bluuebunny/crossref_metadata_2025 huggingface dataset:
Patriarchal paradox: gender performance and men's nursing careers
Authors: Kellett Peter , M. Gregory David , Evans Joan
Published: February 2014

Purpose

– In this paper, the authors situate existing scholarship about men in nursing within the broader gendered landscape of the profession and society. As a consequence, the need to reframe the discourse about men in nursing from the current emphasis on personal or collective experiences to collective action becomes apparent. The paper aims to discuss these issues.

Design/methodology/approach

– A critical synthesis of scholarship addressing men in nursing serves as the basis for a conceptual paper which challenges the existing discourse on men in nursing.

Findings

– The experiences and careers of men in nursing are profoundly shaped by patriarchal power structures that situate caregiving within the realm of the feminine. Although men generally benefit in the context of patriarchal society, men in nursing are subject to a patriarchal paradox that marginalizes their performance of masculinity and situates them as unlikely caregivers. Therefore, men in nursing are preoccupied with balancing the contradictions and tensions in their lives associated with enacting a contextual performance of masculinity depending on the social context of their gender performance.

Originality/value

– A comprehensive synthesis of the existing men in nursing literature is presented and these findings are situated within a broader discussion of gender in nursing and society. This analysis provides the impetus for a “call to action” for nursing to comprehensively and meaningfully address the negative consequences of patriarchal forces on the profession of nursing.
The new neck of femur fracture target: experience in a district general hospital
Authors: Britton Edward , Nash William
Published: February 2014

Purpose

– The hip fracture “best practice tariff” (BPT) came into effect in April 2010. It advocated two key improvements: surgery within 36hrs of arrival in the emergency department; and multi-disciplinary care directed by ortho-geriatrician from admission to discharge. The aim of this paper is to look at the 36 hours to operation target and its implications for orthopaedic department trauma service staff in a busy district general hospital, and to evaluate the measures implemented to meet the target.

Design/methodology/approach

– Trauma-list data, collected from a theatre management system, was compared with trauma patients placed on elective and emergency lists, before and after designated daily trauma lists were implemented.

Findings

– After a designated daily trauma list was introduced, a significant rise (from 56 per cent to 85 per cent) became evident in the proportion of patients operated on within 36hrs, between November 2010 to February 2011, while hip fracture cases managed on the elective list fell from 24 per cent to 17 per cent.

Practical implications

– Despite adding a half-day trauma list, the trauma service has insufficient capacity to achieve the new BPT for all hip fracture patients in the hospital. Therefore, there is a significant knock-on effect for managing patient overspill on elective services. Will the significant changes in service provision designed to achieve this BPT be cost effective?

Originality/value

– This paper aims to answer how busy department staff address an issue that professionals in every English hospital are facing.
Listening to patients: improving the outpatient service
Authors: Mercieca Cecilia , Cassar Sara , A. Borg Andrew
Published: February 2014

Purpose

– This paper assesses the patients' healthcare information needs and expectations when they attend a rheumatology outpatient clinic. It proposes that obtaining the patients' perspectives about the services they use is an essential service-development tool. The aim of this paper is to expand the current domains used to evaluate these perspectives.

Design/methodology/approach

– This paper is an exploratory study, looking at quality assessment and improvement based on Donabedian's quality model in a rheumatology outpatient setting. A structured interview schedule addressing care pathways was used and 70 consecutive patients were recruited.

Findings

– The article provides insights about how relevant change can be brought about when service development is contemplated. It suggests that patients are important stakeholders in the ongoing service development process.

Research limitations/implications

– Because rheumatological conditions tend to be chronic and require long-term follow-up, the results may lack generalisability. Therefore, researchers are encouraged to test propositions in different clinical settings.

Practical implications

– The article highlights healthcare delivery areas that are not meeting patient expectations. Some recommendations (such as informing waiting patients regularly about any delays) require minimal additional resources for successful implementation. Service providers need to obtain the patients' healthcare perspectives to ensure that services are built around their needs.

Originality/value

– This article fulfils an identified need to study how patients perceive service quality.
Patient results and laboratory test accuracy
Authors: Katayev Alexander , K. Fleming James
Published: February 2014

Purpose

– Traditional quality control materials used for monitoring the clinical laboratory test accuracy might be non-commutable with patient samples and may not detect systematic errors. The aim of this paper is to describe a method to monitor inter-instrument bias using result distributions that are independent of the control's commutability.

Design/methodology/approach

– Serum calcium data collected within a laboratory network were assessed. A reference interval was calculated using a computerized, indirect Hoffmann's algorithm using all data across a laboratory network without excluding any results. Results outside the reference interval were considered as the zero-bias distribution. Three allowable bias levels were then calculated to determine the corresponding shift in abnormal results for each bias level in both directions from the zero-bias distribution. The observed result distributions in three laboratories within the network were compared for bias performance after one year of the reference interval study.

