mouse. Appropriate antibody binding sites are present on both natural and recombinant forms of Ber e 1, suggesting that the impact of lipid is at the induction phase, rather than antibody recognition, and is possibly required for efficient antigen presentation.
Increasing prevalence of atopic eczema in Taiwanese adolescents from 1995 to 2001
Authors: Lee Y.‐L. , Li C.‐W. , Sung F.‐C. , Guo Y.L.
Published: April 2007

Background
The prevalence of atopic eczema in adolescents has recently been reported as increasing in many countries, a phenomenon yet to be fully explained. This study compared the prevalence of atopic eczema among Taiwanese adolescents with individual‐level risk factors and community‐level data of temperature, relative humidity, and air pollutants to determine whether changes in these factors could explain the observed change in prevalence.

Methods
We conducted two nationwide, cross‐sectional surveys of atopic illness and symptoms among Taiwanese 12–15‐year‐old schoolchildren in 1995–1996 and 2001. The effects of personal and environmental factors were assessed and temporal changes of outdoor monitoring data were also compared with the prevalence difference of atopic eczema.

Results
A total of 42 919 adolescents from the 1995 to 1996 survey and 10 215 adolescents from the 2001 survey attended schools located within 1 km of 22 monitoring stations. The 12‐month prevalence of atopic eczema increased significantly during this period [adjusted prevalence ratio (PR)=1.43, 95% confidence interval (CI) 1.21–1.70 in boys; PR=1.77, 95% CI 1.49–2.10 in girls]. After adjustment for potential risk factors, the prevalence differences were statistically unchanged. Although parental education level contributed the most, changes in personal and environmental factors might not explain the observed prevalence increases of atopic eczema. Temporal change in the relative humidity was significantly associated with prevalence increase among boys but its contribution was also small.

Conclusion
Correlates of the investigated risk factors that have changed over time still underlie the prevalence increases of atopic eczema in Taiwanese adolescents. The exact reasons for the rising trends remain to be elucidated.
Summer drought alters plant‐mediated competition between foliar‐ and root‐feeding insects
Authors: STALEY JOANNA T. , MORTIMER SIMON R. , MORECROFT MICHAEL D. , BROWN VALERIE K. , MASTERS GREGORY J.
Published: April 2007

Summer droughts are predicted to increase in severity and frequency in the United Kingdom, due to climate change. Few studies have addressed the impacts of drought on interactions between species, and the majority have focussed on increases in CO2 concentration and changes in temperature. Here, the effect of experimental summer drought on the strength of the plant‐mediated interaction between leaf‐mining Stephensia brunnichella larvae and root‐chewing Agriotes larvae was investigated. Agriotes larvae reduced the abundance and performance of S. brunnichella feeding on a mutual host plant, Clinopodium vulgare, as well as the rate of parasitism of the leaf‐miner. The interaction did not, however, occur on plants subjected to a severe drought treatment, which were reduced in size. Changes to summer rainfall, due to climate change, may therefore reduce the occurrence of plant‐mediated interactions between insect herbivores.
Sleep patterns and Insomnia management in Korean‐American older adult immigrants
Authors: Sok Sohyune R.
Published: April 2007

Aims.  This study aimed to describe sleep patterns and insomnia management in first generation Korean‐American older adult immigrants. Specifically, this research examined differences in sleep interruption factors, use of sleep promotion aids, sleep characteristics and insomnia management between men and women who are first generation Korean‐American older adult immigrants.

Background.  Older adults feel that their sleep is shallow, interrupted frequently and is insufficient. If sleep changes are severe, it is difficult for older adults to maintain an awakened state during the day.

Design.  This was a descriptive survey study.

Methods.  The survey included a set of four questionnaires. All measures were self‐administered. In the data analysis, descriptive statistics was used to analyse demographic characteristics. The chi‐squared test and t‐test were used to examine the differences between men and women.

Results.  Most subjects experienced sleep interruption (n = 43, 82·6%) and were not satisfied with their sleep (n = 42, 80·8%). A quarter of the subjects had experience with complementary/alternative therapies to manage insomnia, although 40 subjects (76·9%) wanted to use complementary/alternative therapies to manage their insomnia.

Conclusions.  The study shows that first generation Korean‐American older adult immigrant men and women report sleep interruptions and dissatisfaction with the quality of their sleep. Women were more likely in want of using complementary/alternative therapies for insomnia management than men. Women may have longed more for their traditional healthcare practices. The high degree of sleep disruption in this sample may relate to living in a different culture.

