bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are head injury guidelines being met?
Authors: Campbell Anna , Reilly David 
Published: January 2007

PurposeTo assess how the 2003 NICE guidelines about head‐injured patients are implemented at a large district general hospital, and how the existing shortfalls might be improved.Design/methodology/approachA six‐month audit was performed and the care of all head‐injured patients discharged or dying over a six‐month period was assessed in the following fields: admission criteria, number of responsible consultants, number of wards receiving patients, timing of transfer to specialist centres and CT scanning and skull X‐rays (SIGN guidelines were used for the latter as NICE currently recommends CT for all patients needing imaging), quality of neurological observations, criteria for re‐scanning, transfer for rehabilitation, advice and arrangements for follow‐up, and assignment of case managers.FindingsImaging rates were poor, observation timing was inadequate and discharge information or follow‐up arrangements were unsatisfactory. Care could be much improved by allowing one unit/ward and one firm to be in sole charge of head‐injured patients.Originality/valueThis case study provides practical advice for any busy hospital striving to maintain national standards in the care of head‐injured patients.
Clinical governance – the turn of continuous improvement?
Authors: Peak Matthew , Burke Rebecca , Ryan Steven , Wratten Karen , Turnock Rick , Vellenoweth Christopher 
Published: January 2007

PurposeTo provide an overview of a model for clinical governance in the National Health Service that incorporates continuous improvement and innovation as a core theme.Design/methodology/approachThe paper considers the core functions of clinical governance and how these are related to established structures and roles within the modern NHS. A case study approach is used to describe the implementation of a theoretical model in a large teaching NHS Trust.FindingsA clinical governance cycle is described that comprises three functional domains: accountability, assurance, and innovation. For each domain there is a definable outcome and a key role. Critical success factors for implementation of the model are described.Originality/valueThis paper introduces a new model for clinical governance that focuses on continuous improvement. The paper will be of particular interest to managers and lead clinicians responsible for the development of robust systems for clinical governance and modernisation in the NHS.
Day case surgery from the wards or a dedicated unit – do the same standards apply?
Authors: Cosker T.D.A. , Elsayed S. , Michael P. , Preece M. 
Published: January 2007

PurposeDay surgery is now a major element of surgical practice. The paper aims to examine if those patients undergoing day surgery from in‐patient wards receive the same standard of care as those attending a formal day case surgical unit (DCSU), which is important.Design/methodology/approachTwo cohorts of 50 consecutive patients undergoing day surgery either on an in‐patient ward or in the DCSU were asked about the pre‐operative checks that had been made in relation to their safe discharge.FindingsConfirmation by in‐patient ward staff of safety issues outlined in guidelines published by the Royal College of Surgeons of England was variable. Of particular concern was that at least two of the recommendations relate to important safety issues such as driving a motor vehicle.Originality/valueThis paper is of use because ensuring that patients fulfil the Royal College's guidelines for day case surgery is important, no matter what surgery the patient undergoes. Patient safety may be compromised by failing to verify that patients are being discharged into a safe environment.
Patient assessment of surgeons' interpersonal skills
Authors: Al‐Shawi A.K. , MacEachern A.G. , Greco M.J. 
Published: January 2007

PurposeAims to assess the surgeons' communication skills with patients in the orthopaedic department of the authors' district general hospital.Design/methodology/approachA departmental prospective audit was conducted involving all consultants and middle grade surgeons. Then authors used a validated questionnaire (Doctors' Interpersonal Skills Questionnaire (DISQ)) completed by patients and analysed independently. Feedback was obtained through individual confidential reports and a study group meeting.FindingsA total of 402 patient evaluations were received and the average interpersonal skills index was 72 per cent ranging between 55 per cent and 87 per cent. The highest scores were given for respect shown, warmth of greeting and patients' confidence in the surgeon's abilities. The lowest scores were given for time given to patients to express their concerns.Research limitations/implicationsThe research has an incomplete audit circle. A second audit is required following appropriate training to alleviate the deficiencies reported in the first audit and prove the benefit.Practical implicationsThis audit highlighted important deficiencies in our interpersonal skills that could potentially be addressed by way of targeted training. This kind of assessment should become an essential part of the annual appraisal process of all hospital doctors.Originality/valueThis paper is the first to report the results of a departmental assessment process of hospital doctors using the DISQ.
Clinical guidelines in severe pre‐eclampsia and eclampsia
Authors: Whitworth M.K. , Reid F. , Arya R. , Smith R.A. , Baker P.N. , Myers J. 
Published: January 2007

