bluuebunny/crossref_metadata_2025_split huggingface dataset:
Water security, global change and land–atmosphere feedbacks
Authors: Dadson Simon , Acreman Michael , Harding Richard 
Published: October 2013

Understanding the competing pressures on water resources requires a detailed knowledge of the future water balance under uncertain environmental change. The need for a robust, scientifically rigorous evidence base for effective policy planning and practice has never been greater. Environmental change includes, but is not limited to, climate change; it also includes land-use and land-cover change, including deforestation for agriculture, and occurs alongside changes in anthropogenic interventions that are used in natural resource management such as the regulation of river flows using dams, which can have impacts that frequently exceed those arising in the natural system. In this paper, we examine the role that land surface models can play in providing a robust scientific basis for making resource management decisions against a background of environmental change. We provide some perspectives on recent developments in modelling in land surface hydrology. Among the range of current land surface and hydrology models, there is a large range of variability, which indicates that the specification and parametrization of several basic processes in the models can be improved. Key areas that require improvement in order to address hydrological applications include (i) the representation of groundwater in models, particularly at the scales relevant to land surface modelling, (ii) the representation of human interventions such as dams and irrigation in the hydrological system, (iii) the quantification and communication of uncertainty, and (iv) improved understanding of the impact on water resources availability of multiple use through treatment, recycling and return flows (and the balance of consumptive and conservative uses). Through a series of examples, we demonstrate that changes in water use could have important reciprocal impacts on climate over a wide area. The effects of water management decisions on climate feedbacks are only beginning to be investigated—they are still only rarely included in climate impact assessments—and the links between the hydrological system and climate are rarely acknowledged in studies of ecosystem services. Nevertheless, because water is essential not only for its direct uses but also for the indirect functions that it serves (including food production, fisheries and industry), it is vital that these connected systems are studied. Building on the examples above, we highlight recent research showing that assessment of these trade-offs is particularly complex in wetland areas, especially in situations where these trade-offs play to the advantage of different communities.
Structural holes in hospital organisations
Authors: Kang Sherman Heng Hock , Loosemore Martin 
Published: September 2013

Purpose
– The delivery of high quality healthcare services to the community requires the integration of information from a wide range of sources within a complex and highly dynamic environment. Using structural holes theory the challenges and opportunities of integration are explored from a facilities management (FM) perspective.

Design/methodology/approach
– Using a critical realism methodology, structured interviews with hospital stakeholders are undertaken in a case study of a large tertiary hospital in Australia. Data are analysed using social network analysis to explore the existence of structural holes.

Findings
– Effective FM in the health sector requires intrapreneurial skills to broker connections between functionally and culturally distinct actors located in a highly disconnected communication network structure.

Originality/value
– This research reveals, for the first time, the detailed communication structure of relationships among FM services in a hospital. By identifying the existence of structural holes in hospital organisations, it illuminates significant untapped brokerage potential of facilities managers in facilitating greater integration. These insights into communication structure have important implications for the practice of FM in better supporting healthcare service delivery.
Low carbon retrofit: attitudes and readiness within the social housing sector
Authors: Swan William , Ruddock Les , Smith Luke 
Published: September 2013

Purpose– The study was designed to assess the attitudes, strategic readiness and drivers and barriers to the adoption of sustainable retrofit within the UK social housing sector.Design/methodology/approach– The study was undertaken using a structured questionnaire that was completed by 130 providers of social housing.Findings– The study showed that social housing providers were aware of the sustainable retrofit agenda, but with varying levels of strategic readiness. Immediate benefits to residents were seen as important drivers, as opposed to more remote issues such as climate change. The emerging nature of the sustainable retrofit market was seen as a major potential risk for residents.Research limitations/implications– The study represents a snap-shot of adoption and effectiveness issues, therefore does not show the trajectory of adoption which should be addressed in a follow-up study.Practical implications– The social housing sector has been viewed as a market maker for the sustainable retrofit market. The study shows the attitudes of the sector to this role.Social implications– The study has implications for the understanding social housing providers’ engagement with the sustainable retrofit market to address fuel poverty and climate change. Social housing's role as market maker has implications for policies such as Green Deal and Energy Company Obligation.Originality/value– The study covers approximately 20 per cent of the social housing stock under management and gives a robust perspective of current views on adoption and effectiveness of retrofit technologies within the social housing sector. This is useful for both other social housing providers and policy makers.
Lifestyles management and community engagement in scoping a “health café”
Authors: Mary Poland Fiona , Fox Margaret , Lambert Nigel , Lambert Rodney , Fordham Richard 
Published: September 2013

