bluuebunny/crossref_metadata_2025_split huggingface dataset:
Boundary work as inner and outer dialogue: dieticians in Sweden
Authors: Wikström Ewa 
Published: May 2008

PurposeThis purpose of this paper is to examine the ways in which one occupational group used boundary work to increase their influence and power with more influential occupational groups in a medical setting.Design/methodology/approachA qualitative interview study is used to investigate an occupational group (hospital dieticians) as it tried to increase its influence in a setting of established occupational groups. Data were collected through semi‐structured interviews with dieticians and managers at a university hospital, and by the examination of selected hospital documents.FindingsThis study concludes that the dieticians' boundary work to become more influential in a setting of established groups was characterized by their boundary setting actions as inner dialogue and their boundary spanning actions as outer dialogue. In the inner dialogue, the dieticians established a professional group and a vocabulary for the continuous communication of their unique competence that could relate to the existing medical knowledge. In the outer dialogue, the dieticians structured and made sense of their setting by the labelling of roles as power entities and by using self‐images and metaphors.Research limitations/implicationsThis research was designed to describe the dieticians' efforts and experiences in the studied setting. Therefore, the data provide access to one occupational group but not to the other groups in that setting. A second limitation is the absence of observations.Practical implicationsThis research contributes to the knowledge of the relevance of practitioners involved in boundary work aimed at improving professional collaboration. The study is helpful in identifying important boundaries that facilitate the establishment of collaborative relationships, and the development of accounts, procedures and routines.Originality/valueThe research focuses on how influence on practice is constituted through boundary work.
Tackling youth restiveness in the Niger Delta region of Nigeria through entrepreneurship
Authors: Ikechukwu Owualah Sunday , Ogechukwu Obokoh Lawrence 
Published: May 2008

PurposeThis study aims to investigate the efficacy of entrepreneurship training in providing meaningful self‐employment for the restive youths in the Niger Delta region of Nigeria in order to channel their youthful energies into more productive economic activities instead of vandalism and hostage‐taking.Design/methodology/approachData obtained from a structured questionnaire on a random sample of 100 youths in Delta, Bayelsa and Rivers States was factor analysed with varimax rotation to identify the most critical factors likely to influence entrepreneurial career. Spearman's ρ was applied to ascertain the overall agreement among the respondents on state basis.FindingsGovernment, non‐governmental organisations (NGOs) and institutional financial support, personal traits, experience and tolerance for risks, role model influence and availability of infrastructure and personal financial resources were the factors rated important in influencing a career in entrepreneurship.Research limitations/implicationsThe small size of the sample and focus on a limited number of states in the Niger Delta region limit the generalisability of this study.Practical implicationsYouths can be empowered through entrepreneurship taking advantage of its job creation potentials.Originality/valueThis study provides state policy makers, oil companies and NGOs additional insights about the strategies to resolve a problem that is increasingly taking its toll on oil and gas exploration and production in the region.
Social enterprise resisting social accounting: reflecting on lived experiences
Authors: Gibbon Jane , Affleck Arthur 
Published: May 2008

PurposeThe advantages of using social accounting (SA) by social enterprises are widely evident (e.g. Social Audit Network, New Economics Foundation). The data gathered by the authors, through introductory SA workshops and training attended by 30 organisations and a single case study, are used with the purpose of demonstrating that the barriers and resistance to SA are widespread.Design/methodology/approachThe paper focuses upon the analysis of the lived experiences of SA discussed by 31 workshop participants and the more detailed experience of one participant organisation over two years. An action research approach was used across the training project, with insider action research used with the single case organisation.FindingsThe research develops a deeper understanding of the issues (real and perceived) surrounding the barriers and resistance to SA, how they could be overcome and leads to the formulation of mechanisms to address them.Research limitations/implicationsThis work is based upon a project working with a sample of social enterprises and gives a view of the lived experiences of practitioners approaching SA for the first time, it does not claim generalisability.Practical implicationsThe research is of use to social enterprise practitioners and trainers struggling with decisions as to how to approach SA whilst overcoming barriers and resistance. If SA is appropriate then these insights should aid the development of a “model” of SA that is fitting. It also furthers an understanding around the issues of accountability and value measurement within social enterprise and how this needs to be supported at an organisational and government level.Originality/valueUnderstanding of resistance in the context of social enterprise this offers a unique understanding for other social enterprises to reflect upon their own organisation and determine, if SA is suitable for them. If SA is appropriate for their organisation, then these insights should aid the development of a “model” of SA that is fitting for their organisation.
Business planning training for social enterprise
Authors: Conway Clifford 
Published: May 2008

