bluuebunny/crossref_metadata_2025_split huggingface dataset:
Continuous improvement strategies across manufacturing SMEs of Northern India
Authors: Sraun Jagdeep Singh , Singh Harwinder 
Published: April 2017

Purpose
The purpose of this paper is to investigate the contributions of successful continuous improvement (CI) strategic implementation to competitive manufacturing. It also seeks to critically examine the level of importance of CI strategy implementation in Indian manufacturing organizations.

Design/methodology/approach
A reasonably large number of manufacturing organizations with successful experience of CI approach have been surveyed to assess the contributions of CI strategies and approach towards accruing useful benefits. The study involves working out the correlations between various CI strategies and manufacturing performance parameters to ascertain the contributions of significant strategies towards realization of manufacturing performance improvement.

Findings
The results of investigation demonstrated that CI strategies and approach significantly aimed at improving the quality of product manufactured by small- and medium-scale manufacturing enterprises. Supportive tools have negative impact on manufacturing performance parameters. Total productive maintenance strategies have highly significant impact on manufacturing performance improvement.

Practical implications
The study establishes that CI strategic implementation can systematically contribute towards realization of significant manufacturing performance enhancements.

Originality/value
The study highlights both positive and negative potentials of CI strategic implementation affecting performance improvements. The achievements of Indian manufacturing organizations through proactive CI approach have been evaluated and the critical impact of CI strategies has been identified for enhancing the effectiveness of CI activities in the Indian context.
The use of fortified foods to treat malnutrition among older adults: a systematic review
Authors: Douglas Joy W. , Lawrence Jeannine C. , Knowlden Adam P. 
Published: April 2017

Purpose
Food fortification with common kitchen ingredients has been suggested to improve nutritional intake. The purpose of this paper was to systematically review the efficacy of food fortification on calorie and protein intake among older adults.

Design/methodology/approach
A systematic search was conducted using Boolean search logic and seven research databases to identify interventions using fortified foods to increase calorie and protein intake among older adults. Ten studies published in English since 1996 were eligible for inclusion. Study quality was evaluated using an adapted Modified Jadad Questionnaire.

Findings
Food fortification was associated with increased calorie intake in eight studies, increased protein intake in five studies, and increased body weight in three studies. However, studies were limited by lack of rigor in methodology and small sample sizes.

Originality/value
Food fortification may improve calorie and protein intake, but results are limited by study weaknesses. Additionally, it is unclear whether improved intake results in improved clinical outcomes.
Delivering person-centred holistic care for older people
Authors: Beech Roger , Ong Bie Nio , Jones Sue , Edwards Vicky 
Published: April 2017

Purpose
This paper is an evaluated case study of the Wellbeing Coordinator (WBC) service in Cheshire, UK. WBCs are non-clinical members of the GP surgery or hospital team who offer advice and support to help people with long-term conditions and unmet social needs remain independent at home. The paper aims to discuss this issue.

Design/methodology/approach
A mixed method design assessed the outcomes of care for recipients and carers using interviews, diaries and validated wellbeing measures. Service utilization data, interviews and observations of WBC consultations enabled investigation of changes in processes of care. Data were analysed using simple descriptive statistics, established instrument scoring systems and accepted social science conventions.

Findings
The WBC complements medical approaches to supporting people with complex health and social care problems, with support for carers often a key service component. Users reported improvements in their wellbeing, access to social networks, and maintenance of social identity and valued activities. Health and social care professionals recognized the value of the service.

Practical implications
The WBC concept relieves the burden on health and social care professionals as the social elements of ill-health are addressed. A shift in thinking from ill-health to wellbeing means older people feel more able to regain control over their own lives, being less dependent on consulting professionals.

