bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing congestion in emergency obstetric care in public hospitals in Tamil Nadu
Authors: Rajasulochana Subramania Raju , Matranga Domenica 
Published: August 2018

Purpose
The purpose of this paper is to assess congestion as the simultaneous occurrence of desirable health output (e.g. maternal admissions) along with undesirable output (e.g. still births (SB)), in emergency obstetric care settings of public hospitals in Tamil Nadu.

Design/methodology/approach
The study is based on a cross-sectional data set of 97 public hospitals collected by the statistical cell of Tamil Nadu Health Systems Project for the year 2013–2014. The study uses three inputs – beds, doctors and nurses; three desirable outputs – maternal admissions, neonatal admission and live births; and four undesirable outputs – SB, intra-uterine deaths, neonatal deaths and maternal deaths. Congestion analysis, a variant of the data envelopment analysis (DEA) method and slack analysis, has been applied to detect an excessive use of some inputs or a shortfall in some outputs across these hospitals. Furthermore, the association between congestion and some contextual factors has been examined.

Findings
On an average, the hospitals in our sample can increase the total amount of outputs by 62.8 percent by improving overall efficiency, and about 34.2 percent of this inefficiency can be attributed to congestion. Analysis of sub-samples showed that government hospitals at the taluk level have higher congestion than district headquarter hospitals. Congestion seems to decrease with greater hospital volume up to a limit; beyond that, it increases in obstetric care settings.

Originality/value
Hospital-based efficiency studies in the Indian context, so far, have estimated relative efficiency among hospitals using the classical DEA method, but ignoring adverse health outcomes. Congestion analysis, an advance in the DEA method, considers how much the desirable outputs can be increased as also how much undesirable outputs affect efficiency.
A framework for assessing quantity surveyors’ competence
Authors: Dada Joshua Oluwasuji , Jagboro Godwin Onajite 
Published: August 2018

Purpose
The purpose of this paper is to develop a conceptual framework for assessing quantity surveyors’ competence level.

Design/methodology/approach
Delphi survey research approach was adopted for the study. This involved a survey of panel of experts, constituted among registered quantity surveyors in Nigeria, and obtaining from them a consensus opinion on the issues relating to the assessment of quantity surveyors’ competence. In total, 27 out of the shortlisted 38 member panel provided valid results in the two rounds of Delphi survey conducted. A conceptual framework linking educational training, professional capability and professional development is developed.

Findings
The findings establish the ratings of the identified three competence criteria. On a scale of 0–100 percent rating, educational training was scored 34.04 percent, professional capability 45.22 percent and professional development 20.74 percent.

Originality/value
The proposed framework provide a conceptual approach in assessing quantity surveyor overall competence. Specifically, it demonstrates the significance of the identified three competence criteria groupings in the training, practice and development of quantity surveying profession. It could therefore serves as foundation of on how quantity surveyors are trained, developed and evaluated.
Does outsourcing always work? A critical evaluation for project business success
Authors: Sandhu Maqsood Ahmad , Shamsuzzoha Ahm , Helo Petri 
Published: August 2018

Purpose
The purpose of this paper is to deal with the importance and obstacles of outsourcing strategy in project business in terms of product development perspectives. This strategy is intrinsically analyzed and evaluated with respect to the strategic business environments.

Design/methodology/approach
The objective of this research is to analyze the advantages and limitations of the outsourcing that have been identified in prior studies. This research has attempted to investigate the performance implications of outsourcing strategies in terms of theoretical considerations and implementation perspectives.

Findings
In this study, the authors have presented a general overview of outsourcing strategies in terms of both light and dark sides of this approach. Various driving forces of outsourcing strategy along with critical success factors are articulated within project to product development perspectives.

Research limitations/implications
Future research could be continued to measure various performance variables such as productivity, sales, revenues, career opportunities, manifest in power struggles, change jobs, change organizational cultures, etc. in multiple case companies, which affect with the success or failure of outsourcing arrangements.

Practical implications
The term outsourcing is nowadays a widely known business strategy, where manufacturing firms share partly or fully of their production process with outside organizations or suppliers. The research approach as articulated within this paper would be beneficial for project business organizations and specially the product designers and project managers for planning and developing their strategic business potentials with respect to outsourcing and in-sourcing decisions.