Relevance to clinical practice.  Health professionals need to assess sleep patterns and consider an array of methods including complementary/alternative therapies to manage insomnia.
From monitoring physiological functions to using psychological strategies. Nurses’ view of caring for the aneurysmal subarachnoid haemorrhage patient
Authors: Hedlund Mathilde , Ronne‐Engstrom Elisabeth , Ekselius Lisa , Carlsson Marianne
Published: April 2007

Aims.  The aims of this study were: (1) to describe nurses’ views of the physical and supportive needs of patients who have suffered a subarachnoid haemorrhage (SAH), (2) to describe nurses’ views of changes in social circumstances and (3) changes in the mental condition of patients after SAH.

Background.  As patients with SAH are generally younger and predominantly female compared with other stroke groups they may have different needs of nursing support to facilitate adaptation. Caring for persons surviving stroke involves advanced nursing skills such as monitoring neurological functions in neurointensive care and providing physical care during rehabilitation.

Design.  Explorative descriptive design.

Method.  Semi‐structured interviews were performed with 18 nurses in neurointensive and rehabilitation care. A qualitative latent content analysis was conducted.

Results.  Nurses viewed patients’ need for support as a process ranging from highly advanced technological care to ‘softer’ more emotional care. However, shortages in the communication between neurointesive and rehabilitation nurses regarding this support were acknowledged. Changes in social circumstances and mental conditions were viewed both as obstacles and advantages regarding return to everyday life. Nurses also viewed that the characteristics of the group with SAH was not particularly different from the group with other types of stroke.

Conclusions.  Support to patients with SAH is viewed as a process carried out by nurses at neurointensive care units and rehabilitation units. Shortages in communication, regarding this support, were acknowledged. Obstacles and advantages with respect to returning to everyday life could apply to any stroke group, which could make it more difficult for nurses to detect the specific needs of patients with SAH.

Relevance to clinical practice.  The communication between neurointensive nurses and rehabilitation nurses regarding support to patients with SAH is not satisfactory. Occasionally the specific needs of patients with SAH are not recognized.
Advanced nursing practice: an idea whose time has come
Authors: Callaghan Leonard
Published: April 2007

Aims and objectives.  This paper aims to analyse the concept of advanced nursing practice critically and to demonstrate an appreciation of the development of the role of the advanced nurse practitioner in the Irish context.

Background.  The concept of advanced nursing practice has existed in the US since the 1960s and in the UK since the early 1980s. The first signs of the advanced nurse practitioner began to emerge in Ireland in the late 1990s as a result of increasing demands and changes occurring within nursing and health care. Currently, there are 31 advanced nurse practitioners in the country, many of whom practice in the general setting. Strategies are in place to introduce advanced nursing practice into other nursing disciplines in the future.

Methods.  A literature review was conducted to address the various issues inherent within this concept.

Results.  There is a body of evidence indicating that advanced nursing practice has brought about an improvement in patient outcomes. In light of this, the advanced nurse practitioner has a valuable role to play in providing a beneficial contribution and filling a gap in healthcare services.

Conclusion.  This paper has demonstrated that nursing continues to be a dynamic and ever‐changing phenomenon where the onus is firmly on the advanced nurse practitioner as expert, leader and collaborator, to capture the hearts and minds of nurses and healthcare workers, so as to challenge traditional values and transform clinical practice. Failure to do so may allow medicine or other interested parties to shape the future of nursing or even absorb it.

Relevance to clinical practice.  Nurses working at an advanced level are striving to develop their expertise, initiate nurse‐led services and practice, in collaboration with other professionals in an effort to provide the highest quality care to the patient. Although the idea of the advanced nurse practitioner is relatively new to nursing in Ireland, it is the result of an idea whose time has come and there is nothing more powerful than an idea whose time has come.
Adherence to clean intermittent self‐catheterization procedures: determinants explored
Authors: Van Achterberg Theo , Holleman Gerda , Cobussen‐Boekhorst Hanny , Arts Rita , Heesakkers John
Published: April 2007

Aims & objectives.  The aim of the current study was to explore factors that hinder or promote adherence to clean intermittent self‐catheterization (CISC) procedures in adults.

Background.  Clean intermittent self‐catherization is associated with favourable patient outcomes, but adherence to the procedure is not addressed in the international literature.

Methods.  Relevant factors were explored in two studies. The first study (n = 10) addressed mastery and short‐term adherence, whereas the second study (n = 20) addressed long‐term adherence in these patients. Determinants of patient adherence were derived from pre‐structured interviews with patients, using a content‐analysis procedure.