PurposeThis article aims to assess the standard local recommended management of women with severe pre‐eclampsia and eclampsia in relation to recommendations in a national clinical guideline using a criterion‐based survey.Design/methodology/approachA total of 227 maternity units in the UK were asked to provide a copy of their guideline for the management of severe pre‐eclampsia and eclampsia. Responses were obtained from 107 units (47.1 per cent), 37 units were using regional guidelines and 72 guidelines were available for assessment. A total of ten audit criteria were agreed by committee, based on national recommendations. Guidelines were then audited to assess concurrence with these criteria.FindingsThe standard of guidelines was highly variable with only four guidelines (4.5 per cent) satisfying all ten key guideline points. The majority of guidelines had clear criteria for inclusion (87.5 per cent) but in almost a quarter of all guidelines no mention was made of informing consultant staff once these criteria were met.Practical implicationsThe study shows that the standard of local guidelines for management of these potentially fatal conditions is highly variable. Confidential inquiry has repeatedly recommended the use of regional guidelines. Perhaps it is time for the development of a national guideline representing consensus agreement of an evidence‐based approach.Originality/valueIn the UK eclampsia and pre‐eclampsia continue to be a leading cause of maternal mortality and morbidity. This paper provides a valuable insight into the standard of guidelines used in the management of these conditions.
Mental health tribunals: an issue for clinical governance
Authors: Dibben Claire , Luen Wong Mai , Hunt Neil 
Published: January 2007

PurposeThe purpose of this article is to examine reasons given by Mental Health Review Tribunals for discharging patients from detention and the effect the length of detainment had on the immediate outcome of discharged patients and to examine the effect on outcome from quality of reports and sources of evidence presented to the MHRTs.Design/methodology/approachAll documentation pertaining to MHRTs heard in the Cambridge area over a 12‐month period were reviewed.FindingsA quarter of tribunals heard were discharged, as they did not fulfil the legal criteria for detention. RMO non‐attendance was significant in this group. Unfavourable short‐term outcomes suggest that half of these discharges were premature. Improved aftercare compliance was associated with longer duration on a Section of the Mental Health Act prior to MHRT discharge.Research limitations/implicationsThis study reflects practice in the service (with a relatively small number of in‐patient sections) and may not be generalisable to other populations.Practical implicationsImprovement in the quality of evidence including risk assessments provided at tribunals should prevent premature discharges whilst maintaining the balance between civil liberties and good clinical care.Originality/valueThis paper highlights the need for improvement in clinical practice and training. Whilst it is primarily of interest to doctors, all professionals involved in MHRTs can learn from it.
Commander's evaluation in the context of business decision‐making: a multi‐perspective approach
Authors: Schraeder Mike , Morrison Rodger 
Published: January 2007

PurposeThe purpose of this article is the application of commander's evaluation, used for making decisions in military organizations, to the context of business decisions.Design/methodology/approachThe scope of this article incorporates salient issues related to business decision making. This is followed by an overview of how commander's evaluation is used to make decisions.FindingsWhile used predominantly in military organizations, commander's evaluation has important implications for business decision making. Developmental advantages associated with incorporating this method of making decisions into non‐military organizations are elucidated.Practical implicationsUtilizing a commander's evaluation approach provides the business decision‐maker with multiple perspectives and options, while also increasing the likelihood of success.Originality/valueThis article makes a unique contribution to the literature by providing practical strategies for incorporating the use of commander's evaluation into the process of making decisions in business.
Organizational change, learning and metrics: hard and soft ways to effective organizational change
Authors: Garratt Bob 
Published: January 2007

PurposeTo explore the nature of learning in organizations. To link organizational change to learning.Design/methodology/approachThe article looks initially at some historical factors before getting into practical issues.FindingsLearning and organizational change need to be linked. The use of the Organizational Capability Survey is outlined.Practical implicationsThe article shows how an Organizational Capability Survey can be used. It also alludes to the use of web‐based approaches.Originality/valueThe article will be of value to anyone in organizations struggling with major change.
Diffusion of landscaping services in organizations: a two nation study of determinant factors
Authors: Oly Ndubisi Nelson , Chukwunonso Nnaemeka C. 
Published: January 2007