Purpose– The purpose of this paper is to underpin a scoping study commissioned by community leaders to assess the potential for creating a “health café” in the centre of Boston, in eastern England, UK, to facilitate healthier lifestyles.Design/methodology/approach– A mixed methods and framework analytic approach was adopted, using documentary, focus group, interview and survey data. The paper drew on social marketing principles to enhance the community relevance of findings.Findings– Community stakeholders and public were generally supportive of a “health café” facility in the town centre. Accessibility and a welcoming environment were seen as key factors. A wide range of health-related services in addition to providing healthy foods were proposed. Key issues identified were: a wider role of the facility as a community “health hub”; appropriate marketing approaches; food provision issues and sustainability. All groups contacted saw the word “health” as off-putting.Research limitations/implications– As with many commissioned scoping studies, the timetable for delivery was very short, just three months, significantly influencing the choices of methodological approaches taken up. This made it important to provide a multi-disciplinary multi-methods design to enhance triangulation and a research team with extensive community research experience including previous research in this region. It was also important to specify and locate any knowledge claims from the findings.Practical implications– The research helped engage community stakeholders to tap a diversity of views which could be adopted by community leaders into their ongoing health strategies and development plans for a “health hub” for Boston.Originality/value– The paper provides important information for those embarking on community health education projects and particularly in how to tailor health research methods to real-world timescales and stakeholder perspectives. Insights are also provided into community attitudes, understandings and behaviours towards healthy living in a part of the UK with a well-documented history of poor health.
Examining the impact of experience on value in social marketing
Authors: Zainuddin Nadia 
Published: September 2013

Purpose– The purpose of this paper is to examine the impact of experience levels on consumers' value perceptions in their use of a social marketing preventative health service. The study uses services thinking to investigate customer value in a social marketing consumption situation.Design/methodology/approach– An online, self-completion survey was conducted onn=853 Australian women who were users of breastscreening services.Findings– Experienced users derived higher levels of functional and emotional value than novice users and reported higher levels of satisfaction and behavioural intentions to use the service again. However, path analysis indicated that satisfaction was a stronger driver of behavioural intentions for novice users.Practical implications– The findings highlight the need to understand and segment target audiences in more meaningful ways beyond traditional demographic segmentation. There is a need to understand the value benefits that target audiences seek and acknowledge that these value and service experience perceptions are likely to change over time as target audiences transition from novice to experienced users. This is useful in allowing health services to consider ways of providing a degree of customisation to target audiences, resulting in higher levels of satisfaction, particularly amongst novice users, leading to behavioural intentions to return.Originality/value– Two novel approaches are used to understand social marketing behaviour: value theory and a services perspective. Through the examination of experience levels, this study acknowledges the enduring nature of many social marketing behaviours, allowing social marketers to examine differences in target audiences' experiences based on whether they are new to or familiar with a behaviour. This provides a fresh perspective in understanding target audiences in social marketing through an understanding of their value perceptions which influence their behaviour, and how these value perceptions are likely to change over time.
Mild Chronic Kidney Disease Associated with Greater Risk of Arterial Stiffness in Elderly Adults
Authors: Liu I‐Ting , Wu Jin‐Shang , Yang Yi‐Ching , Huang Ying‐Hsiang , Lu Feng‐Hwa , Chang Chih‐Jen 
Published: October 2013

