bluuebunny/crossref_metadata_2025 huggingface dataset:
Household food providers’ attitudes to the regulation of food marketing and government promotion of healthy foods in five countries in the Asia Pacific region
Authors: Worsley Anthony , Wang Wei Chun , Sarmugam Rani , Pham Quynh , Februhartanty Judhiastuty , Ridley Stacey
Published: June 2018

Purpose

The purpose of this paper is to understand middle class household food providers’ attitudes to the regulation of food marketing and the promotion of healthy food practices.

Design/methodology/approach

A cross-sectional, online questionnaire survey was administered to 3,925 urban respondents in Indonesia, Melbourne, Shanghai, Singapore and Vietnam. Cross-tabulation, confirmatory factor analyses and multiple regression analyses were employed.

Findings

Most respondents supported government communications to promote healthy eating and to a lesser extent, regulatory measures to control unhealthy food marketing. Personal values and country of residence were more strongly associated with the respondents’ views than demographic variables. Overall, strongest support for nutrition promotion and for stricter regulation of food marketing was seen in Shanghai, Indonesia and Vietnam. Broadly, two groups were identified across the region: those who held equality-nature or tradition-security-conformity personal values, who disapproved of food marketing but supported government health promotion campaigns, and, those with stronger hedonist values who held opposite views.

Research limitations/implications

First, a wider range of personal values could be included in future studies to better represent Asian values. Second, changes in population views could be assessed in future longitudinal studies. Finally, future studies should include dietary assessments and the views of people from a variety of socio-economic and cultural backgrounds.

Practical implications

These findings suggest that health policy makers and communicators need to frame their communications to match the world views of household food providers in their countries.

Originality/value

The study provides confirmation of attitude-values theories within five different countries in the Asia Pacific region and demonstrates the importance of personal values and country of residence in influencing food providers’ views.
Factors influencing consumers’ willingness to participate in new food product development activities
Authors: Hoppe Alexia , De Barcellos Marcia Dutra , Perin Marcelo Gattermann , Jacobsen Lina Fogt , Lähteenmäki Liisa
Published: June 2018

Purpose

Consumers can be an interesting source of knowledge if companies manage to attract them to an interactive process of new product development (NPD). The purpose of this paper is to investigate factors influencing consumers’ willingness to participate in NPD activities.

Design/methodology/approach

A survey with 1,038 respondents was held in Denmark. Food products for weight management were used as an example to further explore these issues and test the research hypotheses. Data were analysed by means of hierarchical regression analysis.

Findings

Results indicated that consumer innovativeness is a key factor to stimulate participation. An increase in either cognitive or emotional dimensions also encourages consumer interaction with the company. Weight perception and willingness to participate is moderated by age group. These findings can help managers to identify key segments when developing new food products for weight management.

Originality/value

This study has proposed and tested a model based on relevant literature and validated scales using a model generation approach to discuss motivations and factors that influence willingness to participate in NPD projects in the food sector.
Landscape view, height preferences and apartment prices: evidence from major urban areas in Indonesia
Authors: Hasanah Andi Nidaul , Yudhistira Muhammad Halley
Published: June 2018

Purpose

Landscape view is a crucial factor in house-buying decisions. Landscape views provide an amenity to residents, and this can influence the house or apartment owners in their residence decisions. Yet, the relative value of different types of view potentially differs. Additionally, the value of each type of view may differ depending on an apartment’s elevation above the ground level. In this study, the authors aim to estimate the value of landscape views on apartment prices in major urban areas in Indonesia.

Design/methodology/approach

This paper evaluates to what extent various landscape views including mountain, sea, river, lake, street, urban village, garden and sports center views affect apartment prices in major urban areas in Indonesia. Two hedonic regression approaches are used: ordinary least squares and semiparametric regression. The latter is used to accommodate a possible non-linearity in the relationship between price and apartment characteristics. The model also incorporates housing and locational characteristics as control variables.

Findings

Using online apartment market data, the estimates in this paper show some degree of heterogeneity in the value of various views to the extent of providing negative externalities. Mountain, street and sports center views are associated with higher apartment prices. Sea, lake and garden views are statistically insignificant in explaining the prices. In contrast, the unappealing nature of the rivers and their surrounding creates a negative impact on prices. The estimates also suggest that an apartment’s floor height plays a significant role in the valuation of views.

Originality/value

There is little research on landscape view effects on apartment prices, especially in Indonesia. In addition, the relationship between the value of views and height preferences has seldom been analyzed. This paper provides the valuation of an extensive list of landscape views in urban areas in Indonesia. The estimation results also suggest that the value of views may differ depending on the floor on which an apartment lies.
Why research is needed in women entrepreneurship in India: a viewpoint
Authors: Agarwal Sucheta , Lenka Usha
Published: June 2018

Purpose

The spirit of entrepreneurship among nationals of a country leads and contributes significantly to the growth process of a country. In this drive, there cannot be gender biases among men and women. The government in India has taken several initiatives to increase the participation of women entrepreneurs and, thus, making a partner to the growth and development process of the country. The initiatives in this direction were taken up through five-year development policy plans commencing from the fifth five-year plan (1974-1978). The focus of five-year plans since then has been reoriented toward women welfare stressing more specifically on women empowerment through women entrepreneurship programs. The purpose of this paper is to appraise the series of development plans and programs initiated for the empowerment of women entrepreneurship in India.

