bluuebunny/crossref_metadata_2025 huggingface dataset:
Collaborating across the researcher-practitioner divide
Authors: Vo Linh Chi , Kelemen Mihaela
Published: August 2017

Purpose

The purpose of this paper is to contribute to bridging the gap between researchers and practitioners. It does so by comparing the various models of academic-practitioner collaboration and introducing Dewey’s democratic experimentalism as a promising alternative.

Design/methodology/approach

The conceptual implications are drawn from an analysis and discussion of the literatures in the field of organizational knowledge production, co-production and Deweyan studies.

Findings

Democratic experimentalism offers a much needed platform for a collaborative relationship between academics and practitioners that leads to knowledge that is rigorous and relevant to practice.

Originality/value

While the current models of academic-practitioner collaboration provide mechanisms for knowledge co-production, the Dewey’s democratic experimentalism goes further to emphasize the nature of the relationship between academics and practitioners in such common endeavor to ensure that all of them are equal co-creators of knowledge.
The relationship between subjective well-being and workplace ostracism
Authors: Zhang Suchuan , Shi Qiao
Published: August 2017

Purpose

The purpose of this paper is to examine the effect of subjective well-being (SWB) on workplace ostracism, by focusing on the moderating role of emotional intelligence (EI). SWB is taken here as a construct of three components: life satisfaction, positive affect (PA), and negative affect (NA).

Design/methodology/approach

The theoretical model was tested using data collected from employees in different firms from different provinces in China. Analyses of multisource and lagged data from 677 employees indicate that as predicted, EI moderates the relationship between SWB (life satisfaction, PA, and NA) and workplace ostracism.

Findings

The findings show that when employees demonstrate high levels of EI, the negative relationships between life satisfaction, PA and workplace ostracism were strengthened, and the positive relationship between NA and workplace ostracism was weakened.

Originality/value

First, the results empirically demonstrate that EI is one moderator of the relationship between SWB and workplace ostracism. Second, the study contributes to the field of workplace ostracism by indicating some critical antecedents. Third, the present study examines the moderating role of EI in the relationship between SWB and workplace ostracism among Chinese employees.
Mediation effect of novelty ecosystems on intrapreneurial behaviour process within an organisational dynamic environment among Kenyan universities
Authors: Kibirango Moses Mpiima , Munene John C. , Balunywa Waswa J. , Obbo Jovent K.
Published: August 2017

Purpose

The purpose of this paper is to examine, explain, predict and guide the processes, mechanisms and outcomes of intrapreneurial behaviour to provide evidence that novelty ecosystems mediate the relationships between generative influence, positive deviance and intrapreneurial behaviour. It also enlightens the capacity of replicating the intrapreneurial best practices.

Design/methodology/approach

The study uses an integrated approach of entrepreneurship and complexity theories. Its subjects were full-time designated university employees in the Republic of Kenya. A total number of 244 employees were selected using snowball sampling technique from ten public and private universities in the Kenya. A self-administered questionnaire was used to collect data.

Findings

The structural equation modelling path analysis and the bootstrapping results confirmed full mediation of novelty ecosystems in the relationship between generative influence and intrapreneurial behaviour. The findings, further, verified that novelty ecosystems partially mediate the relationship between positive deviance and intrapreneurial behaviour.

Research limitations/implications

Subjective appraisals were used, despite the fact that studied variables are ultimately based on what employees perceive. Future research should generate and include more objective measures.

Practical implications

Intrapreneurial behaviour can only be explained and predicted through novelty ecosystems. University leaders need to fully understand and facilitate novelty ecosystems.

Social implications

A deeper understanding of the power of generative influence, positive deviance and novelty ecosystems will not be fully realized until researchers devote as much energy and attention to facilitation as has been devoted to conflict.

Originality/value

This study extends existing intrapreneurial research into complexity approach.
Strengthening the bond and enhancing team performance
Authors: Lu Luo , Fan Hsueh-Liang
Published: August 2017

Purpose

Using interpersonal relationship development as a metaphor for team process, the purpose of this paper is to explore critical psychological mechanisms transforming team inputs into successful work outcomes, at the individual level.

Design/methodology/approach

The participants in this study were full-time employees in Taiwan. The authors employed a two-phase design to examine the developmental aspect of, and the enhancer for the team process. Paper-based questionnaires were used to collect data. All the research constructs were assessed at the individual level, thus analysis was conducted at the same level.

Findings

The results from 338 Taiwanese employees revealed that perceived psychological similarity (i.e. value and attitudinal congruence, a team input) led to favorable work outcomes (i.e. job satisfaction and team performance) through the linking mechanism of team cohesion. Furthermore, team members’ trait emotional intelligence (EI) amplified the positive relationship between psychological similarity and team cohesion.

Practical implications

First, managers should purposefully assemble employees with similar values and interests to work together, giving the team a good start with the like minds. Second, the results indicated that trait EI as a key personal resource enhances the positive relationship between psychological similarity and team cohesion. Workplace learning interventions should be implemented to improve employees’ emotion management skills.

