bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pain, Agitation, and Delirium Guidelines
Authors: Jablonski Juliane , Gray Jaime , Miano Todd , Redline Gretchen , Teufel Heather , Collins Tara , Pascual-Lopez Jose , Sylvia Martha , Martin Niels D. 
Published: April 2017

Background:
Societal guidelines exist for the management of pain, agitation, and delirium (PAD) in critically ill patients. This contemporary practice aims for a more awake and interactive patient. Institutions are challenged to translate the interrelated multivariable concepts of PAD into daily clinical practice and to demonstrate improvement in quality outcomes. An interdisciplinary goal-directed approach shows outcomes in high-acuity surgical critical care during the early stages of implementation.

Methods:
This study was a prospective preintervention and postintervention design. A formal PAD clinical practice guideline targeting standardized assessment and “light” levels of sedation was instituted. All mechanically ventilated patients admitted to a 24-bed surgical intensive care unit (ICU) at an academic medical center during a 6-month period were included (3 months before and 3 months after implementation). Sedation and agitation were measured using the Richmond Agitation Sedation Scale (RASS), pain measured using a Behavioral or Numeric Pain Scale (NPS/BPS), and delirium using the Confusion Assessment Method for the Intensive Care Unit. Total ventilator days with exposure to continuous opioid or sedative infusions and total ICU days where the patient received a physical activity session exercising out of bed were recorded.

Results:
There were 106 patients (54 at preintervention and 52 at postintervention). Mean percentage of RASS scores between 0 to −1 increased from 38% to 50% postintervention (P < .02). Mean percentage of NPS/BPS scores within the goal range (<5 for BPS and <3 for NPS) remained stable, 86% to 83% (P = .16). There was a decrease in use of continuous narcotic infusions for mechanically ventilated patients. This was reported as mean percentage of total ventilator days with a continuous opioid infusing: 65% before implementation versus 47% after implementation (P < .01). Mean percentage of ICU days with physical activity sessions increased from 24% to 41% (P < .001). Overall mean ventilator-free days and ICU length of stay were 5.4 to 4.5 days (P = .29) and 11.75 to 9.5 days (P = .20), respectively.

Conclusion:
Measureable patient outcomes are achievable in the early stages of PAD guideline initiatives and can inform future systems-level organizational change. Pain, agitation, and delirium assessment tools form the foundation for clinical implementation and evaluation. High-acuity surgical critical care patients can achieve more time at goal RASS, decreased ventilator days, and less exposure to continuous opioid infusions, all while maintaining stable analgesia.
Implementing Family Meetings Into a Respiratory Care Unit
Authors: Loeslie Vicki , Abcejo Ma Sunnimpha , Anderson Claudia , Leibenguth Emily , Mielke Cathy , Rabatin Jeffrey 
Published: April 2017

Background:
Substantial evidence in critical care literature identifies a lack of quality and quantity of communication between patients, families, and clinicians while in the intensive care unit. Barriers include time, multiple caregivers, communication skills, culture, language, stress, and optimal meeting space. For patients who are chronically critically ill, the need for a structured method of communication is paramount for discussion of goals of care.

Objective:
The objective of this quality improvement project was to identify barriers to communication, then develop, implement, and evaluate a process for semistructured family meetings in a 9-bed respiratory care unit.

Methods:
Using set dates and times, family meetings were offered to patients and families admitted to the respiratory care unit. Multiple avenues of communication were utilized to facilitate attendance. Utilizing evidence-based family meeting literature, a guide for family meetings was developed. Templates were developed for documentation of the family meeting in the electronic medical record.

Results:
Multiple communication barriers were identified. Frequency of family meeting occurrence rose from 31% to 88%. Staff satisfaction with meeting frequency, meeting length, and discussion of congruent goals of care between patient/family and health care providers improved. Patient/family satisfaction with consistency of message between team members; understanding of medications, tests, and dismissal plan; and efficacy to address their concerns with the medical team improved.

Discussion:
This quality improvement project was implemented to address the communication gap in the care of complex patients who require prolonged hospitalizations. By identifying this need, engaging stakeholders, and developing a family meeting plan to meet to address these needs, communication between all members of the patient’s care team has improved.
Patients’ and Families’ Satisfaction With Visiting Policies in Cardiac Intensive Care Units
Authors: Khaleghparast Shiva , Joolaee Soodabeh , Maleki Majid , Peyrovi Hamid , Ghanbari Behrooz , Bahrani Naser 
Published: April 2017

Background:
Families play a vital role in the recovery of patients admitted to intensive care units. They can help patients to adapt themselves to the crisis and feel more satisfied.

