bluuebunny/crossref_metadata_2025 huggingface dataset:
PB2418 CLINICAL PRESENTATION AND MOLECULAR IDENTIFICATION OF ALPHA GLOBIN VARIANTS
Authors: Salcioglu Z. , Aydoğan G. , Akıcı F. , Bayram C. , Özdemir G. N.
Published: June 2019

Background:

Alpha thalassemia is the most common genetic disease inthe world with the prevalence of carriers ranging from 5–50% in several populations. Alpha thalassemia, characterized by variable degrees of α‐globin chain deficit is highly prevalent throughout the world. Alpha thalassemia syndromes are caused by mutations on one or more of the four α‐globin genes.

Aims:

The aim of this study was to determine alpha thalassemia mutations in our patients and to evaluate types of mutations.

Methods:

In a retrospective review of 52 patients with alpha thalassemia. followed at our centre from 1990 to 2018. Information of patients were retrieved from patient files and from the records contained in the electronic information processing environment created after 2005. The samples were investigated for α‐thalassemia mutations.

Results:

Presending ages of our patients ranged between one year and 13 years of age (5 ± 4.3 year). Twenty four of them were girls and 28 were boys. Fourteen patients (27%) were asymptomatic at the time of diagnosis, 32 (61.5%) of whom were diagnosed in patients with unsolved hypochromic microcytic anemia and 6 (11.5%) by family history. Thirteen different mutations were determined in patients. The most common mutation was the 3.7 gene deletion and was found in 23 patients (44.2%). Others common mutations were the 20.5 kb gene deletion (18; 34.6%), MED gene deletion (2;3.8%), α2 polyA2 (2;3.8%). Double gen mutations were determined in 27 patients (51.9%). The most common double gen mutation was the 3.7 gene deletion and was found in 8 patients (29.6%).

Summary/Conclusion:

Alpha thalassemia should be considered in the differential diagnosis of hypochromic microcytic anemia especially in cases without iron deficiency and b‐thalassemia carrier state. Genetic testing should be performed for the suspicious cases. We also recommend that a national database with all mutations in Turkey.
Opioid Toxidrome Following Grapefruit Juice Consumption in the Setting of Methadone Maintenance
Authors: Ershad Muhammed , Cruz Maricel Dela , Mostafa Ahmed , Mckeever Rita , Vearrier David , Greenberg Michael I.
Published: June 2019

Background:

Methadone is a synthetic mu-opioid receptor agonist used in the treatment of chronic pain and opioid dependence. Methadone is metabolized by several cytochrome P450 isoenzymes; primarily CYP3A4, CYP2B6, and CYP2D6 before renal and fecal elimination. Exposure to substances like grapefruit juice, that inhibit these isoenzymes may result in increased blood levels of methadone, and thus may manifest clinically as unexpected opioid toxicity.

Case:

A 51-year-old male was found unresponsive. He was hypoxic and bradypneic with pinpoint pupils. Multiple boluses followed by infusion of naloxone were required before improvement of respiratory status. Upon awakening, the patient reported participating in an opioid treatment program where he is administered 90 mg of oral methadone daily and denied any other substance use. On further questioning, he admitted to drinking grapefruit juice (estimated to be approximately 500 mL/day) every day for 3 consecutive days before presentation. The patient was discharged home after being counseled to stop drinking grapefruit juice.

Discussion:

Grapefruit juice is known to be an inhibitor of the CYP3A4 isoenzyme. Various studies demonstrate that through CYP3A4 inhibition, grapefruit juice increases serum levels of opioids, such as methadone, though no clinically significant effects have been reported.

Conclusions:

Grapefruit juice inhibits the metabolism of methadone, raising its serum levels. To our knowledge, this is the first reported case in which the interaction between grapefruit juice and methadone was significant enough to cause an opioid toxidrome. It is, therefore, recommended that opioid treatment programs (OTPs) advise patients about this interaction before administering methadone.
Estimating the causal effect of annual PM2.5 exposure on mortality rates in the Northeastern and mid-Atlantic states
Authors: Yitshak-Sade Maayan , Kloog Itai , Zanobetti Antonella , Schwartz Joel D.
Published: June 2019

Background:

Dozens of cohort studies have associated particulate matter smaller than 2.5 µm in diameter (PM2.5) exposure with early deaths, and the Global Burden of Disease identified PM2.5 as the fifth-ranking mortality risk factor in 2015. However, few studies have used causal modeling techniques. We assessed the effect of annual PM2.5 exposure on all-cause mortality rates among the Medicare population in the Northeastern and mid-Atlantic states, using the difference-in-differences approach for causal modeling.

Methods:

We obtained records of Medicare beneficiaries 65 years of age or more who reside in the Northeastern or mid-Atlantic states from 2000 to 2013 and followed each participant from the year of enrollment to the last year of follow-up. We estimated the causal effect of annual PM2.5 exposure on mortality rates using the difference-in-differences approach in the Poisson survival analysis. We controlled for individual confounders, for spatial differences using dummy variables for each ZIP code and for time trends using a penalized spline of year.