Originality/value

Adopting the interpersonal relationship development perspective to study team process, the findings have confirmed the important roles of perceived psychological similarity among members and individual’s EI for team functioning. The authors’ endeavor has demonstrated the value of solid theoretical basis and the benefit of an individual-level analysis in delineating the mediating processes that explain why certain inputs affect team effectiveness and viability.
Perception is reality: change leadership and work engagement
Authors: Caulfield Jay L. , Senger Anthony
Published: August 2017

Purpose

The purpose of this paper is to investigate how employee perceptions of change and leadership might impact work engagement following major organizational change.

Design/methodology/approach

Social media invited US workers recently experiencing major organizational change to anonymously complete a web-based survey requesting qualitative and quantitative responses. Values-based coding and thematic analysis were used to explore qualitative data. Hierarchical and linear regression, and bootstrapped mediation were used to analyze quantitative data.

Findings

Analysis of qualitative data identified employees’ perceptions of ideal change and ideal leadership were well supported in the change leadership literature. Analysis of quantitative data indicated that employee perceptions of leadership fully mediated the relationship between employee perceptions of change and work engagement.

Practical implications

Study findings imply that how employees perceive change is explained by how they perceive leadership during change, and that these perceptions impact work engagement. Although these findings appear commonsensical, the less than stellar statistics on major organizational change may encourage leaders to become more follower-focused throughout the change process.

Originality/value

The study makes a contribution to an understudied area of organizational research, specifically applied information processing theory. This is the first study that identifies employee perceptions of leadership as a mediator for perceptions of change and work engagement. From a value perspective, leaders as successful change agents recognize significant cost savings in dollars and human welfare by maintaining healthy workplaces with highly engaged workers.
Authentic leadership and turnover intention: does organizational size matter?
Authors: Oh Jinuk , Oh Semi
Published: August 2017

Purpose

The purpose of this paper is to address two of the ongoing theoretical and empirical questions in the literature on authentic leadership: does authentic leadership negatively influence employees’ turnover intentions by enhancing their levels of affective commitment? and does organizational size act as a boundary condition for the mediating effects of affective commitment in the link between authentic leadership and turnover intentions?

Design/methodology/approach

A moderated mediation model of the affective process linking authentic leadership and turnover intentions was developed and tested on a sample of 375 employees working in South Korean firms.

Findings

The negative indirect effects of authentic leadership on employees’ turnover intentions through changes in the levels of affective commitment were significant. Furthermore, the mediated relationship between authentic leadership and turnover intentions via employees’ levels of affective commitment was stronger in smaller organizations.

Practical implications

The findings of the present study may be useful to practitioners who are interested in employee retention. They can mitigate against turnover intentions by enhancing the authentic leadership qualities of the managers. More specifically, this approach is especially ideal for small organizations.

Originality/value

This study corroborates the results of previous studies in highlighting the pervasive effects of authentic leadership on turnover intentions via enhancing employees’ levels of affective commitment. Moreover, organizational size as a boundary condition for the aforementioned relationship was empirically examined.
Analysis of user satisfaction for unisex medical uniforms
Authors: Kim Injoo , Brandewie Brooke , Kim Myoung-Ok
Published: August 2017

Purpose

This paper aims to analyze the medical uniform wearers’ needs by surveying the current medical uniform sizing system and issues, and to evaluate fit satisfaction level of medical uniform wear by gender with scrub shirts, pants and coats.

Design/methodology/approach

Research was conducted using a quantitative questionnaire, and the respondents’ data results were analyzed using SPSS.

Findings

The distinguished difference from the medical uniform and daily wear was that the medical garments’ sizing system had only alphabet sizing options, and the wearing ease was larger than that of daily wear. Fabric preferences included the combination of “stretch fabrics + non-stretch fabrics”. All male respondents’ satisfaction levels were reported higher than those of female respondents. Respondents were the least satisfied with the pants, followed by the shirts, and the coat in that order. As the current medical uniform has been developed based on the male figure, there were significant needs overall for improving the fit of the female medical uniform.

Practical implications

The study quantified fit satisfaction levels to suggest specific improvements that should be made to the design and fit of the female pants along with the coat using new comfortable textiles to achieve better performance for all medical staff.

Originality/value

This research specifically evaluated fit satisfaction levels of the medical uniform provided by hospital institutions in Ohio, attempting to suggest improvements for future medical uniform and design development to increase overall fit satisfaction.
Preoperative effects of mifepristone for dilation and evacuation after 19 weeks of gestation: a randomised controlled trial
Authors: Shaw KA , Lerma K , Shaw JG , Scrivner KJ , Hugin M , Hopkins FW , Blumenthal PD
Published: August 2017

Objective

To evaluate mifepristone as an adjunct to, or replacement for, osmotic dilators for cervical preparation in surgical abortion after 19 weeks of gestation.

Design

Site‐stratified, double‐blinded randomised controlled trial.

Setting

Two tertiary care teaching hospitals.

Population

Women undergoing dilation and evacuation at 19–236/7 weeks of gestation from November 2013 through November 2015.

