bluuebunny/crossref_metadata_2025_split huggingface dataset:
Winterbourne View Hospital: a glimpse of the legacy
Authors: Flynn Margaret , Citarella Vic 
Published: August 2013

PurposeThis paper concerns the fall‐out from a TV programme which exposed the arbitrariness of cruelty at a private hospital that purported to provide assessment, treatment and rehabilitation to adults with learning disabilities, autism and mental health problems. The paper seeks to address the issues involved.Design/methodology/approachIt describes the principal findings of a Serious Case Review which was commissioned after the TV broadcast, and outlines some of the activities designed to reduce the likelihood of such abuses recurring.FindingsFrom policy, commissioning, regulation, management, service design and practice perspectives, events at Winterbourne View Hospital highlight a gulf between professionals, professionals and their organisations, and leadership shortcomings.Originality/valueThe English government responded promptly and encouragingly to the wretched circumstances of patients at Winterbourne View Hospital with a “Timetable of Actions”. The Serious Case Review which was commissioned after the TV broadcast contributed to the growing scepticism of “out of sight, out of mind” placements. It covered wide‐ranging territory.
“An unnoticing environment”: deficiencies and remedies – services for adults with learning disabilities
Authors: Green Sheree Louise 
Published: August 2013

PurposeThis article aims to outline simple measures which, by making better use of existing legislation and provision, could change the day‐to‐day experience of individuals with learning disabilities currently in long stay hospitals, whilst phased local provision is being sourced for them. The proposals will also promote the safety and dignity of the minority of patients who ultimately cannot be settled successfully within their own community. Further, these measures may help ensure that any individual undergoing assessment and treatment at such a unit, for whatever period, and for whatever reason, will receive care in an environment where abuse cannot go unnoticed or unchecked.Design/methodology/approachThe paper provides a review of the potential to use current legislation and provision to better effect, highlighted by case studies.FindingsCommissioners contracting with providers could include measures to promote the safety and protection of adults with learning disabilities from abuse at little or no cost to the commissioning authority.Originality/valueThis is an original piece of work – developed from a short opinion/comment piece (750 words) originally prepared for the benefit of mental health lawyers in the Law Society Gazette. It is primarily of value, however, to social workers, care providers, adult safeguarding teams, advocacy services and commissioners of services.
A series of tsunamis are underway: leaders must learn how to surf the waves
Authors: Vilstrup Hansgaard Jeppe , Mikkelsen Kenneth 
Published: August 2013

PurposeThe purpose of this paper is to discuss the rapid changes occurring in the business world, fundamentally shifting the way we work, connect, and collaborate in the modern workplace.Design/methodology/approachThe authors discuss problems connected with the matrix organization.FindingsIn today's world, organizations are collapsing and failing in every direction. With few exceptions, the business models that organizations use to manage processes and people date from the industrial era. They were invented for mass‐production of inputs into outputs and the underlying thinking was elitist and hierarchical. Throughout the twentieth century, managers have adjusted the models but they have not changed fundamentally.Originality/valueThe paper shows that if attention is not paid to planning for and resolving these issues, there is a strong probability that entire organizations will be wiped out by this interrelated series of tsunamis in the near future.
UK media: managing turbulence and uncertainty
Authors: Oliver John 
Published: August 2013

PurposeBusinesses increasingly find themselves competing in highly dynamic markets, making visibility of the future limited and the strategic way forward ambiguous. The purpose of this paper is to present the findings from a survey of UK media executives and identify their outlook for the industry, and an evaluation of their usage and satisfaction with the tools that they use to manage their businesses.Design/methodology/approachThe survey sampled 24 UK media executives who had responsibility for strategy and other functional areas of their business.FindingsThe survey found four strong themes amongst media executives. These were related to the launch of new products and services, seeking innovation through collaborative partnerships, leveraging their brand and content through new platforms, and uncertainty regarding the future direction of the industry.Practical implicationsThe paper will provide media executives with a better understanding of the management tools at their disposal and how these can be used to improve performance in a number of key areas. Non‐media executives will be able to draw on the paper's findings to see how other firms are managing turbulent and uncertain market conditions.Originality/valueThis is the first survey of the UK media industry in terms of examining the strategic tools that are being used to manage media firms through turbulence and uncertainty.
The end of the strategy world as we know it?
Authors: Bell Gareth 
Published: August 2013