Design/methodology/approach

The paper is developed based on the concepts, policies and practices being implemented across the regions to promote women entrepreneurs. The methodology adopted to assess and analyze the relevant components very much matches the existing practices. The paper relates the concepts, programs and practices. This study has revealed certain issues based on the available data and information on women entrepreneurship to establish a view and rational as of why research is needed in the area of women entrepreneurship. To support this concept, the study has considered the experiences of two important states of India, namely, Uttar Pradesh and Uttarakhand.

Findings

The study reveals that Government of India has launched several policies and development programs to infuse the spirit of entrepreneurship among the women groups and thereby not only making them financially self-sustained but also to contribute to the growth process of the economy. However, there remain many gaps in achieving the goals due to the variety of factors. This becomes more significant as the level of women entrepreneurship in India is very low as compared to other economies and also between the men and women entrepreneurs within the country. The study brings out the need and importance for the future research in the area of women entrepreneurship and thereby exploring the areas of concern and bringing out needed improvements to strengthen the women entrepreneurship programs and policies.

Originality/value

This research provides a future direction to the academicians, researchers and policymakers to provide a framework to reorient the programs and policies for the cause of women entrepreneurship growth in India. The paper very much emphasis that the research findings will have influence on government policies and serve as an effective tool for implementation of state programs meant for woman entrepreneurs more effectively and efficiently. The ultimate impact of research findings will be an economic change in the quality of life of woman enterprise in the society.
No one can whistle a symphony: how hospitals design for daily cross-boundary collaboration
Authors: Prætorius Thim , Hasle Peter , Nielsen Anders Paarup
Published: June 2018

Purpose

The purpose of this paper is to investigate how and with which mechanisms health care professionals in practice design for collaboration to solve collective hospital tasks, which cross occupational and departmental boundaries.

Design/methodology/approach

An in-depth multiple-case study of five departments across four hospitals facing fast to slow response task requirements was carried out using interviews and observations. The selected cases were revealing as the departments had designed and formalized their daily hospital operations differently to solve collaboration and performance issues.

Findings

Local collaboration across occupational and departmental boundaries requires bundles of behavioral formalization elements (e.g. standardized plans, resource allocation decisions, assigned formal roles, and handoff routines), and liaison devices (e.g. huddles, boards, and physical proximity), which are used in parallel or sequence. The authors label this “designed collaboration bundles.” These bundles supplement the central organizational structures, processes, and support systems less capable of ensuring fluent coordination at the front line.

Practical implications

Health care professionals and hospital managers can consider designing bundles of organizational design features to proactively develop and ensure collaboration capable of solving collective tasks and bridging departmental and occupational silos to improve health care delivery.

Originality/value

This research paper addresses the fundamental organizational challenge of how to achieve efficient collaboration by studying how formal structures and processes are used in combination on the hospital floor, thereby going beyond previous research that studies these mechanisms individually.
Unraveling the impact of destination reputation on place attachment and behavior outcomes among Chinese urban tourists
Authors: Su Lujun , Huang Yinghua , Hsu Maxwell
Published: June 2018

Purpose

The impact of destination reputation on tourists’ behavior has not received sufficient attention in the tourism literature. Built upon the signaling theory and the well-documented stimulus-organism-response framework, the purpose of this paper is to propose and assess a theoretical model that captures relationships among destination reputation, place attachment, tourist satisfaction, and the search for alternative destinations.

Design/methodology/approach

Using the covariance-based structural equation modeling technique, this study empirically tested the conceptual model with a convenience sample of Chinese tourists who visited a popular coastal urban tourism destination in China.

Findings

Findings reveal that destination reputation positively impacts perceived place dependence, place identity, and tourist satisfaction. In addition, place dependence positively affects tourist satisfaction, but place identity has no significant impact on tourist satisfaction. As expected, tourist satisfaction negatively influences tourists’ search for alternative destinations; however, place identity positively influences tourists’ search for alternative destinations.