Methods

Participants were randomised to receive (1) mifepristone alone (n = 27), (2) osmotic dilators with mifepristone (n = 27) or (3) osmotic dilators with placebo (n = 21) with all receiving pre‐procedure misoprostol.

Main outcome measures

Operative time, preoperative cervical dilation and complications.

Results

We enrolled 75 participants; mean gestation 21 weeks. Pre‐procedure cervical dilation was ≥3 cm in 4, 52, and 57% of participants in groups 1, 2, and 3, respectively (P < 0.005). Mifepristone with misoprostol for cervical preparation resulted in longer procedure times compared with osmotic dilators, with median total procedure times of (1) 18.5 (8–52), (2) 12 (7–25), and (3) 13 (6–26) minutes (P ≤ 0.005). Excluding time required for manual dilation, procedure times were similar: median times from dilation complete to evacuation complete were (1) 10.5 (4–23), (2) 8.5 (5–24), and (3) 10 (4–20) minutes (P = 0.10). Complications occurred in seven cases, six with trainees and one with an attending physician (P = 0.03), with difference by study group not reaching statistical significance (P = 0.12).

Conclusions

Elimination of osmotic dilators has the potential to decrease burden and opportunity cost of cervical preparation. The longer procedure time, related to manual dilation, is offset by decreasing dilator‐related preoperative time and discomfort. Provider experience may impact risk when eliminating dilators.

Tweetable abstract

Mifepristone and misoprostol for cervical preparation prior to D&E has potential to reduce barriers to care.
Critical assessment of thioguanine treatment for inflammatory bowel diseases: Is it time to rehabilitate this treatment?
Authors: Movva Ramya , Haywood Alison , Khan Sohil A , Florin Timothy HJ , Oancea Iulia
Published: August 2017

OBJECTIVE

The potential therapeutic effect of thioguanine in the management of inflammatory bowel disease (IBD) is hindered due to association with vascular hepatotoxicity. The study aimed to assess the evidence for efficacy of thioguanine in IBD management and the association with nodular regenerative hyperplasia (NRH) and other thioguanine‐related hepatotoxicities.

METHODS

Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines were used for literature search. Due to the lack of randomized controlled trials (RCTs), the search was extended to observational studies. Quality of the included studies were graded A to C based on evaluation tools used to determine efficacy (subjective and objective grading tools) and nodular regenerative hyperplasia safety (liver biopsy and imaging tools).

RESULTS

Two hundred and ninety studies were identified, but following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines only 13 studies were evaluated for efficacy and safety of thioguanine. Outcome measures were consistent across the included studies. Thioguanine appeared efficacious and well‐tolerated in patients who were intolerant/non‐responsive to existing immunomodulators. There was a trend toward a positive association between dose of thioguanine and NRH but not with other adverse events such as liver biochemical abnormalities or with portal hypertension.

CONCLUSIONS

The evidence to support thioguanine treatment is limited to observational studies. While encouraging, there is a need for prospective RCTs to determine the role of thioguanine in the management of IBD.
Advances and bottlenecks in microbial hydrogen production
Authors: Stephen Alan J. , Archer Sophie A. , Orozco Rafael L. , Macaskie Lynne E.
Published: August 2017

Biological production of hydrogen is poised to become a significant player in the future energy mix. This review highlights recent advances and bottlenecks in various approaches to biohydrogen processes, often in concert with management of organic wastes or waste CO2. Some key bottlenecks are highlighted in terms of the overall energy balance of the process and highlighting the need for economic and environmental life cycle analyses with regard also to socio‐economic and geographical issues.
Microbial biotechnology and circular economy in wastewater treatment
Authors: Nielsen Per Halkjær
Published: August 2017

Microbial biotechnology is essential for the development of circular economy in wastewater treatment by integrating energy production and resource recovery into the production of clean water. A comprehensive knowledge about identity, physiology, ecology, and population dynamics of process‐critical microorganisms will improve process stability, reduce CO2 footprints, optimize recovery and bioenergy production, and help finding new approaches and solutions. Examples of research needs and perspectives are provided, demonstrating the great importance of microbial biotechnology.
Focused cardiac ultrasound is feasible in parturients; a prospective observational study
Authors: Jain D. , Grejs A. M. , Bhavsar R. , Bang U. , Sloth E. , Juhl‐Olsen P.
Published: August 2017

Background

In pregnancy, the major causes of morbidity and mortality include diseases that affect circulation profoundly and restoration of normal circulation is a key objective. Focused cardiac ultrasound provides information on the individual determinants of circulation and has a significant impact on patient management. This study aimed to determine the feasibility of focused cardiac ultrasound in term parturients.

Methods

Forty parturients underwent focused cardiac ultrasound. Parasternal long‐axis, parasternal short‐axis, 4‐chamber and subcostal views were performed in the left‐lateral position and the supine position by a novice operator. All images were graded on the following scale: 1 = no image; 2 = poor and insufficient image; 3 = sufficient image quality; 4 = good image quality; 5 = perfect image quality. A cut‐off grade of three signified images sufficient for clinical decision‐making.

