bluuebunny/crossref_metadata_2025 huggingface dataset:
Other alternative oral opioids
Authors: Makin Matthew
Published: May 2011

Some opioids may have advantages over morphine in specific circumstances because of their pharmacokinetic and pharmacodynamic profiles. The fentanyl analogues may have greatest utility for episodic pain. Theoretical advantages such as NMDA receptor antagonism and inhibition of the re-uptake of biogenic monoamines have not been confirmed as producing better efficacy or tolerability in clinical studies.
Transdermal opioids
Authors: Feathers Luke , Faull Christina
Published: May 2011

Transdermal opioids can provide good pain relief. They are useful when the oral route of administration is not possible, but should not be used when rapid titration of analgesia is required. Theymay aid compliance and may cause less constipation and somnolence than morphine. They may be the patient’s method of choice.
Other routes of opioid administration
Authors: Zeppetella Giovambattista
Published: May 2011

The oral route is the commonest route of opioid administration. In some instances, clinical circumstances make a switch to an alternative route of administration desirable. Common alternative routes include oral transmucosal, rectal, inhaled and topical administration. The evidence base for alternatives to the oral route is often from case reports; the strongest evidence is for oral transmucosal fentanyl citrate in the management of breakthrough pain. There are few non-oral licensed preparations available and most use is off-label.
Spinal opioids
Authors: Simpson Karen H. , Baranidharan Ganesan
Published: May 2011

Spinal opioids mediate their main actions via mu receptors in the brain and in the substantiagelatinosa within the dorsal horn of the spinal cord. Neuraxial opioids can be very useful when the World Health Organization (WHO) analgesic ladder fails to provide adequate analgesia or leads to unmanageable adverse effects. Intrathecal drug delivery has advantages over epidural drug delivery such as low dose requirements and fewer longer-term complications. Careful patient selection is crucial and should include intrathecal test dosing. Multidisciplinary team work and good post-procedure support are essential for the ongoing management of intrathecal drug delivery to optimize analgesia and manage adverse events.
Opioids in special circumstances
Authors: Murtagh Fliss , Edmonds Polly , Farnham Chris
Published: May 2011

Regarding opioids in renal disease, the degree of renal impairment should be established where possible, using estimated glomerular filtration rate. Choice of opioid is important. In severe renal impairment avoid repeated administration of opioids with known toxic metabolites (such as codeine, dihydrocodeine, morphine and diamorphine), and avoid modified release preparations. Use preferred opioids (buprenorphine, fentanyl and alfentanil) carefully, start at very low doses, with increased dose interval, and titrate against clinical response.

Regarding opioids in liver disease, many patients with hepatic dysfunction have pain requiring opioid analgesics. The liver dysfunction needs to be severe for clinical issues around prescribing in palliative care to become relevant. Avoid opioids with long half lives and modified release preparations; if toxicity develops, it will be prolonged. Opioids should be used with caution eg low starting doses, increased dose interval and careful monitoring. Alternative opioids do not have any specific advantages. Regarding opioids in respiratory disease, opioids are known to have respiratory depressant side effects. Clinicians may be anxious about prescribing opioids in patients with chronic lung disease. In practice, patients seem to develop tolerance to the respiratory depressant side effects. Careful titration with normal release opioids and regular clinical review means these drugs can be used in patients with respiratory disease. Regarding prescribing opioids in patients with a history of drug misuse, patients with a history of substance misuse develop pain. Substance misuse can be a barrier to adequate pain management. Effective pain control requires good communication, boundary setting and team working. British Pain Society guidance should guide practice.
Critical care organisation and management
Authors: Singer Mervyn , Webb Andrew R.
Published: May 2011

Abstracts and keywords to be supplied.
Cardiovascular drugs
Authors: Singer Mervyn , Webb Andrew R.
Published: May 2011

Abstracts and keywords to be supplied.
Renal drugs
Authors: Singer Mervyn , Webb Andrew R.
Published: May 2011

Abstracts and keywords to be supplied.
Gastrointestinal drugs
Authors: Singer Mervyn , Webb Andrew R.
Published: May 2011

Abstracts and keywords to be supplied.
Resuscitation
Authors: Singer Mervyn , Webb Andrew R.
Published: May 2011

Abstracts and keywords to be supplied.
Respiratory disorders
Authors: Singer Mervyn , Webb Andrew R.
Published: May 2011

Abstracts and keywords to be supplied.
Renal disorders
Authors: Singer Mervyn , Webb Andrew R.
Published: May 2011

Abstracts and keywords to be supplied.
Gastrointestinal disorders
Authors: Singer Mervyn , Webb Andrew R.
Published: May 2011

Abstracts and keywords to be supplied.
Hepatic disorders
Authors: Singer Mervyn , Webb Andrew R.
Published: May 2011

Abstracts and keywords to be supplied.
Trauma and burns
Authors: Singer Mervyn , Webb Andrew R.
Published: May 2011

Abstracts and keywords to be supplied.
Pain and post‐operative critical care
Authors: Singer Mervyn , Webb Andrew R.
Published: May 2011

