bluuebunny/crossref_metadata_2025 huggingface dataset:
Identify the reality: re‐build, manage and lead
Authors: Rabey Gordon
Published: August 2005

Purpose

To show that the skills of managing and leading are both essential for those holding in‐charge positions wishing to generate the optimum contribution of employee effort. Organisational success and continuity lie in identifying the reality, clarifying the purpose, providing the resources, and working with and trusting people to achieve it.

Design/methodology/approach

The outcome of literature research, organisational consultations, and a recognition of how the compartmentalisation of activities can blur the forward vision.

Findings

Marketplace activities, business uncertainties and staff movements make planned implementation difficult and the needs of the moment will always receive priority attention.

Practical implications

The coordination of the total activities of the organisation through the use of the senior team, improved communication and the recognition of special effort.

Originality/value

Implementation of the points espoused here should increase operational effectiveness – the outcomes will confirm it.
Whatever happened to leadership?
Authors: Kearsley Mike
Published: August 2005

Purpose

Proposes to provide a summary of ideas with regard to leadership and management with the author's interpretation of these and some of the issues these raise.

Design/methodology/approach

Discussion of the manager versus leader debate followed by a discussion of organisational leadership (as opposed to individual leadership) with specific reference to the kaizen (Japanese) approach.

Findings

That leadership programs have frequently failed to produce leaders and that groups tasked with leadership development often do not produce leaders either for their organisation or within their own group.

Research limitations/implications

No real statistics or research evidence is provided. The conclusions are subjective and anecdotal.

Practical implications

It should cause readers to consider their own organisational development and whether leaders can be created.

Originality/value

The recent views of the CIPD and Prof. John Adair are included.
Thermo‐mechanical model to predict the tribological behaviour of the composite PEEK‐CF30/steel pair in dry sliding using multiple regression analysis
Authors: Paulo Davim J. , Cardoso Rosária
Published: August 2005

Purpose

PEEK is an abbreviation for polyetheretherketone, a high performance engineering semicrystalline thermoplastic. This material can operate at higher temperatures and has excellent friction and wear properties, which are optimised in the specially formulated tribological grade PEEK‐CF30. The purpose of this work was to develop a thermo‐mechanical model to predict the tribological behaviour of the composite PEEK‐CF30/steel pair, in dry sliding, related to friction and wear with the pv factor, the temperature and the sliding distance, using multiple regression analysis (MRA).

Design/methodology/approach

This paper presents a new thermo‐mechanical model to predict the tribological behaviour of the composite PEEK‐CF30/steel pair, in dry sliding, using MRA. A plan of experiments was performed on a pin‐on‐disc machine PLINT TE67HT®.

Findings

The objective was to establish a thermo‐mechanical model to predict the PEEK‐CF30 behaviour related to friction and wear with the pv factor (product of apparent pressure of contact and sliding velocity), the temperature and the sliding distance. This model was obtained by multiple linear regression. Finally, confirmation tests were performed to make a comparison between the obtained results from the mentioned model and the experimental results.

Originality/value

The novel element of this paper is the application of design experiments and MRA in tribological model behaviour in an advanced material – PEEK‐CF 30.
Research on experimentation of green cutting with water vapor as coolant and lubricant
Authors: Han Rongdi , Liu Junyan , Sun Yongfeng
Published: August 2005

Purpose

Nowadays, green cutting has become the focus because of its ecological problem and the necessary environment protection, so that the research on experimentation of green cutting with water vapor as coolant and lubricant is studied because water vapor has many benefits of cheapness, no pollution, no harm and no recycling and handling.

Design/methodology/approach

The vapor generator and the vapor feed system are manufactured, the distribution of temperature and velocity of vapor jet flow are simulated by MATLAB program, and under the conditions of compress air, oil water emulsion, water vapor as coolant and lubricant and dry cutting, respectively, the turning experimentation of comparison which the tool is YT15, and the working material is steel 45.

Findings

Water vapor, as coolant and lubricant, the cutting force is reduced, respectively about 30‐40, 20‐30 and 10‐15 percent by comparing to dry cutting, compressed air and oil water emulsion. The cutting temperature is, respectively about 30, 40 and 50 percent with the other conditions of dry cutting, compressed air and oil water emulsion. The friction coefficient and the chip deformation coefficient are correspondingly decreased and the surface roughness value has been diminished too. Through analysis of the experimental results, water vapor as coolant and lubricant possesses better lubricating action because of the excellent penetration performance and the low lubrication layer shearing strength of water vapor.

Originality/value

Water vapor as coolant and lubricant provides a novel method for realizing no contamination green cutting.
Absence management
Authors: Howarth Jon
Published: August 2005

Purpose

To introduce strategies for managing absence and building a positive attendance culture.

Design/methodology/approach

Devises a strategy to build an attendance culture.

Findings

An attendance policy, procedure and trained managers will improve attendance.