Results

Images sufficient for clinical decision‐making were obtained in all patients when including all imaging views. 37/40 (93 %) patients presented images of grade ≥ 4, whereas 10/40 (25%) patients had images of grade 5. Image grades were higher in the left lateral position (all P < 0.001). Parturients with a body mass index ≤ 30 kg/m2 did not present different image grades than parturients with a higher body mass index (P = 0.753). Subcostal views could not be obtained.

Conclusion

Focused cardiac ultrasound is feasible in the obstetric population and images of sufficient quality for clinical decision‐making were obtained in all parturients by an operator with limited experience.
Can Real Estate Investors Avoid Specific Risk?
Authors: Baum Andrew , Colley Nick
Published: August 2017

Using modern portfolio theory, the traditional asset allocation process employs measurements of risk and return delivered by asset classes—for example, stocks, bonds, and real estate—to build efficient portfolios. To build efficient portfolios in practice using this type of analysis requires that the risk and return characteristics of the asset class can be replicated in real portfolios. This may be true of stocks and bonds, but is it true of real estate? Using new analysis coupled with previous UK‐based research based on the uniquely rich MSCI (IPD) dataset for UK direct real estate, this paper compares the risk and return characteristics of real estate investment approaches (direct exposure, balanced and specialist unlisted funds, a multi‐manager approach, and listed securities) relative to a UK market index. Based on a random stochastic simulation of historic performance data from 2003 to 2012, we conclude that the difficulty of diversifying away specific risk in such a lumpy asset class means that it is extremely difficult and/or costly to access or replicate direct property market returns. This suggests that an investor/manager setting out to deliver returns in line with a market index would have to demonstrate significant levels of skill. While listed real estate, which is more readily diversifiable, fails to deliver returns that are correlated with direct real estate in the short term (one to five years), it is clear that multi‐manager strategies were able to deliver returns that more effectively replicated a direct benchmark. However, multi‐manager fees negatively impacted on net returns. Specific risk can be avoided by real estate investors, but at a cost.
Moral disapproval and perceived addiction to internet pornography: a longitudinal examination
Authors: Grubbs Joshua B. , Wilt Joshua A. , Exline Julie J. , Pargament Kenneth I. , Kraus Shane W.
Published: August 2017

Background and Aims

Internet pornography use is an increasingly common, yet controversial, behavior. Whereas mental health communities are divided about potentially problematic use patterns, many lay people identify as feeling dysregulated or compulsive in their use. Prior work has labeled this tendency perceived addiction to internet pornography (PA). This study's aims were to (1) assess the association between PA at baseline and other factors, including actual levels of average daily pornography use and personality factors and (2) assess the associations between baseline variables and PA 1 year later.

Design

Two large‐scale community samples were assessed using online survey methods, with subsets of each sample being recruited for follow‐up surveys 1 year later.

Setting

United States.

Participants

Participants were adults who had used pornography within the past 6 months recruited in two samples. Sample 1 (n = 1507) involved undergraduate students from three US universities and sample 2 (n = 782) involved web‐using adults. Subsets of each sample (sample 1, n = 146; sample 2, n = 211) were surveyed again 1 year later.

Measurements

At baseline, we assessed average daily pornography use, PA and relevant predictors (e.g. trait neuroticism, trait self‐control, trait entitlement, religiousness, moral disapproval of pornography use). One year later, we assessed PA.

Findings

Cross‐sectionally, PA was correlated strongly with moral disapproval of pornography use [sample 1, Pearson's correlation: r = 0.68 (0.65, 0.70); sample 2, r = 0.58 (0.53, 0.63)]. Baseline moral disapproval [sample 1, r = 0.46 (0.33, 0.56); sample 2, r = 0.61 (0.51, 0.69)] and perceived addiction demonstrated relationships with perceived addiction 1 year later. We found inconclusive evidence of a substantial or significant association between pornography use and perceived addiction over time [sample 1, r = 0.13 (−0.02, 0.28); sample 2, r = 0.11 (−0.04, 0.25)].

Conclusions

Perceived addiction to internet pornography appears to be related strongly to moral scruples around pornography use, both concurrently and over time, rather than with the amount of daily pornography use itself.
Effect of genetic European taurine ancestry on milk yield of Ankole‐Holstein crossbred dairy cattle in mixed smallholders system of Burundi highlands
Authors: Manirakiza J. , Hatungumukama G. , Thévenon S. , Gautier M. , Besbes B. , Flori L. , Detilleux J.
Published: August 2017