Originality/value
In this paper a high-level decision-making model for outsourcing and a cause and effect type framework are demonstrated with a view to ease the decision-making process for the organizations managers.
Development of a three-tier assessment model: a case study
Authors: Lau Henry C. , Ip Andrew , Lee CKM , Ho GTS 
Published: August 2018

PurposeThe purpose of this paper is to propose a three-tier assessment model (TAM), aiming to identify and evaluate the competitiveness level of companies. The existing problem is that companies find it difficult to choose a proper model which can be deployed to benchmark with competitors in terms of their competiveness level in the marketplace. Most of the available models are not appropriate or easy to use. The proposed assessment model is able to provide an insight for better planning and preparation so as to gain a better chance of success comparing with their competitors. Most importantly, the proposal model adopts a pragmatic approach and can be implemented without going through tedious mathematical calculations and analysis.Design/methodology/approachTAM embraces three different approaches deployed in various stages of the application process. The first stage is to identify the relevant criteria using hierarchical holographic modeling and the second stage is to assess the associated weightings of these criteria used to rate the potential competitiveness of related companies. The technique used in stage two is known as fuzzy analytic hierarchy process (FAHP) which is a combination of two well-established methods including fuzzy logic and analytical hierarchical programming. In stage three, a technique known as technique for order preference by similarity to the ideal solution (TOPSIS) is adopted to benchmark the level of competitiveness covering several companies in the same industry.FindingsIn this paper, a case study is conducted in order to validate the feasibility and practicality of the proposed model. Results indicate that TAM can be easily applied in various industrial settings by practitioners in the field for supporting operations management practices.Research limitations/implicationsSignificant amount of work is needed to ensure that the proposed model can be practically deployed in real industrial settings.Practical implicationsThis proposed model is able to capitalize on the benefits of the HMM, FAHP and TOPSIS methods and offset their deficiencies. Most importantly, it can be applied to various industries without complex modification.Originality/valueThis paper suggests a hybrid model to assess competitiveness level embracing three different techniques with the unique feature which is able to provide an insight for better planning and preparation in order to excel competitors. Companies may be able to follow the procedures and steps suggested in the paper to implement the model which is proven to be pragmatic and can be applied in real situations.
Is organizational evolution Darwinian and/or Lamarckian?
Authors: Grandinetti Roberto 
Published: August 2018

PurposeRecently, some biologists have argued that the time has come to replace separation between Lamarckism and Darwinism with their connection. The aim of this paper is to understand whether this paradigm shift in the interpretation of biological evolution offers useful insights for dealing with the unresolved issue of how industries and their organizational populations evolve.Design/methodology/approachLamarckism and Darwinism are two approaches that have contrasted or interwoven with each other in the study of biological evolution, just as they have in the study of organizational evolution. This paper provides a critical analysis of the long history of the debate through to the recent, revolutionary discoveries in evolutionary microbiology obtained in the wake of the genomic revolution.FindingsFrom this new research frontier emerge three important findings: adaptive variations are no longer an anomaly that is peculiar to human organizations, but rather correspond to a widely observed phenomenon in the biological world; the same can be said for the process of horizontal replication; Lamarckism and Darwinism are not two mutually exclusive interpretations of evolution but two dimensions of evolution that coexist in various ways. Lamarckian dimension of evolution and the Darwinian one, handled in the light of these results, may help to understand the evolutionary logic that underpins specific stages of the history of industries.Originality/valueThe paper presents a new way of looking at industries and their firms from an evolutionary perspective.
Health information systems in Namibia
Authors: Nengomasha Cathrine Tambudzai , Abankwah Ruth , Uutoni Wilhelm , Pazvakawambwa Lilian 
Published: August 2018

Purpose
This paper aims to report some findings of a study that investigated health information systems (HISs) in Namibia with a view of establishing the nature of these systems and coming up with recommendations on how these could be enhanced.

Design/methodology/approach
This study applied a mixed methods research approach, using interviews and survey questionnaire to collect data. Survey data were analysed for descriptive statistics using SPSS and data from interviews were analysed applying content analysis for data analysis.

Findings
The findings of this study indicate fragmented HISs resulting in duplication of diagnosis, tests and treatment. The findings show that there were errors in capturing data into the systems, which could compromise the reliability of the data and compromise service delivery.

Research limitations/implications
This study was limited to two (Khomas and Oshana) of the fourteen regions in Namibia; therefore, further studies could look at other regions, as the study findings cannot be generalised to the entire country.

Practical implications
The findings and recommendations, particularly those relating to the public health sector, could inform policies and procedures, especially those relating to the patient health passport (card), and the way health information is shared within and across health sectors.

Originality/value
This study focused on health information sharing, whereas a previous study on HISs concentrated on quality of healthcare.
Beyond disgorgement: the impact of Kokesh on the SEC’s pursuit of equitable remedies
Authors: Karp Brad , Ehrlich Andrew , Reisner Lorin , Soloway Audra , Tarlowe Richard , Lichtenstein Maia , Vizcarrondo Peter 
Published: August 2018

Purpose
This paper aims to explain the US Supreme Court’s ruling in Kokesh v. SEC, which limited the U.S. Securities and Exchange Commission’s (SEC) ability to seek the remedy of disgorgement and to examine how lower courts have applied the ruling to other types of equitable relief that that the SEC commonly pursues.