Practical implications

Managers should actively manage employee attendance.

Originality/value

Savings to employee costs and improved morale.
Two million dollars times three
Authors: Woodsworth Anne
Published: August 2005

Purpose

To address the issue of using grant funding in the US public libraries. With reduced funding as in most public libraries, the three New York City library systems have partnered with the Urban Library Council (ULC), funded by The Wallace Foundation, to provide additional funds from these alternative sources of income.

Design/methodology/approach

Explores the current programs and services offered at Brooklyn Public Library (BPL) under the grant‐funded sources. In using the funds, this project gave the library a chance to directly connect its goals with the new funds, as well as meet new capacity‐building goals to set the library in new directions.

Findings

The new funding resulted in new staff, retooling positions and activities, task forces and committee work to give buy‐in from different interested parties, and results included expanded services and programs.

Originality/value

Beyond evaluating the need for the funding at this system, much success can be found in the city‐wide collaboration found in this project with all three systems and the ULC working together on this project. These Tri‐Li (three library system) working groups are just one of the many valuable elements of reading this case.
Who's your donor?
Authors: Griffin Gregory J.
Published: August 2005

Purpose

To show how the use of a database of potential donors may increase the success of fund‐raising activities.

Design/methodology/approach

Explains how a database was used to collect information on potential donors. Each donor was given a value reflecting the strength of their connection to the library. These rankings were based on past gifts, areas of interest, and career, to name a few.

Findings

By using a database to collect, maintain, and monitor fund‐raising activities at the Syracuse University Library, the library has been able to collaborate with other university units and has achieved more visibility and success in development activities.

Originality/value

This study suggests a practical model that could be adopted by other libraries in similar institutions. Early results from the Syracuse University Library experience have been positive, and the library is now positioned as an important partner in campus fund‐raising activities.
Preservation and metadata
Authors: Maxymuk John
Published: August 2005

Purpose

To outline the various metadata schemes and digital initiatives undertaken by the library community to preserve material in digital formats.

Design/methodology/approach

Surveys a number of library metadata initiatives and digital repositories to illustrate that, even in the ever‐changing technological world, preservation is essential.

Findings

Digital technology changes at an ever‐increasing rate, which makes it difficult to preserve digital information. Nonetheless, if information digitally created today is to be useful in the future, it is important to save it in many ways, and migrate it to modern formats when possible.

Originality/value

This review reminds us that preservation is key if we are to ensure that information created now is still accessible in the future.
Gran Centre Granollers – “city, culture and commerce”
Authors: Andres Coca‐Stefaniak J. , Parker Cathy , Barbany Amadeu , Garrell Xavier , Segovia Enric
Published: August 2005

Purpose

Town centre management (TCM) schemes in Spain have generally evolved primarily from a retail perspective, led by small and medium sized (SME) retailers. However, their development has often focused on business goals (e.g. profit, increase in footfall, etc). In doing so, they have often overlooked the very social issues that have embedded retail historically in the socio‐economic matrix of our towns and cities. This paper, adopting a case‐study approach, seeks to re‐address this imbalance by exploring some of the key success factors of Gran Centre Granollers (GCG) – one of Spain's most advanced retailer‐led TCM schemes located in Granollers (near Barcelona).

Design/methodology/approach

This paper, adopting a case‐study approach, explores some of the key success factors ofGCC..

Findings

GCG's visionary motto of “city, culture and commerce” and its inclusive approach to the management of the area's stakeholders have captured the imagination of the town's independent retailers (75 per cent of them are members of the scheme). It has also proved pivotal in engaging the town's residents with the scheme's vision, purpose and ethical values. This is reflected in the success of their customer loyalty credit card initiative and the steady growth of the scheme's membership from ten to three hundred businesses in the last ten years.

Originality/value

This case study should be of interest to town centre managers, SME retailers, researchers in the social sciences and students of urban regeneration and retail management.
Part I. A framework of partnering for infrastructure maintenance
Authors: Olsson Ulf , Espling Ulla
Published: August 2005

The nature of maintenance is complex and greatly influenced by relationship among various actors involved in execution of maintenance tasks. The relationship factor becomes more critical when outsourcing maintenance tasks. The most important success factor is creating mutual “goodwill trust” between partners. Another important factor is the use of economic incentives for both parties. A formal partnering process, top management support and relevant outcome measures are also important for a partnership to be positive. Partnering is a potential “tool” to create success. Based on a review of the partnering literature and experiences from Swedish railway sector, a partnering framework for maintenance contracts has been developed. The partnering framework considers four main factors, namely requirements and potential for partnering, the partnering process, success elements and measures on partnering success.
Bayesian analysis of some static system models
Authors: Sharma K.K. , Rathi Shubhi , Namita
Published: August 2005

This study deals with the Bayesian analysis of the reliability characteristics of some static system models. Recognizing the fact that overestimation (underestimation) of reliability function or mean time to system failure (MTSF), hazard rate is more serious than that resulting due to its underestimation (overestimation), an asymmetric loss function, called the linear exponential (LINEX), has been used in the analysis. The results are also given for the squared error loss function (SELF).
Judging the quality of internet‐based health information
Authors: Childs Sue
Published: August 2005

Purpose

To overview the topic of the quality assessment and quality control of health information on the internet, particularly information targeted at patients, carers and health consumers.