Different breeding systems associated with specific bovine genetic resources have coexisted in Burundi. To prepare for the development of a national action plan for the improvement of bovine genetic resources in Burundi, we aimed at performing genetic characterization of Ankole and Ankole × European crossbred individuals and assessing the effect of European ancestry on milk productivity of cows kept under the mixed crops livestock system. To that end, we genotyped 37 Ankole and 138 crossbred individuals on 42 636 SNPs and combined these genotypes with those from 21 cattle breeds, representative of the bovine genetic diversity. We also measured milk yield not suckled and estimated suckled milk. Given the results, we confirmed the indicine × African taurine admixed origin of the Ankole in Burundi and showed that crossbred individuals present a high proportion of European ancestry (i.e. 57% on average). As the proportion of European ancestry increased, milk yield increased by 0.03 ± 0.01 l/day, at a lower extent than expected. We also observed that breeders were unable to correctly evaluate the European proportion in their livestock. Our results may provide useful information for objective dairy breeding in Burundi. As an example, an ex‐situ conservation program of Ankole within the framework of value chains is proposed as an accompanying strategy to improve the sustainability of the crossbreeding program.
The effect of acetazolamide on intra‐ocular pressure after Trendelenburg positioning – a randomised double‐blind crossover trial in volunteers
Authors: Vitish‐Sharma P. , King A. J. , Abbas A. , Maxwell‐Armstrong C. , Guo B. , Acheson A. G.
Published: August 2017

Recent evidence suggests Trendelenburg positioning can produce a significant rise in intra‐ocular pressure. Peri‐operative vision loss in patients undergoing laparoscopic colorectal surgery has been reported with the rise in intra‐ocular pressure suggested as a possible factor. Acetazolamide decreases intra‐ocular pressure by reducing the formation of aqueous humour, so we aimed to investigate if it could attenuate the intra‐ocular pressure rise that can occur in the Trendelenburg position. Nine healthy volunteers were recruited and randomly assigned to a double‐blind crossover comparison of placebo or acetazolamide with a minimal 4 days’ washout period before the second study day. One and a half hours after taking the medication, volunteers lay head‐down at 17° for 4 h. Intraocular pressure measurements were repeated in both eyes every 30 min over a 4‐h period. There were two males and seven female volunteers, with a mean (SD) age of 54.3 (18.5) years. The mean (SD) increase in intra‐ocular pressure following 4 h in the Trendelenburg position was 3.17 (4.63) mmHg after the placebo, and 0.02 (4.01) mmHg (p = 0.02) after acetazolamide. We have shown than acetazolamide can attenuate the rise that occurs in intra‐ocular pressure when in the Trendelenburg position.
The higher prevalence of truncal obesity and diabetes in American than Chinese patients with chronic hepatitis C might contribute to more rapid progression to advanced liver disease
Authors: Rao H. , Wu E. , Fu S. , Yang M. , Feng B. , Lin A. , Fei R. , Fontana R. J. , Lok A. S. , Wei L.
Published: August 2017

Background

Chronic hepatitis C virus (HCV) infection is the leading cause of cirrhosis and hepatocellular carcinoma (HCC) in the United States (US) and an emerging cause in China.

Aim

To compare the clinical characteristics of hepatitis C patients in the US and China, and factors influencing disease stage.

Methods

Prospective study of 2 cohorts of HCV patients recruited at 1 site in the US and 3 sites in China. Standardised questionnaire on risk factors and medical history were used and diagnosis of cirrhosis and HCC was based on pre‐defined criteria.

Results

One thousand nine hundred and fifty seven patients (1000 US and 957 China) were enrolled. US patients were more likely to be men (61.4% vs 48.5%), older (median age 57 vs 53 years), obese (38.4% vs 16.8%) and diabetic (21.8% vs 10.8%). A significantly higher per cent of US patients had cirrhosis (38.2% vs 16.0%) and HCC (14.1% vs 2.7%). Investigator estimated time at infection in US was 10 years earlier than in Chinese patients but US patients were more likely to have advanced disease even after stratifying for duration of infection. Study site in the US, older age, truncal obesity, diabetes and prior HCV treatment were significant predictors of advanced disease on multivariate analysis.

Conclusions

HCV patients in the US had more advanced liver disease than those in China. We speculate that underlying fatty liver disease may be a major contributor to this difference, and management of glycometabolic abnormalities should occur in parallel with anti‐viral therapy to achieve optimal outcomes.
“I don’t know what I was expecting”: Home visits by neonatology fellows for infants discharged from the NICU
Authors: Hobbs Janice E. , Tschudy Megan M. , Hussey‐Gardner Brenda , Jennings Jacky M. , Boss Renee D.
Published: August 2017

Background

When families transition from the neonatal intensive care unit (NICU) to the home, they become responsible for their infant's daily medical needs. Though neonatology physicians prepare families for hospital discharge, it is unclear how much clinicians understand about how their teaching and instructions translate into home care. The goal of this study was to evaluate the influence of a home visiting program on neonatology fellows’ understanding of family needs soon after hospital discharge.

Methods

Neonatology fellows conducted a home visit for an infant recently discharged. Before the visit, fellows reviewed their original discharge instructions, along with information about the family's neighborhood. During the home visit, fellows reviewed their discharge planning with families and discussed any challenges experienced. Afterwards, fellows completed a semi‐structured interview; these transcriptions were manually coded for themes.

