bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sources of Geographic Variation in Health Care: Evidence From Patient
Migration*
Authors: Finkelstein Amy , Gentzkow Matthew , Williams Heidi 
Published: July 2016

Abstract
We study the drivers of geographic variation in U.S. health care utilization, using an empirical strategy that exploits migration of Medicare patients to separate the role of demand and supply factors. Our approach allows us to account for demand differences driven by both observable and unobservable patient characteristics. Within our sample of over-65 Medicare beneficiaries, we find that 40–50% of geographic variation in utilization is attributable to demand-side factors, including health and preferences, with the remainder due to place-specific supply factors.
Elevated Intraoperative Serum Lactate During Craniotomy Is Associated With New Neurological Deficit and Longer Length of Stay
Authors: Brallier Jess W. , Dalal Pavan J. , McCormick Patrick J. , Lin Hung-Mo , Deiner Stacie G. 
Published: July 2016

Background:
Hundreds of thousands of craniotomies are performed annually in the United States. During craniotomy, elevated serum lactate is a concerning and not infrequent occurrence. Elevated intraoperative serum lactate may occur as a result of global hypoperfusion or localized intracerebral ischemia from surgical retraction or inadequate blood supply. The distinction between systemic and hypoperfusion confined to the brain is important because the treatment differs. For example, fluid resuscitation may be indicated in the former but not the latter.

Methods:
To address whether elevated intraoperative serum lactate is associated with hypoperfusion confined to the brain or systemic hypoperfusion, we performed a retrospective cohort study of elective adult (age above 18) craniotomy cases. These included 436 surgeries which were performed at our institution under general anesthesia between May 2011 and August 2013.

Results:
Elevated intraoperative serum lactate in craniotomy patients is associated with new neurological deficits (odds ratio, 2.11) and longer length of stay (20% less likely to be discharged on a given day). Elevated lactate was not associated with systemic complications such as myocardial infarction or mortality.

Conclusions:
Our findings highlight the importance of conducting a definitive prospective study analyzing the clinical impact and mechanism behind hyperlactatemia in the craniotomy population. Knowledge of the serum lactate level may be of value in guiding intraoperative anesthetic and surgical decision-making.
Association Between Perioperative Hyperglycemia and Survival in Patients With Glioblastoma
Authors: Hagan Katherine , Bhavsar Shreyas , Arunkumar Radha , Grasu Roxana , Dang Anh , Carlson Richard , Cowles Charles , Arnold Benjamin , Potylchansky Yuri , Rahlfs Thomas F. , Lipski Ian , Walsh Caroline , Jimenez Federico , Nguyen Anh T. , Feng Lei , Cata Juan P. 
Published: July 2016

Background:
Several studies have examined the association between hyperglycemia in the first 10 to 12 weeks following surgery and postoperative survival in glioblastoma multiforme (GBM) patients. We hypothesize that episodes of hyperglycemia before, during and/or following surgery for primary GBM are independent predictors of disease progression and mortality.

Materials and Methods:
A total of 162 adult patients were included in the analysis. All patients received adjuvant temozolamide. The progression free survival (PFS) and overall survival (OS) rates at 1 and 5 years were analyzed using different glycemic cutoff values. Multivariate analyses were conducted to test the association between preoperative, intraoperative and postoperative hyperglycemia with PFS and OS.

Results:
Kaplan-Meier curves revealed a trend toward increased PFS and OS with lower glucose concentrations with the exception of glucose concentrations >180 mg/dL in the intraoperative/postoperative day 0 time period. Univariate analysis of blood glucose levels did not demonstrate a statistically significant effect on PFS in any time period, however hyperglycemia was statistically significant for OS in the preoperative time period. Although, multivariate analysis showed no statistically significant association with hyperglycemia on PFS, a statistically significant decrease in OS was seen for plasma glucose concentrations >112 mg/dL (P=0.01) and >180 mg/dL (P=0.01) in the preoperative period. There was a decreasing effect on OS with blood glucose concentrations greater than the median in multiple time periods (P=0.02).