Abstracts and keywords to be supplied.
Obstetric emergencies
Authors: Singer Mervyn , Webb Andrew R.
Published: May 2011

Abstracts and keywords to be supplied.
Death and the dying patient
Authors: Singer Mervyn , Webb Andrew R.
Published: May 2011

Abstracts and keywords to be supplied.
Respiratory monitoring
Authors: Singer Mervyn , Webb Andrew R.
Published: May 2011

Abstracts and keywords to be supplied.
Cardiovascular monitoring
Authors: Singer Mervyn , Webb Andrew R.
Published: May 2011

Abstracts and keywords to be supplied.
Neurological monitoring
Authors: Singer Mervyn , Webb Andrew R.
Published: May 2011

Abstracts and keywords to be supplied.
Laboratory monitoring
Authors: Singer Mervyn , Webb Andrew R.
Published: May 2011

Abstracts and keywords to be supplied.
Fluids
Authors: Singer Mervyn , Webb Andrew R.
Published: May 2011

Abstracts and keywords to be supplied.
Respiratory drugs
Authors: Singer Mervyn , Webb Andrew R.
Published: May 2011

Abstracts and keywords to be supplied.
Percutaneous Coronary Intervention and Thrombolysis in AMI & other ACS
Authors: Visser Frans , Simoons Maarten
Published: May 2011

• Acute coronary syndromes (ACS) comprise an evolving acute myocardial infarction (AMI) presenting with or without ST-elevation and unstable angina

• Patients presenting with an ST-elevation MI require immediate reperfusion therapy by primary percutaneous coronary intervention (PCI) or, if such is not available, thrombolysis

• Cardiologists, emergency care physicians, general practictioners and ambulance services should collaborate to develop a national or regional system to optimise AMI therapy, given the national or local facilities and available resources

• A subgroup of high-risk patients presenting with ACS without ST-elevation benefit from PCI or coronary artery bypass graft surgery

• In all patients with ACS intensive anti-platelet and anti-thrombotic therapy is warranted, as well as B-blockers, ACE-inhibitors and statins.
Anti-Platelet and Anti-Thrombotic Therapy Post-AMI
Authors: Dawson Dana , Fox Keith
Published: May 2011

• Acute coronary syndromes (ACS) encompass a spectrum of presentations which include unstable angina, non-ST-elevation myocardial infarction (NSTEMI or NSTE-ACS), and ST-elevation myocardial infarction (STEMI or STE-ACS)

• Anti-platelet and anti-thrombotic agents are administered as ancillary therapy to myocardial reperfusion in patients presenting with an acute coronary syndrome, to maintain the patency of the infarct-related coronary artery

• More specific and potent inhibitors of platelet activation and of the coagulation cascade are emerging with the aim being to further improve clinical outcomes in patients presenting with an acute coronary syndrome, without increasing the risks of major bleeding.
Cardioprotection During Cardiac Surgery
Authors: Pepper John
Published: May 2011

• Overall early mortality for cardiac surgery is low at 2–3% but in high risk patients it can be high as 10–15%

• The demography of cardiac surgical patients is changing to older and sicker patients

• Myocardial ischaemia-reperfusion injury and the systemic inflammatory response are closely related

• Several pharmacological agents that have been demon-strated to confer cardioprotection in the experimental setting have been applied to the clinical setting of cardiac surgery. However, the transfer of these findings from the bench to the bedside has been largely disappointing

• Potential cardioprotective strategies include pharma-cological agents such as adenosine, and mechanical interventional strategies such as acute normovolaemic haemodilution and remote ischaemic preconditioning.
Pseudomonas baetica sp. nov., a fish pathogen isolated from wedge sole, Dicologlossa cuneata (Moreau)
Authors: López Jose R. , Diéguez Ana L. , Doce Alejandra , De la Roca Elena , De la Herran Roberto , Navas Jose I. , Toranzo Alicia E. , Romalde Jesus L.
Published: June 2011

Five Gram-negative bacterial isolates, recovered from an outbreak that occurred in March 2006 in Huelva, Spain, affecting adult diseased cultured wedge sole [Dicologlossacuneata(Moreau)], were characterized phenotypically and genotypically in order to clarify their taxonomic position. On the basis of 16S rRNA gene sequence analysis, the isolates were included in the genusPseudomonas, within thePseudomonas fluorescens-related species group, their closest relatives being thePseudomonas jesseniiandPseudomonas koreensissubgroups. The highest sequence similarities were recorded with the type strains ofPseudomonas reinekei,P. moorei,P. umsongensis,P. jesseniiandP. mohnii(99.4–99.3 % similarity). Sequence analysis of the housekeeping genesgyrBandrpoDclearly differentiated the isolates from currently describedPseudomonasspecies, the highest sequence similarities recorded to type strains being below 95 % for both genes. Phylogenetic analysis using concatenated sequences of the three genes showedPseudomonas moraviensisDSM 16007TandP. koreensisDSM 16610Tas the closest reference strains. DNA–DNA hybridization assays with related strains confirmed that these isolates belong to a novel species of the genusPseudomonas, for which the namePseudomonas baeticasp. nov. is proposed. The type strain is strain a390T( = CECT 7720T = LMG 25716T). The novel species could be easily distinguished from phylogenetically related species by several phenotypic characteristics, including gelatin hydrolysis, acid production from glucose and growth at 6 % NaCl. Virulence assays revealed that the novel species is pathogenic for wedge sole.
Targeted mRNA Oxidation Regulates Sunflower Seed Dormancy Alleviation during Dry After-Ripening
Authors: Bazin Jérémie , Langlade Nicolas , Vincourt Patrick , Arribat Sandrine , Balzergue Sandrine , El-Maarouf-Bouteau Hayat , Bailly Christophe
Published: June 2011