ObjectivesTo assess the association between arterial stiffness and mild and moderate chronic kidney disease (CKD), independent of other cardiometabolic factors in an elderly population.DesignCross‐sectional study.SettingHealth examination data from National Cheng Kung University Hospital from 2006 to 2009.ParticipantsEligible subjects aged 60 and older (N = 1,251).MeasurementsAn average bilateral brachial–ankle pulse wave velocity (baPWV) of 1,400 cm/s or greater was defined as high baPWV. Based on the 2003 Clinical Practice Guidelines for Chronic Kidney Disease from the National Kidney Foundation, mild and moderate CKD were defined as CKD Stages 1 and 2 and Stages 3 to 5, respectively.ResultsParticipants with a baPWV of 1,400 cm/s or greater (n = 1,028) had lower estimated glomerular filtration rates (eGFRs) but higher serum creatinine levels and greater prevalences of mild and moderate CKD, diabetes mellitus, prediabetes mellitus, hypertension, and prehypertension than those with baPWV less than 1,400 cm/s (n = 223). In the multivariate analysis, mild (odds ratio (OR) = 2.58, 95% confidence interval (CI) = 1.02–6.54) and moderate (OR = 3.75, 95% CI = 1.02–13.81) CKD were positively associated with greater baPWV (≥1,400 cm/s). Age, prediabetes mellitus, diabetes mellitus, prehypertension, and hypertension were also independently associated with greater baPWV. In the multiple linear analysis, moderate (β = 120.45, P < .001) and mild CKD (β = 69.90, P = .01) were positively associated with baPWV. There was also an independently inverse correlation between eGFR and baPWV (β = −0.69, P = .04).ConclusionMild and moderate CKD increased the risk of greater arterial stiffness in elderly adults. Age, prediabetes mellitus, diabetes mellitus, prehypertension, and hypertension were also important correlates of increased arterial stiffness.
Outcomes of Feeding Problems in Advanced Dementia in a Nursing Home Population
Authors: Hanson Laura C. , Ersek Mary , Lin Feng Chang , Carey Timothy S. 
Published: October 2013

ObjectivesTo describe quality of care for feeding problems in advanced dementia and probability and predictors of weight loss and mortality.DesignProspective cohort.SettingTwenty‐four nursing homes (NHs).ParticipantsNursing home residents with advanced dementia and feeding problems and family surrogates (N = 256).MeasurementsFamily reported on quality of feeding care at enrollment and 3 months. Chart reviews at enrollment and 3, 6, and 9 months provided data on feeding problems, treatments, weight loss of more than 5% in 30 days or more than 10% in 6 months, and mortality. Organizational variables were obtained from administrator surveys and publically reported data.ResultsResidents with advanced dementia and feeding problems had an average age of 85; 80% had chewing and swallowing problems, 11% weight loss, and 48% poor intake. Family reported feeding assistance of moderate quality; 23% felt the resident received less assistance than needed. Mortality risk was significant; 8% died within 3 months, 17% within 6 months, and 27% within 9 months. Residents with advanced dementia who had stable weight over 3 months had a 5.4% rate of significant weight loss and a 2.1% risk of death over the next 3 months. Residents with advanced dementia and weight loss over 3 months had a 38.9% chance of stabilizing weight over the next 3 months but also had a 19.2% chance of dying. Weight loss was the only independent predictor of death.ConclusionWeight loss is a predictor of death in advanced dementia. Treatments can often stabilize weight, but weight loss should be used to trigger discussion of goals of care and treatment options.
Association Between Treatment or Usual Care Region and Hospitalization for Fall‐Related Traumatic Brain Injury in the Connecticut Collaboration for Fall Prevention
Authors: Murphy Terrence E. , Baker Dorothy I. , Leo‐Summers Linda S. , Allore Heather G. , Tinetti Mary E. 
Published: October 2013