PurposeThis paper seeks to explain how the course content of a Graduate Certificate in Social Enterprise was varied to meet the unique business planning training needs for social enterprise.Design/methodology/approachThe research began with a review of the literature covering generic and social enterprise business planning, the findings of which were applied into the design of the course.FindingsThe paper concludes that although there are a number of similarities in business planning needs for start‐up commercial and social enterprise business plans, the differences are, however, significant enough to require that course design should take these into account and thus avoid delivering a generic programme that does not fully meet student needs.Practical implicationsAcademic and professional deliverers of business planning programmes are strongly recommended not to offer generic offerings but instead tailor to the needs of the social enterprise sector.Originality/valueThis paper will be of interest to providers of programmes aimed at social enterprises as well as social enterprise practitioners responsible for staff training. The literature in this area is still nascent while the development of accredited courses is still quite new and therefore the paper helps contribute to the development of best practice in the delivery of programmes to this sector.
Social entrepreneurship in the social policy curriculum
Authors: Gunn Robert , Durkin Chris , Singh Gurnam , Brown John 
Published: May 2008

PurposeThis paper aims to describe and analyse the development of a teaching module that introduces undergraduate students to the core skills required to develop and manage a welfare organisation. It makes particular reference to social enterprise.Design/methodology/approachThe paper explores the political and educational context which inspired this initiative and the theoretical basis for the approach used. A particular focus is placed on the entrepreneurial aspects of the development. It moves on to describe the delivery of the module to the first cohort of students and includes their assessment of the learning and an evaluation of how they performed the assessment task.FindingsStudents were very positive about the content of the module; the teaching style employed and reported that it had inspired them to be entrepreneurial.Practical implicationsStudents who are now paying large sums in fees may well be motivated to enrol on courses that are practice based or enhance professional development through engaging with “real world” issues. Such courses equip them with the skills and knowledge they need to boost their chances of pursuing a career in an area that fits their personal motivations, values and interests.Originality/valueThe paper addresses the real life experience of delivering enterprise skills training to social policy students, a group not traditionally associated with this type of approach. The paper will be of interest to students, academics and practitioners in the fields of contemporary welfare delivery and management who are interested in developing entrepreneurship skills training in higher education and workplace settings.
Lean and learning: action learning for service improvement
Authors: Pedler Mike , Abbott Christine 
Published: May 2008

PurposeThe purpose of this paper is to examine questions concerning service improvement and the possible contribution of action learning as a means of bringing about both personal and organisational development. A second companion paper deals with the facilitation issues in this context (submitted to Leadership in Health Services, December 2007).Design/methodology/approachThis research reports on the experiences of participants on a leadership development programme, who were seeking to effect service improvements in their professional domains. Data were collected via telephone interviews, focus groups, action learning sets and a world cafe event.FindingsThe paper concludes that the definition of “service improvement” is multiple and problematic. It concludes that action learning and service improvement can be natural partners but only if the action learning design is crafted to the specifics of the context.Research limitations/implicationsThis case study was developed at a time of great turmoil in the NHS. The findings may be taken as indicative and instructive rather than reproducible.Practical implicationsNHS service improvements are failing to keep pace with targets due to an over‐reliance on centrally initiated programmes and a deficit in local efforts. NHS and other managers will find this paper useful to help them bring about service improvements at local level.Originality/valueAs far as the authors know there are no other published accounts of service improvement initiatives developed via action learning.
Validating the primary provider theory in emergency medicine
Authors: Guarisco Joseph S. , Bavin Stefoni A. 
Published: May 2008

PurposeThe purpose of this paper is to provide a case study testing the Primary Provider Theory proposed by Aragon that states that: disproportionate to any other variables, patient satisfaction is distinctly and primarily linked to physician behaviors and secondarily to waiting times.Design/methodology/approachThe case study began by creating incentives motivating physicians to reflect and improve behaviors (patient interactions) and practice patterns (workflow efficiency). The Press Ganey Emergency Department Survey was then utilized to track the impact of the incentive programs and to ascertain any relationship between patient satisfaction with the provider and global patient satisfaction with emergency department visits by measuring patient satisfaction over an eight quarter period.FindingsThe findings were two‐fold: firstly, the concept of “pay for performance” as a tool for physician motivation was valid; and secondly, the impact on global patient satisfaction by increases in patient satisfaction with the primary provider was significant and highly correlated, as proposed by Aragon.Practical implicationsThese findings can encourage hospitals and physician groups to place a high value on the performance of primary providers of patient care, provide incentives for appropriate provider behaviors through “pay for performance” programs and promote physician understanding of the links between global patient satisfaction with physician behaviors and business growth, malpractice reduction, and other key measures of business success.Originality/valueThere are no other case studies prior to this project validating the Primary Provider Theory in an urban medical center; this project adds to the validity and credibility of the theory in this setting.
Kinetic barriers and the role of topology in protein and RNA folding
Authors: Sosnick Tobin R. 
Published: May 2008