After-ripening is the mechanism by which dormant seeds become nondormant during their dry storage after harvest. The absence of free water in mature seeds does not allow detectable metabolism; thus, the processes associated with dormancy release under these conditions are largely unknown. We show here that sunflower (Helianthus annuus) seed alleviation of dormancy during after-ripening is associated with mRNA oxidation and that this oxidation is prevented when seeds are maintained dormant. In vitro approaches demonstrate that mRNA oxidation results in artifacts in cDNA–amplified fragment length polymorphim analysis and alters protein translation. The oxidation of transcripts is not random but selective, and, using microarrays, we identified 24 stored mRNAs that became highly oxidized during after-ripening. Oxidized transcripts mainly correspond to genes involved in responses to stress and in cell signaling. Among them, protein phosphatase 2C PPH1, mitogen-activated protein kinase phosphatase 1, and phenyl ammonia lyase 1 were identified. We propose that targeted mRNA oxidation during dry after-ripening of dormant seeds could be a process that governs cell signaling toward germination in the early steps of seed imbibition.
Real‐time business process monitoring using formal concept analysis
Authors: Kang Bokyoung , Jung Jae‐Yoon , Wook Cho Nam , Kang Suk‐Ho
Published: June 2011

Purpose

The purpose of this paper is to help industrial managers monitor and analyze critical performance indicators in real time during the execution of business processes by proposing a visualization technique using an extended formal concept analysis (FCA). The proposed approach monitors the current progress of ongoing processes and periodically predicts their probable routes and performances.

Design/methodology/approach

FCA is utilized to analyze relations among patterns of events in historical process logs, and this method of data analysis visualizes the relations in a concept lattice. To apply FCA to real‐time business process monitoring, the authors extended the conventional concept lattice into a reachability lattice, which enables managers to recognize reachable patterns of events in specific instances of business processes.

Findings

By using a reachability lattice, expected values of a target key performance indicator are predicted and traced along with probable outcomes. Analysis is conducted periodically as the monitoring time elapses over the course of business processes.

Practical implications

The proposed approach focuses on the visualization of probable event occurrences on the basis of historical data. Such visualization can be utilized by industrial managers to evaluate the status of any given instance during business processes and to easily predict possible subsequent states for purposes of effective and efficient decision making. The proposed method was developed in a prototype system for proof of concept and has been illustrated using a simplified real‐world example of a business process in a telecommunications company.

Originality/value

The main contribution of this paper lies in the development of a real‐time monitoring approach of ongoing processes. The authors have provided a new data structure, namely a reachability lattice, which visualizes real‐time progress of ongoing business processes. As a result, current and probable next states can be predicted graphically using periodically conducted analysis during the processes.
Modelling mechanical behaviour of rubber concrete using evolutionary polynomial regression
Authors: Ahangar‐Asr Alireza , Faramarzi Asaad , Javadi Akbar A. , Giustolisi Orazio
Published: June 2011

Purpose

Using discarded tyre rubber as concrete aggregate is an effective solution to the environmental problems associated with disposal of this waste material. However, adding rubber as aggregate in concrete mixture changes, the mechanical properties of concrete, depending mainly on the type and amount of rubber used. An appropriate model is required to describe the behaviour of rubber concrete in engineering applications. The purpose of this paper is to show how a new evolutionary data mining technique, evolutionary polynomial regression (EPR), is used to predict the mechanical properties of rubber concrete.

Design/methodology/approach

EPR is a data‐driven method based on evolutionary computing, aimed to search for polynomial structures representing a system. In this technique, a combination of the genetic algorithm and the least square method is used to find feasible structures and the appropriate constants for those structures.

Findings

Data from 70 cases of experiments on rubber concrete are used for development and validation of the EPR models. Three models are developed relating compressive strength, splitting tensile strength, and elastic modulus to a number of physical parameters that are known to contribute to the mechanical behaviour of rubber concrete. The most outstanding characteristic of the proposed technique is that it provides a transparent, structured, and accurate representation of the behaviour of the material in the form of a polynomial function, giving insight to the user about the contributions of different parameters involved. The proposed model shows excellent agreement with experimental results, and provides an efficient method for estimation of mechanical properties of rubber concrete.