Results:

We included 112,376,805 person-years from 15,401,064 people, of whom 37.4% died during the study period. The interquartile range (IQR) of the annual PM2.5 concentration was 3 µg/m3, and the mean annual PM2.5 concentration ranged between 6.5 and 14.5 µg/m3 during the study period. An IQR incremental increase in PM2.5 was associated with a 4.04% increase (95% CI = 3.49%, 4.59%) in mortality rates.

Conclusions:

Assuming no omitted predictors changing differently across ZIP codes over time in correlation with PM2.5, we found a causal effect of PM2.5 on mortality incidence rate.
Ultraviolet radiation exposure and breast cancer risk in the Nurses’ Health Study II
Authors: VoPham Trang , Bertrand Kimberly A. , DuPré Natalie C. , James Peter , Vieira Verónica M. , Tamimi Rulla M. , Laden Francine , Hart Jaime E.
Published: June 2019

Background:

Ultraviolet (UV) radiation exposure, the primary source of vitamin D for most people, may reduce breast cancer risk. To date, epidemiologic studies have shown inconsistent results.

Methods:

The Nurses’ Health Study II is a U.S. nationwide prospective cohort of female registered nurses. A UV exposure model was linked with geocoded residential address histories. Early-life UV exposure was estimated based on the state of residence at birth, age 15, and age 30. Self-reported breast cancer was confirmed from medical records. Time-varying Cox regression models adjusted for established breast cancer risk factors were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).

Results:

From 1989 to 2013, 3,959 invasive breast cancer cases occurred among 112,447 participants. Higher UV exposure during adulthood was not associated with invasive breast cancer risk overall (adjusted HR comparing highest to lowest quintile = 1.00; 95% CI = 0.90, 1.11, P for trend = 0.64) or according to estrogen receptor (ER) status. There were suggestive inverse associations between ER− breast cancer and early-life UV exposure at birth (adjusted HR = 0.94; 95% CI = 0.88, 1.01 per interquartile range increase [15.7 mW/m2]), age 15 (adjusted HR = 0.96; 95% CI = 0.89, 1.04 per 18.0 mW/m2), and age 30 (adjusted HR = 0.90; 95% CI = 0.82, 1.00 per 27.7 mW/m2).

Conclusions:

Ambient UV exposure during adulthood was not associated with risk of invasive breast cancer overall or by ER status. However, we observed suggestive inverse associations between early-life UV exposure and ER− breast cancer risk.
Animal Models
Authors: Saloman Jami L. , Albers Kathryn M. , Cruz-Monserrate Zobeida , Davis Brian M. , Edderkaoui Mouad , Eibl Guido , Epouhe Ariel Y. , Gedeon Jeremy Y. , Gorelick Fred S. , Grippo Paul J. , Groblewski Guy E. , Husain Sohail Z. , Lai Keane K.Y. , Pandol Stephen J. , Uc Aliye , Wen Li , Whitcomb David C.
Published: June 2019

At the 2018 PancreasFest meeting, experts participating in basic research met to discuss the plethora of available animal models for studying exocrine pancreatic disease. In particular, the discussion focused on the challenges currently facing the field and potential solutions. That meeting culminated in this review, which describes the advantages and limitations of both common and infrequently used models of exocrine pancreatic disease, namely, pancreatitis and exocrine pancreatic cancer. The objective is to provide a comprehensive description of the available models but also to provide investigators with guidance in the application of these models to investigate both environmental and genetic contributions to exocrine pancreatic disease. The content covers both nongenic and genetically engineered models across multiple species (large and small). Recommendations for choosing the appropriate model as well as how to conduct and present results are provided.
Discordant Marker Expression Between Invasive Breast Carcinoma and Corresponding Synchronous and Preceding DCIS
Authors: Visser Lindy L. , Elshof Lotte E. , Van de Vijver Koen , Groen Emma J. , Almekinders Mathilde M. , Sanders Joyce , Bierman Carolien , Peters Dennis , Hofland Ingrid , Broeks Annegien , van Leeuwen Flora E. , Rutgers Emiel J. Th , Schmidt Marjanka K. , Schaapveld Michael , Lips Esther H. , Wesseling Jelle
Published: June 2019

Ductal carcinoma in situ (DCIS) is considered a potential precursor of invasive breast carcinoma (IBC). Studies aiming to find markers involved in DCIS progression generally have compared characteristics of IBC lesions with those of adjacentsynchronousDCIS lesions. The question remains whethersynchronousDCIS and IBC comparisons are a good surrogate forprimaryDCIS andsubsequentIBC. In this study, we compared both primary DCIS and synchronous DCIS with the associated IBC lesion, on the basis of immunohistochemical marker expression. Immunohistochemical analysis of ER, PR, HER2, p53, and cyclo-oxygenase 2 (COX-2) was performed for 143 primary DCIS and subsequent IBC lesions, including 81 IBC lesions with synchronous DCIS. Agreement between DCIS and IBC was assessed using kappa, and symmetry tests were performed to assess the pattern in marker conversion. The primary DCIS and subsequent IBC more often showed discordant marker expression than synchronous DCIS and IBC. Strikingly, 18 of 49 (36%) women with HER2-positive primary DCIS developed an HER2-negative IBC. Such a difference in HER2 expression was not observed when comparing synchronous DCIS and IBC. The frequency of discordant marker expression did not increase with longer time between primary DCIS and IBC. In conclusion, comparison of primary DCIS and subsequent IBC yields different results than a comparison of synchronous DCIS and IBC, in particular with regard to HER2 status. To gain more insight into the progression of DCIS to IBC, it is essential to focus on the relationship betweenprimaryDCIS andsubsequentIBC, rather than comparing IBC withsynchronousDCIS.
Increasing Compliance with a New Interunit Handoff Process: A Quality Improvement Project
Authors: Pino Felicity A. , Sam Kenneth J. , Wood Stacey L. , Tafreshi Paresa A. , Parks Stacy L. , Bell Priscilla A. , Hoffman Elizabeth A. , Koebel Lindsey M. , St. Peter Shawn D.
Published: June 2019