Results

Fellows identified several common women/family discharge challenges. These challenges fall into four domains: (1) inadequate discharge preparation, (2) medicalization of the home, (3) family adjustment to new “normal,” and (4) the relevance of social context to discharge planning. Most (90%) fellows reported the home visit experience would affect their future NICU discharge practices and all agreed that home visits should be a part of neonatology training.

Conclusions

Home visits allowed neonatology fellows to examine how their discharge preparation did, or did not, meet the family's needs. Incorporating home visits into neonatology training could help fellows learn about the relevance of social and community factors that are difficult to assess in the inpatient setting.
Detection and care practices for postpartum depressive symptoms in public‐sector obstetric units in Mexico: Qualitative results from a resource‐constrained setting
Authors: Place Jean Marie S. , Allen‐Leigh Betania , Billings Deborah L. , Dues Kiya M. , de Castro Filipa
Published: August 2017

Background

Postpartum depression (PPD) is amenable to detection and treatment, but effectively addressing it is contingent on policies, practices, and health care providers working together to address the issue. The aim of this study is to describe a sample of health care providers’ existing practices in public‐sector obstetric units in Mexico related to detecting and offering care to women with depressive symptomology.

Methods

Semi‐structured interviews with 40 health care providers (16 physicians, 13 nurses, three social workers, and eight psychologists) from one tertiary‐level and two secondary‐level, public‐sector obstetric units, were conducted by members of a trained research team from May to July 2012. Qualitative data were analyzed in Spanish according to Grounded Theory, using Nvivo 10 software.

Results

Lack of hospital guidelines, training, and time constraints are reasons given for not detecting PPD symptoms among women. Providers reported that their role is cursory and limited to giving women anticipatory guidance for what to expect emotionally after childbirth or providing a trusting atmosphere for women to express their feelings. Care is fragmented and inadequate, in part because of the lack of protocols that define who makes mental health referrals and where. Providers indicated PPD is important but not prioritized in health care for pregnant and postpartum women.

Conclusion

Critical needs in obstetric units include formal mental health care detection and care protocols during the perinatal period, strategies to address mental health needs despite short hospital stays, and training for providers on how to implement detection and care protocols and strategies.
“Everyone thought I was a very very bad person… no one want to know you like the nurses and doctors”: Using focus groups to elicit the views of adults with learning disability who use challenging behaviour services
Authors: Haydon‐Laurelut Mark , Edmonds Jane , Daynes Shona , Clare Amy , Byles Rosalind , Barber Victoria
Published: August 2017

Accessible summary

We wanted to find out what adults with learning disabilities who receive challenging behaviour services thought about challenging behaviour and the services they receive.

We met with people in small groups and talked with them about challenging behaviour.

There were barriers to attending the groups like services not having enough staff or transport.

People in the groups told us what they thought of words like challenging behaviour, what they understood about challenging behaviour services, and what it was like meeting with them.

Background

Following scandals such as Winterbourne view, Department of Health, (A national response to Winterbourne View Hospital, 2012) seeks changes in challenging behaviour services. A key part of this change is ensuring people with learning disabilities who use challenging behaviour services have more personalised support and their voices are heard.

Materials and Methods

This article describes a study that used focus groups to explore challenging behaviour and challenging behaviour services with people with learning disabilities who used community‐based challenging behaviour services. We analysed the focus groups using thematic analysis.

Results

We found three main themes: Engaging with service terminology: the language of Challenging Behaviour; Locating and Framing behaviour; and Engaging with Professionals.

Conclusion

People with learning disabilities who receive challenging behaviour services are able to participate in focus groups and tell us about their experiences. Further consideration is required concerning how people with learning disabilities experience their engagement with challenging behaviour services. This study has led to a larger study currently in progress.
“Made in Canada”: Local production networks in the Canadian fashion industry
Authors: Brydges Taylor
Published: August 2017

The fashion industry is a highly globalized industry increasingly dominated by international firms that favour flexible, efficient supply chains in order to produce trendy clothing at the lowest price. While much of the fashion industry follows the logics of global production networks, this paper presents a case where small, independent firms have chosen instead to engage with local production networks. Drawing on interviews with 87 independent fashion designers and key informants, this paper examines the following question: In the context of global production, why do independent fashion designers choose to work locally? In answering this question, three key findings are presented: the motivations of designers who emphasize timeless design and high‐quality local manufacturing; the strategies employed by designers to cultivate exclusivity and loyalty through the distribution of their collections; and the ways in which unique consumption experiences are utilized to articulate the values of their brand to consumers. While operating outside of the traditional fashion system provides independent fashion designers with the space for creativity, innovation, and control over their brand, it will be argued it also creates challenges with respect to growth beyond their niche market.
Motion Perception and Form Discrimination in Extremely Preterm School‐Aged Children
Authors: Benassi Mariagrazia , Bolzani Roberto , Forsman Lea , Ådén Ulrika , Jacobson Lena , Giovagnoli Sara , Hellgren Kerstin
Published: August 2017

