bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feedback in incident reporting – more needed
Authors: Basu Abhijit , Gopinath Deepa , Anjum Naheed , Hotchkies Susan 
Published: January 2009

PurposeThe purpose of this paper is to determine the prevalence of feedback following adverse clinical incident reporting among trainee doctors in obstetrics and gynaecology within the Northwestern Deanery of England.Design/methodology/approachAn anonymous questionnaire was circulated among the Specialist Registrar trainees within the specialty attending a regional teaching session. The questionnaire was analysed.FindingsThere were 50 responses, of those 45 (90 per cent) had been involved in an adverse clinical incident; 44 had submitted an incident form related to the incident. Three had submitted incident forms without being involved in an adverse incident. Most (80 per cent) had submitted an incident form as well as a related statement. Feedback was available to 23 (51 per cent) of those involved in adverse incidents. More of the senior trainees received feedback than the junior ones. A lecture on clinical incident reporting was available to only 35(70 per cent) of the respondents on the hospital induction day at their latest clinical placement.Research limitations/implicationsThis study is limited to adverse clinical incident reporting among the trainees in a single specialty within one deanery in UK; hence the small numbers.Practical implicationsThis study demonstrates the presence of awareness regarding adverse incident reporting among the trainees in a high‐risk specialty. It also shows the suboptimal rate of feedback following adverse incident reporting, which does not encourage a learning environment. It is suggested that a lecture should be dedicated to incident reporting at the junior doctors' induction day programme in every hospital.Originality/valueThis paper highlights the lack of adequate feedback following adverse clinical incident reporting.
Burden or blessing?
Authors: Grabs Anthony J. 
Published: January 2009

PurposeThe purpose of this paper is to present possible benefits of establishing a national trauma database to assist patient safety and continued clinical excellence in Australia.Design/methodology/approachThe paper outlines how the management of trauma patients is organised.FindingsIt is shown that to continue to engage clinicians, rationalisation of clinical governance structure is required. This will require leadership to improve efficacy and reduce duplication of workloads.Originality/valueIt is concluded that, given the right conditions, Australia could commence a national trauma database similar to the American or British systems where minimum data sets are recorded and reap the benefits with improved safety and outcome in trauma patients on a national basis.
The role of the GP trainer: medicolegal aspects
Authors: Mackenzie Peter , Anthony Sandy 
Published: January 2009

PurposeThe purpose of this paper is to consider the medicolegal aspects of working as a GP trainer.Design/methodology/approachA brief review of the legislation and guidance affecting GP trainers. From this, an analysis of the major risks GP trainers face, and the steps they should take to minimise those risks, is conducted.FindingsThere are a number of high‐risk areas for GP trainers. Lack of awareness of a GP registrar's competencies can lead to problems. There is risk in a GP registrar being unfamiliar with the practice, its procedures and physical layout. Out‐of‐hours training is particularly hazardous. A GP registrar who is poorly performing can present a serious risk to patient safety.Practical implicationsGP trainers should put in place procedures to mitigate these risks. A realistic assessment of a GP registrar's skills; a comprehensive induction; adequate supervision out of hours and systems for dealing with poor performance are essential elements of a GP trainer's role.Originality/valueThe paper highlights the benefit for GP trainers in considering the risks they may face and taking steps to address them.
A critical review of patient satisfaction
Authors: Gill Liz , White Lesley 
Published: January 2009

PurposeThis paper aims to review the patient satisfaction literature, specifically meta‐analyses, which critically analyses its theory and use; then to present evidence for perceived service quality as a separate and more advanced construct.Design/methodology/approachPapers that judiciously review the development and application of patient satisfaction were identified; along with studies addressing the conceptual and methodological deficiencies associated with the concept; and the current perceived service quality theory.FindingsPatient satisfaction has been extensively studied and considerable effort has gone into developing survey instruments to measure it. However, most reviews have been critical of its use, since there is rarely any theoretical or conceptual development of the patient satisfaction concept. The construct has little standardisation, low reliability and uncertain validity. It continues to be used interchangeably with, and as a proxy for, perceived service quality, which is a conceptually different and superior construct.Practical implicationsThe persistent use of patient satisfaction to evaluate the client's perception of the quality of a health service is seriously flawed. The key to solving this dilemma may be for the healthcare sector to focus on perceived health service quality by considering the specific concepts and models that can be found in the services marketing literature. This literature offers more advanced consumer theories which are better differentiated and tested than existing healthcare satisfaction models.Originality/valueThe paper points out that there is an urgent need for differentiation and standardisation of satisfaction and service quality definitions and constructs, and argues for research to focus on measuring perceived health service quality.
Do types of organizational culture matter in nurse job satisfaction and turnover intention?
Authors: San Park Jae , Hyun Kim Tae 
Published: January 2009