Originality/value

In this paper, a new evolutionary data mining approach is presented for the analysis of mechanical behaviour of rubber concrete. The new approach overcomes the shortcomings of the traditional and artificial neural network‐based methods presented in the literature for the analysis of slopes. EPR provides a viable tool to find a structured representation of the system, which allows the user to gain additional information on how the system performs.
Treatment of quantum zero‐point energy constraint in simulations of molecular dynamics
Authors: Tada Shigeru
Published: June 2011

Purpose

It has been well known that the quantum zero‐point energy (ZPE) cannot be conserved in simulations of atoms and molecules dynamics based on classical mechanics. The purpose of this paper is to examine fundamental issues related to the treatment of quantum ZPE constraint in simulations of atoms and molecules dynamics.

Design/methodology/approach

The ZPE is well known to be a quantum mechanical expectation value that is equivalent to an ensemble average when this value is interpreted to classical mechanics. An important point is that the ensemble‐averaged energies on simulations are expected to obey the ZPE criteria rather than those of individual simulation. The point is elucidated using quasiclassical trajectory calculations with a popular hydrogen atom‐diatom direct collision process incorporating a potential energy surface of a triatomic hydrogen system.

Findings

The results obtained by using standard classical trajectory calculations agree well with the quantum calculations. Using them, the author found that the classical results remain valid even if some trajectory calculations have vibrational energies that are less than the ZPE.

Originality/value

It is found that the ensemble‐average of each trajectory calculation can provide results that are consistent with quantum mechanical ones that obey the ZPE criteria, without the introduction of any additional constraint conditions for atoms and simulation algorithms.
Political connections, corporate governance and audit fees in Malaysia
Authors: Aswadi Abdul Wahab Effiezal , Mat Zain Mazlina , James Kieran
Published: June 2011

Purpose

The purpose of this paper is to examine the relationship between political connection, corporate governance and audit fees in Malaysia. Specifically, it is argued that politically connected firms are perceived to be riskier and thus require auditors to undertake greater audit efforts which in turn lead to higher audit fee. Furthermore, it is also hypothesised that the demand for better corporate governance practices requires more audit effort exert from the auditors, and the demand for higher quality work is expected to be stronger for politically connected firms as these firms are being perceived to have higher risks. This is turn results in higher fees paid to the external auditor.

Design/methodology/approach

This paper employs panel regression analysis. The panel data set consists of 382 non‐financial firms (1,022 observations) for three years from year 2001 to 2003.

Findings

Based on 1,022 firm‐year observations for the period of 2001 to 2003, the results reveal that politically connected firms pay higher audit fees, while firms with better governance demand a higher audit quality, leading to higher audit fees. However, there is no evidence to support that corporate governance demands for a higher quality audit especially for politically connected firms.

Originality/value

This paper contributes to the corporate governance‐audit fees literature by examining a large number of corporate governance variables based on the Malaysian Code on Corporate Governance. In particular, instead of using several individual governance variables such as audit committee, board structure or composition, this study condensed the large number of corporate governance variables into a single index. Furthermore, this study was conducted in Malaysia, which is a unique environment that offers clear identifiable segments based along ethnic line, whereby, politically favoured firms are generally given special privileges by the government.
Bankruptcy Perils in China: The GITIC Tale
Authors: Bottini Thomas H.
Published: June 2011

The 1999 bankruptcy of Guangdong International Trust & Investment Corporation (GITIC) remains as China’s largest bankruptcy of a state owned enterprise. Passive foreign investors constituted the majority of the general creditors. This article recounts some particulars of contentious issues which were decided adversely to the general creditors. Some shortcomings of the proceedings are explained, especially relating to the identification of the Chinese governmental entities which owed large amounts of money to GITIC. Questions are raised regarding possible application of the GITIC decision‐making process to bankruptcies involving non‐state owned enterprises.
Effects of Exchange Rate Uncertainty on Mexican Foreign Trade
Authors: Grube Brian T. , Samanta Subarna K.
Published: June 2011

The behavior of current account balance and the value of the domestic currency has been a focal point of much policy discussion for a long time. Most of the OECD countries have experienced volatile exchange rates as well as current account deficits for most of the last two decades. Conventional wisdom holds that appreciation of domestic currency leads to increased trade deficit and vice versa. This paper examines the long run equilibrium relation between exchange rate risk and the volume of foreign trade in Mexico. Mexico is one of the countries in Latin America that has been moving towards a free market economy, featuring free trade as the main driving force behind its endeavor for economic development. So, it is of keen interest to examine how the exchange rate fluctuations and its uncertainty has influenced the economy during such institutional changes.
Parent‐Affilate Agency Conflicts and Foreign Entry Mode Choice
Authors: Young Baek H.
Published: June 2011