Originality/value

Few studies in the tourism literature explore the role of destination reputation in the tourist decision-making process. The present study’s unique contribution lies in its examination of destination reputation on tourists’ behavior. In addition, this study includes the search for alternative destinations as an important behavioral outcome into the proposed model. Some tourists explore alternative destinations even though they are willing to revisit and spread positive messages about the destination they already visited. Therefore, the continuous searching behavior is worthy of investigation in tourism studies.
Grassroots festival keeps city alive during severe drought
Authors: Mason Andrew , Scollen Rebecca
Published: June 2018

Purpose

This paper aims to discuss the role of a grassroots initiative in engaging local people in an innovative place-making fringe festival. Festivals such as the Carnival of Flowers are a major tourism event for regional cities like Toowoomba and contribute to place-making through marketing and engagement. Within the professional management of such events, there exists space for innovation and genuine community involvement, which can assist in authentically reflecting place identity. Avant Garden (2007-2008) models a successful grassroots fringe festival, initiated by community members in response to the challenge of long-term drought. Avant Garden engaged locals and tourists in a positive re-imagining of place via site-specific public artworks generated by the community.

Design/methodology/approach

A survey of 504 visitors to Toowoomba’s public gardens during the first weekend of the 2007 Carnival of Flowers examined how Avant Garden was received by the community.

Findings

The paper suggests that fringe festivals can provide place-making capacity in broadening festivals as an expression of local identity. Fringe festivals can allow authentic community engagement within a mainstream festival and can indicate longer-term innovations to place branding.

Practical implications

The paper includes implications for festival managers about effective ways to engage community in grassroots initiatives which reflect innovation, authenticity and greater diversity.

Originality/value

The paper provides a study of a visual arts fringe festival in the context of place management. The project described allows a “bottom up” approach to engaging the local community which provides authenticity and broadens the scope of an existing mainstream garden festival.
“Fête de la Soupe”: rural identity, self-representation, and the(re)-making of the village in France
Authors: Ducros Hélène B.
Published: June 2018

Purpose

The purpose of this paper is to explore a grassroot festival in rural France organized around the concept of soup. The annual fête de la soupe held in a village in Auvergne provides a small-scale example of the ways in which space, time and festivalization interact in placemaking.

Design/methodology/approach

Ethnographic research highlights the motivations and experiences of the organizers and volunteer-participants, as well as some of the organizational challenges.

Findings

Revealing that the profit motive and economic outcomes are not dominant, this paper shows instead that the fête constitutes a space of relation-building between place and people, between people themselves and an introspective moment over the past and future of place as “rural”. While preserving rurality symbolized and mediated by the exchange of soup as the ultimate peasant dish, the festival is also an opportunity for villagers to revitalize the rural and showcase it as a place of creativity.

Originality/value

The study addresses the experience of volunteers and organizers in festivals, uses qualitative methods to do so and focuses on festivals in the rural setting, filling three gaps identified by others in the literature.
Multiple place/s: exploring the link between urban politics and rural festival environments
Authors: Catanzaro Michelle , James Elissa
Published: June 2018

Purpose

This paper aims to explore how the entertainment economy excludes individuals and facilitates private investment, the problematic shift towards a “creative economy” and increased regulations within Sydney’s entertainment sector. It also examines how a grass-roots, rural festival can be regarded as an extension of the urban context. It discusses the alternative counterculture(s) that exist despite (or perhaps because of) increasing inaccessibility and regulation, using as a case study an activist collective created in this climate, the Marrickville Warehouse Alliance, focusing specifically on its Star Shitty River Retreat festival.

Design/methodology/approach

A phenomenological, mixed-method approach is used with a focus on qualitative in-depth interviews with festival organisers.

Findings

This paper demonstrates how politics, embedded within urban place, can be transported to a rural festival site. The phenomenological accounts recorded with the festival organisers, paired with key theories within the literature, demonstrate how organising committees can shape the understanding of place and politics in grass-roots festival environments.

Social implications

By leaving “no trace” on the site and engaging with and contributing to the indigenous community, the Star Shitty River Retreat festival can be categorised as a type of “creative enhancement”, in which a shared environment of political and communal understanding creates a unique, yet temporary, sense of place within a rural setting.

Originality/value

There is limited literature on the Australian festival context. The finding that rural festival sites can be regarded as an extension of the urban context lends itself to the concept of de-territorialisation or blurring of city boundaries, reinforcing how a festival’s geographical location is of little significance when supported by “portable communities”.
Millennial managers: exploring the next generation of talent
Authors: Gerard Nathan
Published: June 2018

Purpose

While considerable scholarly attention has been given to “millennials” (those born between 1981 and 1997), little is known of this generation’s ability to influence healthcare organizations and managerial roles in particular. This paper aims to clarify why millennials enter the healthcare management field and how their motivations correlate with preferences for working in various healthcare sectors and with various patient populations.

Design/methodology/approach

Survey data were collected from 107 millennials pursuing bachelor degrees in healthcare management by using a modified version of the multidimensional work motivation scale. Further data were collected on millennials’ preferences for working in various healthcare sectors and with various patient populations. Correlational analyses were conducted to examine the relationship between types of motivation and workplace preferences. Cross-cultural differences were also examined within this generational set.

Findings

Results indicate a significant positive relationship between intrinsic motivation and preferences for working on the payer side of the industry and within finance and IT functions. Findings also reveal a significant positive relationship between prosocial motivation and preferences for working with more vulnerable patient populations. Variance in work motivation among cultural sub-sets of millennials suggests different upbringings, or alternatively, cultural relativity of the motivational constructs themselves.