Design/methodology/approach

The context and background of the issue are explained. A range of key quality initiatives is described. The debates on the topic are presented. A health consumer tool produced by the author is described. Items from the literature are used to support the arguments presented.

Findings

A range of quality initiatives exists, but there is neither an internationally agreed set of criteria nor a quality assessment tool. Little evidence exists to demonstrate that the criteria are correlated with good quality web sites and that the quality assessment tools are valid.

Research limitations/implications

Research is needed: to identify the positive or negative effects of the use of health information from the internet on health outcomes: to understand how health consumers use the internet and choose information sources and how this behaviour matches with existing quality initiatives; to explore how criteria correlate with good quality health sites.

Practical implications

This paper is a useful overview of this topic for library and information professionals in both the health and non‐health fields.

Originality/value

This paper raises awareness of this topic with library and information professionals interested in performance measurement. Hopefully it will stimulate research activity on this topic from this professional group.
A coordination framework for supply chain inventory alignment
Authors: Piplani Rajesh , Fu Yonghui
Published: August 2005

Purpose

A traditional supply chain, all too often, is a sequence of weakly connected activities both within and outside the organization and leads to many misalignments. Tackling this inherent lack of coordination is a major value creation opportunity for supply chain managers. This paper aims to present a coordination framework, called ASCEND, to align the inventory decisions in decentralized supply chains.

Design/methodology/approach

The framework rests on three pillars – multi‐agent technology, coordination theory, and optimization technology. Inventory alignment is transformed into a decentralized constraint satisfaction optimization problem, which is then solved using a genetic algorithm‐based coordination process. The guiding principle of this framework is the establishment of a proper incentive alignment mechanism through cost‐sharing and service level contracts, taking into account the associated dependencies.

Findings

The results of the pilot study indicate that the coordination framework reduces the supply chain inventory‐holding cost, compared with the “as‐is” scenario. Interestingly, the results also indicate that not all the supply chain partners will experience lower inventory costs in the absence of a proper incentive alignment mechanism. Only through cost sharing and service level contracts can the value of coordination be realized by each partner in a supply chain network!

Practical implications

The coordination approach is applied to a pilot supply chain. The results of the case study lead to 10.4 percent (average) reduction in supply chain inventory‐holding costs, validating the efficacy of the coordination framework.

Originality/value

This research has resulted in the development of a supply chain coordination framework, which requires the establishment of a proper incentive alignment mechanism, based on cost‐sharing and service level contracts, and taking into account the associated dependencies.
Barriers and levers towards knowledge management configurations
Authors: Martini Antonella , Pellegrini Luisa
Published: August 2005

Purpose

Seeks to discuss barriers/drivers to the selection and implementation of different knowledge management configurations in the process of product innovation.

Design/methodology/approach

Building on literature and the previous survey‐based research results, this study compares on a longitudinal perspective the approaches of two companies with similar conditions but adopting different choices in terms of ICT and organisational tools to support the knowledge management process.

Findings

Case studies highlight how firms adopting a KMC that differ from the one indicated by the previous survey‐based research model show an intention to align to it in the near future. Hence, it seems that a match exists between the configuration expected from the model and the intended configuration planned by the company. Using longitudinal case studies the paper analyses the barriers that hamper the transition of firms toward the approach that better suits their contingent situation. These barriers are mainly at the level of industry trend, lack of culture from users and loss of champions. This paper also analyses the enablers, which strengthen the alignment between the configuration expected from the model and the intended configuration the company planned. These are the social interaction between employees, the pressures from headquarters, the internal commitment from top managers, the technological development and the ICT maturity.

Originality/value

The paper validates two hypotheses. H1: there is a match between the configuration expected from the research model (driven by contingencies) and the intended configuration planned by the company: the contingent approaches which disagree with the model represent different stages of maturity within an evolutionary path which drives toward the configuration expected from the model. H2: there are barriers/enablers, which hamper/foster the transition toward the intended configuration. It also analyses the barriers.
Transverse myelitis following general and epidural anaesthesia in a paediatric patient
Authors: Martinez‐Garcia E. , Pelaez E. , Roman J. C. , Perez‐Gallardo A.
Published: August 2005