Design/methodology/approach
This study explains why the Supreme Court in Kokesh ruled that disgorgement is a “penalty” and that the five-year limitations period therefore was applicable to actions seeking disgorgement; discusses a footnote in Kokesh that left open the question of whether the SEC has the power to pursue disgorgement at all; and reviews four recent cases that grapple with the application of Kokesh to injunctions and lifetime bars.

Findings
Lower courts and the SEC have not settled on how Kokesh might impact equitable remedies commonly pursued by the SEC, but recent cases indicate that the effect of Kokesh may be broader than its narrow holding suggests.

Originality/value
Practical guidance from experienced white collar and regulatory defense lawyers that consolidates several recent developments in one piece.
Disease severity and economic burden in Japanese patients with systemic lupus erythematosus: A retrospective, observational study
Authors: Tanaka Yoshiya , Mizukami Akiko , Kobayashi Akihiro , Ito Chie , Matsuki Taizo 
Published: August 2018

AbstractAimTo describe the healthcare resource utilization (HRU), direct medical costs and clinical characteristics for Japanese patients with mild, moderate or severe systemic lupus erythematosus (SLE). The primary objectives were to describe HRU and examine the direct medical costs for Japanese patients with mild, moderate, or severe SLE over the 3‐year study period. Secondary objectives included recording patient demographics, clinical characteristics and frequency and cost of mild, moderate or severe flares. Exploratory objectives included a description of treatment patterns, and to explore which factors affect medical costs.MethodsThis retrospective, observational cohort study identified patients with SLE (diagnosed April 2010 to March 2012), from the Japan Medical Data Center claims database.ResultThe study cohort comprised 295 patients with mild (28, 9.5%), moderate (134, 45.4%), or severe (133, 45.1%) SLE. Outpatient visits, hospitalizations and emergency room stays were experienced by 295 (100%), 116 (39.3%) and 31 (10.5%) patients, respectively, over the 3‐year study period. Over the 3‐year period, the mean total direct medical cost was US$27 004, and cost increased with SLE severity: mild, $5549 moderate, $15 290; and severe, $43 322 (analysis of variance, P < 0.0001). During this period, the majority of patients (282, 95.6%) experienced at least one flare episode and the mean (standard deviation) frequency was 5.5 (3.3) flares. The mean total direct medical cost per flare increased with SLE severity.ConclusionThis descriptive study provides information on the economic burden and clinical characteristics of Japanese patients with SLE based on claims data; high levels of HRU and direct medical costs were exhibited, particularly in patients with moderate or severe disease.
Evidence‐based guidelines for intra‐articular injection in knee osteoarthritis: Formulating and evaluating research questions
Authors: Xing Dan , Wang Qi , Yang Ziyi , Hou Yunfei , Zhang Wei , Chen Yaolong , Lin Jianhao 
Published: August 2018

AbstractObjectiveTo formulate and evaluate clinical questions about intra‐articular injection for knee osteoarthritis in developing clinical practice guidelines and to introduce a new methodology for framing relevant questions.MethodsWe framed the clinical questions and evaluated the importance of these questions according to the following four steps: (a) first round questionnaire survey intended to get the clinical questions from doctors; (b) evaluating importance of questions via second round questionnaire survey intended to summarize and rank the clinical questions; (c) consensus conference was conducted by clinical and methodological experts; and (d) confirm the important clinical questions according to PICO (Patients, Intervention, Comparison and Outcomes) principles.ResultsAfter the first round questionnaire survey, the number of clinical questions was 26. Thirteen of these 26 questions were regarded as important questions by the second questionnaire survey. Ultimately, the 13 important clinical questions were determined in a consensus conference. All included questions were deconstructed by clinical experts and methodologists based on the PICO principles.ConclusionThe present study describes an approach about the selection of clinical questions and importance evaluation. Relevant important clinical questions about intra‐articular injection for knee osteoarthritis are determined according to the methodology. It could help other guideline developers to utilize this method to frame clinical questions.
Effect of a single pre‐operative 125 mg dose of methylprednisolone on postoperative delirium in hip fracture patients; a randomised, double‐blind, placebo‐controlled trial
Authors: Clemmesen C. G. , Lunn T. H. , Kristensen M. T. , Palm H. , Foss N. B. 
Published: August 2018

