bluuebunny/crossref_metadata_2025_split huggingface dataset:
“You call it a structure taboo!” Relating consultant experiences to changing dynamics in healthcare
Authors: van Nistelrooij Antonie , Homan Thijs 
Published: March 2019

Purpose
The purpose of this paper is to provide a comprehensive reflective perspective on the effects of an intervention in a healthcare organization, as experienced by a consultant. What does a consultant experience when things flounder?

Design/methodology/approach
This paper applies a complex responsive process approach as a research perspective and autoethnography as a method to better understand the tensions of a consultant in interacting with members of a client-system.

Findings
Focusing on the experiences of the first author during his work as a consultant in a healthcare institution. This approach contributes to the literature by providing a witness, rather than an aboutness, perspective on the experiences of a consultant during a completely unexpected event.

Research limitations/implications
This paper is limited by looking at one case in the public sector. It should be considered as exploratory research.

Originality/value
The paper can be of value to consultants who are working as a facilitator, as well as to management scholars and practitioners in the field of change management.
Outsourcing of aviation technical services – a literature survey
Authors: Holkeri Jukka 
Published: March 2019

Purpose
The outsourcing of maintenance and other technical services is a growing trend and phenomenon in both military and civil aviation. The purpose of this paper is to characterize and analyze this trend by summarizing the existing research concerning outsourcing and the related service provider selection processes in this industry.

Design/methodology/approach
The concepts are identified and synthesized using a framework that articulates contexts, observed outcomes and generation mechanisms.

Findings
The expected growth trend of outsourcing was confirmed by the literature, and cost was also observed as a driver for the decision to outsource. However, one conclusion is that outsourcing of technical services is not solely cost-driven in aviation as clarity and partnership-type relations (working together for a common goal) appear to be the key success factors in the eventual working relationship.

Research limitations/implications
The focus of the published scientific material may be different compared to that of the actual industry. Empiric research is recommended to complement this literature survey.

Social implications
Improving the understanding of outsourcing activities may enable better efficiencies and even improve safety in aviation.

Originality/value
The concepts developed in this paper provide a suitable platform for further studies. In addition, the concepts serve as a concise introduction to the subject.
Strategic corporate real estate management practice in Ghana
Authors: Boakye-Agyeman Naana Amakie , Bugri John Tiah 
Published: March 2019

PurposeThe success of every business depends to a large extent on its corporate real estate (CRE), given that, it is the physical assets that support its operations. To achieve this success, organizations must adopt a strategic approach to CRE management. The purpose of this paper is to examine the extent of adoption of strategic corporate real estate management (SCREM) practice in Ghana based on the views of CRE managers.Design/methodology/approachThe embedded mixed method approach was adopted for the study. In total, 72 CRE managers were selected from 35 institutions in 5 sectors (tertiary education, health, banking, security and service industry) where real estate is a requirement for accreditation using a multi-stage sampling technique.FindingsAn analysis of the existing practices underpinning SCREM in Ghana showed that SCREM has not been adopted completely in Ghanaian institutions. No organization has a complete systematic structure in place for SCREM as the practice is evolving. This finding correlates the global trend that CRE is not strategically managed like other corporate resources.Practical implicationsCurrent SCREM practices in Ghana, as divulged by this research, provide useful insight into the current status quo of SCREM and what must be done to ensure that CRE achieves its attribute of value adding.Originality/valueThe paper outlines the elements of SCREM practice, adding to the limited literature on the practice in Ghana and worldwide. It also sets the stage for further research in SCREM practice and CRE performance.
The leptin sensitizer celastrol reduces age‐associated obesity and modulates behavioral rhythms
Authors: Chellappa Karthikeyani , Perron Isaac J. , Naidoo Nirinjini , Baur Joseph A. 
Published: March 2019

