bluuebunny/crossref_metadata_2025 huggingface dataset:
Is workplace spirituality associated with business ethics?
Authors: Ayoun Baker , Rowe Louis , Yassine Fatima
Published: July 2015

Purpose

– The purpose of this paper is to empirically explore the potential association between spirituality and business ethics in a hotel workplace.

Design/methodology/approach

– A scenario-based quantitative approach was used to collect data from 165 practicing professionals in the hotel industry.

Findings

– The results show that spirituality, as measured by the Spiritual Transcendence Scale (STS), did not correlate significantly with measures of ethical perception, ethical judgment, ethical intention or perceived moral intensity. There was, however, evidence to suggest that spirituality may be able to contribute incrementally to future research.

Research limitations/implications

– This study demonstrates that the dynamic associations between spirituality and ethics may produce different outcomes in different industry settings.

Practical implications

– If hotel companies focus on developing ethical standards, the effects on the business ethics of managers could be considerably greater than relying on the spirituality of managers or the encouragement of expression of spirituality in the workplace.

Originality/value

– Although the relationship between spirituality and ethics seems to be sensible, the empirical assessments on how managers’ workplace spirituality relate to their business ethics is notably lacking. The present study sought to fill this gap in literature.
Pricing strategies for resort fees: consumer preferences favor simplicity
Authors: Repetti Toni , Roe Susan , Gregory Amy
Published: July 2015

Purpose

– The purpose of this study is twofold: to determine hotel customers’ preference among hotel amenities pricing strategies, specifically a bundled, all-inclusive charge in the form of a resort fee, a limited choice resort fee at a lower price or a la carte pricing, and to determine whether hotel customer prefer bundled or partitioned pricing when faced with a mandatory resort fee.

Design/methodology/approach

– An online survey of participants aged 18 years and older who had taken an overnight leisure trip in the past six months is conducted. A fixed-choice set conjoint analysis is performed to analyze the 353 usable surveys.

Findings

– Results of this conjoint analysis show that 67 per cent of respondents prefer bundled pricing over partitioned pricing. Respondents also show higher utility for no resort fee and paying for amenities based on usage instead of being forced to pay a mandatory resort fee.

Practical implications

– Guest preferences for pricing strategies can provide hotel operators with valuable information on how to establish pricing structures. Results suggest that hotel operators could benefit from presenting a bundled price inclusive of room rates and mandatory fees.

Originality/value

– This is the only known study that examines mandatory fees in which customers receive additional amenities or services in exchange for an additional surcharge. This study also adds to the literature on pricing research in the hospitality industry.
“Do your internal branding efforts measure up?”
Authors: Erkmen Ezgi , Hancer Murat
Published: July 2015

Purpose

– This study aims to understand the effect of brand citizenship behaviors of hospitality employees on customers’ relation with the brand. A model, which links employee behaviors to customers’ evaluation of brand performance, brand trust and brand commitment, is proposed to provide further insight into how customers form their relation with a brand.

Design/methodology/approach

– Data were collected from both customer-contact employees and passengers of a corporate airline company. Structural equation modeling was used to test the proposed model by using both employee and customer data in the same research model.

Findings

– The results showed that even brand citizenship behaviors of employees did not affect brand commitment of customers directly; these behaviors explain customers’ commitment to a brand through influencing perceived brand performance of customers and their trust toward a brand. Overall, this study provided support for the impact of employees’ brand-related behaviors on consumers’ relation with the brand.

Research limitations/implications

– The results suggest that hospitality employees contribute to the brand success through their behaviors. This helps organizations to enhance brand-related behaviors of their employees to ensure long-term relationships not only with customers but also with their employees in a labor-intensive and high customer contact industry.

Originality/value

– This research was one of the first to analyze the effects of employees’ brand supporting behaviors on consumers by using both employee and consumer data in the same research model within the hospitality context.
Dynamics of internationalisation of the hotel industry: the case of Spain
Authors: Brida Juan Gabriel , Driha Oana Madalina , Ramón-Rodríguez Ana B. , Scuderi Raffaele
Published: July 2015

Purpose

– This paper aims provides an empirical analysis of the development of the internationalisation process in the Spanish hotel industry, which has experienced major changes during the past decade. The degree of internationalisation between 2000 and 2010 is used as a proxy variable with the aim of mapping the development of international strategies.

Design/methodology/approach

– A longitudinal dataset measuring the internationalisation of Spanish hotel chains is used. Cluster analysis identifies the different behaviour of groups of firms during the analysed period.

Findings

– Two different clusters are detected, which can be attributed to different internationalisation strategies over time. Small and medium (SME) hotel companies seem to follow a different path of development than more established multinational companies. Over time, the entire group tends to be more compact, whereas the distance between the clusters is shown to diverge in final years. The groups’ composition suggests that business-networking relationships can be a strategy of particular importance for SMEs pursuing international expansion.