Conclusions:
Preoperative hyperglycemia is associated with poor OS after GBM surgery.
Unlocking the Doors to Patient Satisfaction in Pediatric Orthopaedics
Authors: Peng Frederick B. , Burrows James F. , Shirley Eric D. , Rosen Paul 
Published: July 2016

Background:
Despite efforts to enhance the patient experience, many health care providers continue to struggle to improve patient satisfaction as the identification of tangible quality improvement areas remains difficult. This dilemma is particularly relevant in pediatric settings, where patient satisfaction measures have not been as thoroughly studied in subspecialties such as orthopaedics. We investigate this issue to identify the major drivers of patient satisfaction in pediatric orthopaedics, which has significant financial and professional implications for both hospital administrators and health care providers. Although recent patient experience studies emphasize on improving access to care and nurturing hospitality by facilities upgrades or staff development, we hypothesized that the patient-physician relationship remains the most important factor in patients’ assessment of their experiences.

Methods:
Patient satisfaction surveys were collected from outpatient visits to pediatric orthopaedic practices at 5 locations in 3 states. Data were aggregated as monthly percentages of responses on a 5-point Likert scale. Month over month Pearson product-moment correlation coefficients were generated between top responses for “Likelihood of Your Recommending Our Practice to Others” (LTR) and other variables.

Results:
In total, 6195 families completed satisfaction surveys. The variables most predictive of likelihood to recommend the practice were “Staff Worked Together” (r=0.82), “Friendliness/Courtesy of Care Provider” (r=0.80), “Cheerfulness of Practice” (r=0.80), “Likelihood of Recommending Care Provider” (r=0.80), and “Care Provider’s Information about Medications” (r=0.78).

Conclusions:
Measurements of the patient-physician relationship, along with overall cheerfulness and staff collaboration, have the strongest relationships to LTR. These results suggest that patient satisfaction is influenced by more than just the patient-physician relationship, and may have significance in aiding pediatric orthopaedic clinics in their quality assurance/quality improvement plans of enhancing the patient experience.

Level of Evidence:
Level III—prognostic.
Risk Categorization Predicts Disability in Pain‐associated Functional Gastrointestinal Disorders After 6 Months
Authors: Cunningham Natoshia R. , Jagpal Anjana , Peugh James , Farrell Michael K. , Cohen Mitchell B. , Mezoff Adam G. , Lynch‐Jordan Anne , Kashikar‐Zuck Susmita 
Published: July 2016

ABSTRACTIntroduction:For a large portion of youth, pain‐associated functional gastrointestinal disorders (FGIDs) are associated with significant impairment over time. Clinically feasible methods to categorize youth with FGIDs at greatest risk for persistent pain‐related impairment have not yet been identified.Methods:Measures of functional disability, pain intensity, and anxiety were collected on 99 patients with FGIDs (ages 8–18) during a visit to a pediatric gastroenterology office to assess for the presence of risk. Follow‐up data were obtained on a subset of this sample (n = 64) after 6 months, either in person or via mail. The present study examined whether a greater number of risk factors at baseline predicted greater pain‐related disability at follow‐up.Results:Patients were divided into 4 groups based on number of risk factors present at the initial assessment: 0 (18.2%), 1 (24.2%), 2 (26.3%), and 3 (31.3%). The presence of 2 or 3 risk factors significantly predicted greater disability at follow‐up compared to those with 0 risk factors (R2 = 0.311) and those with just 1 risk factor (Cohen's d values of –1.07 and –1.44, respectively).Discussion:A simple approach to risk categorization can identify youth with FGIDs who are most likely to report increased levels of pain‐related impairment over time. These findings have important clinical implications that support the utility of a brief screening process during medical care to inform referral for targeted treatment approaches to FGIDs.
A clonally reproducing generalist aphid pest colonises diverse host plants by rapid transcriptional plasticity of duplicated gene clusters
Authors: Mathers Thomas C. , Chen Yazhou , Kaithakottil Gemy , Legeai Fabrice , Mugford Sam T. , Baa-Puyoulet Patrice , Bretaudeau Anthony , Clavijo Bernardo , Colella Stefano , Collin Olivier , Dalmay Tamas , Derrien Thomas , Feng Honglin , Gabaldón Toni , Jordan Anna , Julca Irene , Kettles Graeme J. , Kowitwanich Krissana , Lavenier Dominique , Lenzi Paolo , Lopez-Gomollon Sara , Loska Damian , Mapleson Daniel , Mauster Florian , Moxon Simon , Price Daniel R. G. , Sugio Akiko , van Munster Manuella , Uzest Marilyne , Waite Darren , Jander Georg , Tagu Denis , Wilson Alex C. C. , van Oosterhout Cock , Swarbreck David , Hogenhout Saskia A. 
Published: July 2016