A 13‐year‐old girl developed transverse myelitis 2 weeks after an uncomplicated, combined general and epidural anaesthetic for orthopaedic surgery. Since epidural anaesthesia had been used, a causal relationship might have been assumed. We review the aetiology and pathogenesis of acute transverse myelitis and the role of anaesthesia in this disorder. Although a causal relationship cannot be assumed and regional anaesthesia in children is considered safe, we would like to re‐emphasise the management principles and practices that may improve the benefit‐to‐risk ratio of these techniques.
Growth hormone improves protein catabolism and growth in prepubertal children with HIV infection
Authors: Hardin Dana S. , Rice Julie , Doyle Marilyn E. , Pavia Andrew
Published: August 2005

Introduction Poor linear growth and weight loss are well documented in children with human immunodeficiency virus (HIV) infection and past studies in adults and children have reported that loss of lean tissue mass (LTM) associated with accelerated rates of protein catabolism. We undertook this study to test the hypothesis that human recombinant GH would improve linear height in HIV‐infected children. Our second goal was to determine if GH could reverse protein catabolism in HIV‐infected children.

Methods We studied six HIV‐infected children (mean age 9·2 years, Tanner stage I, CD4 counts 110 000–292 000, two girls, four boys). Measures of protein turnover were conducted using the stable isotope 1‐[13C] leucine. Body composition was measured by dual X‐ray absorptiometry (DXA) scan for determination of LTM. Viral burden and IGF‐1 levels were measured. Studies were conducted at baseline and 6 months.

Results The baseline growth velocity of these children was only 3·9 cm/year. After 6 months of GH, growth velocity increased to 7·9 cm/year. Protein catabolism, represented as leucine rate of appearance (Ra) in the fasted state, was high at baseline, but decreased significantly after 6 months of GH therapy. Lean tissue mass significantly improved in all subjects. Viral burden did not increase significantly in any subject during GH therapy.

Conclusion These results suggest that GH improves height and weight and reduces protein catabolism in HIV‐infected children without negative effect on viral burden.
Tumour surveillance imaging in patients with extrapituitary tumours receiving growth hormone replacement
Authors: Chung T. T. , Drake W. M. , Evanson J. , Walker D. , Plowman P. N. , Chew S. L. , Grossman A. B. , Besser G. M. , Monson J. P.
Published: August 2005

Objective  GH replacement is widely used in the management of patients with adult‐onset (AO)‐GH deficiency (GHD). In most cases, AO‐GHD arises as a result of pituitary/peripituitary tumours and/or their treatment, but the effect of GH replacement on recurrence/regrowth of these tumours is unknown. The aim of this study was to examine the effect of GH replacement in a group of patients with primary tumours of the parasellar region, many of which (e.g. craniopharyngioma, glioma or germ cell tumours) might be anticipated to have a higher recurrence rate than secretory and nonsecretory anterior pituitary tumours.

Patients and design  We report here our experience of prospective imaging in 50 consecutive patients (21 males; mean age 45·9 years) with nonanterior pituitary parasellar tumours treated with GH. All had severe GHD (peak serum GH 9 mU/l or less on dynamic testing) and were treated with an identical dose–titration regimen to maintain serum IGF‐I concentrations between the median and upper end of the age‐adjusted normal range. The primary diagnoses were: craniopharyngioma (28), germ cell tumour (8), arachnoid cyst (4), meningioma (4), glioma (4) and mensenchymal tumour (2). External pituitary irradiation had been given to 37 (74%) of patients.

Measurements  Surveillance imaging (magnetic resonance imaging (MRI) 70%, computed tomography (CT) 16%, both 14%) was performed at baseline (prior to GH), at 6–12 months, and then again yearly or as clinically indicated. Median follow‐up was 36 months (range 7–129 months). All images were reviewed by the same radiologist.

Results  Four patients had an apparent increase in tumour volume but in only one patient was it considered necessary to abandon GH replacement. In two of the four cases marginal increases in cystic parasellar tumours were not progressive; and in the fourth case apparent recurrence of a suprasellar germ cell tumour was shown to be acellular fibrous tissue only on biopsy. In all other cases either the appearances were unchanged or the amount of tissue was reduced during long‐term follow‐up on GH.

Conclusions  Overall, GH appears safe with respect to tumour recurrence over this time period in this patient group. Comparison with similar prospective series in patients not receiving GH replacement is desirable.
Androgen receptor polymorphism (CAG repeats) and androgenicity
Authors: Canale D. , Caglieresi C. , Moschini C. , Liberati C. D. , Macchia E. , Pinchera A. , Martino E.
Published: August 2005

Objective  Polymorphism of the androgen receptor (AR) has been related to various pathophysiological conditions, such as osteoporosis and infertility. The objectives of this study were to evaluate the frequency of distribution in a normal Italian population and to assess CAG repeats (CAGr) in other conditions, such as hypoandrogenism, potentially influenced by AR polymorphism.