PurposeThe purpose of this paper is to provide an interview with Rita Gunther McGrath, Columbia Business School Professor, and author of The End of Competitive Advantage: How to Keep Your Strategy Moving as Fast as Your Business.Design/methodology/approachThe paper takes the form of an interview.FindingsIn the following interview, Rita Gunther McGrath discusses the demise of traditional strategy practices, proposing a more flexible approach in response to the volatile environment in which we live.Originality/valueMcGrath signals the end of sustainable competitive advantage, suggesting that businesses must organize for the “waves of transient advantage” that are now commonplace.
Chemical Properties of a Polysaccharide Purified From Solid‐State Fermentation of Auricularia Auricular and its Biological Activity as a Hypolipidemic Agent
Authors: Zeng Feng , Zhao Chao , Pang Jie , Lin Zhanxi , Huang Yifan , Liu Bin 
Published: August 2013

AbstractA water‐soluble crude polysaccharide was extracted by hot water from Auricularia auricular mycelium grown under solid‐state fermentation (SSF). The crude polysaccharide was purified by DEAE Sephadex A‐50 and Sephadex G‐200 chromatography. Fourier transform infrared spectroscopy and nuclear magnetic resonance (1H NMR) spectroscopy were used to investigate the structure of the purified A. auricular polysaccharide (AAP‐I) and revealed that it is α‐glycosidically linked. After 14 and 28 days of AAP‐I orally administered, the AAP‐I significantly decreased the levels of total cholesterol, triglyceride, and low‐density lipoprotein cholesterol in mice in which hyperlipidemia had been induced by a high fat diet (P < 0.05). The results revealed that AAP‐I from SSF of A. auricular mycelium possesses potent hypolipidemic properties. The polysaccharide may be useful as a functional food additive and a hypolipidemic agent.
Ultrasound measurement of subglottic diameter and an empirical formula for proper endotracheal tube fitting in children
Authors: KIM E. J. , KIM S. Y. , KIM W. O. , KIM H. , KIL H. K. 
Published: August 2013

BackgroundThe appropriate endotracheal tube (ETT) size is commonly determined using age‐based formula; ETT size determination based on ultrasound (US) measurement of subglottic diameter (SD), the narrowest portion of the paediatric upper airway, may provide a better method for accurate fit. We aimed to validate ETT size determination using US measures of SD before intubation to establish an empirical formula for ETT fitting based on SD and biographic parameters.MethodsWe included 215 children aged 1–72 months undergoing general anaesthesia. US was performed on the anterior neck to measure SD during mask ventilation under anaesthesia. Endotracheal intubation was performed with a cuffed ETT selected by age‐based recommendation; the transverse outer diameter (OD) of the ETT within the trachea at the subglottis level (OD‐ETT at SD) was measured.ResultsThe OD‐ETT at SD was correlated with the actual OD‐ETT outside the trachea (R2 = 0.635), showing the validity of ultrasonographic measurement; moreover, the US‐measured SD revealed strong correlation with the actual OD‐ETT (R2 = 0.834). US‐measured SD and biographic data (age, height and weight) showed little correlation in children less than 12 months but good correlation (age, height) in children older than 12 months (P < 0.01).ConclusionsUS‐measured OD‐ETT at SD was in good agreement with the actual OD‐ETT, suggesting that US‐measured SD helps in choosing the appropriate ETT diameter for children. In children older than 12 months, the equation ‘OD (mm) = 0.01 × age (months) + 0.02 × height (cm) + 3.3’ may help select the appropriate ETT.
About the role and underlying mechanisms of cofactors in anaphylaxis
Authors: Wölbing F. , Fischer J. , Köberle M. , Kaesler S. , Biedermann T. 
Published: August 2013