Results.  A list of 16 determinants of mastery and short‐term adherence and a list of 12 determinants of long‐term adherence was found. Most of these determinants were found in both older (≥65 years of age) and younger patients. However, five determinants of mastery and short‐term adherence and six determinants of long‐term adherence were specific to patients under the age of 65.

Conclusion.  Our findings give a first insight into CISC adherence. General determinants of adherence relate to knowledge, complexity of the procedure, misconceptions, fears, shame, motivation and quality and continuity of professional care. Furthermore integrating CISC in everyday life can be difficult. In younger patients, availability of materials, physical impairments and resistance to a sickness role can further compromise adherence.

Relevance to clinical practice.  Issues of knowledge, fears, motivation and potential psychological impact of performing CISC should be addressed prior to deciding on CISC and instructing patients. Follow‐up care should be improved to include re‐evaluations of skills, discussing adherence, integrating CISC in daily activities and general coping issues.
Public Health Nurses and the delivery of quality nursing care in the community
Authors: Markham Trish , Carney Marie
Published: April 2007

Aim.  The aim of the study was to explore factors which impact on quality nursing care in the community from the Public Health Nurse's (PHN) perspective.

Background.  Public Health Nursing has significantly evolved over the past few years with the delivery of quality nursing being a focus point. This study explores factors that impact upon the delivery of quality care in Public Health Nursing in Ireland. The findings provide an opportunity for an additional perspective to be included in the existing international findings and act as a starting point from which further research can be built.

Method.  A qualitative method using semi‐structured interviews were conducted. Interviews were taped and content analysed.

Findings.  Four main categories emefrged from the data, namely role change, components of quality nursing care, barriers to quality nursing care and the factors that facilitate the delivery of quality nursing care in the community. PHNs strive for evidence‐based practice; they acknowledged their inability to achieve this and referred to factors that inhibited them from reaching their goal.

Conclusion.  Enhanced education for PHNs will equip them in the delivery of a quality service and have a positive impact on patient care. Better communication is required between PHNs, line managers and the multidisciplinary team. The delivery of community services need to be reviewed and developed further in accordance with the health strategy policy.

Relevance to clinical practice.  This study has identified the evolution in clinical practice associated with the changing role and scope of Public Health Nursing. Clinical practice has evolved over time to incorporate societal change, technological advances and the delivery of an evidence‐based service responsive to identified need. This study identified the presence of an increase in the specialist clinical work being undertaken as a result of new technological advances entering the community working environment.
A study on investigating unplanned readmission patterns
Authors: Chan Moon Fai , Wong Frances Kam Yuet , Chang Katherine Ka Pik , Chow Susan Ka Yee , Chung Loretta Yuet Foon , Lee Rance Pui‐Leung , Lee Wai Man
Published: April 2007

Aim. To explain frequent hospital readmissions, this study aimed to determine whether definable subtypes exist within a cohort of subjects with chronic illness with regard to factors associated with a patient's readmission patterns and to compare whether these factors vary between subjects in groups with different profiles.

Research method. A descriptive correlational survey was conducted and data were collected by using a structured questionnaire. Seventy‐four readmitted subjects were recruited in three general hospitals in Hong Kong.

Outcome measures. Five outcome variables were employed in the study: predisposing characteristic, need factors, health behaviour, health status or outcomes and enabling resources.

Results. A cluster analysis yielded two clusters. Each cluster represented a different profile of the sample on patient use of healthcare services. Cluster A consisted of 41·9% (n = 31) and Cluster B consisted of 58·1% (n = 43) of the patients. Cluster A patients, more of whom were male, were younger, more educated, had higher activities of daily living scores and fewer of them had received community nurse services than patients of Cluster B. Cluster A patients (32·3%) had more than one readmission record within 28 days than Cluster B patients (9·3%, p = 0.017).

Conclusion. Our study shows that community nurse services can reduce the rate at which they are readmitted a second time. However, such services may have a positive effect only on a group of patients whose profile is similar to the patients in Cluster B and not for patients such as those in Cluster A. A clear profile may help healthcare policy makers make appropriate strategies to target a specific group of patients to reduce their readmission rates.