Originality/value
The WBC is a new service focussing on the individual in their health, social and economic context. Process and outcomes evaluations are rare in this field.
Mini pretreatment system integrated with micro pre-concentrator and micro GC column
Authors: Zhang Yanni , Sun Jianhai , Zhu Xiaofeng , Liu Jinhua , Ning Zhanwu 
Published: April 2017

Purpose
As the concentration of environmental samples was generally very low and existing analytical instruments had limited sensitivity, developing mini pre-treatment systems for effectively concentrating the components was very important and necessary. The purposed of this paper is to develop mini pretreatment system integrated with micro pre-concentrator and micro GC column.

Design/methodology/approach
In this work, a mini pre-treatment system integrated with a micro pre-concentrator and a micro gas chromatograph (GC) column was proposed. The micro pre-concentrator filled with single-walled carbon nanotubes as adsorbent materials was able to effectively concentrate the trace environmental sample, which dramatically improved the response of detectors. In addition, instead of conventional columns, micro GC columns were able to effectively separate gas mixtures, which are able to overcome low resolution and poor anti-interference ability of portable instruments.

Findings
The results demonstrated that the proposed pre-treatment system was able to concentrate the trace sample with a concentration factor of 15 and effectively separate the gas mixtures with a resolution over 1.5.

Originality/value
A mini pre-treatment system integrated with a micro pre-concentrator and a micro GC column was proposed.
Gas concentration detection via multi-channeled air sampling method
Authors: Hou Longfei , Wang Dan , Du Bingxuan , Qian Xinmin , Yuan Mengqi 
Published: April 2017

Purpose
The purpose of this paper is to present a new technique for monitoring gas leakage in underground pipelines to prevent dangerous explosions.

Design/methodology/approach
A novel system for monitoring methane concentration in underground spaces was developed by integrating the multi-channeled air sampling method with an infrared gas sensor. A pipe installation methodology (without excavation) was established and verified accordingly.

Findings
The proposed approach was proven successful in reducing the quantity of sensors needed for real-time monitoring of underground pipeline leakage by about 80 per cent. Furthermore, this system lowers total operational cost by as much as 60 per cent.

Originality/value
The results presented here represent a possible solution to reducing the public safety risks associated with explosions and fires caused by pipeline leakage in underground spaces. Its total cost is low and its monitoring efficiency is high.
Beyond guidelines: discretionary practice in face‐to‐face triage nursing
Authors: Johannessen Lars E.F. 
Published: April 2017

AbstractThis article draws on ethnographic data from a Norwegian emergency primary care clinic (EPCC) to explore nurses’ discretionary application of guidelines. Specifically, it analyses nurses’ discretionary use of the Manchester Triage System (MTS) when performing face‐to‐face triage, that is, assessing the urgency of patients’ complaints. The analysis shows how nurses assessed patients at odds with MTS prescriptions by collecting supplementary data, engaging in differential diagnostic and holistic reasoning, relying on emotion and intuition, and allowing colleagues and patients to influence their reasoning. The findings also show how nurses’ reasoning led them to override guidelines both overtly and covertly. Based on this evidence, it is argued that nurses’ assessments relied more on internalised ‘triage mindlines’ than on codified triage guidelines, although the MTS did function as a support system, checklist and system for supervisory control. The study complements existing research on standardisation in nursing by providing an in‐depth analysis of nurses’ methods for navigating guidelines and by detailing how deviations from those guidelines spring from their clinical reasoning. The challenges of imposing a managerial logic on professional labour are also highlighted, which is of particular relevance in light of the drive towards standardisation in modern healthcare.
Electroencephalographic patterns of lithium poisoning: a study of the effect/concentration relationships in the rat
Authors: Hanak Anne‐Sophie , Malissin Isabelle , Poupon Joël , Risède Patricia , Chevillard Lucie , Mégarbane Bruno 
Published: April 2017