Patients and measurements  CAGr polymorphism was determined in a group of 91 healthy normoandrogenized subjects, 29 hypoandrogenized patients (hypoplasia of prostate and seminal vesicles, reduced beard or body hair, etc.) and 29 infertile patients by direct sequencing.

Results  The mean (± SD) number of CAG repeats [(CAGr)n] was 21·5 (± 1·7) in the control group, 21·4 (± 2·0) in the infertile patients and 24·0 (± 2·9) in the hypoandrogenic males. The difference was statistically significant between this last group and the other two (P < 0·0001), while there was no difference between normal controls and infertile patients. The frequency distribution showed a shift towards higher CAG length in hypoandrogenized patients compared to controls and infertile patients. If we used a cut‐off point of 24·9 (2 SD above the mean), the percentage of patients with 25 or more CAGr repeats was 38% among hypoandrogenized patients, 7% among infertile patients and 5% among the control group. In hypoandrogenized subjects (CAGr)n correlated slightly with testis and prostate volume. The number of CAG repeats was not associated with any of the hormonal parameters, including testosterone, evaluated in the three groups.

Conclusions  Our normal population, representing subjects from Central Italy, is superimposable on other European populations with regard to (CAGr)n distribution. Hypoandrogenic males have a shift in the frequency distribution towards longer (CAGr)n. Infertile patients are not statistically different from the control group. These findings suggest that, given the same amount of circulating testosterone, as in our hypoandrogenized and control group, the final net androgenic phenotypical effect is due to AR polymorphism.
Emily Dix, palaeobotanist – a promising career cut short
Authors: Burek Cynthia
Published: August 2005

Emily Dix, the Coal Measures palaeobotanist, was born on 21 May 1904. She was one of four daughters in a family of five children brought up in Penclawdd – a South Welsh cockling port then surrounded by coal and copper smelting industries near Swansea. Emily was a bright and gregarious girl, gaining at the age of 18 the Central Welsh Board Higher Certificate in History, Botany and Geography with distinctions in history and botany. Her success was an indication of what was to come.
Eighty‐four consecutive cases of tinea faciei in Siena, a retrospective study (1989–2003)
Authors: Romano C. , Ghilardi A. , Massai L.
Published: August 2005

Consecutive cases of tinea faciei diagnosed in Siena between 1989 and 2003 were studied retrospectively for differences in clinical form, demographic data and species of dermatophyte isolated. The series consisted of 84 cases (59 females, 25 males) with a mean age of 27 years. Mean age of females (32.4 years) was significantly greater than that of males (14.2 years). The dermatophytes most frequently isolated were Microsporum canis (38 cases) and Trichophyton rubrum (31 cases). Clinical form was typical of tinea in 54 subjects (64.3%) and was tinea incognito because of inappropriate therapy in the other 30 (35.7%) subjects. The mean age of patients with the typical form (19.2 years) was significantly lower than that of those with tinea incognito (41.1 years). All cases in the age range 6–15 years had typical tinea, whereas the maximum frequency of cases with tinea incognito was 46–50 years. In the group with tinea incognito there was a majority of women and the dermatophytes isolated differed with gender. No such difference was observed in the group with typical tinea.
Cunninghamella pneumonia in postbone marrow transplant patient: first case report from India
Authors: Sivakumar S. , Mathews Mary S. , George Biju
Published: August 2005

Cunninghamella bertholletiae, a rare causative agent of mycosis among immunocompromised patients has been reported with increased frequency from western countries in recent years. We report a case of C. bertholletiae pulmonary infection in a 42‐year‐old male patient who developed graft‐vs.‐host disease following bone marrow transplantation. In spite of intensive antifungal chemotherapy following clinical diagnosis, he died of pulmonary failure. To our knowledge this is the first report from India and third report of post‐BMT C. bertholletiae infection ever published.
Malassezia and Candida colonisation on glans penis of circumcised men
Authors: Atilla Aridoğan I. , Ilkit Macit , Izol Volkan , Ates Aylin
Published: August 2005

The Malassezia yeast are members of the normal human cutaneous flora in adults. They also are reported as part of the microflora of the male genital region in mostly uncircumcised males. It has been reported that Malassezia sympodialis and Malassezia globosa are the most frequent yeast belonging to the resident microflora of the penis as in other human skin areas. The aim was to evaluate the prevalence of Malassezia and Candida yeast colonisation on the glans penis of circumcised males. Impression preparations were made on modified Dixon agar. The isolates were identified by morphological and physiological characteristics. A total of 245 circumcised males were included in the study. Of the 245 patients examined, 55 (22.4%) were found to have a mycologically proven yeast fungi on their glans penis. In 17 (30.9%) Malassezia, in 36 (65.5%) Candida, in one (1.8%) Malassezia and Candida, and in one (1.8%) Saccharomyces strains were detected. Malassezia furfur (66.7%) was the most common species among the lipophilic yeast, followed by Malassezia globosa (11.1%), Malassezia obtusa (11.1%) and Malassezia slooffiae (11.1%). Candida albicans was the most common non‐lipophilic yeast (46.0%), that was isolated among the other yeast, followed by unidentified Candida strains (18.9%), Candida tropicalis (8.1%), Candida glabrata (8.1%), Candida parapsilosis (8.1%), Candida zeylanoides (5.4%), Candida guilliermondii (2.7%) and Saccharomyces cerevisiae (2.7%). The results of this study showed that Malassezia species were also colonised like Candida on the glans penis of circumcised males.
Tensions and constraints for nurses in hospital‐in‐the‐home programmes
Authors: Duke Maxine , Street Annette
Published: August 2005