Findings

– Performance levels for bias were: minimum allowable <1.27 percent; desirable <0.85 percent; and optimal <0.42 percent. Zero bias result distribution above and below the reference interval for calcium was 3.92 percent and 2.53 percent respectively. All three laboratories performed within the desirable allowable bias level.

Originality/value

– Bias-monitoring process using patient result distributions allows managers to: assess systematic error between laboratory instruments; improve laboratory quality control; and strengthen patient risk management.
Safeguarding the public by regulating health and social care professionals: lessons from Mid-Staffordshire and the Law Commission review
Authors: Spencer-Lane Tim
Published: February 2014

Purpose

– The purpose of this paper is to consider the final report of the Mid Staffordshire NHS Foundation Trust Public Inquiry and the Law Commissions’ review of health and social care professional regulation – and how these will impact on the professional regulation bodies.

Design/methodology/approach

– Summary and discussion of the relevant recommendations made by the Mid Staffordshire NHS Foundation Trust Public Inquiry and the initial Government response, and consultation responses to the Law Commissions’ provisional proposals for law reform of health and social care professional regulation.

Findings

– Future legislation is likely to be based on the recommendations of the Mid Staffordshire NHS Foundation Trust Public Inquiry and the Law Commissions.

Originality/value

– Overview of the Mid Staffordshire NHS Foundation Trust Public Inquiry and the initial Government response, and consultation responses to the Law Commissions.
Firms' customer responsiveness and performance: the moderating roles of dyadic competition and firm's age
Authors: Pehrsson Anders
Published: February 2014

Purpose

– The literature reports mixed findings on the performance impact of market orientation and a lack of attention to the moderating roles of dyadic competition and firm's age. The purpose of this paper is to explore the relationship between customer responsiveness and performance of industrial firms and to consider the moderators.

Design/methodology/approach

– Drawing on competitive dynamics literature, a contingency model is developed. Hypotheses were tested on 350 Swedish industrial firms that market clean technology to business customers.

Findings

– First, the main competitor's cost leadership weakens the positive performance impact of the industrial firm's customer responsiveness. An interpretation would be that it is difficult for product firms to overcome competition based on low costs. Second, the industrial firm's age weakens the positive performance impact of the industrial firm's customer responsiveness. This indicates that the firm's responsiveness advantage diminishes as strategies of competing firms converge.

Research limitations/implications

– By adding literature on competitive dynamics the study contributes to theory. The article shows that dyadic competition and firm's age matter for the relationship between customer responsiveness and performance.

Practical implications

– The industrial firm may keep an efficient customer responsiveness strategy by reducing its vulnerability to low costs of the main competitor. Also, an ability of developing the content of the firm's responsiveness strategy would favor the strategy uniqueness and efficiency.

Originality/value

– The article presents a new model that shows the performance impact of the industrial firm's customer responsiveness, including the moderating roles of the main competitor's competitive strategy and the firm's age. By including the contingencies, the model explains mixed findings in the literature regarding relationships between customer responsiveness and performance.
Understanding new service development and service innovation through innovation modes
Authors: Gremyr Ida , Witell Lars , Löfberg Nina , Edvardsson Bo , Fundin Anders
Published: February 2014

Purpose

– The purpose of this paper is to explore the role of innovation modes in understanding challenges of integrated NSD and NPD, and the use of structured NSD processes in manufacturing firms.

Design/methodology/approach

– The research is based on a two-stage multiple case study. The first stage is an interview study of 17 key informants representing manufacturing firms in the machine industry. The second stage is an in-depth study of three service innovations at three manufacturing firms based on 16 interviews with key informants.

Findings

– The results of the study show that NSD processes are often more structured if the service is developed separately from the product. The fact that different innovation modes benefit from varying degrees of structure in the development process means that integrated service development can be challenging. Furthermore, service innovations often follow a trajectory of innovation modes before succeeding in the market. Some innovation modes occur within the NSD process, while others occur outside the process. One success factor for NSD is the fit between the innovation modes and the NSD process, rather than the NSD process per se.

Originality/value

– This research uses innovation modes to explain why NSD in manufacturing firms is often performed on an ad hoc basis, and how service innovations go through a trajectory of innovation modes. In this way, the study contributes to theory development of service innovation, and specifically service innovations in manufacturing firms.
Absorptive capacity and network orchestration in innovation communities – promoting service innovation
Authors: Nätti Satu , Hurmelinna-Laukkanen Pia , J. Johnston Wesley
Published: February 2014

Purpose

– The purpose of this study is to increase understanding of service innovation in networks. Especially the most loosely coupled forms of innovation networks, innovation communities, can be valuable in service innovation, but may not be manageable in the traditional sense. Rather, they may require orchestration characterized by discreet guidance that also accommodates the specific nature of services. Through informed orchestration, it is possible to deal with several contingencies, and influence the absorptive capacity at the network level to generate new service innovations.