Research limitations/implications

Despite offering key insights into the next generation of healthcare managers, this study is limited by a sample of millennials from one large, metropolitan university in the USA and thus may not represent the views of all millennials.

Practical implications

To select, retain and develop the next generation of healthcare managers, it is incumbent upon organizations to better understanding millennials’ motivations and preferences.

Originality/value

This study is the first of its kind to illuminate the motivations and preferences that underpin a key and growing segment of the healthcare workforce. Millennials, now the largest and most diverse generation on the planet, are poised to change the landscape of health care.
Priming employees’ promotion focus
Authors: Yang Fu , Qian Jing , Liu Jun
Published: June 2018

Purpose

The purpose of this paper is to examine the relationship between servant leadership and customer service behaviors by probing the mediating role of promotion focus and the moderating role of internal locus of control.

Design/methodology/approach

The authors hypothesized an indirect relationship between servant leadership and customer service behaviors through promotion focus. Also, the authors predicted that the positive relationship between servant leadership and promotion focus would be stronger for employees with low internal locus of control. The authors tested the theoretical model with data gathered across two phases over three months from 280 supervisor-subordinate dyads.

Findings

Results indicated that servant leadership was positively related to customer service behaviors via promotion focus. Results also showed that internal locus of control moderated the relationship between servant leadership and promotion focus, such that the relationship was stronger for employees low on internal locus of control. Furthermore, this moderated mediated model was supported. As predicted, the indirect effect was stronger when internal locus of control was low.

Research limitations/implications

This study extends the regulatory focus theory to the service context to investigate how and when servant leadership enhances customer service behaviors. The authors suggested promotion focus as a key mediating mechanism and revealed internal locus of control as a boundary condition for the effectiveness of servant leadership.

Originality/value

This study highlights the importance role of promotion focus in fostering customer service behaviors and provides novel theoretical insight regarding when servant leadership enhances customer service behaviors.
Exploring sustainable supply chain management: a social network perspective
Authors: Lu Haiyan Emma , Potter Andrew , Sanchez Rodrigues Vasco , Walker Helen
Published: June 2018

Purpose

The implementation of sustainable supply chain management (SCM) calls for an acknowledgement of uncertainty inherent in complex environment. Confucianist society forms social networks in Confucianist society, called guanxi networks, influence economic behaviours and business practices in the workplace. The purpose of this study is to explore how these social networks influence the implementation of sustainable SCM. In doing so, this study aims to critically investigate the constructs of guanxi networks, their impact on flow of supply chain capital and how this leverages the implementation of sustainable SCM.

Design/methodology/approach

Two systematic literature reviews are conducted to understand the constructs of social networks in Confucianist culture and their impacts on the flow of supply chain capitals. The reviews also analyse evidence related to the economic, social and environmental practices to reveal the current state of the literature and research gaps. Propositions and a framework are developed to support future research in this area.

Findings

The constructs of ganqing, renqing, xinren and mianzi in guanxi networks have expanded the contexts of social networks in Western literature. Guanxi networks increase the flow of supply chain capital and generate trust between players, thus enhancing capabilities to implement sustainable SCM. Guanxi networks also create the mechanism of network governance with which to increase sustainable SCM implementation under the institutional logics of sustainability.

Research limitations/implications

The conceptual framework and justification are based on the reviews of current studies in the field. Future empirical study is encouraged to test the propositions, both in Confucianist culture and other countries with culture of social networks.

Originality/value

Social networks are socially constructed concepts. The constructs of guanxi networks revealed in this study have developed the knowledge of Western-based social network theory. Besides, arguments from a social network perspective provide an alternative answer to explain increased behavioural commitment and companies’ investment in sustainable SCM. This study helps practitioners understand the logic of this social norm and to use it to maximise their operation outputs, including sustainable SCM implementation.
Contact line friction and surface tension effects on seismic attenuation and effective bulk moduli in rock with a partially saturated crack
Authors: Rozhko Alexander Y. , Bauer Andreas
Published: June 2018