Introduction:

Current literature demonstrates that standardizing interunit patient handoff improves communication, information transfer, and patient safety. However, few studies have focused on increasing staff compliance with new handoff processes. The purpose of this quality improvement project was to incorporate both user input into process design and on-the-job coaching with a newly introduced nurse handoff process between the postanesthesia care unit and Medical/Surgical units. We hypothesized that staff compliance would be 100% within 90 days.

Methods:

The team’s intervention consisted of (1) involving representative frontline nursing staff in the standardization and modification of the handoff process and (2) providing on-the-job coaching as the new process was being trialed at the bedside. We designed the handoff process during a 2-day workshop and a 1.5-week pilot. Data included the number of observed noncompliant process elements and handoff duration. Three sequential 30-day plan-do-study-act cycles were followed, during which compliance observations and user feedback were used to refine the design and coaching iteratively.

Results:

A total of 1,800 process elements were observed and coached throughout a 90-day trial period. The number of observed noncompliant elements decreased from 15% (92) to 4% (22) from the first 30-day interval to the final 30-day interval. There was no undesirable increase in handoff duration (mean, 8.05 ± 4.72 minutes), and several potential errors—related to orders, charting, and patient placement—were prevented by using the new handoff.

Conclusions:

User input and on-the-job coaching resulted in iteratively increasing frontline compliance with a new standardized handoff process.
Prevent Safety Threats in New Construction through Integration of Simulation and FMEA
Authors: Colman Nora , Stone Kimberly , Arnold Jennifer , Doughty Cara , Reid Jennifer , Younker Sarah , Hebbar Kiran B.
Published: June 2019

Introduction:

The built environment may impact safety and decisions made during the design phases can have unintended downstream effects that lead to patient harm. These flaws within the system are latent safety threats (LSTs). Simulation-based clinical systems testing (SbCST) provides a clinical context to examine the environment for safety threats postconstruction. Integration of Failure Mode Effect Analysis (FMEA) with SbCST provides a framework to identify, categorize, and prioritize LSTs before patient exposure.

Methods:

We implemented SbCST in a newly constructed pediatric subspecialty outpatient center before opening. We used in-situ simulations to evaluate both routine and high-risk clinical scenarios pertinent to each clinical area. FMEA was used as a methodology to assign risk, prioritize, and categorize LSTs identified during the simulation.

Results:

Over 3 months, we conducted 31 simulated scenarios for 15 distinct subspecialty clinics involving 150 participants and 151 observers. We identified a total of 334 LSTs from 15 distinct clinics. LSTs were further classified into process/workflow, facility, resource, or clinical performance issues.

Conclusions:

Integration of SbCST and FMEA risk assessment is effective in evaluating a new space for safety threats, workflow, and process inefficiencies in the postconstruction environment, providing a framework for prioritizing issues with the greatest risk for harm.
Comprehensive characterisation of molecular host-pathogen interactions in influenza A virus-infected human macrophages
Authors: Clohisey Sara , Parkinson Nicholas , Wang Bo , Bertin Nicolas , Wise Helen , Tomoiu Andru ,   FANTOM5 Consortium, Summers Kim M. , Carninci Piero , Forrest Alistair A. , Hayashizaki Yoshihide , Digard Paul , Hume David A. , Baillie J. Kenneth
Published: June 2019

Macrophages in the lung detect and respond to influenza A virus (IAV), determining the nature of the immune response. Using terminal depth 5’-RNA sequencing (CAGE) we quantify transcriptional activity of both host and pathogen over a 24-hour timecourse of IAV infection in primary human monocyte-derived macrophages (MDM). We use a systems approach to describe the transcriptional landscape of the host response to IAV contrasted with bacterial lipopolysaccharide treated MDMs, observing a failure of IAV-treated MDMs to induce feedback inhibitors of inflammation. Systematic comparison of host RNA sequences incorporated into viral mRNA (“snatched”) against a complete survey of background RNA in the host cell enables an unbiased quantification of over-represented features of snatched host RNAs. We detect preferential snatching of RNAs associated with snRNA transcription and demonstrate that cap-snatching avoids transcripts encoding host ribosomal proteins, which are required by IAV for replication.