Design/methodology/approach

– These issues are examined through literature review and a case study.

Findings

– The findings suggest that individual orchestration mechanisms may be more closely connected to certain contingencies than others, and that both orchestration mechanisms and contingency factors have a role in absorptive capacity development within service innovation networks.

Research limitations/implications

– While the case study approach limits the possibility to make wide generalizations, the in-depth insights provide valuable knowledge.

Practical implications

– There has been a shift from inter-firm competition towards competition between networks of organizations, increasing relevance of absorptive capacity at the network level.

Originality/value

– Despite the recent increase in service innovation literature, research on service innovation taking place in networks is scant. Knowledge on some aspects can be derived from more traditional notions on technological innovation, but both the distinctive features of services and central characteristics of innovation networks make it necessary to reconsider some of the established views. In particular, managing – or rather orchestrating – service innovation is still a challenging area.
Unlocking our community assets in designing a sustainable pathway to recovery in mental health
Authors: Lilley William
Published: February 2014

Purpose

– The purpose of this paper is to highlight case studies of how housing associations have worked effectively with the NHS and adult social care in developing a joined approach to mental health recovery.

Design/methodology/approach

– This is primarily two case studies from Bromford.

Findings

– These are just case studies contributed by the Bromford on existing examples.

Originality/value

– All material is original and any reference is attributed to the original author.
Housing and health – a public health perspective
Authors: Phillips Adrian , Baker Andy
Published: February 2014

Purpose

– The purpose of this paper is to provide a viewpoint on homelessness and health gained from a practical public health perspective.

Design/methodology/approach

– Views derived from local review as well as other national epidemiology and research.

Findings

– That housing has real impacts upon health especially for those who are homeless.

Research limitations/implications

– This is a viewpoint from a major city in England.

Practical implications

– Homelessness leads to extreme vulnerability. There are other aspects of the home environment that impact elsewhere in the public sector, especially the health service. Vulnerable individuals are more likely to become homeless which can lead to exacerbation of vulnerability.

Originality/value

– This is a viewpoint derived solely from local practice.
In the mood for [the right kind of] social marketing communication
Authors: Anghelcev George , Sar Sela
Published: February 2014

Purpose

– The effectiveness of social marketing communication should depend both on message features and on the psychological characteristics of message recipients. This premise was tested in an experiment focused on why consumers may respond differently to different types of pro-recycling advertisements. The message feature was the way in which the advertisements were framed. The psychological characteristic of the message recipient was the respondent's mood. The paper aims to discuss these issues.

Design/methodology/approach

– Hypotheses were tested in the context of an experiment focused on paper recycling.

Findings

– It was hypothesized that congruity between mood and the frame of the message would result in more favorable message evaluations and higher intentions to recycle than incongruity. Supporting the study's hypotheses, the data showed that participants in a negative mood had higher intentions to recycle paper and evaluated pro-recycling advertisements more favorably when the ads emphasized avoiding negative consequences as opposed to attaining desired benefits. Among participants in a positive mood, desired benefit advertisements induced higher intentions to recycle paper and were evaluated more favorably than advertisements framed in terms of avoiding negative consequences.

Practical implications

– A clear message placement strategy is suggested to increase the effectiveness of social marketing communication campaigns.

Originality/value

– This mood congruity effect has not been reported before in the context of pro-environmental communication. Furthermore, the study provides empirical evidence of the underlying psychological mechanisms that cause the observed interaction. The evidence suggests the data could be predictive of similar response patterns in other social marketing communication domains (e.g. in response to health messages, volunteering, charity, etc.).
Gender and message appeal: their influence in a pro-environmental social advertising context
Authors: Noble Gary , Pomering Alan , W. Johnson Lester
Published: February 2014

Purpose

– In this article, message appeals along with the moderating effect of gender are examined on frequently used measures of ad effectiveness (i.e. ad likability, attitude to the issue, and behavioral intention) in the emerging domain of pro-environmental social advertising. The paper aims to discuss these issues.

Design/methodology/approach

– This study employed a between-subjects 2 (gender)×3 (message appeal) factorial design, administered through a commercial online consumer panel firm based in the USA, which included 444 respondents across three markets: Australia, the UK and the USA.

Findings

– Results show that of three frequently used message appeals (rational, negative emotional, and positive emotional), rational ad appeals are not as effective as emotional appeals. The study also shows that females respond more strongly to negative emotional appeals than males, while there is no significant difference in how males and females responded to positive emotional or rational ad appeals. In addition, the study demonstrates that the measure of ad likability, which is frequently used as a reliable copy-test measure in commercial marketing situations, is not a valid measure of ad effectiveness in the context of social advertising.