AbstractAnaphylaxis is the systemic and most severe presentation of type I allergy. A number of conditions were identified that modulate the onset of anaphylaxis such as co‐ or augmentation factors, which significantly lower the allergen dose necessary for triggering anaphylaxis. Next to physical exercise or alcohol consumption, co‐administration of nonsteroidal anti‐inflammatory drugs (NSAID) or concomitant infectious diseases are well‐documented cofactors of anaphylaxis. Registries for anaphylaxis document a role for cofactors in about 30% of anaphylactic reactions. Some disease entities such as ‘wheat‐dependent exercise‐induced anaphylaxis’ (WDEIA) are explicitly characterized by elicitation of anaphylaxis only in the presence of at least one such cofactor. Using WDEIA as a model disease, studies demonstrated that exercise increases skin prick test reactivity to and bioavailability of the allergen. Additional data indicate that alcohol consumption and NSAID administration display similar effects. Modulation of the cellular activation threshold is another mechanism underlying cofactor‐induced anaphylaxis, most likely also functional when infectious diseases orchestrate elicitation of anaphylaxis. Cofactors are increasingly accepted to play a fundamental role in eliciting anaphylaxis. Consequently, to improve patient management modalities, a better understanding of the underlying mechanisms is warranted. This review aims to update clinicians and clinical scientists on recent developments.
Outcomes of cholecystectomy for treatment of acute cholecystitis in octogenarians
Authors: Nikfarjam Mehrdad , Yeo David , Perini Marcos , Fink Michael A. , Muralidharan Vijayaragavan , Starkey Graham , Jones Robert M. , Christophi Christopher 
Published: August 2013

AbstractBackgroundThe independent influence of advanced age on outcomes in contemporary series treated by early cholecystectomy is undetermined.MethodsElderly patients, aged 80 years and older, with histology proven acute cholecystitis treated by cholecystectomy on initial presentation between 2005 and 2011 were compared to all others.ResultsIn total, 411 patients had histologically proven acute cholecystitis, of whom 71 (17%) were aged 80 years and older. Elderly patients were more likely to have ischaemic heart disease, underlying diabetes and chronic renal failure. There was greater conversion from laparoscopic to open surgery in the elderly (21% versus 7%; P = 0.001). Elderly patients were more likely to have gangrenous cholecystitis (44% versus 31%; P = 0.033) and common bile duct stones (27% versus 17%; P = 0.048). Elderly patients had more complications (31% versus 13%; P < 0.001), a higher mortality rate (4% versus 1%; P = 0.038) and a longer median post‐operative length of stay (7 days versus 3 days; P < 0.001). Age ≥ 80 (P = 0.004) was an independent risk factors for complications.ConclusionAge 80 years and older is independently associated with increased morbidity following cholecystectomy for treatment acute cholecystitis at initial presentation.
How Do Teachers Talk About Economic Inequality? The Complexity of Teaching at a Socioeconomically Integrated Elementary School
Authors: White Elizabeth S. , Mistry Rashmita S. , Chow Kirby A. 
Published: August 2013

This study examined elementary school teachers’ experiences at a socioeconomically integrated school. Specifically we focused on the ways that teachers address privilege and promote friendships among economically diverse students and the challenges they face in doing so. Open‐ended interviews were conducted with teachers (N = 25) in prekindergarten through sixth grades. Results indicated that while socioeconomic status (SES) was the most frequently mentioned domain of student difference, teachers were unsure about how to effectively address SES in the classroom. Some teachers reported working (unsuccessfully) to mask SES differences among students, though this became increasingly difficult in the upper elementary grades. Additionally, teachers described challenges associated with having an economically heterogeneous student body including parents’ differential power and involvement at the school and the lack of geographic proximity among students. Findings highlight the need for clear and specific classroom‐ and school‐based strategies to better address SES differences among students in socioeconomically integrated school settings. Implications for teacher practice are discussed.
Participation, interaction and social presence: An exploratory study of collaboration in online peer review groups
Authors: Zhao Huahui , Sullivan Kirk P. H. , Mellenius Ingmarie 
Published: August 2013