This population‐based study evaluated motion and form perception in 71 children born extreme premature (EPT; < 27 gestational weeks), aged 6.5 years, as compared to a matched group of 79 control children born at term. Motion and form perception were evaluated by motion coherence and form coherence tests. The EPT group showed a poorer performance on both tasks as compared to the control group. However, after controlling for IQ and visual acuity, the EPT group showed only a significant deficit in motion perception. No association was found between motion perception accuracy and gestational age, previous retinopathy of prematurity, or previous intraventricular hemorrhage in the EPT group. The results highlight the long‐term motion perception deficits in children born EPT.
Corticosteroid and long‐acting ß‐agonist therapy reduces epithelial goblet cell metaplasia
Authors: Lachowicz‐Scroggins M. E. , Finkbeiner W. E. , Gordon E. D. , Yuan S. , Zlock L. , Bhakta N. R. , Woodruff P. G. , Fahy J. V. , Boushey H. A.
Published: August 2017

Background

Bronchial epithelial goblet cell metaplasia (GCM) with hyperplasia is a prominent feature of asthma, but the effects of treatment with corticosteroids alone or in combination with a long‐acting β2‐adrenergic receptor agonist (LABA) on GCM in the bronchial epithelium are unknown.

Objectives

To determine whether corticosteroid alone or in combination with a LABA alters protein and gene expression pathways associated with IL‐13–induced goblet cell metaplasia.

Results

We evaluated the effects of fluticasone propionate (FP) and of salmeterol (SM), on the response of well‐differentiated cultured bronchial epithelial cells to interleukin‐13 (IL‐13). Outcome measures included gene expression of SPDEF/FOXa2, gene expression and protein production of MUC5AC/MUC5B and morphologic appearance of cultured epithelial cell sheets. We additionally analysed expression of these genes in bronchial epithelial brushings from healthy, steroid‐naïve asthmatic and steroid‐treated asthmatic subjects. In cultured airway epithelial cells, FP treatment inhibited IL‐13–induced suppression of FOXa2 gene expression and up‐regulation of SPDEF, alterations in gene and protein measures of MUC5AC and MUC5B and induction of GCM. The addition of SM synergistically modified the effects of FP modestly—only for gel‐forming mucin MUC5AC. In bronchial epithelial cells recovered from asthmatic vs healthy human subjects, we found FOXa2 and MUC5B gene expression to be reduced and SPDEF and MUC5AC gene expression to be increased; these alterations were not observed in bronchial epithelial cells recovered after treatment with inhaled corticosteroids.

Conclusion and Clinical Relevance

Corticosteroid treatment inhibits IL‐13–induced GCM of the airways in asthma, possibly through its effects on SPDEF and FOXa2 regulation of mucin gene expression. These effects are modestly augmented by the addition of a long‐acting ß‐agonist. As we found evidence for drug treatment counteracting the effects of IL‐13 on the epithelium, we conclude that further exploration into the mechanisms by which corticosteroids and long‐acting β2‐adrenergic agonists confer protection against pathologic airway changes is warranted.
Primary hyperparathyroidism in Chinese children and adolescents: A single‐centre experience at Peking Union Medical College Hospital
Authors: Wang Wenbo , Kong Jing , Nie Min , Jiang Yan , Li Mei , Xia Weibo , Meng Xunwu , Xing Xiaoping , Wang Ou
Published: August 2017

Objective

Primary hyperparathyroidism (PHPT) in children is thought to be extremely rare. Our study aimed to summarize the clinical characteristics and the molecular genetics in patients with paediatric PHPT in China.

Design

Retrospective observational study.

Methods

A total of 59 paediatric PHPT patients (onset age <18 years) admitted to Peking Union Medical College Hospital from 1975 to 2015 were retrospectively identified. A group of 118 adult PHPT patients who presented during the same period were selected for comparing clinical characteristics between the two groups. Germline mutation analyses of the MEN1, CDC73, RET, CDKN1B and CaSR genes were performed in 24 patients.

Results

Only one paediatric patient (1.7%) with PHPT was asymptomatic. Bone involvement, urolithiasis, acute pancreatitis and hypercalcaemic crisis were present in 86.4%, 39.0%, 6.8% and 10.2% of cases, respectively. Paediatric PHPT presented more commonly with rickets/osteomalacia compared to adult PHPT. Fifty‐seven paediatric patients underwent surgery. Adenoma, hyperplasia, atypical adenoma and carcinoma occurred in 80.7%, 10.5%, 7.0% and 1.8% of cases, respectively. Of the 24 paediatric patients screened for genetic mutations, two patients were found to carry MEN1 mutations and six were found to carry CDC73 mutations. The mutation rate was 22.2% (4/18) in sporadic patients.