ObjectivesTo evaluate the association between the treatment region (TR) or usual care region (UCR) of the Connecticut Collaboration for Fall Prevention (CCFP), a clinical intervention for prevention of falls, and the rate of hospitalization for fall‐related traumatic brain injury (FR‐TBI) in persons aged 70 and older and to describe the Medicare charges for FR‐TBI hospitalizations.DesignUsing a quasi‐experimental design, rates of hospitalization for FR‐TBI were recorded over an 8‐year period (2000–2007) in two distinct geographic regions (TR and UCR) chosen for their similarity in characteristics associated with occurrence of falls.SettingTwo geographical regions in Connecticut.ParticipantsMore than 200,000 persons aged 70 and older.InterventionClinicians in the TR translated research protocols from the Yale Frailty and Injuries: Cooperative Studies of Intervention Techniques, a successful fall‐prevention randomized clinical trial, into discipline‐ and site‐specific fall‐prevention procedures for integration into their clinical practices.MeasurementsRate of hospitalization for FR‐TBI in persons aged 70 and older.ResultsConnecticut Collaboration for Fall Prevention's TR exhibited lower rates of hospitalization for FR‐TBI than the UCR (risk ratio = 0.84, 95% credible interval = 0.72–0.99).ConclusionThe significantly lower rate of hospitalization for FR‐TBI in CCFP's TR suggests that the engagement of practicing clinicians in the implementation of evidence‐based fall‐prevention practices may reduce hospitalizations for FR‐TBI.
Modelling genetic reorganization in the mouse spinal cord affecting left–right coordination during locomotion
Authors: Rybak Ilya A. , Shevtsova Natalia A. , Kiehn Ole 
Published: October 2013

Key points
EphA4, Netrin‐1 and DCC are axon guidance molecules involved in mid‐line crossing of axons of commissural and other spinal interneurons. Absence of these molecules in mice lead to specific locomotor pattern transformations.
We use a computational model of the bilateral spinal neural networks to simulate the genetically induced transformations in EphA4, Netrin‐1 and DCC mutant mice.
The model closely reproduces the changes in the locomotor patterns in these mutants, including transformations from the normal left–right alternating pattern to a synchronized hopping pattern in EphA4 and Netrin‐1 mutants, uncoordinated left–right activity in the DCC mutant, and re‐establishment of the alternating patterns in EphA4 and DCC mutant cords by augmentation of inhibitory interactions.
The model suggests mechanistic explanations for the locomotor transformations and provides insights into the organization of the locomotor network in the spinal cord.
Abstract  The spinal neural circuit contains inhibitory (CINi) and excitatory (CINe) commissural interneurons with axons crossing the mid‐line. Direction of these axons to the other side of the cord is controlled by axon guidance molecules, such as Netrin‐1 and DCC. The cord also contains glutamatergic interneurons, whose axon guidance involves the EphA4 receptor. In EphA4 knockout (KO) and Netrin‐1 KO mice, the normal left–right alternating pattern is replaced with a synchronized hopping gait, and the cord of DCC KO mice exhibits uncoordinated left and right oscillations. To investigate the effects of these genetic transformations, we used a computational model of the spinal circuits containing left and right rhythm‐generating neuron populations (RGs), each with a subpopulation of EphA4‐positive neurons, and CINi and CINe populations mediating mutual inhibition and excitation between the left and right RGs. In the EphA4 KO circuits, half of the EphA4‐positive axons crossed the mid‐line and excited the contralateral RG neurons. In the Netrin‐1 KO model, the number of contralateral CINi projections was significantly reduced, while in the DCC KO model, the numbers of both CINi and CINe connections were reduced. In our simulations, the EphA4 and Netrin‐1 KO circuits switched from the left–right alternating pattern to a synchronized hopping pattern, and the DCC KO network exhibited uncoordinated left–right activity. The amplification of inhibitory interactions re‐established an alternating pattern in the EphA4 and DCC KO circuits, but not in the Netrin‐1 KO network. The model reproduces the genetic transformations and provides insights into the organization of the spinal locomotor network.
Endogenous zinc depresses GABAergic transmission via T‐type Ca2+ channels and broadens the time window for integration of glutamatergic inputs in dentate granule cells
Authors: Grauert Antonia , Engel Dominique , Ruiz Arnaud J. 
Published: October 2013