Objective:
In this study, we examined the patients’ and families’ satisfaction with the current visiting policies in cardiac intensive care units in the largest Cardiovascular Medical and Research Center of Iran.

Method:
This research used a cross-sectional descriptive design. To do so, 303 patients admitted to those cardiac intensive care units and their families responded to a 2-part questionnaire between September 2014 and March 2015.

Results:
The results showed that 55.1% of the participants were dissatisfied with the limited visiting policies of the cardiac intensive care units, whereas the satisfaction rate was 14.2%. The remaining participants (30.7%) were slightly satisfied with the visiting policies in cardiac intensive care units.

Conclusions:
Patient-centered care is an expectation among patients and their families in the cardiac intensive care units. It seems that a change in visiting policies is necessary.
Ergothioneine Antioxidant Function: From Chemistry to Cardiovascular Therapeutic Potential
Authors: Servillo Luigi , D'Onofrio Nunzia , Balestrieri Maria Luisa 
Published: April 2017

Abstract:
Ergothioneine (ESH), the betaine of 2-mercapto-l-histidine, is a water-soluble naturally occurring amino acid with antioxidant properties. ESH accumulates in several human and animal tissues up to millimolar concentration through its high affinity transporter, namely the organic cation transporter 1 (OCTN1). ESH, first isolated from the ergot fungus (Claviceps purpurea), is synthesized only by Actinomycetales and non-yeast–like fungi. Plants absorb ESH via symbiotic associations between their roots and soil fungi, whereas mammals acquire it solely from dietary sources. Numerous evidence demonstrated the antioxidant and cytoprotective effects of ESH, including protection against cardiovascular diseases, chronic inflammatory conditions, ultraviolet radiation damages, and neuronal injuries. Although more than a century after its discovery has gone by, our understanding on the in vivo ESH mechanism is limited and this compound still intrigues researchers. However, recent evidence about differences in chemical redox behavior between ESH and alkylthiols, such as cysteine and glutathione, has opened new perspectives on the role of ESH during oxidative damage. In this short review, we discuss the role of ESH in the complex machinery of the cellular antioxidant defense focusing on the current knowledge on its chemical mechanism of action in the protection against cardiovascular disease.
Decision tree analysis of wine consumers’ preferences: evidence from an emerging market
Authors: Jovanović Miomir M. , Kašćelan Ljiljana , Joksimović Miljan , Kašćelan Vladimir 
Published: April 2017

Purpose
The purpose of this paper is to analyse the interactive and individual influences of socio-demographic and behavioural-cognitive factors on the frequency and quality of wine consumption, as well as importance of the brand and advertising on selection.

Design/methodology/approach
The survey was prepared on the basis of the selected factors. The research was carried out on a sample of 207 randomly selected respondents. The analysis was done using the classification decision tree.

Findings
The results show the dominant influence of socio-demographic factors, such as region, place of living (urban-rural areas), family size, age, income and education of consumers as well as behavioural-cognitive factors, such as the price importance, place of purchase and product characteristics, in all analysed target variables. Apart from the similarities with traditional wine markets, the specificities related to an emerging market have also been determined.

Research limitations/implications
The limitations of this research concern sample size as well as the research conducted over the period of one year.

Practical implications
The practical objective of this paper is to help wine marketers to develop more effective positioning strategies for a specific emerging market.

Originality/value
This research combines critical factors based on related studies, including the antecedents and outcome variables, to develop more comprehensive models for better understanding of the wine consumers’ behaviour. In major and traditional wine-making countries, the consumption of wine is fairly predictable. In emerging markets, the commercial strategies are, for the most part, based on certain specificities and are quite interesting for the surveys.
Reaching beyond the wire: challenges facing wireless for the last mile
Authors: Yankelevich Aleksandr , Shapiro Mitchell , Dutton William H. 
Published: April 2017

Purpose
This paper aims to provide a critical perspective on the major opportunities and challenges facing the future of wireless access to broadband internet services in the USA. In particular, it seeks to develop realistic expectations for new entrants and existing wireline broadband providers, hoping to diversify into wireless to extend the reach of broadband to previously underserved markets.

Design/methodology/approach
The paper synthesizes a series of empirical case studies of efforts to develop wireless projects across the USA. Cases were chosen to reflect variations in recent initiatives related to spectrum used, housing density, topography, types of services provided and the type of entity providing them. Findings are supplemented by a thorough review of applicable sections of the Code of Federal Regulations, Federal Communications Commission Orders and state and local regulations.