Research limitations/implications

– While the study included participants from three countries, Australia, the UK and the USA, the obvious limitation of the experimental design lies in the limited sample size. Further, while the ads' cognitive processing load was kept consistent across the three conditions, it may be possible that linguistic nuances across these markets might affect the ads' processing demands from one market to another. The consistency of the study's manipulation checks, however, might serve to offer support for the copy approach taken here.

Originality/value

– This study reinforces previous studies in both the commercial and social marketing fields that suggest practitioners should be cautious of placing too much emphasis on this measure as an indicator of future ad performance.
Pricing myopia: do leading companies capture the full value of their pricing strategies?
Authors: Carricano Manu
Published: February 2014

Purpose

– Many companies lack insights or fact-based support for the pricing decisions they make in an increasingly complex environment. In order to optimize their pricing process, managers need to identify key indicators that may influence the performance of their decisions. The purpose of this paper is to report an investigation of pricing determinants in large companies manufacturing capital goods in France. First a conceptual framework is proposed, in order to fill several gaps identified in the literature on pricing practices and more precisely by operating a distinction between environmental variables (determinants), decision making (pricing strategy and price and product-line structures) and its consequence in terms of price level.

Design/methodology/approach

– The author conducted an empirical research on the determinants of the pricing process. This study consistedof a questionnaire survey addressed to pricing managers (or executives in charge of pricing) in 98 of the largest manufacturing companies in France about their new-product pricing decision-making process.

Findings

– The author studies environmental determinants and their influence on the pricing and describes the structure of pricing determinants as a five dimensions construct: market-based, value-based, position-based, competition-based and production-based. The results show that firms rely on environmental determinants as indicators of their pricing flexibility. These indicators operate as pricing levers: a good position on these variables gives firms more pricing power. But in the vast majority of the cases, companies extensively relied on competitive conditions instead of taking advantage of a favorable position, described as pricing myopia.

Originality/value

– This paper describes current pricing practices in leading companies with key informants (mainly pricing managers) highly involved in the pricing decision process, and contrasts two pricing orientations, pricing power vs pricing myopia.
Management of customer assets for increased value capture in business markets
Authors: Nenonen Suvi , Storbacka Kaj
Published: February 2014

Purpose

– The last two decades have seen a surge of interest in the concept of value in business markets. Furthermore, extant literature suggests that value capture can be conceptualized as the return on the firm's customer assets. However, the existing customer asset management literature has a strong bias towards consumer markets. Thus, the purpose of this paper is to create a conceptual framework for managing customer assets for improved value capture in a business market context, and to illustrate the use of the framework empirically.

Design/methodology/approach

– The authors approach the topic with conceptual development and a longitudinal case illustration from a globally operating forestry product firm.

Findings

– The findings of the study indicate that B2B firms can increase their value capture by dividing their customer base into customer portfolios, which are managed with differentiated customer management concepts targeted to increase the economic profit contribution of each customer portfolio.

Practical implications

– The business practitioners in B2B contexts are likely to find the proposed customer portfolio approach to managing the customer assets more approachable than the prevailing customer lifetime models. In order to gain maximum value capture benefits from portfolio-specific customer management concepts, they should be approached cross-functionally instead of limiting them to the domains of marketing and sales.

Originality/value

– The study contributes to literature on value capture and customer asset management by providing a framework for managing customer assets for increased value capture that is applicable to business markets and circumvents the majority of challenges associated with the customer lifetime value models.
Pricing capabilities: the design, development, and validation of a scale
Authors: Liozu Stephan , Hinterhuber Andreas
Published: February 2014

Purpose

– The literature has paid increased attention to pricing capabilities as a set of distinctive, complex activities, routines, and processes that drive company performance. Despite this emphasis, little research has addressed the pricing-capabilities construct itself, and no accepted measure of pricing capabilities exists. The purpose of this paper, therefore, is to document the design, development, and validation of a dedicated pricing-capabilities scale, PRICECAP.

Design/methodology/approach

– Qualitative plus three quantitative surveys.

Findings

– The present research describes the development of a ten-item measure, PRICECAP, that can be used to assess organizational capabilities related to pricing.

Research limitations/implications

– The reliability and validity of the scales were assessed through three separate quantitative studies using exploratory and confirmatory analysis. The PRICECAP scale has a variety of potential applications and can serve as a framework for future empirical research in marketing theory as well as an instrument to assess, compare, and develop pricing capabilities in marketing practice.

Originality/value

– Empirical research has provided scales to measure value creation but a scale to measure value capture – i.e. pricing – capabilites is lacking. This study covers this gap and provides a new, parsimonious, ten-item construct to measure pricing capabilities.
Determinants of corporate foreign exchange risk hedging
Authors: Chong Lee-Lee , Chang Xiao-Jun , Tan Siow-Hooi
Published: February 2014

Purpose

– The purpose of this study is to delineate the factors influencing the use of financial derivatives by non-financial firms in managing their exchange rate exposure. In total, 219 non-financial firms are surveyed in regard to their financial hedging decision.