Key points
Zinc inhibits ionotropic receptors commonly found at central synapses, as well as a wide variety of voltage‐activated ion channels that modulate neuronal excitability and neurotransmitter release.
We found that zinc chelation facilitated GABAergic signalling in dentate granule cells and that blocking T‐type Ca2+ channel activity abolished this effect. Zinc chelation reduced spike threshold, increased spike width and shifted the input–output relationship in dentate interneurones, which is consistent with increased excitability.
In granule cells, zinc chelation narrowed the window for the integration of glutamatergic inputs originating from perforant path synapses.
These results demonstrate that zinc modulates dentate interneurone function and regulates spike routing to local and hippocampal targets.
Abstract  Zinc actions on synaptic transmission span the modulation of neurotransmitter receptors, transporters, activation of intracellular cascades and alterations in gene expression. Whether and how zinc affects inhibitory synaptic signalling in the dentate gyrus remains largely unexplored. We found that mono‐ and di‐synaptic GABAergic inputs onto dentate granule cells were reversibly depressed by exogenous zinc application and enhanced by zinc chelation. Blocking T‐type Ca2+ channels prevented the effect of zinc chelation. When recording from dentate fast‐spiking interneurones, zinc chelation facilitated T‐type Ca2+ currents, increased action potential half‐width and decreased spike threshold. It also increased the offset of the input–output relation in a manner consistent with enhanced excitability. In granule cells, chelation of zinc reduced the time window for the integration of glutamatergic inputs originating from perforant path synapses, resulting in reduced spike transfer. Thus, zinc‐mediated modulation of dentate interneurone excitability and GABA release regulates information flow to local targets and hippocampal networks.
Pharmacokinetic Interaction between Maraviroc and Fosamprenavir-Ritonavir: an Open-Label, Fixed-Sequence Study in Healthy Subjects
Authors: Vourvahis Manoli , Plotka Anna , Mendes da Costa Laure , Fang Annie , Heera Jayvant 
Published: October 2013

ABSTRACTThis open-label, fixed-sequence, phase 1 study evaluated the pharmacokinetic interaction between maraviroc (MVC) and ritonavir-boosted fosamprenavir (FPV/r) in healthy subjects. In period 1, subjects received 300 mg of MVC twice daily (BID; cohort 1) or once daily (QD; cohort 2) for 5 days. In period 2, cohort 1 subjects received 700/100 mg of FPV/r BID alone on days 1 to 10 and then FPV/r at 700/100 mg BID plus MVC at 300 mg BID on days 11 to 20; cohort 2 subjects received FPV/r at 1,400/100 mg QD alone on days 1 to 10 and then FPV/r at 1,400/100 mg QD plus MVC at 300 mg QD on days 11 to 20. Pharmacokinetic parameters, assessed on day 5 of period 1 and on days 10 and 20 of period 2, included the maximum plasma concentration (Cmax), the concentration at end of dosing interval (Cτ), and the area under the curve over dosing interval (AUCτ). Safety and tolerability were also assessed. MVC geometric mean AUCτ,Cmax, andCτwere increased by 149, 52, and 374%, respectively, after BID dosing with FPV/r, and by 126, 45, and 80%, respectively, after QD dosing. Amprenavir (the active form of the prodrug fosamprenavir) and ritonavir exposures were decreased in the presence of MVC with amprenavir AUCτ,Cmax, andCτdecreased by 34 to 36% in the presence of FPV/r plus maraviroc BID and by 15 to 30% with FPV/r plus MVC QD both compared to FPV/r alone. The overall all-causality adverse-event (AE) incidence rate was 96.4%; all AEs were of mild or moderate severity. Commonly reported treatment-related AEs (>20% of patients overall) included diarrhea, fatigue, abdominal discomfort, headache, and nausea. No serious AEs or deaths occurred. In summary, maraviroc exposure increased in the presence of FPV/r, whereas MVC coadministration decreased amprenavir and ritonavir exposures. MVC dosed at 300 mg BID with FPV/r is not recommended due to concerns of lower amprenavir exposures; however, no dose adjustment is warranted with MVC at 150 mg BID in combination with FPV/r based on the available clinical data. MVC plus FPV/r was generally well tolerated; no new safety signals were detected.