The effect of surface phenomena occurring at the interfaces between immiscible fluids and a solid on the seismic attributes of partially saturated rocks has not yet been fully studied. Meanwhile, over the past two decades considerable progress has been made in the physics of wetting to understand effects such as contact line friction, contact line pinning, contact angle hysteresis, and equilibrium contact angle. In this paper, we developed a new rock physics model considering the aforementioned effects on seismic properties of the rock with a partially saturated plane‐strain crack. We demonstrated that for small wave‐induced stress perturbations, the contact line of the interface meniscus will remain pinned, while the meniscus will bulge and change its shape through the change of the contact angles. When the stress perturbation is larger than a critical value, the contact line will move with advancing or receding contact angle depending on the direction of contact line motion. A critical stress perturbation predicted by our model can be in the range of ∼102−104 Pa, that is typical for linear seismic waves. Our model predicts strong seismic attenuation in the case when the contact line is moving. When the contact line is pinned, the attenuation is negligibly small. Seismic attenuation is associated with the hysteresis of loading and unloading bulk moduli, predicted by our model. The hysteresis is large when the contact line is moving and negligibly small when the contact line is pinned. Furthermore, we demonstrate that the bulk modulus of the rock with a partially saturated crack depends also on the surface tension and on the contact angle hysteresis. These parameters are typically neglected during calculation of the effecting fluid moduli by applying different averaging techniques. We demonstrate that contact line friction may be a dominant seismic attenuation mechanism in the low frequency limit (<∼10 Hz) when capillary forces dominate over viscous forces during wave‐induced two‐phase fluid flow.
Common Threats and Managing Reputation in Executive Search Firms
Authors: Harvey William S. , Beaverstock Jonathan V. , Li Hongqin
Published: June 2018

A free video abstract to accompany this article can be found online at:https://www.youtube.com/watch?v=IziwDorbeGU

This paper provides important insights into how executive search firms can successfully manage their reputations to overcome major threats to their organizations. The paper focuses on three threats faced by executive search firms: the global financial crisis; questions around the sector's professional status; and the proliferation of social media for recruitment. Our data show that there was not a single coherent response from firms, but a piecemeal approach that focused on three forms of reputation management. First, diversifying service offerings; second, highlighting their symbolic capital; and third, connecting their firms to clients and candidates through partners. Building on our data and the theoretical literature, we provide a framework for understanding how professional service firms can manage their reputations in response to common threats, based on three categories from the English idiom ‘keep up with the Joneses’. First, moving away from the Joneses; second, fencing out the Joneses; third, networking more than the Joneses. We provide theoretical and practical insights around how organizations can manage their reputations in response to threats which are common across sectors.
Distributed leadership and employee cynicism: Trade unions as joint change agents
Authors: Butler Peter , Tregaskis Olga
Published: June 2018

The themes of change management and workplace partnership continue to attract significant academic interest—albeit within discreet literatures. Drawing on longitudinal, qualitative data in a heavy engineering organisation, this article details how a collaborative partnership between management and trade unions, encompassing a distributed leadership format, was configured to enhance organisational capacity for change in the context of significant employee cynicism. Bridging human resource management/organisational behaviour and industrial relations perspectives, the study makes a theoretical contribution to our understanding of the factors underpinning the successful implementation of workplace partnership and the utilisation of distributed leadership configurations. More generally, the work informs leadership theory through its scrutiny of distributed leadership in situations of high conflict.
Clinical characteristics of adolescent cases with Type A insulin resistance syndrome caused by heterozygous mutations in the β‐subunit of the insulin receptor (INSR) gene
Authors: Takasawa Kei , Tsuji‐Hosokawa Atsumi , Takishima Shigeru , Wada Yasunori , Nagasaki Keisuke , Dateki Sumito , Numakura Chikahiko , Hijikata Atsushi , Shirai Tsuyoshi , Kashimada Kenichi , Morio Tomohiro
Published: June 2018

Background

Type A insulin resistance (IR) is a rare form of severe congenital IR that is frequently caused by heterozygous mutations in the insulin receptor (INSR) gene. Although Type A IR requires appropriate intervention from the early stages of diabetes, proper diagnosis of this disease is challenging, and accumulation of cases with detailed clinical profiles and genotypes is required.

Methods

Herein we report on six peripubertal patients with clinically diagnosed Type A IR, including four patients with an identified INSR mutation. To clarify the clinical features of Type A IR due to INSR mutation, we validated the clinical characteristics of Type A IR patients with identified INSR mutations by comparing them with mutation‐negative patients.

Results

Four heterozygous missense mutations within the β‐subunit of INSR were detected: Gly1146Arg, Arg1158Trp, Arg1201Trp, and one novel Arg1201Pro mutation. There were no obvious differences in clinical phenotypes, except for normal lipid metabolism and autosomal dominant inheritance, between Type A IR due to INSR mutations and Type A IR due to other factors. However, our analysis revealed that the extent of growth retardation during the fetal period is correlated with the severity of insulin signaling impairment.

Conclusions

The present study details the clinical features of four patients with genetically proven Type A IR. Further accumulation of genetically proven cases and long‐term treatment prognoses following early diagnosis are required to further elucidate the dynamics of this disease.
Structured tool to improve clinical outcomes of type 2 diabetes mellitus patients: A randomized controlled trial
Authors: Ayadurai Shamala , Sunderland V. Bruce , Tee Lisa B.G. , Md Said Siti N. , Hattingh H. Laetitia
Published: June 2018

Background

Reviewing pharmacist diabetes intervention studies revealed a lack of structured process in providing diabetes care, leading to varied results from increased to minimal improvements. The aim of this study was to determine the effectiveness of the Simpler tool, a structured clinical guidelines tool, in the delivery of diabetes care. The primary outcome was significant improvement in HbA1c. Secondary outcomes were improved lipid profiles and blood pressure (BP).