Design/methodology/approach

– This study is conducted via a survey and the questionnaires were sent to the treasurers and financial controller of the firms. Descriptive analysis is employed to assess the profiles of the respondents. Then, factor analysis is carried out to determine the factors influencing the use of financial derivatives in Malaysia.

Findings

– The results indicate that the hedging decision of non-financial firms is influenced by their assertive level toward the market and regulators and also how flexible they are for derivative instruments. The intellectual capability that firms acquire to perform hedging strategies is also vital in influencing them to make hedging decision.

Practical implications

– The insights of this survey would assist and prepare firms to hedge their exchange rate risk by employing financial derivatives. Knowing the influences of firms' adoption of currency derivatives would allow policy makers to formulate their policies in boosting the liquidity of Malaysian derivative market.

Originality/value

– This study presents findings on the factors influencing the execution of financial hedging by non-financial firms in Malaysia. Survey data are used to seek for the feedback from the market players in order to provide empirical evidence on the corporate use of financial hedging.
A loop diagram pedagogy: seeing the unseen in the forward market efficiency hypothesis
Authors: Jitmaneeroj Boonlert
Published: February 2014

Purpose

– In an introductory finance course, business school students often report difficulty in dealing with several variables and regression equations in testing the forward market efficiency and its relevant hypotheses: forward rate unbiasedness, rational expectations, risk neutrality and homogeneous expectations. The paper aims to discuss these issues.

Design/methodology/approach

– Although each of these hypotheses may be relatively easy to understand one by one, it is harder to see their linkages. Thus, the author develops the loop diagram for supplementing traditional instruction methods.

Findings

– The author finds that a significant majority of students prefer the loop diagram approach. Furthermore, students using loop diagram display more understanding of the forward market efficiency than those with access to a conventional instruction.

Originality/value

– The loop diagram provides students a simple visual aid for formulating a complete set of regressions and enables them to analyze a richer set of relationships between several hypotheses than what they typically see in finance textbooks.
Information asymmetry in high potential programs
Authors: Dries Nicky , De Gieter Sara
Published: February 2014

Purpose

– The purpose of this paper is to examine the implicit beliefs both high potentials and HR directors hold about the terms of the exchange relationship between high potential employees and their organizations. The paper positions the study within the framework of the psychological contract, exploring specifically whether strategic ambiguity and information asymmetries in high potential programs create a heightened risk of psychological contract breach.

Design/methodology/approach

– A total of 20 high potentials and 11 HR directors from nine different organizations were interviewed. Open and axial coding of the qualitative data was performed by three raters.

Findings

– Information asymmetry in high potential programs, indeed, poses a potential risk for psychological contract breach. Although strategic ambiguity can be an effective communication strategy in that it creates a power imbalance in favor of the organization, at all times a delicate balance must be maintained between leaving room for flexibility and intuitive decision making, and creating perceived promises in high potential employees that are subsequently broken. In fact, through information asymmetry organizations run the risk of achieving the exact opposite of the goals they had for their high potential programs in the first place.

Originality/value

– Hardly any research has been done on the psychological effects of identifying a very small proportion of an organization's workforce as high potentials. In addition, research contrasting employee and employer beliefs about psychological contract terms is scarce.
Reconstructing the gravity gradient anomaly field from surveys with wide line spacing using equivalent source processing: an error analysis
Authors: Barnes Gary
Published: February 2014

When anomalous gravity gradient signals provide a large signal‐to‐noise ratio, airborne and marine surveys can be considered with wide line spacing. In these cases, spatial resolution and sampling requirements become the limiting factors for specifying the line spacing, rather than anomaly detectability. This situation is analysed by generating known signals from a geological model and then sub‐sampling them using a simulated airborne gravity gradient survey with a line spacing much wider than the characteristic anomaly size. The data are processed using an equivalent source inversion, which is used subsequently to predict and grid the field in‐between the survey lines by means of forward calculations. Spatial and spectral error analysis is used to quantify the accuracy and resolution of the processed data and the advantages of acquiring multiple gravity gradient components are demonstrated. With measurements of the full tensor along survey lines spaced at 4 × 4 km, it is shown that the vertical gravity gradient can be reconstructed accurately over a bandwidth of 2 km with spatial root‐mean square errors less than 30%. A real airborne full‐tensor gravity gradient survey is presented to confirm the synthetic analysis in a practical situation.
Valuing seasonal climate forecasts in a state‐contingent manner
Authors: Crean Jason , Parton Kevin , Mullen John , Hayman Peter
Published: February 2014