Practical implications

– This paper develops a better understanding of the changes of the internationalisation patterns of Spanish hotel chains. Findings could address managers in strategic decisions about how to improve competitive position. In particular, they recommend accounting for size, international experience and business network relationships when expanded abroad.

Originality/value

– This paper introduces a new approach based on studying clusters of Spanish hotels according to their internationalisation strategies over the time. Further analysis revealed the role of business network on internationalisation patterns.
Quality of work life and job satisfaction among frontline hotel employees
Authors: Lee Jin-Soo , Back Ki-Joon , Chan Eric S.W.
Published: July 2015

Purpose

– The purpose of this paper is to achieve three objectives: to investigate perceived quality of work life (QWL) need attributes among frontline employees in the lodging industry, to assess the asymmetric relationships between QWL attributes and job satisfaction (JS) and to prioritize QWL attributes for the effective management of JS.

Design/methodology/approach

– Data were analyzed using exploratory factor analysis, impact range-performance analysis and impact-asymmetry analysis.

Findings

– Each QWL attribute showed significant and various asymmetric or linear impacts on JS or job dissatisfaction (JDS).

Practical implications

– Study results provided critical information for hotel managers to prioritize several attributes, such as safe work place, fair pay, empowerment and effective training, to enhance JS and reduce JDS for frontline personnel.

Originality/value

– This study sheds light for identifying the underlying structure of QWL and further investigate the asymmetric relationship between QWL attributes and JS/JDS using need satisfaction, self-determination and three-factor theory in the lodging industry.
Insights on integrated marketing communications: implementation and impact in hotel companies
Authors: Šeric Maja , Gil-Saura Irene , Ozretić-Došen Đurđana
Published: July 2015

Purpose

– The purpose of this paper is to provide insights on integrated marketing communications (IMC) by empirically examining the concept in a new context, that is hotel companies, and comparing its implementation and impact in Italian and Croatian hotels.

Design/methodology/approach

– The study uses survey methodology to assess IMC, approaching managers and guests in high-quality hotels.

Findings

– From the manager’s point of view, both Italian and Croatian hotels show a high level of IMC implementation and significant differences regarding some items. From the guest’s point of view, significant differences are obtained between the two hotel groups. In addition, IMC is found to influence positively and significantly customer satisfaction.

Research limitations/implications

– This research is limited to the Italian and Croatian hotel context. Future studies should approach a greater number of hotels to obtain more representative results.

Practical implications

– Managers need to adopt a holistic vision of marketing communications and regularly analyze consumers’ opinions to understand if their campaign works.

Originality/value

– This paper makes several original contributions, thus filling the existing gap in the literature. First, IMC is analyzed in a new environment, that is high-quality hotels. Second, the study is conducted in Italy and Croatia, where research on IMC is rather neglected. Third, in addition to managers’ opinions, guests’ perceptions are assessed, thus highlighting that consumers need to be considered as true “co-managers” of business strategies.
An empirical investigation of strategic management accounting in hotels
Authors: Pavlatos Odysseas
Published: July 2015

Purpose

– The purpose of this paper is to investigate the relationship between contextual factors, strategic management accounting (SMA) and historical performance in hotels.

Design/methodology/approach

– An empirical survey was conducted on a sample of 106 leading hotels in Greece.

Findings

– The analysis of the survey data indicates that seven contingent factors affect SMA usage in hotels: The seven factors are perceived environmental uncertainty, structure, quality of information system (IS) information, organizational life cycle stage, historical performance, strategy and size. The findings also indicate that lagging performance affects SMA and that this effect is moderated by the perceived environmental uncertainty.

Research limitations/implications

– Some of the limitations are inherent to the survey method used, such as the use of perceptual measures and the potential of common method bias. Data were collected from the Greek hospitality industry, and consequently, the results may be generalizable only to that population.

Practical implications

– The accounting professionals and hotel managers will also be benefited, as the study aims to identify the most relevant SMA tools adopted in the hotel industry, as well as the relationship between these tools and other external and organizational factors.

Originality/value

– This research adds to the current knowledge in management accounting system design in hotels. This paper increases the understanding as to why hotels are more likely to implement SMA. The results provide the first empirical evidence of the relation between SMA usage, organizational factors, external factors and historical performance in hotels.
Performance analysis and improvement of a typical telephone response system of VA hospitals
Authors: Shi Jing , Erdem Ergin , Peng Yidong , Woodbridge Peter , Masek Christopher
Published: July 2015

Purpose

– Telephone response system is the frontline of hospital operations. The purpose of this paper is to analyze a representative telephone response system of Veterans Affairs (VA) hospitals, address the existing inefficiency issues such as long call waiting time, and improve system resilience to changes.

Design/methodology/approach

– Resource sharing schemes are proposed to improve the system performance in answering calls related to appointment booking and medication renewal. Discrete event simulation is adopted to model the current system and the resource sharing schemes.

Findings

– The resource sharing schemes dramatically improve system performance reflected by the decrease of call waiting time and queue, as well as the extreme high utilization of agents in a key unit. Compared with the less desired alternative of hiring additional employees to mitigate the performance issues, the resource sharing schemes perform at par or even better. Sharing more resource during the peak hours can further balance the agent workload.