Relevance to clinical practice. The identification of risk for future healthcare use could enable better targeting of interventional strategies within these groups. The results of this study might provide hospital managers with a model to design specified interventions to reduce unplanned hospital readmissions for each profile group.
Comparison of oral stereognosis in relation to age and the use of complete dentures
Authors: IKEBE K. , AMEMIYA M. , MORII K. , MATSUDA K. , FURUYA‐YOSHINAKA M. , NOKUBI T.
Published: April 2007

Summary  The purpose of this study was to examine the age‐related difference in oral sensory function by testing oral stereognostic ability (OSA) and to determine the effect of wearing complete dentures on OSA. Subjects were 20 dentate and 30 edentulous elderly patients free from oral symptoms and pathologies, and 30 younger dentate students as controls. The OSA tests were conducted with test pieces of 12 shaped forms. The duration time for recognition was noted and the answers were recorded using a three‐point scale. anova and paired t‐tests were used to examine significant differences. P‐values <0·05 were considered to be statistically significant. The OSA score in older dentate participants and complete denture wearers was significantly higher than in younger dentate subjects. However, no significant difference was found in the OSA score between older dentate participants and complete denture wearers. When older edentulous subjects removed the maxillary and mandible complete dentures, the OSA score was significantly lower and the response time significantly longer than with dentures. Within the limitations of this study, an age‐related difference in oral sensory function, as measured by OSA tests, was found. However, oral sensory function was not significantly different between fully dentate persons and complete denture wearers in the elderly.
Mental health crisis at home: service user perspectives on what helps and what hinders
Authors: HOPKINS C. , NIEMIEC S.
Published: April 2007

This paper presents data which emerged during the process of a participatory research study to identify the perspectives of previous users of a home treatment service. Feedback was sought in order to establish the criteria for the development of a service evaluation questionnaire. Seven themes emerged from the data which were then used as a framework for the evaluation questionnaire. These themes have also been used within this paper to present what our participants told us was important to them when they received a service at home at a time of mental health crisis. Although what is described here is the experience of one group of service users in the North of England, we hope that the views of these participants will create a resonance with providers of other home treatment services and expand the knowledge about which aspects of care at home during mental health crisis are viewed as helpful and those aspects which are not.
HLA alleles as predisposal factors for postmenopausal osteoporosis in a Greek population
Authors: Douroudis K. , Tarassi K. , Athanassiades T. , Giannakopoulos F. , Kominakis A. , Thalassinos N. , Papasteriades Ch.
Published: April 2007

It is well established that genetic factors play an important role in the pathogenesis of osteoporosis, a common condition characterized by reduced bone mass and increased fracture risk. The major histocompatibility complex in humans, known as human leukocyte antigen (HLA) region, is the most polymorphic human genetic system and it is known as a cluster of genetic markers, associated with several diseases. In order to evaluate the contribution of HLA alleles in bone mass loss, polymorphisms in the HLA class I (‐A, ‐B and ‐Cw) and class II (‐DR and ‐DQ) antigens were studied in 126 postmenopausal women of Greek origin. It was found that HLA‐B7 (P= 0.069), ‐DR15 (P= 0.019) and ‐DQ6 (P= 0.026) were associated with a lower bone mineral density measured at the forearm. This study shows a significant association between HLA alleles and bone mass loss in the population studied.
Effects of tetracycline on wild‐type and inducible P35So IPT‐5/TETR transgenic tobacco plants
Authors: Quanten Lieve , Chaerle Laury , Noben Jean‐Paul , Van Onckelen Harry , Prinsen Els , Van Der Straeten Dominique , Valcke Roland
Published: April 2007

Introduction of the Agrobacterium ipt gene, coding for isopentenyl transferase, under control of a tetracycline (Tc)‐inducible promoter results in a very specific system in which cytokinin levels can be changed. Because Tc belongs to the group of antibiotics that affect 70S ribosomes, it is important to study the effects of Tc on untransformed plants. Although 1 mg l−1 Tc was previously reported to have no physiological effects, this study revealed several changes in hydroponically grown wild‐type Nicotiana tabacum L. cv. Wisconsin. Therefore, lower Tc concentrations (0.1 and 0.2 mg l−1 Tc) were used to induce ipt‐transgenic (tr) plants. Upon induction, real‐time PCR analysis showed that the ipt gene was expressed several times higher in roots of tr plants, but not in leaves. Consequently, cytokinin levels were also elevated to a large extent in roots. This resulted in a disturbance of the cytokinin to auxin ratio, leading to an obstructed root growth. In leaves, no significant increase in cytokinins was observed. However, phenotypic and physiological effects, which could be attributed to cytokinin, were apparent in leaves of ipt‐induced trs: chlorophyll and carotenoid content were elevated and grana stacking increased. Our study demonstrates that caution has to be taken to determine the ‘safe’ concentration of inducers when using inducible gene‐expression systems.