We applied state‐contingent theory to climate uncertainty at a farm level to assess the value of seasonal climate forecasts in the Central West region of NSW. We find that modelling uncertainty in a state‐contingent manner results in a lower estimate of forecast value than the typical expected value approach. We attribute this finding to a more conservative long‐term farm plan in the discrete stochastic programming (DSP) model, which is better balanced for climate uncertainty. Hence, a climate forecast, even though it still revises probabilities held by farmers, does not call forth such large changes in farm plans and associated farm incomes. We then use the DSP model to assess how attributes of a hypothetical forecasting system, particularly its skill and timeliness, as well as attributes of the decision environment, influence its value. Lastly, we assess the value of current operational forecast systems and show that the value derived from seasonal climate forecasts is relatively limited in the case study region largely because of low skill embodied in forecasts at the time when major farm decisions are being made.
Fear of childbirth in nulliparous and multiparous women: a population‐based analysis of all singleton births in Finland in 1997–2010
Authors: Räisänen S , Lehto SM , Nielsen HS , Gissler M , Kramer MR , Heinonen S
Published: February 2014

Objective

To identify risk factors for fear of childbirth (FOC) according to parity and socioeconomic status, and to evaluate associations between FOC and adverse perinatal outcomes.

Design

A cohort study.

Setting

The Finnish Medical Birth Register.

Population

All 788 317 singleton births during 1997–2010 in Finland.

Methods

Fear of childbirth was defined according to the International Classification of Diseases code O99.80, and its associations with several risk factors and perinatal outcomes were analysed by multivariable logistic regression.

Main outcome measures

Prevalence of, risk factors for and outcomes of FOC.

Results

Fear of childbirth was experienced by 2.5% of nulliparous women and 4.5% of multiparous women. The strongest risk factors for FOC in nulliparous women were depression [adjusted odds ratio (aOR), 6.35; 95% confidence interval (CI), 5.25–7.68], advanced maternal age (aOR, 3.78; 95% CI, 3.23–4.42) and high or unspecified socioeconomic status. In multiparous women, the strongest risk factors for FOC were depression (aOR, 5.47; 95% CI, 4.67–6.41), previous caesarean section (CS) (aOR, 3.02; 95% CI, 2.93–3.11) and high or unspecified socioeconomic status. Among both nulliparous and multiparous women, FOC was associated with higher rates of CS (3.3‐fold and 4.5‐fold higher, respectively) and a lower incidence of low birthweight (<2500 g), small for gestational age babies, preterm birth and low Apgar scores at 1 minute.

Conclusions

High and unspecified socioeconomic status, advanced maternal age and depression are predisposing factors for FOC regardless of parity. Among multiparous women, a previous CS increases vulnerability to FOC. FOC is associated with increased rates of CS, but does not adversely affect other pregnancy outcomes.
The impact of human papillomavirus genotype on colposcopic appearance: a cross‐sectional analysis
Authors: van der Marel J , van Baars R , Quint WGV , Berkhof J , del Pino M , Torné A , Ordi J , Wentzensen N , Schiffman M , van de Sandt MM , Lindeman J , Jenkins D , Helmerhorst TJM , Verheijen RHM , ter Harmsel B , Alonso I
Published: February 2014

Objective

To study colposcopic performance in diagnosing high‐grade cervical intraepithelial neoplasia or cervical cancer (CIN2+ and CIN3+) using colposcopic characteristics and high‐risk human papillomavirus (hrHPV) genotyping.

Design

Cross‐sectional multicentre study.

Setting

Two colposcopy clinics in The Netherlands and Spain.

Population

Six hundred and ten women aged 17 years and older referred for colposcopy because of abnormal cytology.

Methods

A cervical smear was obtained. Colposcopists identified the worst lesion, graded their impression and scored the colposcopic characteristics of the lesions. Up to four biopsies were collected, including one biopsy from visually normal tissue.

Main outcome measures

CIN2+ and CIN3+, positive for HPV16 or other high‐risk HPV types (non‐16 hrHPV‐positive).

Results

The mean age in HPV16‐positive CIN2+ women was 35.1 years compared with 39.1 years in women with other hrHPV types (P = 0.002). Sensitivity for colposcopy to detect CIN2+ was 87.9% (95%CI 83.2–91.5), using colposcopic cut‐off of ‘any abnormality’. The remaining CIN2+ were found by a biopsy from visually normal tissue or endocervical curettage (ECC). Detection of CIN2+ by lesion‐targeted biopsies was not different between HPV16‐positive women [119/135; 88.1% (95%CI 81.2–92.9)] and non‐16 hrHPV‐positive women [100/115; 87.0% (95%CI 79.1–92.3); P = 0.776]. In multivariate analysis, ‘acetowhitening’ [odds ratio (OR) 1.91, 95%CI 1.56–3.17], ‘time of appearance’ (OR 1.95, 95%CI 1.21–3.15) and ‘lesion >25% of visible cervix’ (OR 2.25, 95%CI 1.44–3.51) were associated with CIN2+.