AbstractBackgroundThe prevailing paradigm of host-parasite evolution is that arms races lead to increasing specialisation via genetic adaptation. Insect herbivores are no exception, and the majority have evolved to colonise a small number of closely related host species. Remarkably, the green peach aphid,Myzus persicae, colonises plant species across 40 families and singleM. persicaeclonal lineages can colonise distantly related plants. This remarkable ability makesM. persicaea highly destructive pest of many important crop species.ResultsTo investigate the exceptional phenotypic plasticity ofM. persicae, we sequenced theM. persicaegenome and assessed how one clonal lineage responds to host plant species of different families. We show that genetically identical individuals are able to colonise distantly related host species through the differential regulation of genes belonging to aphid-expanded gene families. Multigene clusters collectively up-regulate in single aphids within two days upon host switch. Furthermore, we demonstrate the functional significance of this rapid transcriptional change using RNA interference (RNAi)-mediated knock-down of genes belonging to the cathepsin B gene family. Knock-down of cathepsin B genes reduced aphid fitness, but only on the host that induced up-regulation of these genes.ConclusionsPrevious research has focused on the role of genetic adaptation of parasites to their hosts. Here we show that the generalist aphid pestM. persicaeis able to colonise diverse host plant species in the absence of genetic specialisation. This is achieved through rapid transcriptional plasticity of genes that have duplicated during aphid evolution.
She’s homely, beautiful and then, hardworking!
Authors: Tijani-Adenle Ganiyat 
Published: July 2016

Purpose
There are assumptions in gender-related media research that increased female status would be accompanied by more and better representation of women. There are also expectations that an increase in the number of women working in the news media will increase the positive representation of women. The aim of this paper is to critique the representation of women leaders and managers in the Nigerian press to assess the extent to which these factors have influenced the representation of women in the West African country.

Design/methodology/approach
Using two methods, qualitative content analysis and interview, this chapter critiques the representation of women leaders and managers in Nigerian Guardian Life and Vanguard Allure (over a period of six months – the last half of 2014) to determine the way women in leadership and management are constructed by checking for frames on stereotypes, gender roles and trivialisation themes. The editors of the two publications are then interviewed to consider the philosophies behind the coverage patterns and assess their knowledge and awareness of the implications of the coverage patterns on the status of women in the sub-Saharan African country.

Findings
It was discovered that the Nigerian press are focusing on re-enforcing traditional gender roles and norms rather than challenging them, and women in leadership and management in the country do not apply sufficient agency in challenging the status quo.

Research limitations/implications
Even though information derived from this study cannot be said to represent the realities in all of Africa, it surely provides a good context within which issues about media representation of women in leadership and management in Africa can be better understood to assess how the cultures on the continent’s various countries affect the realities of the lives of women.