AbstractA key reason for using asynchronous computer conferencing in instruction is its potential for supporting collaborative learning. However, few studies have examined collaboration in computer conferencing. This study examined collaboration in six peer review groups within an asynchronous computer conferencing. Eighteen tertiary students participated in the study. Content analyses of discussion protocols were performed in terms of participation, interaction, and social presence.The results indicate that collaboration does not occur automatically in asynchronous computer conference. Collaboration requires participation because no collaboration occurred in the two groups with low student participation; however, participation does not lead to collaboration, evidenced by student postings receiving no peer responses. Collaboration requires interaction but does not end with interaction, substantiated by different levels of collaboration across different interactional patterns. Social presence helps to realise collaboration through establishing a warm and collegial learning community to encourage participate and interaction, exemplified by the contrast of the group with the highest level of social presence and the group with the lowest level of social presence. A model of understanding and assessing collaboration in online learning is recommended, consisting of participation, interaction and social presence.
Innovations in Practice: pilot evaluation of the supported discharge service (SDS): clinical outcomes and service use
Authors: Ougrin Dennis , Zundel Toby , Corrigall Richard , Padmore Jane , Loh Cheryl 
Published: August 2013

BackgroundThe Supported Discharge Service (SDS) is a model of enhanced care in the community for adolescents after inpatient discharge.MethodsThis study comprised the first 20 patients referred to SDS, largely those with delayed discharges. Service use and clinical outcomes were collected and predictors of total contact time were investigated.ResultsSignificant improvements had been made with SDS. Higher baseline Strengths and Difficulties Questionnaire (SDQ) conduct scores were associated with less contact time.ConclusionsSDS is a feasible model of care. Adolescents with conduct problems may benefit from engagement strategies. Further rigorous evaluation of the model is required.
Interobserver concordance of Ki67 labeling index in breast cancer: Japan Breast Cancer Research Group Ki67 Ring Study
Authors: Mikami Yoshiki , Ueno Takayuki , Yoshimura Kenichi , Tsuda Hitoshi , Kurosumi Masafumi , Masuda Shinobu , Horii Rie , Toi Masakazu , Sasano Hironobu 
Published: August 2013

The standardized assessment of Ki67 labeling index (LI) is of clinical importance to identify patients with primary breast cancer who could benefit from chemotherapy. In this study, we evaluated the interobserver concordance of Ki67 LI assessment. Six surgical pathologists participated and all the slides were prepared from archival breast cancer tissues fixed in 10% buffered formalin for 24 h and stained with MIB‐1. Three independent studies were conducted. In the first study, 30 stained slides were assessed using two different methods: the scoring system, with a positive rate scored from 1 (0–9%) to 10 (90–100%) by visual estimate; and the counting method, with approximately 1000 cells counted in hot spots. In the second study, 20 tumors with Ki67 LI 5–25% were assessed, and in the third study, 15 printed photographs of stained slides were assessed to avoid variations by selecting different fields. In study 1, the counting system (intraclass correlation coefficient [ICC], 0.66 [95% confidence interval 0.52–0.78]) demonstrated a better correlation than the scoring system (ICC, 0.57 [0.42–0.72]). In study 2, the assessment for Ki67 LI of 5–25% demonstrated a correlation (ICC, 0.68 [0.50–0.81]) similar to that of study 1 (unrestricted range of Ki67 LI). In study 3, the assessment of Ki67 LI by counting yielded a good concordance (ICC, 0.94 [0.88–0.97]). In conclusion, there was better concordance with the counting system, and concordance was high when the assessed field was predetermined, indicating that the selection of the evaluation area is critical for obtaining reproducible Ki67 LI in breast cancer.
Preload Reserve Is Restored in Patients With Decompensated Chronic Heart Failure Who Respond to Treatment
Authors: Squara Pierre , Estagnasie Philippe , Belliard Olivier , Squara Fabien , Dib Jean Claude 
Published: August 2013