Graphical Abstract

(A) Overview of bioinformatics pipeline. (B) Host gene expression reveals that human macrophages exposed to IAV exhibit sustained production of key inflammatory mediators and failure to induce expression of feedback inhibitors of inflammation. (C) Unbiased comparison with total background RNA expression demonstrates that IAV cap-snatching has a strong preference for, and aversion to, different groups of host transcripts.
Factors associated with the use of maternal health services by mothers in a post-conflict area of western Côte d’Ivoire in 2016
Authors: Mamadou Samba , Régine Attia-Konan Akissi , Dramane Sangaré Abou , Jules Youan Gotré , Philippe Kouadio Luc , Ramata Bakayoko-Ly
Published: June 2019

Introduction

In Côte d’Ivoire, maternal health service utilization indicators remain low despite improvements in health coverage and the availability of free health care for pregnant women. The objective of the study was to identify the determinants associated with the use of maternal health services in the department of Bloléquin, in western Côte d’Ivoire.

Methods

We conducted a cross-sectional study with an analytical focus. The study sample size was 400 women. Study participants were selected through a two-stage cluster survey. The data were collected using a standardized questionnaire whose items concerned socio-demographic data, the different uses of maternal health services, namely childbirth assisted by a health professional, use of family planning, prenatal consultation and post-natal consultation. Logistic regression was used to investigate factors associated with the use of maternal health services. The significance of the statistical tests was set at 5%. The odds ratios and 95% confidence intervals were calculated and interpreted.

Results

The results showed that women made less use of family planning services (OR=0.4), prenatal consultation (OR=0.2) and assisted childbirth (OR=0.2) when they provided the funding for care themselves. Women with incomes above $26.8 used family planning services 4 times more than those with lower incomes. Married women used prenatal consultations 3 times more often than unmarried women (CI95% = 1.4 - 7.3). Desiring pregnancy increased the use of post-natal consultations by 3 times (CI95% = 1.5 - 6.1).

Conclusion

Improving the use of maternal health services in western Côte d’Ivoire requires taking into account women’s socio-cultural and economic challenges. In initiatives related to the financial empowerment of women, efforts must be made at the level of emotional factors related to pregnancy.
A survey of biosecurity measures applied on dairy cattle farms in Spain
Authors: Villaamil Francisco Javier , Arnaiz Ignacio , Allepuz Alberto , Molins Mikel , Lázaro Mercedes , Benavides Bibiana , Moya Sebastián Jesús , Casal Jordi , Yus Eduardo , Diéguez Francisco Javier
Published: June 2019

Attention to biosecurity has been highlighted as the most important measure to reduce and prevent the introduction of diseases to farms. There is little published information about the biosecurity of dairy cattle in Spain. We therefore aimed to assess and characterize the current application of biosecurity measures on dairy cattle farms in Spain, and relate these to bovine viral diarrhea and infectious bovine rhinotracheitis. From July 2017 to April 2018, data on biosecurity measures for 124 dairy herds were collected using a questionnaire. We also assessed the sanitary status of these farms (efficacy of measures implemented against both diseases using antibody ELISA. Data were analyzed descriptively, and using multiple correspondence analysis and a two-step cluster analysis. Measures to prevent disease introduction were often poorly implemented. Three main clusters of farms were identified: Clusters 1 and 2 included herds of small and intermediate sizes, respectively. These, particularly cluster 1, showed the most deficiencies in the control of vehicles and visitors. However, individual purchases usually involved low numbers of animals, especially in cluster 2, and animals were tested for bovine viral diarrhea and infectious bovine rhinotracheitis at their places of origin or on arrival at farms. Farms in clusters 1 and 2 were frequently under voluntary control programs. Cluster 3 had the largest herd sizes, with somewhat better biosecurity control of vehicles and visitors. However, farms in this cluster also purchased the most animals, sometimes without testing, and hired external workers most often. Farms in cluster 1 showed the best sanitary level, followed by clusters 2 and 3. Collecting data such as these is an important first step to identification of biosecurity shortcomings, and to structuring of adequate follow-up to ensure that measures are implemented correctly on farms in Spain.
Facilitators and Barriers to Linkage to HIV Care and Treatment among Female Sex Workers in a Community-based HIV Prevention Intervention in Tanzania: a qualitative study
Authors: Nyato Daniel , Nnko Soori , Komba Albert , Kuringe Evodius , Plotkin Marya , Mbita Gaspar , Shao Amani , Changalucha John , Wambura Mwita
Published: June 2019

Background

HIV-infected female sex workers (FSWs) have poor linkage to HIV care in sub-Sahara Africa.

Methods

We conducted 21 focus group discussions (FGDs) to explore factors influencing linkage to HIV care among FSWs tested for HIV through a comprehensive community-based HIV prevention project in Tanzania.

Results

Influences on linkage to care were present at the system, societal and individual levels. System-level factors included unfriendly service delivery environment, including lengthy pre-enrolment sessions, concerns about confidentiality, stigmatising attitudes of health providers. Societal-level factors included myths and misconceptions about ART and stigma. On the individual level, most notable was fear of not being able to continue to have a livelihood if one’s status were to be known. Facilitators were noted, including the availability of transport to services, friendly health care providers and peer-support referral and networks.