Methods

A 6‐month parallel multicenter two‐arm, single‐blind randomized controlled trial involving 14 pharmacists at seven primary care clinics was conducted in Johor, Malaysia. Pharmacists without prior specialized diabetes training were trained to use the tool. Patients were randomized within each center to either Simpler care (SC), receiving care from pharmacists who used the tool (n =55), or usual care (UC), receiving usual care and dispensing services (n =69).

Results

Compared with UC, SC significantly reduced HbA1c (mean reduction 1.59% [95% confidence interval {CI} −2.2, −0.9] vs 0.25% [95% CI −0.62, 0.11], respectively;P≤ 0.001), and significantly improved systolic BP (−6.28 mmHg [95% CI −10.5, 2.0] vs 0.26 mmHg [95% CI −3.74, 0.43], respectively;P =0.005). A significantly higher proportion of patients in the SC than UC arm reached the Malaysian guideline treatment goals for HbA1c (14.3% vs 1.5%;P =0.020), systolic BP (80% vs 42%;P =0.001), and low‐density lipoprotein cholesterol (60.5% vs 40.4%;P =0.046).

Conclusions

Using the Simpler tool facilitated the delivery of comprehensive evidence‐based diabetes management and significantly improved clinical outcomes. The Simpler tool supported pharmacists in providing enhanced structured diabetes care.
Effectiveness and cost of radiofrequency ablation and stereotactic body radiotherapy for treatment of early‐stage hepatocellular carcinoma: An analysis of SEER‐medicare
Authors: Parikh Neehar D , Marshall Vincent D , Green Michael , Lawrence Theodore S , Razumilava Nataliya , Owen Dawn , Singal Amit G , Feng Mary
Published: June 2018

Introduction

For early‐stage hepatocellular carcinoma (HCC) patients, ablative strategies are potentially curative treatment options. Stereotactic body radiotherapy (SBRT) has emerged as a promising ablative therapy, although its comparison with radiofrequency ablation (RFA) remains confined to a single institution retrospective review. We sought to characterize the comparative outcomes and cost between the two treatment strategies.

Methods

We conducted a secondary analysis of the Surveillance, Epidemiology, and End Results (SEER)‐Medicare linked database (2004–2011) and identified adult patients with stage I or II HCC and treated with RFA or SBRT as the initial treatment within 6 months of diagnosis. Survival analysis was conducted using Kaplan–Meier curves and multivariate Cox proportional hazard analysis. Factors associated with overall survival and 90‐day hospital admission post‐treatment were identified using propensity score (PS) adjusted multivariate analysis. We performed costs analysis and calculated incremental cost‐effectiveness ratios (ICER).

Results

Four hundred and forty patients were identified, 408 treated with RFA and 32 SBRT. In the overall cohort, 90‐day hospitalization and 1‐year mortality were similar between groups but RFA patients had better overall survival (P < 0.001). Multivariate analysis showed advanced age, higher stage, decompensated cirrhosis, and treatment with SBRT (HR 1.80; 95%CI: 1.15–2.82) was associated with worse survival, but in the PS adjusted analysis, survival and costs were similar between the two groups.

Conclusion

In a national cohort of early stage HCC patients, treatment with RFA vs SBRT resulted in no significant difference in survival, 90‐day hospitalization, or costs. These data highlight the need for a randomized clinical trial comparing these two modalities.
Debugging diversity – a pan‐continental exploration of the potential of terrestrial blood‐feeding leeches as a vertebrate monitoring tool
Authors: Schnell Ida Bærholm , Bohmann Kristine , Schultze Sebastian E. , Richter Stine R. , Murray Dáithí C. , Sinding Mikkel‐Holger S. , Bass David , Cadle John E. , Campbell Mason J. , Dolch Rainer , Edwards David P. , Gray Thomas N. E. , Hansen Teis , Hoa Anh Nguyen Quang , Noer Christina Lehmkuhl , Heise‐Pavlov Sigrid , Sander Pedersen Adam F. , Ramamonjisoa Juliot Carl , Siddall Mark E. , Tilker Andrew , Traeholt Carl , Wilkinson Nicholas , Woodcock Paul , Yu Douglas W. , Bertelsen Mads Frost , Bunce Michael , Gilbert M. Thomas P.
Published: June 2018