Practical implications

– The resource sharing schemes could alleviate staffing shortage, long waiting time, and high-abandonment rate in the bottle-beck unit of the system, and lead to better utilization of scarce resources on the hospital floor. The concept reflects localized centralization efforts in traditionally highly decentralized telephone operations in hospital systems.

Originality/value

– This research provides a structured approach to analyze the operations of a VA telephone response system. The developed simulation model is validated, and this provides a valuable tool for management to analyze the complicated telephone operations of the telephone systems of other VA and non-VA hospitals. Resource sharing constitutes a cost-effective solution for improving system performance and resilience.
Leanness metric evaluation platform in fuzzy context
Authors: Matawale Chhabi Ram , Datta Saurav , Mahapatra Siba  Sankar
Published: July 2015

Purpose

– The purpose of this study is to provide an efficient index system for evaluating leanness extent of the organizational supply chain. In today’s competitive global marketplace, the concept of lean manufacturing has gained vital consciousness to all manufacturing sectors, their supply chains and, hence, a logical measurement index system is indeed required in implementing leanness in practice. Such leanness estimation can help the enterprises to assess their existing leanness level and can compare different industries that are adapting this lean concept.

Design/methodology/approach

– The present work exhibits an efficient fuzzy-based leanness assessment system using trapezoidal fuzzy numbers set.

Findings

– The methodology described here has been found fruitful while applying for a particular industry, in India, as a case study. Apart from estimating overall lean performance metric, the model presented here can identify ill-performing areas toward lean achievement.

Originality/value

– The major contributions of this work have been summarized as follows: development and implementation of an efficient decision-making procedural hierarchy to support leanness extent evaluation; an overall lean performance index evaluation platform has been introduced; concept of generalized trapezoidal fuzzy numbers has been efficiently explored to facilitate this decision-making; and the appraisement index system has been extended with the capability to search ill-performing areas which require future progress.
Corporate Facebook and stakeholder engagement
Authors: Bonsón Ponte Enrique , Carvajal-Trujillo Elena , Escobar-Rodríguez Tomás
Published: July 2015

Purpose

– The purpose of this paper is to provide an initial assessment of corporate Facebook use by Spanish hotel chains. Two aspects are considered: communication activity and stakeholder engagement through this social media platform.

Design/methodology/approach

– Based on a content analysis, data on 109 Spanish hotel chains are collected to describe current practices and identify significant relationships among different variables.

Findings

– The main findings include that their Facebook presence, audiences and levels of activity are positively related to hotel size, while stakeholder engagement is higher in small hotel chains and seems to be influenced by content and media types.

Originality/value

– This research contributes to previous research by providing an assessment of corporate Facebook in the hospitality industry (Spanish hotel chains). The paper considers two aspects: communication activity and stakeholder engagement through this social media platform.
Who negotiates a higher starting salary?
Authors: Xiu Lin , Kang Gerui (Grace) , Roline Alan C.
Published: July 2015

Purpose

– The aim of this study is to examine how personality traits influence interviewees’ negotiation decisions as well as whether and to what extent such effects are moderated by one’s gender and risk attitudes.

Design/methodology/approach

– An experiment was designed in which participants acted as interviewees and were asked to decide whether to initiate negotiations to potentially increase their salary and benefits. A logistic regression analysis and conditional process analysis were used to examine the effects of personality traits (agreeableness and extraversion) on the initiation of salary negotiation, as well as whether and to what extent such effects are moderated by one’s gender and risk attitudes.

Findings

– A significant direct influence of extraversion and risk attitude on a job applicant’s initiation of salary negotiations. It was also found that risk attitudes moderate the effect of personality traits (i.e. agreeableness and extraversion) on individuals’ negotiation decisions. This study thus indicates that the effects of personality traits on job applicants’ initiation of salary negotiations are contingent on their risk attitudes.

Originality/value

– To the authors’ knowledge, this study is the first to investigate the direct as well as moderated effects of personality traits on interviewees’ negotiation behavior in job interviews. The findings of this study thus significantly contribute to the literature in this line of research. Human resource professionals, as well as job seekers, may also benefit from the findings and implications of this study.
A study on the political skill of Korean entrepreneurs contributing to social network guarantee
Authors: Zhan Xi , Kim Choon-kwang
Published: July 2015

Purpose

– This paper aims to set social network, which is recently drawing the most attention in the business administration field, as a major dependent variable of political skill. It is because social network plays a very important role in improving the productivity and performance of firms, and, in actuality, many researches have proved that social network greatly contributes to firm performance.

Design/methodology/approach

– Researches into social network have not yet established that “through what” or “how” social network can be formed and affected.

Findings

– In this study, the authors attempt to connect social network with political skill, which is a cause variable.