Conclusion

Findings of this study underscore the importance of peer-supported linkages to HIV care and the need for respectful, high-quality care.
Implementation of marketing concept and organizational culture in SMEs in Al Buraimi – Oman
Authors: Al Badi Khalid
Published: June 2019

Purpose

The purpose of this paper is to contribute to the understanding of relationship between implementation process of marketing concepts and the culture at the small- to medium-sized enterprise (SME) level of the Omani economy. The marketing culture and behavior provide a comprehensive insight into the implementation process of marketing concepts in SME sector in Oman. This paper seeks to explore the marketing culture of the firm’s members and to what extent they can support or create barriers to the successful implementation of the marketing concept in Al Buraimi region – Oman.

Design/methodology/approach

A quantitative approach was used to explore the impact of organizational culture on the implementation of marketing concepts on SMEs; to achieve the objective of this study, the paper based on a sample of 240 of SME sector in Al Buraimi. Simple Random Sampling was used for the sample distribution. The IBM analysis program Statistical Package for Social Sciences was used to process the data sets.

Findings

The findings of this study support the argument about the positive relationship between the implementation of marketing concepts and organizational culture. In the Omani context, organizational culture is related to the whole society’s culture, which has changed over recent years due to changes in lifestyle and consumer behavior. All of this affects the SME sector and its ability to create new ideas for the marketing process.

Originality/value

The paper finds that there is a logic and structure to the culture and the implementation process of marketing concepts. It helps to identify the impact of the culture of the SME on the implementation of marketing in the SME sector on the Omani economy in light of the new orientation on the part of decision makers in terms of increasing the importance of non-oil activities.
Development of sectoral brands with emphasis on structure and processes
Authors: Lourenção Marina Toledo de Arruda , Miyamaru Letícia , Giraldi Janaina de Moura Engracia , Pádua Silvia Inês Dallavalle de
Published: June 2019

Purpose

Sectoral brand management processes have presented planning, development and implementation challenges. With the aim of reducing these managerial problems, the purpose of this paper is to revise the structure and the processes of the sectoral brands management.

Design/methodology/approach

This is a qualitative exploratory study, with its unit of analysis being the process of managing the brand of the Brazilian fashion sector. Primary data collection was obtained through in-depth interviews with the seven industry associations and with the company responsible for the brand consulting. The secondary data used were reports about the branding process of the brand provided by respondents. Data analysis was provided by using the VSM to modeling sector structure and BPMN to processes modeling.

Findings

The results present a new sectoral brand structure and process to reduce existing barriers. Three sections were carried out: analysis and modeling of the current structure and processes of sectoral brand management; presentation of the current structure and processes problems; analysis and modeling of future structure and processes of sectoral brand management.

Research limitations/implications

A theoretical contribution is provided in the literature of systems, processes and sectoral brands, since there are no previous studies that elaborated a system structure and process for sectoral brands. In addition, other theoretical contribution is the presentation of a future process model that relates brand management process with its system structure, that is, it relates BPM analysis with VSM.

Practical implications

It is also possible to indicate that VSM and BPM can contribute to the management of sectoral brands, through the structural and process problems identification and also by making possible to suggest future management improvements to reduce the barriers that were identified.

Originality/value

The present study originality is the approach of the first analysis of sector brand management with emphasis on its structure and processes that were experienced by the Brazilian fashion sector.
Selection of WEDM parameters to measure the performance and productivity of die steel grade D3 using GRA and fuzzy logic system
Authors: Kumar Sandeep , S. Dhanabalan
Published: June 2019

Purpose

The purpose of this paper is to examine the performance parameters of WEDM to improve the productivity and material removal rate (MRR) with a high surface finish of high chromium-high carbon dies steel.

Design/methodology/approach

The experiments were performed on AGIE CUT 220 CNC WEDM. High chromium-high carbon dies steel (D3) was used in the form of a rectangular plate. The workpiece and the brass wire having diameter ɸ 0.25 mm had linked up with +ve and –ve polarity in the DC power source, respectively. De-ionized water having a conductivity level of 0.6 µs/cm was used as the dielectric medium. The dielectric fluid was flushed from the top and bottom nozzles and material was submerged in the dielectric.

Findings

The WEDM process parameters for D3 die steel had optimized by using Grey relational analysis method couples with Taguchi method. The optimum solution has been calculated for MRR, cutting speed (Cs), machining time and surface roughness (SR) (Ra value). A fuzzy logic model using Matlab was developed for the prediction of performance parameters, namely MRR, cutting speed (Cs), machining time (M/c time) and SR with respect to changes in input parameters.

Research limitations/implications

The fuzzy model shows the 96.19 percent accuracy between the experimental values and the predicted values.

Practical implications

The optimized parameters by multi-parametric optimization method showed considerable improvement in the process and will facilitate the WEDM, tool and die industries, defense and aerospace industries to improve the productivity with the higher surface finish.

Originality/value

This manuscript represents valid work and the authors have no conflict of interests. The attained optimum outcomes had also been examined through a real experiment and established to be satisfactory.
Outsourcing contact centers: internal branding challenges and consequences
Authors: Du Preez Rose , Bendixen Michael
Published: June 2019

Purpose

The purpose of this paper is to develop a deeper understanding of the philosophy adopted by organizations in making the decision to outsource contact centers or not.