AbstractThe prevalence of obesity increases with age in humans and in rodents. Age‐related obesity is characterized by leptin resistance and associated with heightened risk of metabolic disorders. However, the effect of leptin resistance per se has been difficult to disentangle from other effects of aging. Here we demonstrate that celastrol, a natural phytochemical that was previously shown to act as a leptin sensitizer, induces weight loss in aged animals, but not in young controls. Celastrol reduces food intake and lowers fasting glucose without affecting energy expenditure. Unexpectedly, administration of celastrol just before the dark period disrupted circadian rhythms of sleep and activity. This regimen was also associated with loss of lean mass an outcome that would not be desirable in elderly patients. Adjusting the timing of celastrol administration by 12 hr, to the beginning of the light period, avoided interference with circadian rhythms while retaining the reductions in body weight and adiposity. Thus, targeting leptin signaling is an effective strategy to ameliorate age‐associated weight gain, and can profoundly impact circadian rhythms.
PKR knockout in the 5xFAD model of Alzheimer's disease reveals beneficial effects on spatial memory and brain lesions
Authors: Tible Marion , Mouton Liger François , Schmitt Julien , Giralt Albert , Farid Karim , Thomasseau Sylvie , Gourmaud Sarah , Paquet Claire , Rondi Reig Laure , Meurs Eliane , Girault Jean‐Antoine , Hugon Jacques 
Published: March 2019

AbstractBrain lesions in Alzheimer's disease (AD) include amyloid plaques made of Aβ peptides and neurofibrillary tangles composed of hyperphosphorylated tau protein with synaptic and neuronal loss and neuroinflammation. Aβ oligomers can trigger tau phosphorylation and neuronal alterations through activation of neuronal kinases leading to progressive cognitive decline. PKR is a ubiquitous pro‐apoptotic serine/threonine kinase, and levels of activated PKR are increased in AD brains and AD CSF. In addition, PKR regulates negatively memory formation in mice. To assess the role of PKR in an AD in vivo model, we crossed 5xFAD transgenic mice with PKR knockout (PKRKO) mice and we explored the contribution of PKR on cognition and brain lesions in the 5xFAD mouse model of AD as well as in neuron–microglia co‐cultures exposed to the innate immunity activator lipopolysaccharide (LPS). Nine‐month‐old double‐mutant mice revealed significantly improved memory consolidation with the new object location test, starmaze test, and elevated plus maze test as compared to 5xFAD mice. Brain amyloid accumulation and BACE1 levels were statistically decreased in double‐mutant mice. Apoptosis, neurodegeneration markers, and synaptic alterations were significantly reduced in double‐mutant mice as well as neuroinflammation markers such as microglial load and brain cytokine levels. Using cocultures, we found that PKR in neurons was essential for LPS microglia‐induced neuronal death. Our results demonstrate the clear involvement of PKR in abnormal spatial memory and brain lesions in the 5xFAD model and underline its interest as a target for neuroprotection in AD.
Risk factors and an early prediction model for persistent methamphetamine‐related psychiatric symptoms
Authors: Zhang Yang , Sun Yan , Yu Zhoulong , Sun Yankun , Chang Xiangwen , Lu Lin , Chang Suhua , Shi Jie 
Published: March 2019

AbstractMethamphetamine (MA)‐related psychiatric symptoms (MAP) are serious comorbidities of MA use and result in many social problems such as violence and suicide. We investigated the sociodemographic and genetic risk factors for persistent MAP of MA users (MUs) and constructed an early MAP prediction model. Derivation and replication samples had 1734 and 905 MUs, respectively. Symptom Checklist 90, Childhood Trauma Questionnaire, Attention‐Deficit Hyperactivity Disorder (ADHD) Rating Scale‐IV, and Social Support Rating Scale were used to assess the past‐year prevalence of general MAP and life events retrospectively. Genome‐wide association study (GWAS) was used to analyze MAP‐related genetic factors. The prediction model was constructed by integrating the risk life events and clinical and genetic features using logistic regression. Of the 2639 MUs, 1293 (48.83%) had past‐year MAP. The severity of MA addiction (SMA), childhood trauma, childhood ADHD symptoms, and social support were reliable risk factors for persistent MAP. By integrating these risk factors and the polygenic risk score from GWAS from derivation samples, the area under the curve (AUC) of the predictive model for MAP was 0.754 (95% CI 0.717~0.771). The risk factors and prediction model were also verified in replication samples. In addition, SMA, ADHD, and social support were mediators for the effect of the risk genetic factor on persistent MAP. Our study identified several risk factors for persistent MAP and will be helpful for developing scalable tools for the prevention of persistent and general MAP.
The process of developing self‐report measures in intellectual disability: A case study of a complicated grief scale
Authors: O'Keeffe Lynsey , Guerin Suzanne , McEvoy John , Lockhart Karen , Dodd Philip 
Published: March 2019