Economic necessity constrains health‐care expenditure and waiting lists for hospital treatments remain high. As a result, more care is delivered via alternative means, such as same‐day surgery initiatives and home‐care programmes. Acute care delivered in the home to patients who would otherwise require hospitalization is becoming an increasingly acceptable means of treatment. These Hospital‐in‐the‐Home programmes offer increased comfort while delivering comparable outcomes to many patient groups. The purpose of this paper is to generate discussion concerning the tensions that exist for nurses who practice in the home under the auspices of acute‐care institutions. Data drawn from field work that formed part of a critical ethnography is used to generate the discussion. The larger research project explored the constructions of the role of the nurse in four Hospital‐in‐the‐Home programmes in Victoria, Australia. It will be argued that there is significant pressure exerted upon nurses to support the imperative to reduce bed days in acute hospitals by transferring people to their home. At times, this agenda clashes with the nurses’ professional commitment to provide holistic patient care, yet the dilemmas are largely unacknowledged and/or unrecognized by the nurses despite the tension they generate.
Parasuicide, self‐harm and suicide in Aboriginal people in rural Australia: A review of the literature with implications for mental health nursing practice
Authors: Procter Nicholas G
Published: August 2005

With reports of increased rates of suicide and parasuicide among Aboriginal people worldwide, the dual purpose of this background paper is to examine the literature on underlying mental health issues, as well as primary and secondary actions to try to minimize the risk related to this area among Aboriginal people nationally and internationally. The literature review contained in this paper has been developed upon the fundamental belief that prevention of mental health problems, mental illness and suicide should incorporate understanding of the factors that heighten the risk of these occurring and the factors that are protective against them, while simultaneously developing, disseminating and implementing effective interventions that are culturally and linguistically appropriate. To this end, continuity and integration of mental health care for rural Aboriginal people is attendant upon a whole‐of‐community and a whole‐of‐government response that respects the metaphor of cultural and linguistic experiences, as well as the mental health scope of practice.
‘They survive despite the organizational culture, not because of it’: A longitudinal study of new staff perceptions of what constitutes support during the transition to an acute tertiary facility
Authors: Fox Robyn , Henderson Amanda , Malko‐Nyhan Kristina
Published: August 2005

Increasing difficulties of recruitment and retention of nursing staff strongly indicate that organizations should identify factors that contribute to successful transition of new staff to the workplace. Although many studies have identified problems facing new staff, fewer studies have articulated best practices. The purpose of this longitudinal study was to ascertain what new staff perceived as supportive elements implemented by the organization to assist their integration. Sixteen staff in Phase I and 12 staff in Phase II attended focus groups. The focus groups at 2–3 months provided specific information, with particular emphasis on negative interactions with other staff members and inadequate learning assistance and support. Different themes emerged within the focus groups at 6–9 months. Staff discussed being ‘self‐reliant’ and ‘getting to know the system’. Participants indicated that these skills might be beneficial to new staff in the development of organizational ‘know how’ and resourcefulness, rather than relying on preceptor support that, unfortunately, cannot be always guaranteed.
Acute colonic pseudo‐obstruction following major orthopaedic surgery
Authors: Norwood M. G. A. , Lykostratis H. , Garcea G. , Berry D. P.
Published: August 2005

Objective  Acute colonic pseudo‐obstruction (ACPO) has been linked with multiple aetiologies including orthopaedic surgery. However, the actual incidence and natural progression are not well described in these patients. We aim to assess the incidence of ACPO in patients undergoing elective orthopaedic procedures, and to examine for potential exacerbating factors.

Patients and methods  All patients from the orthopaedic directorate that had abdominal imaging in the five years from August 1998 to August 2003 were identified from radiology archives. A manual search of the patients' notes was conducted with data recorded on the patients' history, operative details and their postoperative course including their haematological and biochemical results. Details regarding their ACPO were documented with respect to the onset of symptoms, how the diagnosis was achieved, what treatment was instigated and how the condition progressed. A control group of age and sex matched patients was included for comparison.