Design/methodology/approach

A phenomenological study was used to develop an understanding of industry participants’ experience of the outsourcing of contact centers in South Africa. Ten in-depth interviews were conducted. Content analysis identified key thoughts and common themes. This was used to develop a model for outsourcing.

Findings

Evidence was found to support three propositions developed from the literature regarding the reasons for and the unintended consequences of outsourcing. A model was developed to illustrate how costs can be reduced by outsourcing under different conditions of “headcount constraints” and “failure costs” of customer relationship management.

Research limitations/implications

The study was conducted in a single emerging market. Future research should confirm the validity of this model in other markets.

Practical implications

Outsourcing contact centers can lead to a loss of control over CRM and internal brand management. This can be avoided by paying considerable attention to the governance of the contract. There are two key messages for managers: to resist the short-term attraction of potential cost savings and marketing must play an active role in the outsourcing decision.

Originality/value

New knowledge is provided about the philosophy adopted by organizations when outsourcing contact centers. A model is presented to guide managers in the outsourcing decision-making process.
Role of the eco-natural environment as an alternative attractiveness factor in malls
Authors: Ortegon-Cortazar Leonardo
Published: June 2019

Purpose

The mall industry in Latin America has grown rapidly in the past decade, offering diverse proposals oriented to improving the attractiveness of this commerce format; along this line, despite the fact that several studies have analyzed variables from an ecological perspective based on the relationship of the physical space with the consumers (from a marketing context), there is shortage in research regarding alternative attractiveness factors inspired by nature, although its connection with people’s behavior has been confirmed. Therefore, the purpose of this paper is to answer the following question: Is the perception of environments with natural resources displayed in malls an alternative attractiveness factor for visitors? Thus, does it benefit its own competitive management against other attractiveness variables that focus on offering variety, accessibility, physical design and entertainment?

Design/methodology/approach

The quantitative method is an exploratory factor analysis that is followed by a confirmatory analysis and resulting in a measurement model based on 470 effective questionnaires. The exploratory and confirmatory nature focused on multidimensional verification of the measurement model (including the validation of the eco-natural environment) justified this choice in consistence with prior research that has used goodness of fit criteria.

Findings

The paper not only suggests the existence of a perception factor in the eco-natural environment, but it also determines its comparative importance over other traditional attractiveness factors reported in scientific literature. Particularly because commercial attractiveness is a consequence of how marketing variables are managed by malls and of how consumers respond to said variables, benefiting the visit’s experience.

Practical implications

The paper contributes to malls’ competitive management by suggesting and proving the importance of the eco-natural environment as a commercial attractiveness factor; thus, the results encourage this format’s developers to take into account new ways of persuasion considering its progressive and competitive rise in the past years in Latin America.

Originality/value

There is shortage of research on alternative attractiveness factors for malls; therefore, contrasting the eco-natural environment in a measurement model of commercial attractiveness allows contributing strategic information to the industry, which in turn constitutes an innovative resource to lure and motivate visitors. On the other hand, the paper contributes the state of knowledge of environmental variables over consumers’ assessments.
Taxonomy, distribution and trait data sets of Japanese Collembola
Authors: Hishi Takuo , Fujii Saori , Saitoh Seikoh , Yoshida Tomohiro , Hasegawa Motohiro
Published: June 2019

In community ecology, trait‐based approaches have been strongly recommended in recent years to understand the responses of community functions against environmental changes. Trait‐based approaches have been used to solve the mechanistic rules in the relationship between soil animal communities and environmental change. However, databases of functional traits of soil animals are still lacking. Collembola is one of the most abundant and diverse group in land ecosystems, with more than 400 identified species in Japan. This data set provides taxonomic information, geographic, habitat distributions and 13 morphological trait items of 407 species of Japanese Collembola: described in Japanese literature. The workshop of Japanese Collembola, supported by the Japanese Society of Soil Zoology, summarized the taxonomy for the Japanese Collembola species. The data set presented here is mainly based on their work. The spatial coverage of this data set is in the land area of Japan. Suborder, superfamily, family, subfamily, genus and species names, as well as common Japanese names, are listed in this paper. The species distributions of Japanese Collembola in each global ecozone and in each area within Japan were described. Habitat preference for soil, cave, seashore and tree trunk habitats was recorded. The 13 morphological traits of Collembola species, which are body length; body weight of adult individual; body form; antenna length; furca length; body pigmentation; pairs of ocelli (eyes); post‐antennal organ; pseudocelli; body scale; anal spine; mandible and molar plate are listed in this dataset. These 13 morphological traits in this dataset are covered the most of trait items which have been internationally used in Collembola study. Trait‐based studies of Collembola have mainly been for European species, most of which are not found in Japan or East Asia. These data sets may provide an important first step to incorporating community data from the Asian region to the trait‐based global ecology. Data files are stored in the Ecological Research Data Archives at http://db.cger.nies.go.jp/JaLTER/ER_DataPapers/archives/2019/ERDP-2019-03.
Help‐seeking and people with aphasia who have mood problems after stroke: perspectives of speech–language pathologists
Authors: Ryan Brooke , Bohan Jaycie , Kneebone Ian
Published: June 2019

Background: Access to treatments for mood disorders may pose a challenge to individuals with compromised communication ability. Speech–language pathologists (SLPs) have previously reported that their clients with aphasia decline formal psychological support; however, their role in their clients’ help‐seeking has not been explored.