The use of environmental DNA (eDNA) has become an applicable noninvasive tool with which to obtain information about biodiversity. A subdiscipline of eDNA is iDNA (invertebrate‐derived DNA), where genetic material ingested by invertebrates is used to characterize the biodiversity of the species that served as hosts. While promising, these techniques are still in their infancy, as they have only been explored on limited numbers of samples from only a single or a few different locations. In this study, we investigate the suitability of iDNA extracted from more than 3,000 haematophagous terrestrial leeches as a tool for detecting a wide range of terrestrial vertebrates across five different geographical regions on three different continents. These regions cover almost the full geographical range of haematophagous terrestrial leeches, thus representing all parts of the world where this method might apply. We identify host taxa through metabarcoding coupled with high‐throughput sequencing on Illumina and IonTorrent sequencing platforms to decrease economic costs and workload and thereby make the approach attractive for practitioners in conservation management. We identified hosts in four different taxonomic vertebrate classes: mammals, birds, reptiles and amphibians, belonging to at least 42 different taxonomic families. We find that vertebrate blood ingested by haematophagous terrestrial leeches throughout their distribution is a viable source of DNA with which to examine a wide range of vertebrates. Thus, this study provides encouraging support for the potential of haematophagous terrestrial leeches as a tool for detecting and monitoring terrestrial vertebrate biodiversity.
Effect of a gonadotropin‐releasing hormone analog for ovarian function preservation after intravenous cyclophosphamide therapy in systemic lupus erythematosus patients: a retrospective inception cohort study
Authors: Koga Tomohiro , Umeda Masataka , Endo Yushiro , Ishida Midori , Fujita Yuya , Tsuji Sosuke , Takatani Ayuko , Shimizu Toshimasa , Sumiyoshi Remi , Igawa Takashi , Fukui Shoichi , Nishino Ayako , Kawashiri Shin‐ya , Iwamoto Naoki , Ichinose Kunihiro , Tamai Mami , Nakamura Hideki , Origuchi Tomoki , Murakami Naoko , Kitajima Michio , Kawakami Atsushi
Published: June 2018

Objective

To determine the effect of leuprolide acetate, a synthetic gonadotropin‐releasing hormone analog (GnRH‐a) on ovarian function preservation in systemic lupus erythematosus (SLE) patients treated with cyclophosphamide (CYC) in clinical practice.

Methods

We enrolled 30 premenopausal female SLE patients who fulfilled the 1997 American College of Rheumatology revised criteria and were treated with intravenous CYC (IVCY) in 2008–2017. We used Kaplan–Meier survival estimates to compare the GnRH‐a‐treated patients and those not treated with GnRH‐a as controls. We performed Cox regression analyses to identify factors associated with premature ovarian failure (POF), incidences of cardiovascular events, strokes and osteoporosis after IVCY therapy.

Results

After a mean follow‐up of 41 months, POF developed in one of the 16 GnRH‐a‐treated patients (6%) versus seven of the 14 controls (50%). Significantly improved cumulative ovarian protection over time was observed in the GnRH‐a‐treated group (P = 0.030). The hazard model analysis showed that treatment with GnRH‐a during IVCY therapy is an independent factor associated with POF after IVCY therapy (adjusted hazards ratio = 0.12, 95% CI 0.01–0.67, P = 0.013) but not incidences of cardiovascular events, strokes or osteoporosis.

Conclusion

The combined use of GnRH‐a with IVCY therapy was associated with a significant reduction of POF among premenopausal women with SLE, suggesting that the addition of GnRH‐a can be a strategy to prevent POF among premenopausal women with SLE after IVCY therapy.
Patients’ concerns regarding biological agents in rheumatology
Authors: Pehlivan Yavuz , Orucoglu Nurdan , Pehlivan Seda , Kimyon Gezmis , Zengin Orhan , Kucuk Adem , Sahin Ali , Tomas Nazmiye , Oksuz Mustafa Ferhat , Kisacik Bunyamin , Akar Servet , Onat Ahmet Mesut , Dalkilic Ediz
Published: June 2018

Objective

The potential side effects of biological agents may increase the anxiety levels of patients and influence not only their desire to use these therapies but also their concordance to treatment. This study aimed to determine the level and prevalence of drug‐related concern in patients treated with biological agents and to acquire additional information regarding the related causes.

Materials and Methods

A total of 1134 patients who were using biological agents for at least 3 months with a diagnosis of rheumatic diseases were enrolled. General anxiety levels were evaluated using the State‐Trait Anxiety Inventory (STAI).

Results

The most common cause for drug‐related concerns was the potential side effects of the drugs (59.5%). Among the potential side effects, cancer risk was the most common cause for concern (40.1%), followed by the risk of tuberculosis activation (30.7%). Anxiety levels were higher in patients who experienced side effects than in other patients, and this difference was statistically significant (P < 0.05). STAI trait and state scores were moderately correlated with anxiety levels related to the drug (P < 0.001).