Conclusions

In this population following European screening practice, HPV16‐related CIN2+ lesions were detected at younger age and showed similar colposcopic impression as non‐16 hrHPV high‐grade lesions. There was no relationship between any of the colposcopic characteristics and HPV16 status.
Melatonin Reduces Tachycardia in Postural Tachycardia Syndrome: A Randomized, Crossover Trial
Authors: Green Elizabeth A. , Black Bonnie K. , Biaggioni Italo , Paranjape Sachin Y. , Bagai Kanika , Shibao Cyndya , Okoye Mirian C. , Dupont William D. , Robertson David , Raj Satish R.
Published: February 2014

Background

Postural tachycardia syndrome (POTS) induces disabling chronic orthostatic intolerance with an excessive increase in heart rate (HR) upon standing, and many POTS patients have a hyperadrenergic state. Medications that restrain HR are a promising approach to this problem.

Objective

We tested the hypothesis that melatonin will attenuate the tachycardia and improve symptom burden in patients with POTS.

Methods

Patients with POTS (n = 78) underwent acute drug trials with melatonin 3 mg orally and placebo, on separate mornings, in a randomized crossover design. Blood pressure, HR, and symptoms were assessed while seated and after standing for up to 10 min prior to, and hourly for 4 h following study drug administration.

Results

The reduction in standing HR was significantly greater 2 h after melatonin compared with placebo (P = 0.017). There was no significant difference in the reduction of systolic blood pressure between melatonin and placebo, either with standing or while seated. The symptom burden was not improved with melatonin compared with placebo.

Conclusion

Oral melatonin produced a modest decrease in standing tachycardia in POTS. Further research is needed to determine the effects of regular night‐time use of this medication in POTS.
Three‐dimensional analysis of the early development of the dentition
Authors: Peterkova R , Hovorakova M , Peterka M , Lesot H
Published: February 2014

Tooth development has attracted the attention of researchers since the 19th century. It became obvious even then that morphogenesis could not fully be appreciated from two‐dimensional histological sections. Therefore, methods of three‐dimensional (3D) reconstructions were employed to visualize the surface morphology of developing structures and to help appreciate the complexity of early tooth morphogenesis. The present review surveys the data provided by computer‐aided 3D analyses to update classical knowledge of early odontogenesis in the laboratory mouse and in humans. 3D reconstructions have demonstrated that odontogenesis in the early stages is a complex process which also includes the development of rudimentary odontogenic structures with different fates. Their developmental, evolutionary, and pathological aspects are discussed. The combination of in situ hybridization and 3D reconstruction have demonstrated the temporo‐spatial dynamics of the signalling centres that reflect transient existence of rudimentary tooth primordia at loci where teeth were present in ancestors. The rudiments can rescue their suppressed development and revitalize, and then their subsequent autonomous development can give rise to oral pathologies. This shows that tooth‐forming potential in mammals can be greater than that observed from their functional dentitions. From this perspective, the mouse rudimentary tooth primordia represent a natural model to test possibilities of tooth regeneration.
Three‐dimensional analysis of molar development in the mouse from the cap to bell stage
Authors: Lesot H , Hovorakova M , Peterka M , Peterkova R
Published: February 2014

During four days of prenatal development in the mouse, the morphology of the first lower molar moves from the early cap to the bell stage. Five phenomena characterize this period: growth of the tooth germ; development of the cervical loop; histogenesis of the enamel organ; folding of the epithelial‐mesenchymal junction associated with cusp formation; and change in cellular heterogeneity in the mesenchyme. All these processes are controlled by epithelial‐mesenchymal interactions.

These complex histo‐morphogenetic events have been documented using histological sections and 3D reconstructions. When combined with functional tests in vitro, this approach allowed searching for possible relationships between simultaneous changes occurring in both the epithelial and ecto‐mesenchymal compartments.

Parallel changes that occur in the two tissues could result from different mechanisms, as illustrated by the increasing number of pre‐odontoblasts and pre‐ameloblasts during crown growth. Cell division was involved mainly in the ecto‐mesenchyme, while proliferation and cell re‐organization occurred in the inner dental epithelium. 3D reconstructions also raised still unsolved questions, such as the possible relationship between cusp size and spatial specification of cell kinetic parameters, changes in cell position within the inner dental epithelium, and tracing cell migration in the mesenchyme during development.
Dental management of patients irradiated for head and neck cancer
Authors: Beech N , Robinson S , Porceddu S , Batstone M
Published: February 2014

Patients undergoing radiation therapy as either primary, adjuvant, combination therapy or palliative management of head and neck malignancies are prone to a range of dental complications. Strategies for prevention and management of such complications may be controversial. This article aims to highlight the current understanding and management of the dental needs for patients before, during and after radiation therapy.
Periodontal disease and dental caries among Indigenous Australians living in the Northern Territory, Australia
Authors: Kapellas K , Skilton MR , Maple‐Brown LJ , Do LG , Bartold PM , O'Dea K , Brown A , Celermajer DS , Jamieson LM
Published: February 2014

Background

The aim of this study was to describe the caries experience and severity of periodontal disease in a convenience sample of Indigenous Australians living in the Northern Territory.