Aims: To investigate SLPs’ perspectives on how they currently support help‐seeking for mood problems in people with aphasia and factors they perceive to be impacting service uptake.

Methods & Procedures: A qualitative interview study was conducted. SLPs in Australia working with people with aphasia in a clinical role were recruited. Transcripts of the interviews were subject to qualitative analysis to identify relevant themes.

Outcomes & Results: Eighteen interviews were conducted. One overarching theme and three sub‐themes were identified as central to SLPs’ experience. The overarching theme was of a ‘double whammy’ impact on help‐seeking: people with aphasia were subject to universal barriers associated with seeking help as well as additional barriers imposed by compromised communication. Three themes contributed to the overarching theme: (1) SLPs’ understanding of barriers and facilitators to patients with aphasia seeking help; (2) the role of the SLP as a skilled helper for mood management; and (3) mood and communication as competing rehabilitation priorities.

Conclusions & Implications: SLPs report both universal barriers to help‐seeking and those specific to their clients with aphasia and attempts to overcome these; however, there appears to be a dearth of accessible mental health services for people with aphasia known to SLPs, including psychological/counselling professionals who are skilled in communicating with people with aphasia. Health professionals working within and across post‐stroke and mental health services should recognize that people with post‐stroke aphasia are susceptible to a decline in mental health, are amenable to formal (and tailored) psychological support, and can be supported to seek help.
Hearing the voice of children and young people with a learning disability during the Educational Health Care Plan (EHCP)
Authors: Pearlman Sara , Michaels Dina
Published: June 2019

In England, eliciting the views, feelings and aspirations of young people with special education needs is central to the Special Education Reforms of 2015. However, there is little guidance on how to do this with young people who have intellectual and communication difficulties. In this research project, a questionnaire was developed and used as part of a structured interview, supported by Augmentative and Alternative Communication (AAC) with 22 young people with Moderate, Severe and Profound and Multiple Learning Disability (PMLD). The interview, which expolored the child’s views about their lives at school and at home, was video recorded and clips were played to parents, teachers/and or Speech and Language Therapy (SALT) and NHS Psychology staff. It was hoped that this triangulated, evidence‐based approach to finding out their interpretations of what the child was communicating would provide a valid method. The results were analysed for efficacy and validity of the questionnaire and inter‐assessor reliability of ratings of the videos. Findings showed that by using both conventional and AAC methods, 11 out of the 22 young people were able to indicate responses to 75‐100% of the questions about their lives and preferences and 4 out of the 22 were able to answer 75‐100% of the section about hopes and aspirations for the future. We also found significant differences in ratings of 19 young people by school staff compared to family member and NHS researchers. This shows that it is essential to gather the different views of key people in the young person’s environment. We have concluded that using video footage as a technique to elicit the voice of the child is to be recommended. One problem found with our questionnaire is that the young person’s preferences are not equivalent to views and it would be essential to ask the young person about their experiences of the education they receive, which could then be fed back to their Education Health Care Plan (EHCP)/Annual review to give meaningful service‐user input. This would have to be done creatively and our questionnaire further adapted for those with more severe/PMLD.
Impact of Microclimate on Fatty Acids and Volatile Terpenes in “Kerman” and “Golden Hills” Pistachio (Pistacia vera) Kernels
Authors: Polari Juan J. , Zhang Lu , Ferguson Louise , Maness Niels O. , Wang Selina C.
Published: June 2019

Pistachio is an economically important nut crop in California. Since temperature variations among geographical locations can influence biochemical processes during fruit development, it is of great relevance to understand the impact of growing area over the components that define the nutritional and sensory characteristics of pistachio nuts. Changes in moisture, fat content, fatty acid composition and volatile terpenes were studied during kernel development for “Kerman” and “Golden Hills” varieties in two different California Central Valley microclimates, Lost Hills and Parlier. Moisture content decreased from July to September for both cultivars at both locations. Kerman had a higher moisture content at both locations compared with Golden Hills. Harvest time affected fat content only for Kerman, where the values increased drastically from 21‐July to 4‐Aug, then remained constant. Golden Hills’ fat content remained constant during the period of the study. The main fatty acid in pistachio oil is oleic acid (46% to 59%), followed by linoleic acid (26% to 36%) and palmitic acid (11% to 16%). C16:0, C16:1, C18:2, and C18:3 decreased with harvest time, while C18:1 increased. α‐Pinene was the most concentrated volatile among the cultivars and locations. It decreased with harvest time for both cultivars at both locations, ranging from 105 to 2464 mg/kg. At harvest, Golden Hills and Kerman at Parlier both had higher concentrations of α‐pinene than the two cultivars at Lost Hills. Our results demonstrate that microclimate affects biosynthesis of fatty acids and terpenes in pistachio kernels, the main compounds responsible for pistachio nutritional and sensory characteristics.
Genoprotective Effects of Essential Oil Compounds Against Oxidative and Methylated DNA Damage in Human Colon Cancer Cells
Authors: Thapa Dinesh , Richardson Anthony J. , Zweifel Béatrice , Wallace R. John , Gratz Silvia W.
Published: June 2019