We theoretically identify two levels of agency conflicts related to foreign direct investment (FDI): within a parent firm and between parent(s) and an affiliated firm. For a sample of 182 firms that announced U.S.‐related FDIs in 1995, we examine the effects of agency conflicts on the choice between a wholly owned subsidiary (WOS) and a joint venture (JV), and the relative share ownership of a parent. Firms with higher management ownership, especially the firms that made related FDIs, and firms with higher foreign affiliate monitoring efficiency are more likely to choose a WOS. Differences between U.S. and non‐U.S. parents are also examined.
Estimating the Impact of Risks on Emerging Equity Market Performance: Further Evidence on Data from Rating Agencies
Authors: Ramcharran Harri
Published: June 2011

The allocative efficiency of global financial markets depends on, among other things, the informational reliability of risk data provided by rating agencies. This study extends the current literature by using country risk data from Euromoney to estimate the impact of political, economic, default and credit risks on stock returns, P/E ratios, dividend yield and price/book value ratios of emerging equity markets. The results are mixed, similar to those of studies using data from Institutional Investor Country Credit Ratings and International Country Risk Guide. The failure of rating agencies to predict the Mexican and the Asian crises casts some doubts on these data for analytical purposes. Improvement in the quality of the data is important as other forecasting techniques are considered.
Medical Globalization: “A Fin de Siecle Phenomenon”
Authors: Miller D. Douglas
Published: June 2011

The economic phenomenon of “globalization” has broadly affected the health care industry and the medical profession in the late 20th century. Governmental and private sector managed care reach is expanding globally, as patients are “ecuritized” and traded as covered lives. Arbitrage of health care goods and services is creating commoditization effects, including trans‐border parallel markets (i.e. black markets). Consumers and governments are becoming concerned about privacy issues and product standardization, while Third World challenges remain in the public health realm (i.e., infectious pandemics, sanitation, nutrition and overpopulation).
National Culture and Research and Development Activities
Authors: Pedro Couto Joao , Cabral Vieira Jose
Published: June 2011

This paper examines the effect of national culture on the process of innovation and research and development activities in the subsidiaries of multinational companies. For this purpose, we use a sample of 222 subsidiaries for five European countries. The paper has drawn up two important findings. Firstly, cultural dimensions such as individualism, masculinity, power distance and uncertainty avoidance influence research and development activities of the subsidiaries. Secondly, the type of management model, defined according to the location of the parent company, influence the organization of the research and development activities.
To Localize or to Standardize on the Web: Empirical Evidence from Italy, India, Netherlands, Spain, and Switzerland
Authors: Singh Nitish , Furrer Olivier , Ostinelli Massimiliano
Published: June 2011

With the growth of worldwide e‐commerce, companies are increasingly targeting foreign online consumers. However, there is a dearth of evidence as to whether global consumers prefer to browse and buy from standardized global web sites or web sites adapted to their local cultures. This study provides evidence from five different countries as to whether global consumers prefer local web content or standardized web content. The study also measures how the degree of cultural adaptation on the web affects consumer perception of site effectiveness.
The Regional Nature of the World’s Banking Sector
Authors: Rugman Alan M. , Brain Cecilia
Published: June 2011

Of the forty banks included in the world’s largest 500 firms, none operate on a global basis. All but one are heavily dependent on their home region, with an average of 78.3 percent of their sales being intra‐regional. The other bank is European owned but has a majority of its sales in North America, i.e. it is host‐region oriented. The insularity of the world’s largest banks is not a sector‐ specific factor only nine of the world’s 500 largest firms are global, and the vast majority are like the banks, home‐region based.
Understanding the Structure of China’s Consumer Electronics Market: An Empirical Investigation of Its Consumer Segments
Authors: He Zhiyi , Chen Xiaoyun
Published: June 2011

This study investigates the structure of China’s market by examining the profiles of consumption values from a large scale national survey of 6250 respondents. The study identifies four consumer segments that pursue distinct patterns of consumption values, including: purchase value, social status, performance and aesthetics, and “satisfi cing” needs. These distinct consumption value profiles help to provide a much needed understanding of China’s consumer market that complements existing studies on sociodemographic characteristics. These four distinct segments provide useful positioning and marketing implications for multinational firms operating in the China market.
Market Conditions Favoring Master International Franchising
Authors: Alon Ilan
Published: June 2011

Master international franchising is among the fastest growing methods for international franchisors to expand abroad because this method involves minimal financial risk and a quick go‐to‐market strategy. This article reviews the extant literature and develops propositions relating specific environmental factors to the propensity of franchisors to use master international franchising. We propose that master international franchising is more likely when the economic potential and level of corruption are low; and when the competitive intensity, demand variability, franchise knowledge, masculinity and individualism in society, geographical and cultural distance, country risk, and level of legal protection are high
What Matters Most? A Review of MNE Literature, 1990‐2000
Authors: Eunni Rangamohan V. , Post James E.
Published: June 2011