Conclusion

Anxiety related to biological agents may significantly affect the patients’ anxiety levels. Awareness regarding the patients’ concerns and expectations related to the drug is important to ensure drug adherence and concordance to treatment.
Differences in quality of life determinants according to the presence of fibromyalgia in middle‐aged female patients with systemic lupus erythematosus: a multicenter, cross‐sectional, single‐ethnicity cohort
Authors: Moon Su‐Jin , Kang Kwi Young , Kwok Seung‐Ki , Ju Ji Hyeon , Hong Yeon‐Sik , Park Sung‐Hwan , Jeon Chan Hong , Choi Sang Tae , Song Jung‐Soo , Min Jun‐Ki
Published: June 2018

Objective

The purpose of this study was to identify whether determinants of health‐related quality of life (HRQoL) in middle‐aged female patients with systemic lupus erythematosus (SLE) differed according to the presence or absence of fibromyalgia.

Methods

One hundred and fifty‐two patients with SLE and 139 healthy controls (HCs) completed the Medical Outcomes Study 36‐Item Short Form (SF‐36) and EuroQol EQ‐5D questionnaires about HRQoL. Disease activity and cumulative disease damage were assessed with standard indices. Sleep quality was assessed using the Korean version of the Pittsburgh Sleep Quality Index (K‐PSQI).

Result

The mean EQ‐5D and physical and mental components of SF‐36 were lower in SLE patients with fibromyalgia (n = 41) than in those without fibromyalgia (n = 111) and HCs. The scores in all eight domains of the SF‐36 were lower in SLE patients with fibromyalgia than in patients without fibromyalgia and HCs. Poor sleep (defined as a K‐PSQI > 5) was reported by 85% of SLE patients with fibromyalgia, by 51% of patients without fibromyalgia, and by 33% of HCs. Multivariate logistic regression analysis showed that lower educational level, cumulative organ damage severity and poor sleep quality were independent determinants of HRQoL in SLE patients with fibromyalgia, whereas disease activity, sleep quality and depressive mood were independent determinants of HRQoL in those without fibromyalgia.

Conclusion

Poor sleep quality is the common independent risk factor for poor HRQoL in both middle‐aged SLE patients with fibromyalgia and without fibromyalgia. Sleep quality improvement may improve HRQoL in female SLE patients, even in those without fibromyalgia.
Induction therapy for membranous lupus nephritis: a systematic review and network meta‐analysis
Authors: Tang Kuo‐Tung , Tseng Chien‐Hua , Hsieh Tsu‐Yi , Chen Der‐Yuan
Published: June 2018

Aim

Membranous lupus glomerulonephritis (MLN) is associated with morbidities such as thromboembolism, peripheral edema and/or hyperlipidemia. However, treatment of MLN remains elusive.

Methods

We performed systematic searches on MEDLINE, EMBASE and Cochrane Library database up to November, 2017. Eligible studies included randomized trials or cohort studies which evaluated different immunosuppressants in adult patients with pathologically proved MLN. No language restrictions were applied. Endpoints included complete remission (CR) as the primary outcome, and CR plus partial remission (PR) and proteinuria‐reducing effect as secondary outcomes. Frequentist estimation of a network meta‐analysis (NMA) random‐effect model was performed.

Results

Eight studies (206 patients) were included with a total of six immunosuppressants as an induction therapy for MLN. NMA results showed that both mycophenolate mofetil (MMF) and calcineurin inhibitors (CNI) are effective in the induction of CR and CR plus PR when compared with corticosteroids (CS) alone, but MMF and CNI are also associated with higher infection rates when compared with CS.

Conclusion

Our NMA demonstrated that both MMF and CNI are more effective than CS for induction therapy in MLN patients. However, there are limitations due to intra‐ and inter‐study variability.
Clinical effectiveness of influenza vaccination in patients with rheumatoid arthritis
Authors: Chen Chun‐Ming , Chen Hsuan‐Ju , Chen Wei‐shan , Lin Che‐Chen , Hsu Chih‐Cheng , Hsu Yueh‐Han
Published: June 2018

Objective

To determine the clinical effectiveness of influenza vaccination in patients with rheumatoid arthritis (RA).

Methods

The present study was conducted by using the Taiwan National Health Insurance Research Database. In this retrospective nationwide study, we included 3748 RA patients who received influenza vaccinations in 2008, 2009 and 2010, and 3748 matched RA patients who did not receive influenza vaccinations. We followed the patients from 4 weeks after influenza vaccination to the end of the influenza season in each year. After adjustment for potential confounding factors, including disease‐modifying anti‐rheumatic drugs, we used the Cox proportional hazards regression model to analyze the clinical effectiveness of influenza vaccination.

Results

The influenza vaccination rate in RA patients was 14.8% in 2008, 19.8% in 2009 and 9.50% in 2010. Receiving influenza vaccine was associated with reduced risk of hospitalization for septicemia, bacteremia or viremia (hazards ratio [HR] = 0.65, 95% CI = 0.45–0.94), and lower risk of mortality (HR = 0.62, 95% CI = 0.39–0.97). The effectiveness was particularly significant in elderly patients.

Conclusions

RA patients receiving influenza vaccine have significantly lower morbidity and mortality, particularly in elderly patients. Further studies are needed to explore effective policies to increase the vaccination rate in elderly RA patients.