Findings
Although developments in wireless technology and regulation have permitted novel approaches for using wireless to extend the reach of broadband, myriad challenges must be addressed for successful expansion. These include limitations on throughput, infrastructure and equipment hurdles, regulatory uncertainty and relatively low revenue potential in underserved markets.

Practical implications
This study can serve as a guide to the nuances that wireless broadband providers must take into account when extending service in different settings. Because social and regulatory contexts are critical, the authors anchor their findings in a study of US cases and regulations. Nonetheless, the opportunities and challenges that are explored can be of relevance for practitioners considering wireless access in other countries where comparable situations may arise.

Originality/value
Existing scholarship generally focuses on the opportunities of wireless technologies for extending the reach and quality of broadband without methodically exploring potential hurdles. In this paper, the authors carefully consider both, paying attention to the social, financial, policy and technical challenges that must be addressed to successfully design and implement different wireless initiatives.
World-class broadband
Authors: Sutherland Ewan 
Published: April 2017

Purpose
This paper aims to examine the aspiration to world-class broadband in a number of countries.

Design/methodology/approach
This study includes a review of the various approaches taken by countries, consultants and intergovernmental organisations.

Findings
The term “world class” is used relatively vaguely, without any significant link to long-term improvements in national performance, rather to an aspiration to being close to the leaders.

Research limitations/implications
The use of benchmarking in lobbying needs further study, as does the quality of lobbying.

Practical implications
Governments need to make explicit their policy aims in addition to any world-class headline and need to aim for design improvement in their governance systems.

Originality/value
This is the first review of benchmarking of broadband at the national level.
Lens or prism? How organisations sustain multiple and competing reputations
Authors: Harvey William S. , Tourky Marwa , Knight Eric , Kitchen Philip 
Published: April 2017

PurposeThis paper aims to challenge singular definitions, measurements and applications of corporate reputation which tend to be reductionist. The authors rebuff such narrow representations of reputation by showing the multiplicity of reputation in the case of a global management consulting firm and demonstrate how it has sustained such reputations.Design/methodology/approachUsing a large cross-country qualitative case study based on interviews, focus groups, non-participant observations, workshops and a fieldwork diary, dimensions of reputation are highlighted by drawing on perceptions from multiple stakeholder groups in different geographies.FindingsThe authors find significant differences in perceptions of reputation between and within stakeholder groups, with perceptions changing across dimensions and geographies.Originality/valueThe theoretical implications of the research indicate a plurality of extant reputations, suggesting that a prism is more suited to representing corporate reputation than a singular, lens-like focus which is too narrow to constitute reputation. This paper offers theoretical and practical suggestions for how global firms can build and sustain multiple and competing corporate reputations.
Pleasure and guilt: how do they interplay in luxury consumption?
Authors: Ki Chungwha , Lee Kangbok , Kim Youn-Kyung 
Published: April 2017

Purpose
This paper aims to examine, building upon affect balance theory, whether the two modes of luxury consumption, conspicuous consumption (CC) and style consumption (SC), trigger consumers’ mixed emotions of pleasure and guilt and whether the mixed emotions interactively as well as independently influence consumer loyalty to repurchase luxury.

Design/methodology/approach
Using an online survey and seemingly unrelated regressions (SUR) analysis, the authors test the hypotheses and assess the parallel (double) mediation effects of pleasure and guilt on the relationships between luxury consumption and repurchase intention.

Findings
The authors confirm the relationships between CC and pleasure (+), between SC and pleasure (+), between CC and guilt (+) and between SC and guilt (−); the independent effects of pleasure (+) and guilt (−) on repurchase intention (RI); and the interaction effect of pleasure and guilt on RI (+). The authors further demonstrate that both pleasure and guilt mediate the relationship between CC and RI, whereas only pleasure mediates the relationship between SC and RI.

Research limitations/implications
Future researchers may consider possible mixed emotions other than pleasure and guilt and further explore the dynamics between mixed consumer emotions and consumer loyalty in diverse consumption contexts.

Practical implications
The authors suggest luxury marketers to reduce consumer guilt by promoting SC and by maximizing consumer pleasure, which will lead to greater repurchase intention.