Based on a review of over 450 articles on multinational enterprises published in leading management journals from 1990‐2000, we identified eighteen issues that had engaged the attention of academic scholarship and evaluated their topical relevance. Ironically, very few of them addressed two of the most pressing issues facing business and society at the turn of the last millennium: terrorism and socio‐economic inequality. These glaring omissions suggest a gap between academic scholarship that focuses on “what is,” and research that speculates as to “what could be.” Suggestions are offered on how to close this important gap in the fi eld of international business.
Macao's potential for developing regional Chinese medical tourism
Authors: Lam Ching‐Chi (Cindia) , du Cros Hilary , Vong Tze Ngai (Louis)
Published: June 2011

Purpose

This article aims to examine how Macao could become a destination to attract health and medical tourists from the People's Republic of China (China), as since its return from Portuguese control in 1999 it has been capitalising on its position as a cultural link between Portugal and China

Design/methodology/approach

A study was conducted recently on the possible demand for Western and traditional Chinese medicine practices by mainland Chinese tourists visiting Macao. A survey was undertaken of their views on consuming health and medical tourism products.

Findings

It was found that there is a definite opportunity for medical tourism in Macao among Chinese tourists. The bodycheck is the medical service most highly sort and word‐of‐mouth together with the internet are the most preferred channels for information. Majority also prefer to package their medical trip with tourism activities.

Research limitations/implications

Macao is the perfect place to study outbound Chinese tourists and their potential desire for special interest tourism activities, because they are entitled to enter on independent visas. Eventually, this will be the case in many more destinations and the results could be seen as predictive.

Practical implications

A mismatch between the requirements of the demand side and supply has been discovered and needs to be remedied with more public sector encouragement of this emerging niche.

Originality/value

The first study of its kind is carried out amongst Chinese outbound tourists, who can obtain independent leisure travel visas to tour outside China.
Health travel motivation and activities: insights from a mature market – Switzerland
Authors: Laesser Christian
Published: June 2011

Purpose

The purpose of this paper is to investigate predictors (stated motivation and reported leisure activities) of health travel as opposed to a control group incorporating all other travel of the Swiss resident population, a well‐matured market.

Design/methodology/approach

An a priori segmentation of more than 11,000 trip cases (health travel as opposed to non‐health travel) was chosen as means of methodological concept, and stepwise logistic regressions of 25 types of motivations and 72 types of activities towards group membership served as means of analysis.

Findings

There appears to be a mature perception of health travel in the developed Swiss market, comprising rewarding elements of beauty, indulgence, and regeneration combined with demanding elements such as (challenging and stimulating) sports, including mountain biking, hiking, and golf.

Originality/value

The paper enhances the still slim body of knowledge on health travel.
New perspectives on vacation decision making
Authors: Hyde Kenneth F. , Decrop Alain
Published: June 2011

Purpose

This paper introduces the seven empirical studies on vacation decision making in this special issue of IJCTHR. The paper compares the findings of these seven studies to traditional models of vacation decision making, and highlights a number of new perspectives for research into vacation decision making.

Findings

Five themes appear in these contemporary studies of vacation decision making: the multifaceted nature of the vacation; joint decision making by members of the household; impact of the type of vacation trip on the decision making process; the role of the internet in vacation decision making; and the role of socio‐psychological variables in vacation decision making.

Research limitations/implications

The paper provides recommendations for future research in vacation decision making, in light of contemporary changes in the travel and tourism industry.

Originality/value

The value of this paper lies in its review of traditional approaches to researching vacation decision making, and advice provided for future research on the topic.
The souvenir purchase decision: effects of online availability
Authors: Abendroth Lisa J.
Published: June 2011

Purpose

Prior to e‐commerce, tourists could only purchase souvenirs at a destination. The goal of this research is to develop and test a theory to explain how adding a retail web site affects tourists' decision‐making for souvenir purchases.

Design/methodology/approach

The researcher conducts two experiments using scenarios to simulate a souvenir purchase. The researcher manipulates item type and web site availability, and then measures purchase intent, attitudes toward the souvenir, and regret.

Findings

Purchase limitation increases initial purchase intent by increasing the souvenir's reminder value, regardless of item type. Non‐purchase regrets are greater than purchase regrets, which in turn increases purchase intent at a later time.

Research limitations

The stimuli are necklaces, and although the findings do not show gender effects, the stimuli could limit the generalizability to other souvenir types. The research tests hypotheses using scenarios and less‐experienced travelers. Future research should examine different types of souvenirs in a naturalistic setting.

Practical implications

Retailers should not mention web sites until after a tourist decides not to buy in‐store and should do so subtly.

Originality/value

This research contributes to souvenir research by identifying a purchase limitation, available in‐store only, as a new determinant of a souvenir's reminder value. The research also contributes to scarcity research by identifying reminder value as a new and qualitatively different type of valuation affected by scarcity. Lastly, the research extends the regret literature by reversing inaction inertia at a later purchase opportunity while maintaining a regret minimization goal.
Exploring past and possible future investor housing performance in 19 Auckland City suburbs
Authors: Hargreaves Bob
Published: June 2011

Purpose

Private sector residential property investors aiming to achieve optimal total returns need to be able to identify the best performing suburbs in a city. The purpose of this paper is to analyse the risk‐adjusted investment performance of 19 suburbs within Auckland City and provide some insight into the likely future performance of some of these suburbs.