Accessible Summary

Developing ways of asking adults with intellectual disability about difficult topics such as death is important to our understanding.

This study explores how adults with intellectual disabilities can be supported to report difficult experiences using the example of understanding death and bereavement. The paper describes the way in which we worked with adults with intellectual disabilities to understand how they preferred to talk about death and bereavement.

This process showed us that it is possible to support adults with intellectual disabilities to talk about these difficult experiences. There are important lessons for researchers who want to talk with adults with intellectual disabilities about difficult topics and experiences.

AbstractBackgroundThis paper considers the challenges regarding the development and use of self‐report tools for sensitive, personal topics, in this case experiences of death and bereavement for individuals with intellectual disabilities (ID). These challenges are represented through the experience of the development of a self‐report measure of complicated grief for use with individuals with intellectual disabilities.Materials and methodFocusing on the topic of bereavement, and using a case study format, this paper describes the development of a self‐report measure for complicated grief.ResultsFollowing three phases of questionnaire development, the Complicated Grief Questionnaire for People with Intellectual Disabilities (CGQ‐ID) was adapted for use as a self‐report measure with individuals with intellectual disabilities. The development process, informed by recommendations in the research literature, provides evidence that self‐report is possible with individuals with intellectual disabilities even when the topic is as sensitive as bereavement and when abstract concepts such as emotions are involved.ConclusionsThe adaptation process described here might provide a useful template for the development of other scales on sensitive topics.
Dialectical behaviour therapy for adolescents: a comparison of 16‐week and 24‐week programmes delivered in a public community setting
Authors: Gillespie Conall , Joyce Mary , Flynn Daniel , Corcoran Paul 
Published: March 2019

BackgroundDialectical behaviour therapy for adolescents (DBT‐A) is an intervention with a growing evidence base for treating adolescents with emotional and behavioural dysregulation. Previous studies have reported on varying lengths of treatment, however, and optimal treatment duration has not yet been identified. While the treatment developers initially proposed a 16‐week programme, they have more recently recommended an extension to 24 weeks. This study compares outcomes for adolescents and parent/guardians who participated in 16‐ and 24‐week DBT‐A programmes in a community setting.MethodsEighty‐four adolescents and 100 parent/guardians participated in 16‐week DBT‐A, while 68 adolescents and 67 parent/guardians participated in the 24‐week programme. Outcome measures for adolescents included the presence and frequency of self‐harm, suicidal ideation and depression; and for parents were burden, grief and parental stress. Outcomes were assessed at pre‐ and postintervention. Linear mixed‐effects models were used to estimate the treatment duration effect (24‐week vs. 16‐week) utilising all available data at pre‐ and postintervention.ResultsData analyses showed a reduction in the presence and frequency of self‐harm at postintervention for adolescents in both programmes. Both adolescent and parent participants in the 16‐ and 24‐week programmes also showed changes indicating significant improvement on all self‐report outcome measures (p < .05). A treatment duration effect was identified with adolescents in the 24‐week programme reporting greater gains on measures of suicidal ideation and depression (p < .05). However, drop‐out rates were higher for the 24‐week programme.ConclusionsThe findings of the current study indicate that 24‐week DBT‐A may have additional benefits in comparison to 16‐week DBT‐A in terms of further reductions in suicidal ideation and depression. Given the nature of this study, it was not possible to explore a potential time effect, however, so these results should be interpreted with caution. Further research will assist in determining an optimal programme duration of DBT‐A.
Marine protected areas enhance coral reef functioning by promoting fish biodiversity
Authors: Topor Zachary M. , Rasher Douglas B. , Duffy J. Emmett , Brandl Simon J. 
Published: March 2019