Originality/value

– This approach will give us a better understanding on the formation of social networks and its relationship with political skill, and so eventually, such negative recognition about the politics can be viewed from a different sight of angle.
Beneficiary feedback effects on alpine cushion benefactors become more negative with increasing cover of graminoids and in dry conditions
Authors: Michalet Richard , Schöb Christian , Xiao Sa , Zhao Liang , Chen Tuo , An Li‐zhe , Callaway Ragan M.
Published: July 2015

In facilitative interactions, the beneficiary feedback effect (BFE) has been defined as the effect of beneficiary species (facilitated species) on their benefactor. BFEs have been shown to be dependent on environmental conditions and the composition of the beneficiary community. In alpine cushion systems, BFEs are more negative with more abundant, diverse and phylogenetically aggregated communities of beneficiary species.

We tested the hypothesis that the functional composition of the beneficiary communities correlates with the direction and strength of BFE received by alpine cushion benefactors and specifically that a more negative BFE would occur with increasing density of graminoids and a more positive BFE would occur with increasing density of forbs and legumes. Additionally, we predicted that the negative BFE of graminoids would increase with increasing summer aridity.

We used a data base of alpine cushion communities from 30 sites throughout the world to assess the overall relationship between the composition of beneficiary communities and the total flower density of cushion benefactors, and its variation with increasing drought. Additionally, in order to assess more precisely the role of the functional composition of the beneficiary communities on BFE in a very dry site with cushion benefactors exhibiting contrasting functional compositions of beneficiary communities, we also designed a field study in the Qilian Shan mountain range (China). At this site with a highly continental climate, we compared the number of flowers and fruits of different phenotypes of the alpine cushion species Thylacospermum caespitosum hosting numerous graminoids, numerous forbs or very few beneficiary species.

In the intercontinental study, we found a negative relationship between graminoids and cushion benefactor flower density but no effect of other functional groups. The negative BFE of graminoids increased with increasing summer drought. In the dry Qilian Shan range, we found both a negative effect of graminoids on total flower density and a positive effect of forbs on flower density and fruit set.

Our study indicates that the context dependence of BFE may be partially explained by the composition of beneficiary communities and in particular the negative effect of graminoids.
Experimental reduction of haematocrit affects reproductive performance in European starlings
Authors: Fronstin Raime B. , Christians Julian K. , Williams Tony D.
Published: July 2015

Given the function of haemoglobin and observed increases in haematocrit during periods of increased energetic demands, haematocrit and haemoglobin are assumed to be related to aerobic capacity. Reductions in haematocrit and haemoglobin during reproduction are similar in magnitude to increases associated with aerobically demanding activities, and therefore, we sought to investigate whether these reductions in haematology have consequences for reproductive performance.

We analysed associations between natural variation in haematology in free‐living European starlings (Sturnus vulgaris) and reproductive performance. To test whether transient reductions in haematology during different stages of reproduction (egg production and late incubation/early chick rearing) affected measures of reproductive performance, we also manipulated haematology using phenylhydrazine (PHZ), which lyses red blood cells.

To investigate effects of reductions of haematology during egg‐laying, we treated females with PHZ or saline (control) upon completion of their unmanipulated first clutch and removed eggs to induce the production and rearing of a replacement clutch. To investigate effects of reductions of haematology during chick rearing, we treated females during incubation of the unmanipulated first clutch and then monitored the subsequent hatching and rearing of the clutch.

Individuals with higher haematocrit and haemoglobin initiated nesting earlier. Furthermore, higher haemoglobin levels during incubation were associated with a greater number of chicks fledged.

PHZ treatment prior to egg production resulted in a significant delay in the laying of replacement clutches, but had no effect on provisioning rate or the size or number of chicks fledged. PHZ treatment during incubation and early chick rearing resulted in decreased hatchling mass in all years and a decrease in the size and number of fledglings in one of 2 years. The year that the effect of PHZ was observed appeared to be a particularly difficult year, as hatchling mass, brood size at hatching and at fledging were low among control females compared to other years.

Our results suggest that a reduction in haematology during reproduction can be functionally significant, but that these costs are context‐dependent.
Statewide Hospital Discharge Data: Collection, Use, Limitations, and Improvements
Authors: Andrews Roxanne M.
Published: July 2015

Objectives

To provide an overview of statewide hospital discharge databases (HDD), including their uses in health services research and limitations, and to describe Agency for Healthcare Research and Quality (AHRQ) Enhanced State Data grants to address clinical and race–ethnicity data limitations.

Principal Findings

Almost all states have statewide HDD collected by public or private data organizations. Statewide HDD, based on the hospital claim with state variations, contain useful core variables and require minimal collection burden. AHRQ's Healthcare Cost and Utilization Project builds uniform state and national research files using statewide HDD. States, hospitals, and researchers use statewide HDD for many purposes. Illustrating researchers' use, during 2012–2014, HSR published 26 HDD‐based articles on health policy, access, quality, clinical aspects of care, race–ethnicity and insurance impacts, economics, financing, and research methods. HDD have limitations affecting their use. Five AHRQ grants focused on enhancing clinical data and three grants aimed at improving race–ethnicity data.