Essential oils (EO) are widely used in foods as flavoring and preservative agents. Many of the biological activities of EO have been attributed to major essential oil compounds (EOC) but their direct interaction with colonic epithelial cells and their genotoxic and genoprotective effects are not well established. In this study, the cytotoxicity and genotoxicity of EOC including nerolidol, thymol, geraniol, methylisoeugenol, eugenol, linalool, and a commercial blend (Agolin) were determined. Furthermore, the genoprotective effects of EOC against oxidative and methylating damage were assessed using the comet assay in HT‐29 colorectal adenocarcinoma cells. The majority of EOC were cytotoxic to HT‐29 cells at or above 250 ppm after 24 hr exposure. At noncytotoxic doses, none of the EOC was genotoxic in the comet assay. Genoprotection against oxidative DNA damage was observed for nerolidol (at 62.5 ppm), thymol (at 12.5 ppm), geraniol, and methylisoeugenol (both at 125 ppm), as well as linalool and Agolin (both at 250 ppm). Thymol was the most protective compound against oxidative DNA damage and geraniol (at 125 ppm) also protected cells against methylating DNA damage. This study highlights the potential of EOC such as thymol to protect the colonic epithelium against oxidative DNA damage and geraniol against methylating DNA damage. Further in vivo studies are needed to confirm these findings for safety and efficacy to exploit their potential pharmaceutical or nutraceutical uses for colonic health.
Using discrete systems to exhaustively characterize the dynamics of an integrated ecosystem
Authors: Gaucherel Cédric , Pommereau Franck
Published: June 2019

To understand long‐term ecosystem dynamics, several concepts have been recently proposed that consider ‘basins of attraction’ to express resilience and ‘tipping points’ that express sharp change in an ecosystem's behaviour. However, these temporal features remain difficult to identify and quantify because current models usually focus only on a part of the whole ecosystem behaviour, whereas a holistic approach should be preferred.

We propose an original family of models based on discrete systems and designed to comprehensively characterize ecosystem dynamics holistically and over the long term. We developed a qualitative model based on Petri nets, made up of a relational graph (interaction network) that was then rigorously handled using transition rules. Unlike traditional modelling and graph theory approaches, transition rules can strongly modify the graph structure (i.e. a dynamic topology occurs).

We examined the value of Petri nets when applied to the simple ecosystem of a termite colony. A termite colony comprises of abiotic and biotic components and processes that we explored along all of their possible trajectories.

Several temporal features, such as basins of attraction (i.e. strongly connected states), tipping points (critical transitions along trajectories) and various kinds of collapses (functioning systems whose structures were nevertheless fixed), were easily detected and quantified. We propose that Petri nets developed for more complex ecosystems will provide original insights into their holistic behaviour.
A Cross‐sectional Analysis of Compassion Fatigue, Burnout, and Compassion Satisfaction in Pediatric Emergency Medicine Physicians in the United States
Authors: Gribben Jeanie L. , MacLean Sarah A. , Pour Trevor , Waldman Elisha D. , Weintraub Andrea S.
Published: June 2019

Objectives

The objective was to determine the prevalence of compassion fatigue (CF), burnout (BO), and compassion satisfaction (CS) and identify potential personal and professional predictors of these phenomena in pediatric emergency medicine (PEM) physicians.

Methods

A modified Compassion Fatigue and Satisfaction Self‐Test for Helpers and a questionnaire of personal and professional characteristics were distributed electronically to PEM physicians nationally. The prevalence of these phenomena was calculated. Hierarchical linear regression models for CF, BO, and CS as a function of potential risk factors were constructed.

Results

The final analyzable survey rate represented 22.7% of the physicians invited to participate. The prevalences of CF, BO, and CS were 16.4, 21.5, and 18.5%, respectively. BO score, distress about a “clinical situation,” “physical work environment,” and engaging in prayer/meditation were each significant determinants of higher CF scores, whereas “socializing with family/friends” was significantly associated with lower CF scores. CF score, emotional depletion, and distress due to “coworkers” were each significant determinants of higher BO scores, whereas CS score and “talking with a family member” as a means of self‐care were significantly associated with lower BO scores. Socializing with family/friends and >20 years as PEM provider were each significant determinants of higher CS scores, whereas BO score, emotional depletion, distress about the physical work environment and “administrative issues,” 10% to 24% of time spent caring for pediatric patients, and “talking with life partner” about work‐related distress were each significant determinants of lower CS scores. We acknowledge that the generalizability of our findings is limited by the sample size and by the fact that participants were largely female, Caucasian, and junior faculty and worked in academic medical centers.

Conclusions

PEM physicians are at risk for developing CF, BO, and low CS. Proactive awareness of these phenomena and their predictors may allow providers to better manage the unique challenges and emotional stressors of the pediatric ED to enhance personal well‐being and professional performance.