AbstractPreserving biodiversity and ecosystem function in the Anthropocene is one of humanity's greatest challenges. Ecosystem‐based management and area closures are considered an effective way to maintain ecological processes, especially in marine systems. Although there is strong evidence that such measures positively affect community structure, their impact on the rate of key ecological processes remains unclear. Here, we provide evidence that marine protected areas enhance herbivory rates on coral reefs via direct and indirect pathways. Using meta‐analysis and a path‐analytical framework, we demonstrate that, on average, protected areas increase the species richness of herbivorous fishes, which, in turn, enhances browsing rates on macroalgae. However, in all three regions studied (the Atlantic, Indian, and Pacific Ocean), a small subset of the herbivore assemblage accounted for the majority of browsing. Our results therefore indicate that ecosystem functioning on coral reefs may respond positively to both area closures and the protection of key species.
Isolation, marine transgression and translocation of the bare‐nosed wombat (Vombatus ursinus)
Authors: Martin Alynn , Carver Scott , Proft Kirstin , Fraser Tamieka A. , Polkinghorne Adam , Banks Sam , Burridge Christopher P. 
Published: March 2019

AbstractIsland populations can represent genetically distinct and evolutionarily important lineages relative to mainland conspecifics. However, phenotypic divergence of island populations does not necessarily reflect genetic divergence, particularly for lineages inhabiting islands periodically connected during Pleistocene low sea stands. Marine barriers may also not be solely responsible for any divergence that is observed. Here, we investigated genetic divergence among and within the three phenotypically distinct subspecies of bare‐nosed wombats (Vombatus ursinus) in south‐east Australia that are presently—but were not historically—isolated by marine barriers. Using genome‐wide single nucleotide polymorphisms, we identified three genetically distinct groups (mainland Australia, Bass Strait island, and Tasmania) corresponding to the recognized subspecies. However, isolation by distance was observed in the Tasmanian population, indicating additional constraints on gene flow can contribute to divergence in the absence of marine barriers, and may also explain genetic structuring among fragmented mainland populations. We additionally confirm origins and quantify the genetic divergence of an island population 46 years after the introduction of 21 individuals from the Vulnerable Bass Strait subspecies. In the light of our findings, we make recommendations for the maintenance of genetic variation and fitness across the species range.
Automatic hemodialysis prescriptions by urea kinetic modeling
Authors: Vartia Aarne 
Published: March 2019

AbstractIntroduction Guidelines on hemodialysis (HD) dosing are based on urea kinetics, which can be modeled mathematically. Different schedules can be compared by equivalent continuous clearance.Methods A computer program generating HD prescriptions automatically was developed. In 200 actual HD urea kinetic modeling sessions involving 33 patients the urea distribution volume, generation rate, and concentration profile in the external space were computed using ionic dialysance as dialyzer clearance in the double pool ureakinetic model. Dialyzer in vivo mass area coefficient K0A was calculated from online data with the Michaels’ equation. Data from the modeling sessions were used for generating new prescriptions for the same patients.Findings New prescriptions meeting 12 criteria—technical limits and guideline targets—were generated by the model. They showed a wide range of basic treatment parameters (time and frequency, blood and dialysate flow, and ultrafiltration). In five cases, the dialysis time or frequency should have been increased from the actual to achieve the targets, in 72 cases the frequency could have been decreased. Two methods to emphasize RRF were tested. Using a coefficient of 2.0 for renal urea clearance in computing adjusted equivalent continuous clearance (EKR/Va), as suggested by Casino and Basile, decreased further the required treatment frequency in incremental dialysis.Discussion The model produced plausible individual prescriptions, but some unknown factors caused the determination of the dialyzer in vivo K0A to be inaccurate. The model must be tested with modern devices on patients before integration into dialysis machines and information systems.
The Effect that Structural and Investment Funds have on Voter Behaviour in European Parliamentary Elections
Authors: Henceroth Nathan , Oganesyan Rafael 
Published: March 2019