Design/methodology/approach

The annual pre‐tax and unleveraged investment performance of a residential property is a function of the changes in the value of the property plus the net yield. House price data for the suburbs were taken from the Real Estate Institute of New Zealand. Rental information was obtained from the Department of Building and Housing.

Findings

Surprisingly, the suburb showing the highest average yields was also the suburb recording the greatest increase in house prices. This result appears to be a consequence of government intervention in the form of increased rental subsidies for renters, tax concessions for landlords and low‐deposit home loans aimed for first home buyers.

Research limitations/implications

It is all very well analysing the past performance of suburbs but investors are likely to be more interested in future performance, rather than past performance, when they make buying and selling decisions. In some cases, the characteristics of suburbs that have done well in the past can be useful in identifying suburbs likely to do well in the future.

Practical implications

The hypothesis advanced in this paper is that suburbs with lower than average household income to house price ratios and house income to rent ratios, combined with a trend for household incomes and rents to be increasing above the city‐wide average, are likely to be the best prospects for future residential investment.

Social implications

The main social implication appears to be the unintended consequences of rental subsidies increasing rents and house prices more than the average in the lower priced suburbs.

Originality/value

There has been very little published work comparing total returns on investor housing within a city, by suburb. This has been made possible by the combination of real estate sales information and a comprehensive rental database. In addition, census information on households' incomes at suburban level is also integrated into the study.The study also makes a novel contribution by suggesting variables likely to influence future total returns by suburb.
Investigation on housing affordability in Lanzhou, Northwest China
Authors: Duan Mingchen
Published: June 2011

Purpose

With the rapid increase in both household discretionary income and housing price, how to improve housing affordability is the vital challenge for China, especially for the northwestern region where the household income is lower than that in the eastern region. This paper aims to provide an insight into the housing affordability by analyzing the influence factors of purchasing standard housing in Lanzhou, which is the second largest city in Northwest China.

Design/methodology/approach

Price to income ratio (PIR) and housing affordability index (HAI) approaches were applied in this study to measure housing affordability for Lanzhou.

Findings

The results show that the PIR values for Lanzhou range from 6.02 to 7.23 between 2001 and 2008. The value exhibits an increasing trend before 2004 and a decreasing trend after 2004. The HAI values vary between 62.0 and 83.2 and are higher from 2001 to 2003 than those from 2004 to 2008. It was observed that the level of influence of the household discretionary income, housing price and the mortgage interest rate on these two values differs significantly in the different studied periods. This indicates that housing affordability in Lanzhou is lower than the acceptable level.

Originality/value

The paper establishes an understanding of the level of housing affordability in Northwest China, and provides the basis for the formulation of the new government's housing policy for this region.
Risk factors for breast cancer: epidemiological evidence from Japanese studies
Authors: Iwasaki Motoki , Tsugane Shoichiro
Published: May 2011

Although our understanding of the etiology of breast cancer has improved, many well‐known risk factors are not modifiable and present knowledge has proved insufficient to allow the disease to be overcome. Indeed, incidence and mortality among Japanese women have increased over the past three decades. Here, we review epidemiological evidence from our cohort and case–control studies among Japanese women in comparison with other published findings. Our studies confirm the important role of established factors derived primarily from Western populations, such as menstrual and reproductive factors, anthropometric factors, physical activity, and alcohol intake, in the development of breast cancer. In addition, we provide further evidence to better understand the role of traditional Japanese foods in the etiology of breast cancer. Our cohort study found that a higher intake of isoflavone and higher levels of plasma genistein, but not daidzein, were associated with a decreased risk of breast cancer. Our case–control studies reveal a dose–response pattern for these compounds; specifically, decreased risk as women move from “no” to “moderate” intake and leveling off thereafter. In addition, gene–environment interactions have been revealed in the effects of isoflavones. The evidence reviewed suggests that isoflavone has a protective effect against breast cancer in Asian populations. Conversely, our cohort study did not observe an inverse association between breast cancer risk and the intake of green tea and/or the plasma level of tea polyphenols, but we did find an association between increased risk and active and passive smoking. In conclusion, based on current knowledge, primary prevention according to individual lifestyle modification should focus on alcohol intake, weight control, physical activity, and tobacco smoking. (Cancer Sci 2011; 102: 1607–1614)
Risk of lymph node metastasis in patients with pedunculated type early invasive colorectal cancer: A retrospective multicenter study
Authors: Matsuda Takahisa , Fukuzawa Masakatsu , Uraoka Toshio , Nishi Masataka , Yamaguchi Yuichiro , Kobayashi Nozomu , Ikematsu Hiroaki , Saito Yutaka , Nakajima Takeshi , Fujii Takahiro , Murakami Yoshitaka , Shimoda Tadakazu , Kushima Ryoji , Fujimori Takahiro
Published: May 2011