Results  Thirty‐five patients with ACPO were identified. The operations included 21 hip replacements, 10 knee replacements and 4 spinal operations. The incidence of ACPO was 1.3%, 0.65% and 1.19%, respectively. In comparison to control patients, patients with ACPO had a lower postoperative serum sodium (P = 0.001), a higher serum urea (P = 0.021) and remained in hospital longer (P < 0.001).

Conclusion  ACPO is uncommon in orthopaedic patients, however, its occurrence results in prolonged hospital stay. Attention to patients' postoperative fluid balance and biochemical status may reduce the incidence.
Pedicled flaps in the treatment of nonhealing perineal wounds
Authors: Menon A. , Clark M. A. , Shatari T. , Keh C. , Keighley M. R. B.
Published: August 2005

Introduction  A persistent sinus is an annoying complication following proctectomy. We examined the experience of a single colorectal surgeon in treating this condition using pedicled flaps.

Methods  Case note review of all patients undergoing gracilis muscle transposition, Rectus abdominis muscle flap or omental flap for persistent perineal sinus.

Results  Seventeen patients were identified: seven had gracilis muscle transposition, eight had omental transposition and two had a rectus abdominis flap. 13/17 patients who underwent a flap had a persistent sinus following proctectomy for Inflammatory bowel disease. Four patients who had a gracilis muscle transposition achieved healing. Seven out of eight patients had good results with omental transposition. One patient did well after a rectus abdominis flap.

Conclusions  A gracilis transposition is a relatively simple operation with minimal morbidity useful for superficial sinuses not requiring a muscle bulk. A rectus abdominis flap is a more complex specialized procedure with better results especially in dealing with larger cavities but it may compromise future stoma sites. Omentoplasty has excellent results, but is only available in some patients.
Impact of librarians in first‐year medical and dental student problem‐based learning (PBL) groups: a controlled study
Authors: Koufogiannakis Denise , Buckingham Jeanette , Alibhai Arif , Rayner David
Published: August 2005

Background:  Librarians at the University of Alberta have been involved with teaching undergraduate medical and dental education for several years. After 1 year of increased librarian involvement at the problem‐based learning (PBL), small‐group level, informal feedback from faculty and students suggested that librarians’ participation in PBL groups was beneficial. There was, however, no real evidence to support this claim or justify the high demand on librarians’ time.

Objectives:  The study aimed to determine whether having a librarian present in the small‐group, problem‐based learning modules for first‐year medical and dental students results in an improved understanding of evidence‐based medicine concepts, the nature of medical literature, and information access skills.

Methods: One hundred and sixty‐four first‐year medical and dental students participated in the study. There were a total of 18 PBL groups, each with approximately nine students and one faculty tutor. Six librarians participated and were assigned randomly to the six intervention groups. Students were given pre‐ and post‐tests at the outset and upon completion of the 6‐week course.

Results: Post‐test scores showed that there was a small positive librarian impact, but final exam scores showed no impact. There was also no difference in attitudes or comfort levels between students who had a librarian in their group and those who did not.

Conclusions:  Impact was not sufficient to warrant continued participation of librarians in PBL. In future instruction, librarians at the John W. Scott Health Sciences Library will continue to teach at the larger group level.
Examination of the impact of information‐skills training on the academic work of health‐studies students: a single case study
Authors: Appleton Leo
Published: August 2005

Aim:  To examine the impact of information‐skills training on the academic studies of student midwives. Objectives include ascertaining whether student confidence increases, learning experiences are enhanced and academic standards are improved.

Methods:  A student midwives’ discussion group at a higher education institution, plus an in‐depth interview with the students’ course leader.

Results:  Students reported increased confidence in using library and information resources. Appropriate and timely information‐skills training embedded into health‐studies curricula can lead to students becoming independent and lifelong learners, as well as improving the standard of their academic work.

Conclusion:  Information skills for health‐studies curricula in higher education can be developed and delivered collaboratively by both library and academic staff. This can have very positive effects on both student perceptions and experiences and standards of teaching and learning.
Information needs of United Kingdom primary care clinicians1
Authors: Swinglehurst Deborah A.
Published: August 2005

Background:  The scope of primary care makes knowledge management in this context very challenging, especially as access to information increases and the role of primary care within the NHS expands.

Objectives:  This paper reviews the literature on the information needs of primary care clinicians to enable evidence‐based decision making. Drawing on the literature, and using a specific example of a clinical informaticist service, some lessons are drawn on the role of information professionals in facilitating evidence‐based health care.

Methods:  Literature review. Case study of clinical informaticist service.

Conclusions:  There are numerous barriers to clinicians engaging with evidence‐based practice. However, providing evidence‐based information to clinicians’ questions in a user‐friendly format has the potential to facilitate changes in practice. The successful implementation of information services requires attention to both academic and service dimensions, fostering closer working relationships between clinicians and information professionals.
Australian occupational therapists' use of an online evidence‐based practice database (OTseeker)
Authors: McKenna Kryss , Bennett Sally , Dierselhuis Zoe , Hoffmann Tammy , Tooth Leigh , McCluskey Annie
Published: August 2005

Introduction:  Online databases can support the implementation of evidence‐based practice by providing easy access to research. OTseeker (http://www.otseeker.com), an electronic evidence database, was introduced in 2003 to assist occupational therapists to locate and interpret research.