Originality/value
Prior research focused on either the positive or negative side of consumer emotion. The authors fill in the research void by examining whether mixed emotions coexist in luxury consumption and how they interplay and influence consumer loyalty.
Relationships between social Web, IMC and overall brand equity
Authors: Šerić Maja 
Published: April 2017

PurposeThe purpose of this study is to empirically validate the relationships between social Web, integrated marketing communications (IMC) and overall brand equity and to test the moderating role of national culture on these relationships.Design/methodology/approachData were collected among 475 customers and analysed using the LISREL and partial least squares (PLS) techniques and non-parametric methods.FindingsStrong positive and significant relationships are found between social Web and IMC on the one hand, and IMC and brand equity on the other, the second relationship being even stronger than the first one. Moreover, national culture is found to exert a statistically significant moderating effect on both relationships.Research limitations/implicationsThe findings of this study contribute to the wider knowledge and theoretical understanding of both technology and marketing communications potential in the development of brand equity. The results therefore suggest that brand equity requires a representative brand name and consistent meaning of the brand sustained by social Web and the integration of marketing communications.Practical implicationsConsistency in marketing communications can be considered as a primary basis for brand equity building in companies. Moreover, efficient management of the user-generated content available in social media platforms represents a great challenge for marketers.Originality/valueAlthough the connection between social Web, IMC and brand equity was founded in theory, there is a lack of empirical contributions on the causal relationships among these constructs. This gap is filled by the current empirical contribution. Another significant insight of this work lies in considering the role of national culture in the IMC research.
A test of three basic assumptions of Situational Leadership® II Model and their implications for HRD practitioners
Authors: Zigarmi Drea , Roberts Taylor Peyton 
Published: April 2017

PurposeThis study aims to test the following three assertions underlying the Situational Leadership® II (SLII) Model: all four leadership styles are received by followers; all four leadership styles are needed by followers; and if there is a fit between the leadership style a follower receives and needs, that follower will demonstrate favorable scores on outcome variables.Design/methodology/approachFor the first and second assertions, a proportional breakdown of the four leadership styles observed within a sample of working professionals is presented and discussed. Regarding the third assertion, for ten outcome variables, multiple one-way analyses of variance tested mean differences between followers who experienced leadership style fit (i.e. a fit between received and needed style) and followers who did not experience fit (n= 573). Subscale scores from the Leader Action Profile, the Work Intention Inventory, the Positive and Negative Affect Scale and an adapted form of the Affective/Cognitive trust scale (McAllister, 1995) were used as study measures.FindingsThree of the four leadership styles of the SLII framework were reported as frequently received. All four of the leadership styles were reported as needed. This study also found that follower-reported fit between one’s needed and received leadership style at work resulted in more favorable scores on nine of the ten employee outcomes, as compared to follower-reported misfit.Practical implicationsAs human resource development practitioners seek to educate and train their leaders on how to be more effective with their direct reports, this research provides evidence that all four styles are needed and received, although there were lower instances of reporting the S1 style to be needed or received. Also, the findings demonstrated that when followers view a fit exists between the leadership behaviors they need and the leadership behaviors they receive, greater positive job affect, lower negative job affect, increased cognitive and affective trust in the leader and higher levels of favorable employee work intentions were evident.Originality/valueThis paper builds on the resurgence of studies examining initiating structure and consideration as leader behaviors. This is one of very few recent studies that, by combining initiating structure and consideration, reinvestigates the four leadership styles established by past contingency theories. Specifically, the authors used the SLII framework as a foundation for analysis. Overall, the study supports three of the major assumptions of the SLII framework.
Assessment of modelling strategies for film cooling
Authors: Mazzei Lorenzo , Andreini Antonio , Facchini Bruno 
Published: April 2017

Purpose
Effusion cooling represents one the most innovative techniques for the thermal management of aero-engine combustors liners. The huge amount of micro-perforations implies a significant computational cost if cooling holes are included in computational fluid dynamics (CFD) simulations; therefore, many efforts are reported in literature to develop lower-order approaches aiming at limiting the number of mesh elements. This paper aims to report a numerical investigation for validating two approaches for modelling film cooling, distinguished according to the way coolant is injected (i.e. through either point or distributed mass sources).

Design/methodology/approach
The approaches are validated against experimental data in terms of adiabatic effectiveness and heat transfer coefficient distributions obtained for effusion cooled flat plates. Additional reynolds-averaged naver stokes (RANS) simulations were performed meshing also the perforation, so as to distinguish the contribution of injection modelling with respect to intrinsic limitations of turbulence model modelling.

Findings
Despite the simplified strategies for coolant injection, this work clearly shows the feasibility of obtaining a sufficiently accurate reproduction of coolant protection in conjunction with a significant saving in terms of computational cost.

Practical/implications
The proposed methodologies allow to take into account the presence of film cooling in simulations of devices characterized by a huge number of holes.

Originality/value
This activity represents the first thorough and quantitative comparison between two approaches for film cooling modelling, highlighting the advantages involved in their application.