The authors designed this prospective study to show the relationship between preload reserve and treatment effectiveness of chronic heart failure (CHF). Fifty patients, aged 77±24 years, with decompensated CHF (B‐type brain natriuretic peptide [BNP] >1000 pg/mL) were included. Preload reserve was assessed by the changes in contraction indices during a passive leg raise (PLR). Contraction indices were assessed noninvasively using Bioreactance technology. After 4 days of optimized therapy, the same variables were reassessed and treatment‐induced differences were calculated. Treatment effectiveness was assessed by the 4‐day changes in BNP, body weight, and thoracic fluid content. The authors then compared treatment‐induced changes in preload reserve with treatment effectiveness. Therapy was associated with an overall decrease in heart rate, blood pressure, and cardiac power index (CPi) and with an increase in all preload reserve indices. Treatment effectiveness correlated well with changes in preload reserve. The best correlation was found between treatment‐induced changes in BNP and in PLR‐induced changes of CPi (R=0.63, P<.001). The PLR‐induced changes in CPi increased from 21±48 to 51±48 in BNP responders and decreased from 34±34 to 5±19 mW/m2 in BNP nonresponders (P<.0001). Hence, effective treatment, as indexed by a decrease in BNP, restores the preload reserve in patients with decompensated CHF.
A kinetic compartment model for evaluating salivary gland scintigraphies
Authors: Afzelius Pia , Fuglsang Stefan 
Published: August 2013

SummaryPurposeThe semi‐quantitative analysis of salivary gland scintigraphy with 99mTc‐pertechnetate has been used to evaluate salivary gland function. However, no objective parameters distinguishing abnormal from normal functions have been established thus far. We propose using a simple kinetic model applied to the four major salivary glands. This kinetic model is based on a two‐compartment model and the assumption of first‐order kinetics to characterize normal salivary gland function and other selected parameters to evaluate the normal function of salivary glands.MethodsThirty patients referred for 99mTc‐pertechnetate thyroid scintigraphy were studied. Dynamic imaging of the head in a fixed anterior projection was performed after an intravenous bolus injection of 150 MBq 99mTc‐pertechnetate using a gamma scintillation camera. After 30 min, lemon juice was orally administered through a syringe. Time activity curves were generated for each of the four major salivary glands (i.e. the right and left submandibular and right and left parotid glands). Excretion fractions (the fraction of mobilizable radioactivity after administering lemon juice) and the gland activity‐to‐thyroid activity ratio were calculated. The data were fitted to both a one‐ and two‐phase uptake model.ResultsThe median uptake slope and maximal activity were significantly higher in the parotid glands than the submandibular glands (P<0·0001). The gland‐to‐thyroid ratio was higher in the parotid glands than the submandibular glands (P<0·0001), and the ejection fractions were higher in the parotid glands (P<0·0001). No difference was found in functional contributions of the parotid and submandibular glands.ConclusionsTracer accumulation can be represented by a one‐phase simple uptake model. The background regions that have been previously recommended in the literature are acceptable.
Liver allocation: urgency of need or prospect of success? Ethical considerations
Authors: Bobbert Monika , Ganten Tom M. 
Published: August 2013

AbstractIn German legislation and in Eurotransplant's practice of liver allocation, urgency of need is considered as the primary distribution criterion. However, at a certain stage, the “sickest‐first” principle is regarded as counterproductive as the performance status of these patients receiving an organ is on average critical and mortality and morbidity after liver transplantation increase. Within the medical transplant community, the criterion of prospect for success is highly accepted. As clinicians having a certain scope in decision‐making as “gatekeepers” in regard to which patient gets on the waiting list and at which stage a patient is defined as “not transplantable” and as transplantation centers aspire good success rates, the goal of high prospect for success might become more weighty than intended by legislation and professional guidelines. From an ethical point of view, it is submitted a so‐called mediatory approach in between the two extremes “sickest‐first” and “fittest‐first.” Beyond that, it is argued for further development of a prognostic score for post‐operative outcome after liver transplantation – as long as questions of social justice are borne in mind – to support “objective” decision‐making.