Objectives:  This study explored Australian occupational therapists’ use and perceptions of OTseeker and its impact on their knowledge and practice.

Methods:  A postal survey questionnaire was distributed to two samples: (i) a proportionate random sample of 400 occupational therapists from all states and territories of Australia, and (ii) a random sample of occupational therapists working in 95 facilities in two Australian states (Queensland and New South Wales).

Results:  The questionnaire was completed by 213 participants. While most participants (85.9%) had heard of OTseeker, only 103 (56.6%) had accessed it, with lack of time being the main reason for non‐use. Of the 103 participants who had accessed OTseeker, 68.9% had done so infrequently, 63.1% agreed that it had increased their knowledge and 13.6% had changed their practice after accessing information on OTseeker.

Conclusion:  Despite OTseeker being developed to provide occupational therapists with easy access to research, lack of time was the main reason why over half of the participants in this study had not accessed it. This exploratory research suggests, however, that there is potential for the database to influence occupational therapists’ knowledge and practice about treatment efficacy through access to the research literature.
Acetaminophen, Aspirin, and Caffeine Versus Sumatriptan Succinate in the Early Treatment of Migraine: Results From the ASSET trial
Authors: Goldstein Jerome , Silberstein Stephen D. , Saper Joel R. , Elkind Arthur H. , Smith Timothy R. , Gallagher R. Michael , Battikha Jean‐Pierre , Hoffman Howard , Baggish Jeffrey
Published: August 2005

Objective.—To address the need for a rigorous, direct comparison of prescription and over‐the‐counter (OTC) migraine drugs and to expand the database on early treatment of migraine.

Background.—Most people who experience migraine use OTC medications to treat their symptoms, but no head‐to‐head clinical trials comparing these agents with prescription migraine therapies have been published. In addition, even though most migraineurs treat early in the attack, few studies have been conducted to reflect this treatment pattern.

Methods.—We compared a combination of nonprescription migraine medication (acetaminophen 500 mg, aspirin 500 mg, and caffeine 130 mg) with a prescription migraine product (50 mg sumatriptan) in a randomized, controlled clinical trial in which subjects treated at the first sign of a migraine attack. Subjects who reported vomiting during more than 20% of migraine episodes or who required bedrest during more than 50% of migraine episodes were excluded from the study. Of the 188 subjects randomized, 171 took study medication and were included in the analysis.

Conclusion.—The combination of acetaminophen, aspirin, and caffeine was significantly more effective (P > .05) than sumatriptan in the early treatment of migraine, as shown by superiority in summed pain intensity difference, pain relief, pain intensity difference, response, sustained response, relief of associated symptoms, use of rescue medication, disability relief, and global assessments of effectiveness. An additional, larger clinical trial is needed to confirm these results.
Pain Thresholds in Daily Transformed Migraine Versus Episodic Migraine Headache Patients
Authors: Kitaj Madeleine B. , Klink Michelle
Published: August 2005

Objective.—The objective of this study was to test whether pain thresholds of patients with episodic migraine (EM) are significantly different from transformed migraine (TM) patients as measured by Quantitative Sensory Testing (QST) and Semmes‐Weinstein Monofilaments (SW).

Background.—Although there are many theories, none have undeniably proven why many TM patients are refractory to triptans and other gold standard medications. The hypothesis was that baseline pain thresholds of TM patients are lower than EM patients.

Methods.—Episodic (n = 40) and Transformed (n = 41) migraineurs with and without aura were examined with QST and SW over eight locations (bilateral ophthalmic, maxillary, C4/posterior neck, and forearm). All patients completed two visits, baseline and severe migraine.

Results.—TM patients have lower pain thresholds, than EM patients, as measured on QST and SW testing. A total of 81 out of 129 patients completed both parts of the study at baseline and severe migraine. There were significant differences (P < .05) between EM and TM groups at baseline on maxillary, neck (EM = 45.91°C and TM = 42.94°C), and arm.

Conclusions.—TM patients, clinically known to report skin hypersensitivity during migraine, were found to have lower pain thresholds than EM patients, both with severe migraine, and at baseline, measured by QST and SW mechanical testing. As with Burstein's work in EM patients with lowered pain thresholds during their acute migraine, central sensitization may be the explanation for non‐responsiveness to triptans in a high proportion of TM patients. The difference in pain threshold at the neck location was such a strikingly frequent difference between EM and TM patients, that this indicates the need for future research to clarify the directional relationship and the relative importance of muscular versus peripheral versus central hypersensitivity in the determination of allodynia.