Originality/value
The bulk of feminist research is situated in the North. Not much feminist research is being done in the South, and there appears to be an inadequate engagement with the available few in the literature. This chapter bridges the gap by presenting much needed information about gender, media and organisation in Nigeria; a highly populous multi-ethnic and multi-cultural sub-Saharan African country. Even though information derived from this study cannot be said to represent the realities in all of Africa, it will surely provide a good context within which issues about media, gender and organisation in Africa can be better appreciated.
An investigation into the different styles of the lawyer and construction specialist when mediating construction disputes
Authors: Wall Ray , Ankrah Nii , Charlson Jennifer 
Published: July 2016

PurposeThe purpose of this paper is to assess the views and experiences of mediators from different professional backgrounds practising in the construction industry. Previous research shows that the legal profession dominates construction mediation in both England and Wales.Design/methodology/approachThe phenomenological approach was used to capture the lived experiences of the interviewees and gain insight into their views and practices. The data collection was by semi-structured interviews. The data was then analysed using software to establish themes.FindingsThe major difference in mediator practice discovered between the two groups is the use of the evaluative style by lawyer and facilitative style by non-lawyer mediators. Non-lawyer mediators strongly reported their criticisms of the evaluative style in mediation suggesting that it undermines the parties’ ability to self-determine their own dispute and reduces the level of satisfaction experienced by the parties in the process of mediation. Lawyer mediators supported the use of the evaluative style as an acceptable compromise on the parties’ self-determination and feelings of satisfaction in pursuit of achieving the goal of a settlement in mediation, which was significantly better than the escalation of stress and costs to the parties in the event that the dispute escalates to litigation. In addition, mandatory mediation, the role of advisors/advocates, governance and the future of mediation were explored.Originality/valueThe research is anticipated to be of particular benefit to parties considering referring a construction dispute to mediation.
An outsider’s inside view of ethnic entrepreneurship
Authors: McPherson Mark 
Published: July 2016

PurposeThis paper aims to critically reflect upon the qualitative research strategy adopted by an outsider investigating business practices between first and second-generation South Asian entrepreneurs. The paper presents, explains and justifies the methodological design and outsider strategy used to help overcome a number of operational research issues. In addition, for those considering the use of qualitative methodology for similar research, practical advice is offered to researchers whom do not share the same ethnicity as the informants under investigation.Design/methodology/approachTo implement an outsider strategy, the methodological design draws its theoretical underpinning via a phenomenological paradigm. Issues appertaining to sample design, negotiating access, adopted research instruments are examined, and their uses to overcome potential operational issues justified.FindingsThe complexities, difficulties and successes of an outsider looking in are highlighted. Evident is the impact of personal and structural power relations between researcher and interviewee, as well as potential research problems as a result thereof. The paper stresses the need to ensure the preservation of researcher integrity, credibility and confidentiality, as he/she will encounter situations wherein he/she will be tested to the fullest.Research limitations/implicationsThe research environment within the Greater London area where the respondents are located may not be as generalisable when compared with other parts of the UK and ethnic entrepreneurs therein.Originality/valueThe paper presents an evaluation of a qualitative research strategy used by an outsider to gain an inside view of ethnic entrepreneurship.
The impact of market orientation and learning orientation on organisational performance
Authors: Beneke Justin , Blampied Simon , Dewar Nadine , Soriano Linda 
Published: July 2016

Purpose
This study aims to consider the impact of market orientation and learning orientation on organisational performance in the context of small- and medium-sized enterprises (SMEs) in Cape Town, South Africa. SMEs play a vital role in developing countries’ economies given their large contribution towards employment and the economic output (gross domestic product). However, many SMEs struggle to implement practices that are used to successful ends by their corporate counterparts. In view of this, this study sought to probe this issue within an emerging market context.

Design/methodology/approach
A survey of 162 enterprises, using partial least squares -structural equation modelling path modelling, was used to link the constructs of market orientation, learning orientation and organisational performance.

Findings
The results revealed a significant relationship between market orientation and organisational performance. However, in contrast to other studies in the developed world, this study found that learning orientation has neither a significant effect on organisational performance nor a moderating effect on the relationship between market orientation and organisational performance of SMEs.