SummaryPostoperative delirium is common after hip fracture surgery, and may have a neuro‐inflammatory cause. We conducted a single‐centre, randomised, double‐blind, placebo‐controlled trial of 117 older hip fracture patients to see if a single, pre‐operative intravenous dose of 125 mg methylprednisolone could reduce the severity and/or incidence of postoperative delirium, assessed using the Confusion Assessment Method delirium severity score. Modified intention‐to‐treat analysis found no significant difference in our primary outcome, median (IQR [range]) cumulative Confusion Assessment Method delirium severity score over the first three postoperative days between the methylprednisolone and placebo groups (1 (0–6 [0–39]) vs. 2 (0–10 [0–32]), p = 0.294). Both the prevalence of postoperative delirium (Confusion Assessment Method delirium severity score ≥ 5, 10/59 vs. 19/58, p = 0.048) and the median (IQR [range]) cumulated postoperative (by day 3) fatigue scores (5 (2–6 [0–11]) vs. 6 (4–8 [0–16]), p = 0.008) were significantly lower in the methylprednisolone compared with the placebo group. There were no significant between‐group differences in the rate of completing physiotherapy, postoperative pain, the administration of antipsychotic drugs, infection, length of inpatient stay or 30‐ and 90‐day mortality. No major adverse reactions related to methylprednisolone were recorded. We conclude that a single, pre‐operative dose of 125 mg methylprednisolone does not reduce the severity of postoperative delirium, but may reduce both the prevalence of delirium and the severity of fatigue after hip fracture surgery in older patients, enabling remobilisation and recovery.
Traumatic shaking: The role of the triad in medical investigations of suspected traumatic shaking
Authors: Elinder Göran , Eriksson Anders , Hallberg Boubou , Lynøe Niels , Sundgren Pia Maly , Rosén Måns , Engström Ingemar , Erlandsson Björn‐Erik 
Published: August 2018

AbstractThe Swedish Agency for Health Technology Assessment and Assesment of Social Services (SBU) is an independent national authority, tasked by the government with assessing methods used in health, medical and dental services and social service interventions from a broad perspective, covering medical, economic, ethical and social aspects.The language in SBU's reports are adjusted to a wide audience.SBU's Board of Directors has approved the conclusions in this report.The systematic review showed the following graded results:

There is limited scientific evidence that the triad (Three components of a whole. The triad associated with SBS usually comprises subdural haematoma, retinal haemorrhages and encephalopathy.) and therefore, its components can be associated with traumatic shaking (low‐quality evidence).
There is insufficient scientific evidence on which to assess the diagnostic accuracy of the triad in identifying traumatic shaking (very low‐quality evidence).
Limited scientific evidence (low‐quality evidence) represents a combined assessment of studies of high or moderate quality which disclose factors that markedly weaken the evidence. It is important to note that limited scientific evidence for the reliability of a method or an effect does not imply complete lack of scientific support.Insufficient scientific evidence (very low‐quality evidence) represents either a lack of studies or situations when available studies are of low quality or show contradictory results. Evaluation of the evidence was not based on formal grading of the evidence according to GRADE but on an evaluation of the total scientific basis.
Medicinal Properties of Cannabinoids, Terpenes, and Flavonoids in Cannabis, and Benefits in Migraine, Headache, and Pain: An Update on Current Evidence and Cannabis Science
Authors: Baron Eric P. 
Published: August 2018

BackgroundComprehensive literature reviews of historical perspectives and evidence supporting cannabis/cannabinoids in the treatment of pain, including migraine and headache, with associated neurobiological mechanisms of pain modulation have been well described. Most of the existing literature reports on the cannabinoids Δ9‐tetrahydrocannabinol (THC) and cannabidiol (CBD), or cannabis in general. There are many cannabis strains that vary widely in the composition of cannabinoids, terpenes, flavonoids, and other compounds. These components work synergistically to produce wide variations in benefits, side effects, and strain characteristics. Knowledge of the individual medicinal properties of the cannabinoids, terpenes, and flavonoids is necessary to cross‐breed strains to obtain optimal standardized synergistic compositions. This will enable targeting individual symptoms and/or diseases, including migraine, headache, and pain.ObjectiveReview the medical literature for the use of cannabis/cannabinoids in the treatment of migraine, headache, facial pain, and other chronic pain syndromes, and for supporting evidence of a potential role in combatting the opioid epidemic. Review the medical literature involving major and minor cannabinoids, primary and secondary terpenes, and flavonoids that underlie the synergistic entourage effects of cannabis. Summarize the individual medicinal benefits of these substances, including analgesic and anti‐inflammatory properties.ConclusionThere is accumulating evidence for various therapeutic benefits of cannabis/cannabinoids, especially in the treatment of pain, which may also apply to the treatment of migraine and headache. There is also supporting evidence that cannabis may assist in opioid detoxification and weaning, thus making it a potential weapon in battling the opioid epidemic. Cannabis science is a rapidly evolving medical sector and industry with increasingly regulated production standards. Further research is anticipated to optimize breeding of strain‐specific synergistic ratios of cannabinoids, terpenes, and other phytochemicals for predictable user effects, characteristics, and improved symptom and disease‐targeted therapies.