Conclusion

ICD‐10 implementation will significantly affect the HDD. The AHRQ grants, information technology advances, payment policy changes, and the need for outpatient information may stimulate other statewide HDD changes. To remain a mainstay of health services research, statewide HDD need to keep pace with changing user needs while minimizing collection burdens.
Efficacy of Neutral pH Electrolyzed Water in Reducing Escherichia coli O157:H7 and Salmonella Typhimurium DT 104 on Fresh Produce Items using an Automated Washer at Simulated Food Service Conditions
Authors: Afari George K. , Hung Yen‐Con , King Christopher H.
Published: July 2015

The objective of this study was to determine the efficacy of neutral pH electrolyzed (NEO) water (155 mg/L free chlorine, pH 7.5) in reducing Escherichia coli O157:H7 and Salmonella Typhimurium DT 104 on romaine lettuce, iceberg lettuce, and tomatoes washed in an automated produce washer for different times and washing speeds. Tomatoes and lettuce leaves were spot inoculated with 100 μL of a 5 strain cocktail mixture of either pathogen and washed with 10 or 8 L of NEO water, respectively. Washing lettuce for 30 min at 65 rpm led to the greatest reductions, with 4.2 and 5.9 log CFU/g reductions achieved for E. coli O157:H7 and S. Typhimurium respectively on romaine, whereas iceberg lettuce reductions were 3.2 and 4.6 log CFU/g for E. coli O157:H7 and S. Typhimurium respectively. Washing tomatoes for 10 min at 65 rpm achieved reductions greater than 8 and 6 log CFU/tomato on S. Typhimurium and E. coli O157:H7 respectively. All pathogens were completely inactivated in NEO water wash solutions. No detrimental effects on the visual quality of the produce studied were observed under all treatment conditions. Results show the adoption of this washing procedure in food service operations could be useful in ensuring produce safety.
The Effect of Information on Uncertainty and the Cost of Capital
Authors: Johnstone David
Published: July 2015

It is widely held that better financial reporting makes investors more confident in their predictions of future cash flows and reduces their required risk premia. The logic is that more information leads necessarily to more certainty, and hence lower subjective estimates of firm “beta” or covariance with other firms. This is misleading on both counts. Bayesian logic shows that the best available information can often leave decision makers less certain about future events. And for those cases where information indeed brings great certainty, conventional mean‐variance asset‐pricing models imply that more certain estimates of future cash payoffs can sometimes bring a higher cost of capital. This occurs when new or better information leads to sufficiently reduced expected firm payoffs. To properly understand the effect of signal quality on the cost of capital, it is essential to think of what that information says, rather than considering merely its “precision,” or how strongly it says what it says.
Outside Blockholders' Monitoring of Management and Debt Financing: An Alternative Perspective
Authors: Nikolaev Valeri V.
Published: July 2015

Liao () argues that the monitoring by large outside shareholders (blockholders) exacerbates the conflict between debt and equity and in turn affects the choice and structure of debt financing. The study contends that private debt is more immune to the increase in debt‐equity conflict. Consistent with this argument, companies with outside blockholders are inclined to issue private debt over public debt. Further, private debt exhibits less price protection but relies on more protective covenants than does public debt. The findings are interesting and intuitive. I evaluate the economic arguments in the paper and discuss some of the challenges that the study faces. My conclusion is that the interpretation of the results is more complex than the one the study presents. I offer a broader framework that can be used to shed light on why the governance structure combines equity blockholders and private debt issuance. I also discuss several questions to be addressed by future research.
Cross‐Country Evidence on the Importance of Auditor Choice to Corporate Debt Maturity
Authors: El Ghoul Sadok , Guedhami Omrane , Pittman Jeffrey A. , Rizeanu Sorin
Published: July 2015

We examine the importance of Big Four audits in reducing agency costs evident in corporate debt maturity worldwide. Analyzing a large sample of public firms from 42 countries reveals that the fraction of long‐term debt in firms' capital structures rises with the presence of a Big Four auditor, suggesting that higher‐quality audits substitute for short‐term debt for monitoring purposes. In additional analyses, we find that the role that auditor choice plays in debt maturity is concentrated in firms from countries with strong legal institutions governing property rights and creditor rights. Collectively, our research implies that Big Four audits matter to corporate debt maturity, although the impact is isolated in firms operating in countries with more protective legal regimes.
Association of TCF7L2 Polymorphism with Diabetic Nephropathy in the South Indian Population
Authors: Bodhini Dhanasekaran , Chidambaram Manickam , Liju Samuel , Prakash Visvanathan G. , Gayathri Vijay , Shanthirani Coimbatore S. , Ranjith Unnikrishnan , Anjana Ranjit M. , Mohan Viswanathan , Radha Venkatesan
Published: July 2015