AbstractThis review compares the folding behavior of proteins and RNAs. Topics covered include the role of topology in the determination of folding rates, major folding events including collapse, properties of denatured states, pathway heterogeneity, and the influence of the mode of initiation on the folding pathway.
Eculizumab, a terminal complement inhibitor, improves anaemia in patients with paroxysmal nocturnal haemoglobinuria
Authors: Schubert Jörg , Hillmen Peter , Röth Alexander , Young Neal S. , Elebute Modupe O. , Szer Jeffrey , Gianfaldoni Giacomo , Socié Gérard , Browne Paul , Geller Robert , Rother Russell P. , Muus Petra 
Published: May 2008

SummaryIn paroxysmal nocturnal haemoglobinuria (PNH), chronic destruction of PNH red blood cells (RBCs) by complement leads to anaemia and other serious morbidities. Eculizumab inhibits terminal complement‐mediated PNH RBC destruction by targeting C5. In the phase III, double‐blind, placebo‐controlled, TRIUMPH study, eculizumab reduced haemolysis, stabilized haemoglobin levels, reduced transfusion requirements and improved fatigue in patients with PNH. Herein, we explored the effects of eculizumab on measures of anaemia in patients from the TRIUMPH study and the open‐label SHEPHERD study, a more heterogeneous population. Eculizumab reduced haemolysis regardless of pretreatment transfusion requirements and regardless of whether or not patients became transfusion‐dependent during treatment (P < 0·001). Reduction in haemolysis was associated with increased PNH RBC counts (P < 0·001) while reticulocyte counts remained elevated. Eculizumab‐treated patients demonstrated significantly higher levels of haemoglobin as compared with placebo in TRIUMPH and relative to baseline levels in SHEPHERD (P < 0·001 for each study). Eculizumab lowered transfusion requirement across multiple pretreatment transfusion strata and eliminated transfusion support in a majority of both TRIUMPH and SHEPHERD patients (P < 0·001). Patients who required some transfusion support during treatment with eculizumab showed a reduction in haemolysis and transfusion requirements and an improvement in fatigue. Eculizumab reduces haemolysis and improves anaemia and fatigue, regardless of transfusion requirements.
Highly purified CD38+ sub‐populations show no evidence of preferential clonal evolution despite having increased proliferative activity when compared with CD38− sub‐populations derived from the same chronic lymphocytic leukaemia patient
Authors: Lin Thet Thet , Hewamana Saman , Ward Rachel , Taylor Hannah , Payne Tammy , Pratt Guy , Baird Duncan , Fegan Chris , Pepper Chris 
Published: May 2008

SummaryIn agreement with a recently published manuscript, this present study demonstrated that CD38+ sub‐populations had increased proliferative activity as evidenced by higher Ki‐67 expression (P < 0·0001). This raised the possibility that the CD38+ fraction is exposed to an increased risk of clonal evolution. However, serial fluorescence in situ hybridisation analysis of highly purified CD38+ and CD38− sub‐populations from individual patients revealed no distinct cytogenetic lesions or evidence of preferential clonal evolution in the CD38+ fractions when compared with their CD38− counter‐parts (P = 0·13). Furthermore, telomere length analysis revealed that all of the sub‐populations had similarly short telomeres (P = 0·31) and comparably low telomerase (TERT) expression (P = 0·75) and telomerase activity (P = 0·88). Subsequent examination of cell‐sorted CD38+ and CD38− sub‐populations from paired peripheral blood and bone marrow samples taken on the same day showed no significant difference in CD38, Ki‐67, TERT expression or telomere lengths, indicating that these chronic lymphocytic leukaemia cells were derived from a single pool trafficking between these two compartments. Taken together, our data show that chronic lymphocytic leukaemia cells derived from bimodal patients all have extensive proliferative histories and have undergone a similar number of cell divisions that is mirrored by the episodic expression of CD38.
Pathogenesis of Asthma
Authors: HOLGATE STEPHEN T. 
Published: May 2008