Conclusion

Unlike adults with PHPT, most paediatric PHPT were symptomatic. Rickets/osteomalacia was more common in paediatric patients than in their adult counterparts. Paediatric PHPT patients can be treated successfully with surgical intervention. Genetic screening of the MEN1 and CDC73 genes for mutations should be recommended in paediatric patients due to a relatively high mutation rate.
How Cross‐Linguistic Differences in the Grammaticalization of Future Time Reference Influence Intertemporal Choices
Authors: Thoma Dieter , Tytus Agnieszka E.
Published: August 2017

According to Chen's (2013) Linguistic Savings Hypothesis (LSH), our native language affects our economic behavior. We present three studies investigating how cross‐linguistic differences in the grammaticalization of future‐time reference (FTR) affect intertemporal choices. In a series of decision scenarios about finance and health issues, we let speakers of altogether five languages that represent FTR with increasing strength, that is, Chinese, German, Danish, Spanish, and English, choose between hypothetical sooner‐smaller and later‐larger reward options. While the LSH predicts a present‐bias that increases with FTR‐strength, our decision makers preferred later‐larger options and this future‐bias increased with FTR‐strength. In multiple regressions, the FTR‐strength effect persisted when controlled for socioeconomic and cultural differences. We discuss why our findings deviate from the LSH and ask in how far the FTR‐strength effect represents a habitual constitution of linguistic relativity or an instance of online decision framing.
Intra‐operative predictors of postoperative Takotsubo syndrome in liver transplant recipients—An exploratory case‐control study
Authors: Aniskevich Stephen , Chadha Ryan M. , Peiris Prith , Taner Cemal Burcin , Torp Klaus L. , Thomas Colleen S. , Yataco Maria L. , Pai Sher‐Lu
Published: August 2017

Introduction

Takotsubo syndrome (TTS), also known as Takotsubo cardiomyopathy or stress‐induced cardiomyopathy, has been described following a variety of surgeries and disease states. The relationship between intra‐operative anesthesia management and the development of this syndrome has never been fully elucidated.

Objectives

The primary objective of this study was to determine the relationship of multiple intra‐operative factors on the pathogenesis of TTS.

Methods

A single‐center retrospective review of all liver transplants performed at Mayo Clinic Florida from January 2005 to December 2014. Patients developing left ventricular dilation and a concomitant decrease in ejection fraction, a negative cardiac catheterization, or stress test within 30 days of transplantation were identified. Cases were matched 2:1 to controls with respect to MELD, age, sex, and indication for transplantation. Our evaluation included liver graft characteristics, intra‐operative medications, and intra‐operative hemodynamic measurements.

Results

We identified 24 cases of TTS from a pool of 1752 transplants, for an incidence of 1.4%. No statistically significant differences in intra‐operative measures between the two groups were identified (all P ≥ .08).

Conclusion

Our exploratory, single‐center retrospective review evaluating 46 intra‐operative characteristics found no association with the development of TTS.
Therapeutic inertia in the treatment of hyperglycaemia in patients with type 2 diabetes: A systematic review
Authors: Khunti Kamlesh , Gomes Marilia B. , Pocock Stuart , Shestakova Marina V. , Pintat Stéphane , Fenici Peter , Hammar Niklas , Medina Jesús
Published: August 2017

Aims

Therapeutic inertia, defined as the failure to initiate or intensify therapy in a timely manner according to evidence‐based clinical guidelines, is a key reason for uncontrolled hyperglycaemia in patients with type 2 diabetes. The aims of this systematic review were to identify how therapeutic inertia in the management of hyperglycaemia was measured and to assess its extent over the past decade.

Materials and Methods

Systematic searches for articles published from January 1, 2004 to August 1, 2016 were conducted in MEDLINE and Embase. Two researchers independently screened all of the titles and abstracts, and the full texts of publications deemed relevant. Data were extracted by a single researcher using a standardized data extraction form.

Results

The final selection for the review included 53 articles. Measurements used to assess therapeutic inertia varied across studies, making comparisons difficult. Data from low‐ to middle‐income countries were scarce. In most studies, the median time to treatment intensification after a glycated haemoglobin (HbA1c) measurement above target was more than 1 year (range 0.3 to >7.2 years). Therapeutic inertia increased as the number of antidiabetic drugs rose and decreased with increasing HbA1c levels. Data were mainly available from Western countries. Diversity of inertia measures precluded meta‐analysis.

Conclusions

Therapeutic inertia in the management of hyperglycaemia in patients with type 2 diabetes is a major concern. This is well documented in Western countries, but corresponding data are urgently needed in low‐ and middle‐income countries, in view of their high prevalence of type 2 diabetes.
LEARNING ABOUT EDUCATION
Authors: Emerson Patrick M. , McGough Bruce
Published: August 2017

Limited human capital investment is a common characteristic of low‐income countries despite the fact that estimated returns to educational investment in low‐income countries are generally higher than those in high‐income countries. Empirical evidence suggests that income and credit constraints can only account for a part of this underinvestment. Recent experimental evidence shows that families' misperceptions about the returns to education play a role in their low‐investment levels. This paper builds a heterogeneous‐agent model of human capital and growth that incorporates an adaptive learning mechanism to capture the way agents form perceptions about returns to education. We find natural conditions guaranteeing existence of stable equilibria. Along transition paths, agents' misperceptions about returns to education depress realized returns, which serves to reenforce and perpetuate low human‐capital investment. If human capital investments have both private and public returns, we find multiple stable equilibria, including those which are characterized by low investment and low returns. (JEL D83, O10, I25)