The transcription factor 7‐like 2 (TCF7L2) gene plays a significant role in the development of type 2 diabetes and diabetic nephropathy. The aim of this study was to investigate the association of TCF7L2 rs12255372 (G/T)polymorphism with type 2 diabetic nephropathy in the South Indian population. A total of 2102 subjects, 927 normal glucose tolerant (NGT) subjects, 598 type 2 diabetic subjects without nephropathy (DM), and 577 type 2 diabetic subjects with nephropathy (DN) were genotyped by MassARRAY. As compared to the NGT group, the odds ratio (adjusted for age, sex, BMI, HbA1c, and systolic BP) computed for the GT/TT genotype taking the GG genotype as reference was found to be 2.02 (95% CI: 1.16‐3.51, p = 0.013) for DN and 1.94 (95% CI: 1.36‐2.78, p = 0.0002) for DM. The genotype frequency was not significantly different between the DM and DN groups. In conclusion, the rs12255372 polymorphism in the TCF7L2 gene is associated with type 2 diabetes and DN but its association with DN is mediated through diabetes.
Three suturing techniques for closing fusiform excisions. A randomised controlled study
Authors: Ling Nicholas , Martin Andrew
Published: July 2015

Background/Objectives

Australian doctors perform over one million skin excisions yearly. There are few randomised trials studying wound repair. The objective was to compare two suture techniques with controls for simple elliptical excisions in a prospective, randomised, single‐blinded study.

Materials

One half of each wound was randomised to either one‐layer closure with percutaneous nylon or modified two‐layer closure where superficial closure was effected with adhesive tape. The control was the standard two‐layer closure. Primary outcome measure was wound width at 6 months, with cosmesis as the secondary outcome.

Results

A total of 161 participants with 214 excisions were recruited from general practice. There was no significant difference in the primary outcome of wound width at 6 months between the groups. One‐layer closure showed slight inferiority for cosmesis at 6 months versus the control. There was significant superiority for the modified two‐layer closure versus the control for cosmesis at 6 months, and early wound erythema. Multivariate regression models adjusted for suture technique showed that younger age, wound infection and truncal location were predictors of increased scar width. Older age, wound erythema, and male gender were predictors of poorer patient‐rated outcome.

Conclusion

One‐layer closure is an acceptable choice for elliptical excision wound closure. Modified two‐layer closure may be preferable to standard two‐layer closure for elliptical wounds.
Current concepts in vulvodynia with a focus on pathogenesis and pain mechanisms
Authors: Thornton Alicia M , Drummond Catherine
Published: July 2015

Vulvodynia is a common and debilitating chronic pain syndrome characterised by neuropathic‐type pain. Localised provoked vulvodynia is the most common type, followed by generalised unprovoked vulvodynia. Vulvodynia is a diagnosis of exclusion. The cause is unknown but current research suggests an underlying predisposition to increased sensitivity to pain and peripheral and central neural sensitisation. Musculoskeletal factors also play an important role. Vulvodynia has a significant impact on the quality of life, mood, functional ability and relationships of patients and their partners. It is highly associated with anxiety and depression. Treatment needs to follow a biopsychosocial model and be tailored to the patient. A multimodal and multidisciplinary approach is often most effective. We have suggested a therapeutic ladder.
Exploring divergences in comparative research: citizenship regimes and the spectacular cities of Central Asia and the GCC
Authors: Koch Natalie
Published: July 2015

Interrogating the concept of ‘legality’ and how it relates to local citizenship regimes, this article shows how a focus on cross‐regional divergences can offer theoretical insights into the political implications of projects that, on the surface, appear to be strikingly similar. Taking the case of apparently similar spectacular capital city development schemes in the resource‐rich states of Central Asia and the Gulf Cooperation Council (GCC), I show that there are significant differences in the underlying political geographic and political economic factors that makes them possible, as well as the political relations they sustain and produce. Like most states around the world, foreigners represent a minority of the overall population of the Central Asian states, but in the GCC, citizens are in the minority of the population in most countries. Because of this political configuration, the capital city development schemes are broadly coded as legal and legitimate in the Gulf, but illegal and corrupt in Central Asia. By honing in on these two different regions, this study shows how the state's power to define citizenship, and thus who is entitled to its resources, is a tremendously powerful technology of government, which hinges on actively constructing a binary between the ‘legal’ and ‘illegal’.
A systematic review of the role of community pharmacies in improving the transition from secondary to primary care
Authors: Nazar Hamde , Nazar Zachariah , Portlock Jane , Todd Adam , Slight Sarah P.
Published: July 2015

Aim

We set out to determine the potential contribution of community pharmacists to improve the transfer of care of patients from secondary to primary care settings.

Method

We systematically reviewed the literature on interventions that involved community pharmacy post‐discharge. We considered all relevant studies, including both randomized and non‐randomized controlled trials, irrespective of patient population. Our primary outcome was any impact on patient and medication outcomes, while the secondary outcome was to identify intervention characteristics that influenced all reported outcomes.