SUMMARYWhile asthma is considered an inflammatory disorder of the conducting airways, it is becoming increasingly apparent that the disease is heterogeneous with respect to immunopathology, clinical phenotypes, response to therapies, and natural history. Once considered purely an allergic disorder dominated by Th2‐type lymphocytes, IgE, mast cells, eosinophils, macrophages, and cytokines, the disease also involves local epithelial, mesenchymal, vascular and neurologic events that are involved in directing the Th2 phenotype to the lung and through aberrant injury‐repair mechanisms to remodeling of the airway wall. Structural cells provide the necessary “soil” upon which the “seeds” of the inflammatory response are able to take root and maintain a chronic phenotype and upon which are superimposed acute and subacute episodes usually driven by environmental factors such as exposure to allergens, microorganisms, pollutants or caused by inadequate antiinflammatory treatment. Greater consideration of additional immunologic and inflammatory pathways are revealing new ways of intervening in the prevention and treatment of the disease. Thus increased focus on environmental factors beyond allergic exposure (such as virus infection, air pollution, and diet) are identifying targets in structural as well as immune and inflammatory cells at which to direct new interventions.
Respiratory syncytial virus infection provokes airway remodelling in allergen‐exposed mice in absence of prior allergen sensitization
Authors: Tourdot S. , Mathie S. , Hussell T. , Edwards L. , Wang H. , Openshaw P. J. M. , Schwarze J. , Lloyd C. M. 
Published: May 2008

SummaryBackground
The mechanisms underlying exacerbation of asthma induced by respiratory syncytial virus (RSV) infection have been extensively studied in human and animal models. However, most of these studies focused on acute inflammation and little is known of its long‐term consequences on remodelling of the airway tissue.Objective
The aim of the study was to use a murine model of prolonged allergen‐induced airway inflammation to investigate the effect of RSV infection on allergic airway inflammation and tissue remodelling.Methods
We subjected mice to RSV infection before or during the chronic phase of airway challenges with OVA and compared parameters of airway inflammation and remodelling at the end‐point of the prolonged allergen‐induced airway inflammation protocol.Results
RSV infection did not affect the severity of airway inflammation in any of the groups studied. However, RSV infection provoked airway remodelling in non‐sensitized, allergen‐challenged mice that did not otherwise develop any of the features of allergic airways disease. Increased collagen synthesis in the lung and thickening of the bronchial basal membrane was observed in non‐sensitized allergen‐challenged mice only after prior RSV infection. In addition, fibroblast growth factor (FGF)‐2 but not TGF‐β1 was increased in this group following RSV infection.Conclusion
Our data show for the first time that RSV infection can prime the lung of mice that are not previously systemically sensitized, to develop airway remodelling in response to allergen upon sole exposure via the airways. Moreover, our results implicate RSV‐induced FGF‐2 in the remodelling process in vivo.
Latex allergy: a model for therapy
Authors: Rolland J. M. , O'Hehir R. E. 
Published: May 2008

SummaryAllergy to natural rubber latex products emerged as an important clinical condition following an increase in the use of latex gloves for barrier protection in the early 1980s. In addition to latex glove users, other high‐risk groups with different latex exposure include spina bifida patients and others with multiple surgical procedures. Subjects with fruit and vegetable allergy are also at risk due to cross‐reactive allergens. Following the significant advances in the identification and characterization of common aeroallergens, latex allergy was well placed to become an excellent model of therapy. Awareness of latex allergy and modes of sensitization enabled epidemiological studies to inform allergen avoidance initiatives, substantially reducing inadvertent exposure in major hospitals in Western countries. Spina bifida is often identified in utero or soon after birth, allowing vigorous latex allergen avoidance with enhanced efficacy of primary prevention. However, changing demographics of latex allergy and technological revolution in countries such as China and India are predicted to unleash a second wave of latex allergy reemphasizing the incentive for improved manufacturing procedures for latex products. The desirable high tensile strength and elasticity of natural rubber latex have made the commercial identification of good alternatives very difficult but this would also be attractive for primary prevention. In addition, an effective specific immunotherapy regimen would be valuable for selected high‐risk atopic individuals. Current subcutaneous and sublingual immunotherapy schedules have been tested for treatment of latex allergy with evidence of efficacy but the risks of adverse events are high. For such potent allergens as latex, hypoallergenic but T cell‐reactive preparations are required for clinical use. Identification of allergenic components of latex products, with generation of monoclonal antibodies and recombinant allergens, allowed sequence determination and mapping of T cell and B cell epitopes. Together, these reagents and data facilitated improved diagnostics and investigation of novel‐specific therapeutics. Potential hypoallergenic latex preparations identified include modified non‐IgE‐reactive allergen molecules and short T cell epitope peptides. The co‐administration of adjunct therapies such as anti‐IgE or corticosteroids and of appropriate adjuvants for induction of regulatory T cell response offers promise for clinically effective, safe latex‐specific vaccines.