AbstractStructural and Investment Funds (SIFs) have become the European Union's most robust redistribution programme. In this article, we demonstrate that SIFs have grown large enough in scope that they are now beginning to function similarly to more established macroeconomic determinants of the vote such as unemployment and GDP growth in European Parliamentary elections. Moreover, SIFs have an electoral effect in a type of election that was previously assumed to be merely a referendum on national government performance: second‐order, EP elections. SIFs serve as an example of how robust public spending can have an electoral effect even in a second‐order election environment.
Effectiveness and clinical performance of early implant placement for the replacement of single teeth in anterior areas: A systematic review
Authors: Graziani Filippo , Chappuis Vivianne , Molina Ana , Lazarin Rafael , Schmid Eric , Chen Stephen , Salvi Giovanni E. 
Published: March 2019

AbstractAimTo assess the effectiveness and clinical performance of early implant placement, 4–8 (Type 2) or 12–16 weeks (Type 3) after extraction, in single anterior sites.MethodsStudies reporting on Type 2 and Type 3 implant placement were identified. Findings were summarized in evidence tables. Main outcome was implant survival. Peri‐implant soft and hard tissues changes, periodontal parameters, aesthetics and patient‐reported outcomes were also evaluated. Quality of reporting of the included studies was evaluated through Consort, Newcastle–Ottawa scale and IHE quality appraisal checklist.ResultsNineteen eligible articles (seven from one RCT, three from two CCTs and nine from three case series) reporting on 140 patients and 140 implants were included. Type 3 implants showed comparable results to Type 4: 95% vs. 100% survival rates. Studies reported high values of implant survival, minimal technical and biological complications and high aesthetic scores in both short and long‐term follow‐ups for both Type 2 and Type 3 implant placement. Quality evaluation highlighted important weaknesses in the included trials.ConclusionsLimited data on Type 2 and Type 3 implant placement appear to indicate that they can perform well both short and long term. However, the limited number of cases, the significant heterogeneity of the included studies and the high risk of biases importantly reduce the generalizability of the findings. CRD42018117363.
Impacts of skipping breakfast and late dinner on the incidence of being overweight: a 3‐year retrospective cohort study of men aged 20–49 years
Authors: Kito K. , Kuriyama A. , Takahashi Y. , Nakayama T. 
Published: March 2019

AbstractBackgroundMost studies on the dietary habits and overweight status of men aged 20–49 years have been cross‐sectional, with longitudinal studies being scarce. One‐quarter of Japanese men aged 20–49 years skip breakfast or have dinner within 2 h of bedtime (late dinner); therefore, the effects of these eating habits on men's increasing body weight need to be determined.MethodsWe conducted a retrospective cohort study using health check‐up data provided from several health insurance societies in Japan. Participants comprised 45 524 men employees aged 20–49 years who were followed up for 3 years. The primary outcome investigated was body mass index (BMI) ≥25 kg m−2. We conducted a multivariable logistic regression analysis and calculated the odds ratios for skipping breakfast and late dinner, as well as baseline age, body mass index, smoking status, eating speed, snack‐eating status, alcohol drinking frequency, physical activity, sleep habits, and the interaction between skipping breakfast and late dinner.ResultsOf the participants, 17 706 (38.8%) skipped breakfast and 25 987 (57.1%) had a late dinner. At the 3‐year follow‐up, 5093 (11.2%) had a BMI ≥25 kg m−2. The odds ratios of men skipping breakfast and having a late dinner were 1.18 (95% confidence interval = 1.04–1.33) and 0.92 (95% confidence interval = 0.84–1.01), respectively. The interaction between these factors was nonsignificant.ConclusionsWe suggest that skipping breakfast among men aged 20–49 years was one predictor of being overweight; however, having dinner within 2 h of bedtime was not a predictor.