PurposeEnvironmentalists, researchers, policy makers, governments, and the general public have frequently expressed the concern for the depleting state of the environment. As a panacea, many governments have called on organizations and individuals to pay greater interest in landscaping and embark on landscaping projects through planting trees, shrubs, flowers, and grasses in their immediate and distant environments. Through landscaping, the greenery, beauty, and scenic architecture of a place are preserved. This research, therefore, aims to evaluate landscaping adoption and adoption determinants by Malaysian and Nigerian organizations.Design/methodology/approachBased on the theory of organizational buying behavior and the innovation diffusion theory, a list of potential facilitators of landscaping adoption was derived and used as the basis for collecting data from the organizations. These data were factor analyzed to determine the key dimensions of facilitators for landscaping adoption. On the basis of the resulting dimensions, discriminant analysis was conducted to identify the factors that are sufficient in discriminating between the organizations that have adopted landscaping (adopters) and those that have not done so (non‐adopters).FindingsThe results show that organizational factors such as environmental sensitivity of the firm, organization's size, organization's people, and cost implication, as well as innovation characteristics, namely relative advantage, compatibility, and complexity, are significantly sufficient for discriminating between adopters and non‐adopters. An organization's structure and divisibility are not significant determinants.Practical implicationsThe finding of this research is beneficial in designing strategies for the protection and enhancement of the greenery and beauty of the environment, and for overall environmental management.Originality/valueThe outcome of this research provides valuable pioneer information on factors that discriminate between organizational adopters and non‐adopters of landscaping in Malaysia and Nigeria that can be used to enhance landscaping diffusion and overall environmental management.
An assessment of the cogenerated electrical energy potential for Lithuania
Authors: Kliucininkas Linas , Zieniute Ina , Mockuviene Jolita 
Published: January 2007

PurposeTo analyze the structural changes in electrical energy production sector caused by rapidly growing economy and Lithuania's international environmental commitments to the EU and international organizations.Design/methodology/approachThe case study estimates the environmental‐financial aspects of cogeneration system to be implemented at the boiler house. After quantitative estimation of the electric energy demands the financial comparison of long and mid‐term environmental measures is presented.FindingsThe study responds to European strategy towards doubling the amount of cogenerated electrical power and provides financial‐environmental estimates of cogeneration installations.Research limitations/implicationsInstallation and maintenance of co‐generation system requires high investments, however, in a long‐term perspective it would result in a substantial environmental and financial effect.Practical implicationsThe proposed scheme could be adjusted to the local conditions of the individual country as one of energy production options to bring about a sustainable energy future.Originality/valueThe analyzed quantitative assessment of national cogenerated energy potential serves as a tool for implementation of sustainable energy production in practice.
Strategies for controlling mobile emissions in Cairo
Authors: El Mowafi Samir A. , Gamal Atalla Ahmed 
Published: January 2007

PurposeThe objective of this paper is to evaluate the potential sustainable transportation strategies for Cairo in terms of their impact on emissions over the next ten years. The considered strategies include using cleaner fuel, implementing inspection and maintenance programs and adopting emission standards for new vehicles.Design/methodology/approachThe strategies were evaluated in terms of the expected reductions of particulate matter (PM) and ozone precursors due to the future implementation. Emissions were estimated utilizing a mix of the relevant national and international. Accordingly, a three‐phase integrated strategy is recommended, considering the local technical and institutional aspects.FindingsIn case of no actions taken, emissions of PM and ozone precursors could increase at the year 2013 by 95 and 50 percent, respectively. Implementing the proposed integrated strategy could result in reducing the emissions of PM and ozone precursors by about 53 and 49 percent, respectively.Practical implicationsThe proposed strategy is applicable because the targets are set considering the local aspects. However, the estimated emission reductions could almost compensate for the increase in the fleet size over the time. Therefore, achieving real reductions of emissions requires additional strategies to be considered.Originality/valueOwing to the lack of local emission factors and measurements, this original work highlights the expected impacts of the potential strategies for controlling vehicle emissions in Cairo. Also, the findings indicate the need to consider other additional strategies in the long term planning process.
Environmental pollution around the Muzhievo gold‐base metal deposit, Ukraine
Authors: Shumlyanskyy Vladyslav , Ivantyshyna Olga , Makarenko Mykola , Subbotin Andriy 
Published: January 2007