ObjectivesLithium overdose may result in encephalopathy and electroencephalographic abnormalities. Three poisoning patterns have been identified based on the ingested dose, previous treatment duration and renal function. Whether the severity of lithium‐induced encephalopathy depends on the poisoning pattern has not been established. We designed a rat study to investigate lithium‐induced encephalopathy and correlate its severity to plasma, erythrocyte, cerebrospinal fluid and brain lithium concentrations previously determined in rat models mimicking human poisoning patterns.MethodsLithium‐induced encephalopathy was assessed and scored using continuous electroencephalography.ResultsWe demonstrated that lithium overdose was consistently responsible for encephalopathy, the severity of which depended on the poisoning pattern. Acutely poisoned rats developed rapid‐onset encephalopathy which reached a maximal grade of 2/5 at 6 h and disappeared at 24 h post‐injection. Acute‐on‐chronically poisoned rats developed persistent and slightly fluctuating encephalopathy which reached a maximal grade of 3/5. Chronically poisoned rats developed rapid‐onset but gradually increasing life‐threatening encephalopathy which reached a maximal grade of 4/5. None of the acutely, 20% of the acute‐on‐chronically and 57% of the chronically lithium‐poisoned rats developed seizures. The relationships between encephalopathy severity and lithium concentrations fitted a sigmoidal Emax model based on cerebrospinal fluid concentrations in acute poisoning and brain concentrations in acute‐on‐chronic poisoning. In chronic poisoning, worsening of encephalopathy paralleled the increase in plasma lithium concentrations.ConclusionsThe severity of lithium‐induced encephalopathy is dependent on the poisoning pattern, which was previously shown to determine lithium accumulation in the brain. Our data support the proposition that electroencephalography is a sensitive tool for scoring lithium‐related neurotoxicity.
Working the system: Development of a system model of technology integration to inform learning task design
Authors: Howard Sarah K. , Thompson Kate , Yang Jie , Ma Jun 
Published: April 2017

AbstractThere has been extensive investigation into factors affecting digital technology integration in learning and teaching, but the complexity of integration continues to elude understanding. Thus, questions about how digital technologies can be best used to support learning persist. This paper argues that methods designed to address complex systems are needed to understand the interplay between teaching, learning and digital technologies. Starting with a developing system model of teachers' technology integration, this study revises the model to include factors of students' experience using digital technologies and beliefs about learning. The revised model is then used to demonstrate possible effects of student experiences in a technologically integrated group learning task. Analysis draws on data from a large‐scale Australian study of technology innovation (N = 7406). Data mining techniques are used to identify patterns of students' technology use and perceptions of group work. Findings inform revision of the model to include factors of students' experience and learning and their effects on teachers' practice. Implications for learning design and students' learning experiences are explored.
The incidence of anterior pituitary hormone deficiencies in patients with microprolactinoma and idiopathic hyperprolactinaemia
Authors: Behan L.A. , Moyles P. , Cuesta M. , Rogers B. , Crowley R.K. , Ryan J. , Brennan P. , Smith D. , Tormey W. , Sherlock M. , Thompson C.J. 
Published: April 2017

SummaryIntroductionPatients with microprolactinoma and idiopathic hyperprolactinaemia are not generally considered to be at risk of hypopituitarism and are therefore not routinely screened for this abnormality. In our clinical practice, we have observed a number of patients with nonmacroadenomatous hyperprolactinaemia to have anterior pituitary hormone deficits.AimsWe aimed to establish the frequency and clinical significance of anterior pituitary hormone deficiencies, comparing patients with radiologically proven microprolactinomas and patients with idiopathic hyperprolactinaemia.Study DesignWe retrospectively examined the casenotes of 206 patients with hyperprolactinaemia from our centre. Patients who did not fit the profile of surgically naïve microprolactinoma or idiopathic hyperprolactinaemia or who had incomplete data were excluded, resulting in a study group of 56 patients.ResultsA total of 35 patients with MRI evidence of microprolactinoma were identified, three (8.57%) of whom had one or more anterior pituitary hormone deficiencies. A total of 21 patients with MRI‐negative idiopathic hyperprolactinaemia were identified, nine (42%) of whom had one or more anterior pituitary hormone deficiencies (P<.01). Only one patient in the MRI‐positive group had deficiency that required hormone replacement, in contrast six patients in the MRI‐negative group had deficiencies that were of clinical significance and which required hormone replacement.SummaryThis study shows a clinically significant incidence of anterior pituitary hormone deficiency in patients with idiopathic hyperprolactinaemia. The authors recommend that dynamic pituitary assessment should be considered routinely in this patient group. A prospective study would be required to assess the underlying cause for these abnormalities, as they suggest a nontumour pan‐pituitary process.
A multi‐institutional joint study of contact dermatitis related to hair colouring and perming agents in Japan
Authors: Ito Akiko , Nishioka Kazue , Kanto Hiromi , Yagami Akiko , Yamada Shigeki , Sugiura Mariko , Yasunaga Chihiro , Yoshii Keiko , Kobayashi Hiromi , Adachi Atsuko , Ikezawa Yuko , Washizaki Kumiko , Inui Shigeki , Miyazawa Hitoshi , Oiso Naoki , Nakata Tokio , Matsunaga Kayoko 
Published: April 2017