Depth of invasion in early invasive colorectal cancer is considered an important predictive factor for lymph node metastasis. However, no large‐scale reports have established the relationship between invasion depth of pedunculated type early invasive colorectal cancers and risk of lymph node metastasis. The aim of this retrospective cohort study was to clarify the risk of lymph node metastasis in pedunculated type early invasive colorectal cancers in a large series. Patients with pedunculated type early invasive colorectal cancer who underwent endoscopic or surgical resection at seven referral hospitals in Japan were enrolled. Haggitt’s line was used as baseline and the invasion depth was classified into two groups, head invasion and stalk invasion. The incidence of lymph node metastasis was investigated between patients with head and stalk invasion. We analyzed 384 pedunculated type early invasive colorectal cancers in 384 patients. There were 154, 156, and 74 endoscopic resection cases, endoscopic resection followed by surgical operation, and surgical resection cases, respectively. There were 240 head invasion and 144 stalk invasion lesions. Among the lesions treated surgically, the overall incidence of lymph node metastasis was 3.5% (8/230). The incidence of lymph node metastasis was 0.0% (0/101) in patients with head invasion, as compared with 6.2% (8/129) in patients with stalk invasion. Pedunculated type early invasive colorectal cancers pathologically diagnosed as head invasion can be managed by endoscopic treatment alone. (Cancer Sci 2011; 102: 1693–1697)
Risk of meningioma among users of high doses of cyproterone acetate as compared with the general population: evidence from a population‐based cohort study
Authors: Gil Miguel , Oliva Belén , Timoner Julia , Maciá Miguel A. , Bryant Verónica , de Abajo Francisco J.
Published: May 2011

WHAT IS ALREADY KNOWN ON THIS SUBJECT

• Information from the spontaneous reporting system raised the hypothesis of an increased risk of meningioma in patients treated with high doses of cyproterone acetate (CPA).

• Meningiomas are known to be hormone‐sensitive tumours and express progesterone receptors and CPA has an anti‐androgenic, progestagenic and antigonadotropic effect.

• More formal evidence from epidemiological studies is lacking.

WHAT THIS STUDY ADDS

• This population‐based cohort study supports the hypothesis that the exposure to high dose CPA increases the risk of meningioma

• The increased risk was observed both in men and women and was only relevant for exposures longer than 1 year.

AIM Information from the spontaneous reporting system raised the hypothesis of an increased risk of meningioma in patients treated with high doses of cyproterone acetate (CPA). The objective of this study was to test the hypothesis of an increased risk of meningioma among users of high dose CPA as compared with non‐users in a medical records computerized database.

METHODS A retrospective cohort study was performed in a Spanish primary care database (BIFAP). Meningioma incidence rates were compared in patients exposed to high dose CPA (users) with those non‐exposed and with those exposed to low dose CPA. Poisson regression analysis was used to estimate the incidence rate ratios after adjusting for age and gender.

RESULTS Among 2474 users of high dose cyproterone (6663 person‐years) four meningioma cases were identified, resulting in an incidence rate (IR) of 60.0 (95% CI 16.4, 153.7) per 100 000 person‐years, which was significantly higher than that observed among the non‐users (IR 6.6; 95% CI 6.0, 7.3) and among women users of low dose cyproterone (IR 0.0, 95% CI upper limit 5.5). After adjusting for age and gender, patients exposed to high dose CPA showed an increased risk of meningioma of 11.4 (95% CI 4.3, 30.8) as compared with non‐users.

CONCLUSIONS The results of this study support the hypothesis that the exposure to high dose CPA increases the risk of meningioma.
Parents' experiences of caring for a child with a cleft lip and/or palate: a review of the literature
Authors: Nelson P. , Glenny A.‐M. , Kirk S. , Caress A.‐L.
Published: May 2011

This review brings together for the first time the existing quantitative and qualitative research evidence about the experiences of parents caring for a child with a cleft. It summarizes salient themes on the emotional, social and service‐related experiences of parents and critiques the literature to date, comparing it with wider, selected literature from the field of children's long‐term conditions, including disability. The review suggests that there are similarities and differences between the literatures, in terms of research focus and approach. Similarities are found across children's conditions in the perspectives of parents on emotional, social and service‐related aspects, although much of the cleft literature is focused on the early stages of children's lives. However, the quality of cleft research to date about parents' experiences has also been variable, with a narrow emphasis on cross‐sectional, deficit‐orientated psychological approaches focused mainly on mothers. Despite a substantial literature, little qualitative research has examined parents' perspectives in‐depth, particularly about their child's treatment journey. This contrasts with the wider children's literature, which has traditionally drawn not only on psychological approaches but also on the broader perspectives of sociology, social policy, nursing and health services research, using both qualitative and quantitative methods, often in integrated ways. Such approaches have been able to highlight a greater range of experiences from both mothers and fathers, about caring for a child with a long‐term condition and views about treatment. The review identifies a lack of comparable research in the cleft field to examine parents' experiences and needs at different stages of their children's lives. Above all, research is needed to investigate how both mothers and fathers might experience the long‐term and complex treatment journey as children become older and to elicit their views about decision making for cleft treatments, particularly elective surgeries.