Methods

Data were gathered via self‐reported questionnaire and dental examination by calibrated examiners. Socio‐demographic characteristics were compared with data from the 2011 Australian census while prevalence of periodontal disease and dental caries was compared against weighted estimates from the National Survey of Adult Oral Health 2004–2006. In each comparison, non‐overlapping 95% confidence intervals inferred a significant difference. Within‐study comparisons were assessed via chi‐square, t‐tests and analysis of variance for differences among study participants.

Results

A total of 312 Indigenous Australian participants provided completed data (average age 39.5 ± 10.5 years, 174 males). Of these, 87.5% were confirmed periodontitis cases; 3.5 times that of national‐level estimates. The experience of untreated caries was five times that of national estimates (mean decayed 3.0 versus 0.6). Periodontitis case status was positively associated with older age, male gender and presence of diabetes.

Conclusions

Periodontal disease and untreated caries were significantly more prevalent in this sample of Indigenous Australians compared to the general Australian population. The prevalence of periodontal disease was markedly higher than that previously described for Indigenous Australians.
Hyposalivation in a 16‐year‐old girl: a case of salivary gland aplasia
Authors: Frydrych AM , Koong B
Published: February 2014

Salivary gland aplasia is a rare condition with only a small number of cases reported worldwide. It is more commonly seen in males and can occur either in isolation or association with other defects or syndromes. It may or may not occur with a hereditary background. Scant literature exists detailing the status of sublingual salivary glands in patients with any form of major salivary gland aplasia. This case report describes the clinical and magnetic resonance imaging presentation of a 16‐year‐old girl with major salivary gland aplasia detailing the status of all six major salivary glands.
Efficacy of air/water syringe tip sterilization
Authors: Inger M , Bennani V , Farella M , Bennani F , Cannon RD
Published: February 2014

Background

Dental procedures involve contact between instruments and the patient's tissues, blood or saliva. This study evaluated the efficacy of the standardized sterilization of non‐disposable air/water syringe tips and corrosion and contaminant build‐up in these tips.

Methods

The bacterial contamination of single‐use and multiple‐use non‐disposable air/water syringe tips after routine use and sterilization was compared to that of single‐use disposable tips by microbial culturing on PCA and blood agar plates. The effect of flushing the syringe tips prior to sterilization was also measured. The amount of corrosion in single‐use and multiple‐use non‐disposable syringes was measured by SEM and EDS analyses.

Results

Non‐disposable syringe tips had significantly (p < 0.05) greater bacterial contamination than single‐use disposable tips. There were no statistically different levels of contamination between flushed and non‐flushed non‐disposable syringes or between single‐use and multiple‐use non‐disposable syringes. SEM and EDS analyses showed greater evidence of corrosion and contaminant build‐up in multiple‐use syringes compared to single‐use non‐disposable syringes.

Conclusions

Sterilization of non‐disposable air/water syringes is not completely effective and rinsing, or the number of uses, does not affect the effectiveness of sterilization. There may be a lower risk of cross‐infection from the use of disposable air/water syringe tips, instead of non‐disposable ones.
Subclinical concentrations of chlorhexidine inhibit gelatinase activity of carious dentine in vitro
Authors: Trufello A Mustakis , Orellana B Urzúa , Moraga C Lozano , Puente C Lefimil , Morales‐Bozo I
Published: February 2014

Background

There is evidence that dentine matrix gelatinases are involved in the destruction of carious dentine after demineralization by bacterial acids. It has also been observed that chlorhexidine, in very low concentrations, inhibits the activity of these enzymes in mammalian cells. The goal of this study was to determine if the gelatinase activity of carious dentine may be inhibited by chlorhexidine in clinical use concentrations.

Methods

Gelatinolytic activity was evaluated through zymography and identified by Western blot. The inhibitory effects of chlorhexidine at concentrations of 0.01%, 0.04%, 0.08% and 1% on the enzymatic activity of softened carious dentine samples were determined.

Results

In carious dentine, five bands of gelatinolytic activity were detected, with molecular sizes of 86, 75, 38, 33 and 32 kDa. The two bands of the greatest molecular size corresponded to latent and active metalloproteinase‐9, respectively. Concentrations of chlorhexidine that were greater than or equal to 0.04% were sufficient to inhibit gelatinolytic activity in the observed bands of carious dentine.

Conclusions

These results support the use of chlorhexidine in clinical use concentrations for the treatment and control of dentine caries. Our study demonstrates for the first time the inhibitory effect of chlorhexidine on gelatinases from carious human dentine.