Results

We retrieved 14 studies that met our inclusion criteria. There were four studies reporting outcomes relating to the identification and rectification of medication errors that were significantly improved with community pharmacy involvement. Other patient outcomes such as medication adherence and clinical control were not unanimously positively or negatively influenced via the inclusion of community pharmacy in a transfer of care post‐discharge intervention. Some inconsistencies in implementation and process evaluation of interventions were found across the reviewed studies. This limited the accuracy with which true impact could be considered.

Conclusions

There is evidence that interventions including a community pharmacist can improve drug related problems after discharge. However, impact on other outcomes is not consistent. Further studies are required which include process evaluations to describe fully the context of the intervention so as to determine better any influencing factors. Also applying more stringent controls and closer adherence to protocols in both intervention and control groups would allow clearer correlations to be made between the intervention and the outcomes.
Switching among Equivalents in Chronic Cardiovascular Therapies: ‘Real World’ Data from Italy
Authors: Poluzzi Elisabetta , Veronese Giacomo , Piccinni Carlo , Raschi Emanuel , Koci Ariola , Pagano Paola , Godman Brian , Marchesini Giulio , Boriani Giuseppe , De Ponti Fabrizio
Published: July 2015

Since August 2012, Italian general practitioners are required to prescribe the generic name of medicines, except for refill of chronic therapy. We evaluated the extent of switching among equivalents in chronic cardiovascular therapies, the influence of the 2012 regulatory intervention and of patient‐related or drug‐related factors. Prescriptions of off‐patent anti‐arrhythmics, oral antidiabetics and ACE inhibitors dispensed from August 2011 to August 2013 within the Bologna Local Health Authority (870,000 inhabitants) was collected. The rate of actual switching among equivalents was evaluated monthly. The effect of the regulatory intervention was estimated by interrupted‐time‐series analysis. Adjusted odds ratios (aORs) of switching were calculated for the following: age, gender, number of different equivalents available for each drug and change in dispensing pharmacy between subsequent refills. The average monthly rates of switches were 9.6%, 16.3% and 16.3% for anti‐arrhythmics, antidiabetics and ACE inhibitors, respectively. Values significantly increased soon after the regulatory intervention for ACE inhibitors (+1.81%, p < 0.01), anti‐arrhythmics (+1.46%, p = 0.01) and antidiabetics (+1.09%, p = 0.01), and no significant decreasing trends were observed in the following 12 months. For all drug classes, odd of switching was higher in case of change in dispensing pharmacy (up to aOR = 4.31, 95 CI = 4.26–4.35 for ACE inhibitors) and availability of ≥5 different equivalents (up to aOR = 7.82, 95 CI = 7.39–8.28 for antidiabetics). Switching was lower for age ≥65 for antidiabetics and ACE inhibitors (aOR = 0.92, 95 CI = 0.90–0.93; 0.87, 0.86–0.88, respectively). The Italian regulatory intervention generated an immediate increase, not sustained in time, in switching among equivalents of cardiovascular therapies. Young age, high number of available equivalents and changes in dispensing pharmacy between subsequent refills were associated with switching.
The Development of Children's Memory
Authors: Schneider Wolfgang , Ornstein Peter A.
Published: July 2015

The development of memory has been studied for more than a century and is one of the most active areas of research in cognitive development. In this article, we first describe historical developments in research on children's memory, focusing on systematic studies that began in the late 1960s. We then describe three important new lines of inquiry: short‐ and long‐term memory development in infancy, the development of autobiographical memory, and longitudinal research on memory strategies and metamemory. We end by contrasting research on memory development with that on the development of memory, and identifying an emerging interest in biological and social factors that affect developmental change.
Individual Differences in Childhood Behavior Disorders Associated With Epigenetic Modulation of the Cortisol Receptor Gene
Authors: Dadds Mark R. , Moul Caroline , Hawes David J. , Mendoza Diaz Antonio , Brennan John
Published: July 2015

Behavioral/emotional difficulties in children are the first sign of mental health problems. These problems are however, heterogeneous. A domain that may identify homogenous subgroups is hypothalamic–pituitary–adrenal function. This study tested whether epigenetic regulation of glucocorticoid receptor gene could explain the co‐occurrence of anxiety problems in children with behavior problems. Four‐ to 16‐year‐old clinically referred children (N = 241) were measured for psychiatric symptoms, methylation of target CpG sites in blood or saliva, and morning cortisol levels in those who gave blood. Increased methylation of promoter 1F CpG sites was associated with higher vulnerability to co‐occurring internalizing symptoms and morning cortisol. The results support increasing optimism that epigenetic regulation of key neuroendocrine systems might help explain hitherto unfathomable individual differences in susceptibility to psychiatric symptom profiles.
Expectations About Ethnic Peer Group Inclusivity: The Role of Shared Interests, Group Norms, and Stereotypes
Authors: Hitti Aline , Killen Melanie
Published: July 2015