SummaryBackgroundIn Japan, allergic contact dermatitis caused by hair colouring agents is a considerable problem for those occupationally exposed and also for consumers. Over the last 20 years, p‐phenylenediamine (PPD) has been a common allergen, with ∼7% positive patch test reactions.ObjectivesTo investigate which ingredients caused allergic contact dermatitis related to hair dye and perming solutions in Japan, to assess whether PPD is suitable for screening for hair dye allergy, and to propose allergens for a Japanese hairdresser series.MethodsWe selected 19 hair cosmetic allergens, including PPD, Bandrowski's base, cysteamine HCl, and ammonium thioglycolate. Altogether 203 patients (26 males and 177 females) with suspected contact allergy to hair colouring or perming solutions at 14 hospitals in Japan were included.ResultsThe highest prevalence of positive reactions (35.1%) was for PPD. p‐Methylaminophenol and o‐aminophenol were often positive, both in the PPD‐positive and in the PPD‐negative patients. Moreover, cysteamine HCl often yielded positive test reactions.ConclusionsPPD is insufficient to diagnose contact allergy caused by to hair dyes. We recommend 13 allergens to be included in a Japanese hairdresser series.
Hand eczema, atopic dermatitis and filaggrin mutations in adult Danes: a registry‐based study assessing risk of disability pension
Authors: Heede Nina G. , Thuesen Betina H. , Thyssen Jacob P. , Linneberg Allan , Szecsi Pal B. , Stender Steen , Menné Torkil , Johansen Jeanne D. 
Published: April 2017

SummaryBackgroundAtopic dermatitis and hand eczema often impair the ability of people to work. Only a few studies have investigated whether individuals with loss‐of‐function filaggrin gene (FLG) mutations, who often have severe and early onset of dermatitis, experience occupational consequences.ObjectiveTo investigate the personal consequences of having atopic dermatitis and/or hand eczema and FLG mutations.MethodAdult Danes from the general population (n = 3247) and patients with atopic dermatitis and/or hand eczema (n = 496) were genotyped for common FLG mutations, and completed a questionnaire about skin symptoms and hand eczema. Socioeconomic variables, including disability pension, and information on work in risk occupations were retrieved from national registries. The reasons for granting disability pension were unknown.ResultsDisability pension was associated with hand eczema in the general population, especially among individuals with a history of atopic dermatitis. Moreover, self‐reported hand eczema and atopic dermatitis were associated with particularly high risk of disability pension among FLG mutation carriers [odds ratio (OR) 4.02 and 95% confidence interval (CI): 1.15–14.11; and OR 6.01 and 95%CI: 2.37–15.34, respectively]. Furthermore, 60% of the FLG mutation carriers with atopic dermatitis who developed hand eczema had experienced symptoms before adulthood.ConclusionIn the general population, self‐reported hand eczema and atopic dermatitis, particularly in individuals with a genetically impaired skin barrier, were associated with disability pension, suggesting that FLG mutations carriers with a history of atopic dermatitis and hand eczema could benefit from early attention with respect to choice of occupation.
Determinants of the postpericardiotomy syndrome: a systematic review
Authors: van Osch Dirk , Nathoe Hendrik M. , Jacob Kirolos A. , Doevendans Pieter A. , van Dijk Diederik , Suyker Willem J. , Dieleman Jan M. 
Published: April 2017