PurposeTo give information about the study of environmental pollution as the result of mining activity from minor toxic elements (Hg, Sb, As, Cd, Tl) which are typical for ores from base metal, gold‐base metal and gold deposits.Design/methodology/approachIn order to determine the intensity and extent of pollution as well as the possible threat to the population, ecogeochemical sampling (and consequent laboratory analysis of samples) of dumps, soil, and both surface and ground waters was completed. Analytical study of samples was completed, data were interpreted and maps constructed. To estimate the degree of soil and water contamination with toxic elements, the maximum allowable concentration (MAC) and background content (BC) were chosen as the main criteria of the hazard caused by toxic elements.FindingsThe paper shows the distribution of As, Hg, Sb, Tl, Cd and some “heavy” element (Pb, Zn, Mn, Ni) concentrations in the environment (soil, water) around the Muzhievo gold‐base metal deposit, and indicates the major role of the waste dumps near the deposit as a source of pollution by toxic elements.Practical implicationsThe study gives an example of environmental pollution by toxic elements caused by mining activity around one gold‐base metal deposit in the Transcarpathians. The study could be a guide for mine officials in the development of preventive measures against pollution by toxic elements in soil and water around Muzhievo village.Originality/valueThis paper presents useful information and offers practical help (approach, data interpretation) to researchers and ecologists studying the distribution of minor toxic elements in the environment around active and closed mines in the mercury‐base metal, base metal, gold‐base metal and gold deposits.
When does improper conduct become criminal? Conflicts of interest in the mutual fund industry
Authors: Kotlier Jonathan L. 
Published: January 2007

PurposeTo emphasize the need for financial services companies such mutual funds and brokerage houses to establish internal controls and related procedures for identifying potential conflicts of interest.Design/methodology/approachReviews government investigations into scandals involving the mutual fund industry over the past two years, including late trading, marketing timing, revenue sharing, directed brokerage, and gift‐giving; notes that criminal prosecution in this area is infrequent but still possible; and recommends, given the current landscape, that financial services companies examine their procedures for identifying and eliminating conflicts of interest.FindingsConcludes that recent mutual fund scandals have changed the regulatory landscape and the regulators, and in some cases prosecutors, are committed to aggressively pursuing any possible impropriety or conflict of interest between mutual fund advisors and the investing public.Originality/valueProvides a useful review of recent mutual fund scandals for the purpose of demonstrating to fund managers and directors why they should review their controls and related procedures to identify and eliminate conflicts of interest.
California Securities Laws: a new sheriff in town
Authors: Mendoza Gary 
Published: January 2007

PurposeTo describe State of California Attorney General Bill Lockyer's approach to securities enforcement and to explore the national implications of a state attorney general assuming such authority.Design/methodology/approachDescribes Attorney General Lockyer's recent investigations targeting the mutual fund industy and four resulting enforcement cases, explains Lockyer's intentions not to be constrained by the SEC's actions or applicable federal securities laws if he believes a violation of state law has occurred, and makes practical suggestions as to future developments for securities firms with operations in California.FindingsMakes it clear that, as a result of the expanded authority granted to Attorney General Lockyer by the California state legislature, securities firms must comply with California securities laws even when those laws differ from SEC regulations and federal laws.Originality/valueImportant guidance on recent developments from a California‐based investment compliance lawyer.
Does your firm have a Mutual Fund Suitability Guidelines Manual?
Authors: Cascarelli Joseph C. 
Published: January 2007

PurposeTo describe the need and suggest guidelines for a formal, written manual that provides a firm, its registered representatives, and its supervisory principals a line of defense against costly repercussions from sales practice violations.Design/methodology/approachDiscusses regulations concerning the suitable sales of securities to customers, the legal basis for reasonable supervision, why a brokerage firm's business model should guide it in building its manual, contents of a prototype manual, how investment objectives and risk tolerance should be considered, how performance information is disclosed so it is understandable to the customer, both justifiable reasons and dangers related to switching a customer from one fund to another, commission savings issues (including breakpoints, letters of intent, rights of accumulation, and reinstatement privileges), and home office supervision of reps and supervisory principals.FindingsRegulators are concerned with an investment firm's culture of compliance, including its written supervisory procedures and evidence of supervisor training and compliance performance. To support principals charged with supervising registered reps and investment adviser reps, a firm should have a formal training program that starts out with a well‐thought‐out mutual fund suitability guidelines manual.Originality/valueA hands‐on guide for writing an important manual by a specialized investment compliance lawyer.
Fair value methodologies
Authors: Kraft Paul 
Published: January 2007

PurposeTo describe the application of fair value methodologies to fund operations and emphasize the importance of appropriate valuation procedures.Design/methodology/approachDiscusses the need for appropriate valuation methodologies, describes a recent survey that shows how fair valuation policies and procedures have evolved over time, recommends procedures for adoption of consistent valuation procedures and industry practices, explains recent fund management trends such as the creation of separate valuation committees and the use of third‐party pricing vendors, and warns that valuation is becoming a more frequent subject of SEC examinations.FindingsConcludes that investment companies, private investment companies, boards, and managements are re‐evaluating and updating their valuation policies and procedures, partly in response to increased focus on valuations by the SEC in its examinations.Originality/valueProvides the results of a useful survey on fair value methodologies and important considerations for fund managers and directors as they review and update their valuation methodologies and procedures.