Practical implications
The implications of these findings suggests that, inter alia, the organisation’s implicit marketing plans should be made explicit and shared with employees throughout the enterprise. Moreover, owners and senior managers should embrace a positive marketing philosophy and optimal organisational structure, as well as be willing to assume risks to achieve organisational objectives. However, further research is advocated to understand the nuances distinguishing developing and developed countries.

Originality/value
This is one of the first studies to consider the interrelationships between market orientation, learning orientation and organisational performance in the context of SMEs within an emerging market setting. To the best of the authors’ knowledge, this is pioneering research in the South African domain.
Understanding the midstream environment within a social change systems continuum
Authors: May Cybele , Previte Josephine 
Published: July 2016

PurposeThis paper aims to provide guidance on how midstream social marketing can be used to understand and address wicked problems through adopting a collaborative systems integration approach conceptualised from a macromarketing perspective.Design/methodology/approachRothschild’s motivation, opportunity and ability (MOA) framework is applied in this study to understand veterinarians as midstream microactors in the macrosystem of wicked animal welfare issues. Focus group and individual interview data from veterinarians were analysed through the lens of the MOA framework to understand veterinarians’ as midstream microactors within a systems continuum.FindingsThe MOA of veterinarians to engage downstream targets – cat owners – in behaviour change are identified. Fresh insights reveal the challenges and barriers to simply focusing on veterinarians as the key microactor required to address the wicked problem of cat overpopulation. Challenges identified include the cost of sterilisation to both owners and veterinary practices, alongside vying beliefs about the capacity of individual veterinarians to persuade owners about the benefits of sterilisation to improve animal welfare. Additionally, insight into veterinarians’ perceptions of upstream strategies to address the problem – in terms of marketing, education and law – expose further complications on where regulation and law enforcement can be integrated in future social marketing strategies to address the cat overpopulation problem.Practical implicationsThe application of the MOA framework improves understanding of the concept and practice of midstream social marketing. It provides a practical and strategic tool that social marketers can apply when approaching behaviour change that leverages midstream actors as part of the social change solution.Originality/valueResearch and theorisation in this paper demonstrates an alternative pathway to address wicked problems via a collaborative systems integration approach conceptualised from a macromarketing perspective. Effective long-term change relies on understanding and coordinating a broad macrosystem of interconnected actors along a downstream, midstream and upstream continuum. This starts by understanding the microactions of individual actors within the macrosystem.
Occupational therapy students’ technological skills: Are ‘generation Y’ ready for 21st century practice?
Authors: Hills Caroline , Ryan Susan , Smith Derek R. , Warren‐Forward Helen , Levett‐Jones Tracy , Lapkin Samuel 
Published: July 2016

Background/aimTechnology is becoming increasingly integral to the practice of occupational therapists and part of the everyday lives of clients. ‘Generation Y’ are purported to be naturally technologically skilled as they have grown up in the digital age. The aim of this study was to explore one cohort of ‘Generation Y’ occupational therapy students’ skills and confidence in the use of technologies relevant to contemporary practice.MethodsA cross‐sectional survey design was used to collect data from a cohort of 274 students enrolled in an Australian undergraduate occupational therapy programme.ResultsA total of 173 (63%) students returned the survey. Those born prior to 1982 were removed from the data. This left 155 (56%) ‘Generation Y’ participants. Not all participants reported to be skilled in everyday technologies although most reported to be skilled in word, Internet and mobile technologies. Many reported a lack of skills in Web 2.0 (collaboration and sharing) technologies, creating and using media and gaming, as well as a lack of confidence in technologies relevant to practice, including assistive technology, specialist devices, specialist software and gaming.ConclusionsOverall, the results suggested that this group of ‘Generation Y’ students were not universally skilled in all areas of technology relevant to practice but appear to be skilled in technologies they use regularly. Recommendations are therefore made with view to integrating social networking, gaming, media sharing and assistive technology into undergraduate programmes to ensure that graduates have the requisite skills and confidence required for current and future practice.