AbstractBackgroundPostpericardiotomy syndrome (PPS) is a common complication following cardiac surgery; however, the exact pathogenesis remains uncertain. Identifying risk factors of PPS might help to better understand the syndrome. The aim of this study was to provide an overview of existing literature around determinants of PPS in adult cardiac surgery patients.Material and methodsTwo independent investigators performed a systematic search in MEDLINE, EMBASE and the Cochrane Central Register. The search aimed to identify studies published between January 1950 and December 2015, in which determinants of PPS were reported.ResultsA total of 19 studies met the selection criteria. In these studies, 14 different definitions of PPS were used. The median incidence of PPS was 16%. After quality assessment, seven studies were considered eligible for this review. Lower preoperative interleukin‐8 levels and higher postoperative complement conversion products were associated with a higher risk of PPS. Among other clinical factors, a lower age, transfusion of red blood cells and lower preoperative platelet and haemoglobin levels were associated with a higher risk of PPS. Colchicine use decreased the risk of PPS.ConclusionWe found that both the inflammatory response and perioperative bleeding and coagulation may play a role in the development of PPS, suggesting a multifactorial aetiology of the syndrome. Due to a lack of a uniform definition of PPS in the past, study comparability was poor across the studies.
The PRIAMO study: urinary dysfunction as a marker of disease progression in early Parkinson's disease
Authors: Picillo M. , Palladino R. , Barone P. , Erro R. , Colosimo C. , Marconi R. , Morgante L. , Antonini A. ,   the PRIAMO Study Group
Published: April 2017

Background and purposeNew venues are currently being explored to predict disease progression in Parkinson's disease (PD), such as non‐motor subtypes and models merging motor and non‐motor symptoms (NMS). By involving a subgroup of 585 patients from the PRIAMO (Parkinson Disease Non‐motor Symptoms) study, the present 24‐month longitudinal prospective analysis aimed to demonstrate that urinary dysfunction is an early marker of higher motor and non‐motor burden as well as lower health‐related quality of life.Methods and resultsMultivariable mixed‐effect logistic regression models controlling for demographic and clinical variables showed that the following NMS domains were associated with urinary dysfunction: gastrointestinal [odds ratio (OR) 2.57, 95% confidence interval (CI) 1.67–3.97, P < 0.001], cardiovascular (OR 2.22, 95% CI 1.18–4.17, P = 0.013), skin (OR 1.81, 95% CI 1.06–3.08, P = 0.029), sleep (OR 2.06, 95% CI 1.34–3.16, P = 0.001), pain (OR 1.85, 95% CI 1.21–2.83, P = 0.004), fatigue (OR 2.40, 95% CI 1.56–3.68, P < 0.001), apathy (OR 2.79, 95% CI 1.72–4.52, P < 0.001) and respiratory (OR 1.82, 95% CI 1.02–3.23, P = 0.039). Analysis also demonstrated that urinary dysfunction was associated with higher motor disability (coefficient 1.73, 95% CI 0.68–2.78, P = 0.001) and lower health‐related quality of life (coefficient −0.05, 95% CI −0.08 to −0.02, P < 0.001, and coefficient −3.49, 95% CI −5.21 to −1.77, P < 0.001) but not with more severe cognitive disability (coefficient −0.34, 95% CI −0.92 to 0.24, P = 0.251).ConclusionsThis is the first prospective longitudinal study involving a large cohort of PD patients demonstrating the relevance of urinary dysfunction as an early marker of higher motor and non‐motor disability as well as lower health‐related quality of life. These findings support a role for urinary dysfunction as an early marker of more severe disease progression.