This study investigated three factors that contribute to social exclusion: group norms, individual characteristics, and stereotypes. Non‐Arab American 12‐ and 16‐year‐olds (N = 199) judged their expectations about the inclusivity of Arab American and non‐Arab American peer groups toward new peers characterized by: (a) different ethnic identity but similar interests (e.g., hobbies) and (b) same ethnic identity but different interests. Participants expected that when groups had exclusive norms, Arab American peers would base inclusion decisions on ethnic identity, but that their own non‐Arab group would base decisions on shared interests. Participants who reported stereotypes expected their in‐group to be ethnically less inclusive. With age, ethnic‐based exclusion increased. The findings are discussed in light of current research on developmental intergroup relationships.
Expression of CD11c and EMR2 on neutrophils: potential diagnostic biomarkers for sepsis and systemic inflammation
Authors: Lewis S M , Treacher D F , Edgeworth J , Mahalingam G , Brown C S , Mare T A , Stacey M , Beale R , Brown K A
Published: July 2015

There is a need for cellular biomarkers to differentiate patients with sepsis from those with the non-infectious systemic inflammatory response syndrome (SIRS). In this double-blind study we determined whether the expression of known (CD11a/b/c, CD62L) and putative adhesion molecules [CD64, CD97 and epidermal growth factor (EGF)-like molecule containing mucin-like hormone receptor (EMR2)] on blood neutrophils could serve as useful biomarkers of infection and of non-infectious SIRS in critically ill patients. We studied 103 patients with SIRS, 83 of whom had sepsis, and 50 healthy normal subjects, using flow cytometry to characterize neutrophils phenotypically in whole blood samples. Patients with SIRS had an increased prevalence of neutrophils expressing CD11c, CD64 and EMR2 in comparison with healthy subjects (P < 0·001), but normal expression of CD11a, CD11b, CD62L and CD97. An increase in the percentage of neutrophils bearing CD11c was associated with sepsis, EMR2 with SIRS and CD64 with sepsis and SIRS. Neutrophils expressing CD11c had the highest sensitivity (81%) and specificity (80%) for the detection of sepsis, and there was an association between the percentage of neutrophils expressing EMR2 and the extent of organ failure (P < 0·05). Contrary to other reports, we did not observe an abnormal expression of CD11b or CD62L on neutrophils from patients with SIRS, and suggest that this discrepancy is due to differences in cell processing protocols. We propose that blood neutrophils expressing CD11c and EMR2 be considered as potential biomarkers for sepsis and SIRS, respectively.
Obesity prevalence in Norwegian adults assessed by body mass index, waist circumference and fat mass percentage
Authors: Kjær I. G. H. , Kolle E. , Hansen B. H. , Anderssen S. A. , Torstveit M. K.
Published: July 2015

The prevalence of obesity presents serious public health challenges worldwide and is most commonly estimated by the categorization of body mass index (BMI). The purpose of this study was (i) to describe the sensitivity of BMI, waist circumference (WC) and fat mass percentage in the classification of overweight and obesity and (ii) to describe the prevalence of overweight and obesity using different measurement methods in a national sample of Norwegians. A total of 904 Norwegians (20–85 years) were randomly enrolled. Body weight, height, WC and skinfold thickness were measured; BMI and fat mass percentage (FPskf) were calculated. The sensitivity and specificity varied from 77.0% to 86.9% and from 60.6% to 82.3%, respectively. Area under the curve was 0.837 (95% confidence interval [CI]: 0.801–0.872) for the ability of BMI to predict obesity by FPskf and 0.811 (95% CI: 0.770–0.852) for WC. A total of 12.7% (male: 12.1%, female: 13.4%) were obese based on BMI classifications, 29.1% (male: 36.5%, female: 20.0%) of the sample were obese based on FPskf and 24.3% of men and 37.8% of women were abdominally obese by WC. The agreement between selected measuring methods was fair to good, although the variation in obesity prevalence rates between the different assessments methods varied markedly.
The Integrative Business Experience: Real Choices and Real Consequences Create Real Thinking
Authors: McCord Mary , Houseworth Matthew , Michaelsen Larry K.
Published: July 2015

This article describes an innovation called the Integrative Business Experience (IBE) that links a set of required core business courses to an entrepreneurial practicum course in which two things occur. One is that students are concurrently enrolled in the required core business courses and a practicum course while they create a start‐up business (based on an actual bank loan) and use the profits to finance a hands‐on community service project. The other is that the core courses are taught using the Team‐Based Learning (TBL) to shift the focus of class work from content delivery to content application, and promote the development of interpersonal and team skills.

The wide acceptance of the value of active learning over the past 30 years has supported the foundation of Kolb's Experiential Learning Theory, i.e., learning is transformed through experience. IBE provides students with a transformative experience that can engage them in every learning style in Kolb's model. IBE combined with TBL fosters development of the teamwork, interpersonal, and communication skills necessary for effective problem‐solving.

This article uses Kolb's cycle of learning to describe how and why the real experience provided by IBE enables students to develop the ability to engage in analytical thinking through practical reasoning, reflective exploration of meaning, and multiple framing. Further, because students’ experiences in IBE are real, they are able to reflect on their personal identities and values as they make decisions in both their business and service activities, and experience the consequences of their choices.