PurposeThe purpose of the study is to examine whether and how different types of organizational culture are associated with job satisfaction and turnover intention among hospital nurses in Korea, where the work culture is often considered different from that of Western countries.Design/methodology/approachThe sample for the study consists of 527 nurses working in two public hospitals in Korea. Perceived organizational culture was assessed by a previously validated 20‐item instrument, and job satisfaction and turnover intention were measured by self‐report questionnaires. Factor analysis was employed to construct four different types of culture (consensual, rational, developmental, and hierarchical). The relationship among organizational culture, job satisfaction, and turnover intention was tested by structural equation modeling (SEM).FindingsAmong the different types of culture, consensual culture and rational culture had significant, positive associations with the nurses' job satisfaction. In addition, consensual culture exhibited the strongest, negative association with the turnover intention of the nurses, while hierarchical culture showed a significant, positive association.Research limitations/implicationsConsensual culture that emphasizes teamwork and values human relations was most strongly associated with higher job satisfaction and lower turnover intention of nurses in Korea. However, caution is needed in inferring that organizational culture is the cause of the nursing outcomes because this study is designed as a cross‐sectional study; thus, an association alone was proven and not causality.Practical implicationsManagers should be aware that understanding the organizational culture can help them to determine where to strive to help improve nurses' job satisfaction and retention rate.Originality/valueThe results of the study may be useful to health administrators who wish to decrease nurse turnover. Improving nurses' job satisfaction in the work environment may reduce turnover and help ensure a stable and qualified workforce.
Retention strategies for professional nurses in South Africa
Authors: Pillay Rubin 
Published: January 2009

PurposeOne of the major challenges facing health systems in developing countries is the international migration of professional nurses, coupled with migration from rural to urban areas and gravitation to the private sector from the public sector. This study aims to determine what the future work plans of professional nurses in South Africa are and to determine appropriate, contextually relevant strategies to retain nurses where they are needed most.Design/methodology/approachThis is a cross‐sectional survey of professional nurses conducted throughout South Africa using a pre‐tested and self‐administered questionnaire. A total of 569 professional nurses participated in the study.FindingsOf the respondents, 34.8 percent indicated an intention to change their sector of employment within the next five years while only 30.2 percent reported that they would most likely be still in their current positions as professional nurses in five years' time. Younger nurses, nurses in the public sector and nurses from the more rural provinces were also significantly less likely to be in their current positions within the next five years. Public sector nurses felt that employment security, workplace organisation and the working environment were the most important factors. Private sector nurses, however, rated workplace organisation, employment security and professional practice as being most important.Originality/valueThe paper presents evidence that health provision in South Africa is facing an imminent crisis with the overwhelming majority of nurses planning to leave their current positions. The findings suggest that most nurses, irrespective of whether they intend to stay or leave, feel that the same issues need to be addressed if they are to be persuaded to remain in their current positions. This implies that a homogeneous approach could be adopted across sectors and geographic regions to promote health organisations in a more attractive way to nurses.
“Gerry Robinson and the UK NHS: did he really make a difference?”
Authors: Towill Denis R. 
Published: January 2009

PurposeThis paper seeks to exploit the TV series “inquest” held 12 months after the original programme to assess the impact of Gerry Robinson (if any) on healthcare delivery effectiveness observed at Rotherham General Hospital, UK, in particular, to explicitly identify the positive features in such a way as to better enable transferability of “good practice” between healthcare organisations.Design/methodology/approachThe approach adopted is to first chronicle the areas of perceived progress and delivery shortfalls. Thence via careful reference to the established literature to identify the engineering change modus operandi most likely to yield benefits in typical healthcare scenarios. Additionally, to confirm the expected and identify the unexpected barriers to change.FindingsAs with any highly publicised programme, the Hawthorne Effect on the various “actors” is not entirely negligible. A positive step forward is confirmation that actively involving coal‐face players, including physicians, nurses, and support staff in the success gets results. Examples unfortunately emerge where physicians‐led innovation is stifled by either internal or external bureaucracy.Originality/valueSome reasonably reliable narrative evidence is presented describing what may actually work in healthcare delivery performance improvement programmes.
The domestic savings and economic growth relationship in China
Authors: Hooi Lean Hooi , Song Yingzhe 
Published: January 2009

PurposeThe purpose of this paper is to examine the relationship between the growth of domestic savings and economic growth in China.Design/methodology/approachCointegration and causality tests cover the country as a whole and four of selected representative provinces for the period of 1955‐2004.FindingsChina's economic growth is found to have a long‐running relationship with household savings and enterprise savings. Bilateral causality exists between the domestic savings growth and the economic growth in the short‐run. In the long‐run, a unidirectional causality exists running from the domestic savings growth to the economic growth. However, the provinces show a different statistical relationship between these two variables.Research limitations/implicationsThe data are not up to date and are limited to the annual frequency.Practical implicationsIt would be useful to the policy makers to understand the dynamics involved and where necessary, to make adjustments to the prevailing and future economic policies in order to achieve the rapid and desired economic development and sustainable economic growth.Originality/valueThe paper assesses the cointegration and causality relationship between the growth of domestic savings and economic growth in China.
Economic growth and food policy in urban China
Authors: Kiminami Lily , Kiminami Akira 
Published: January 2009

PurposeThe purpose of this paper is to clarify the influence that economic growth gives to the food consumption in urban China by taking income gap into consideration. It also proposes an appropriate food policy corresponding to the consumers’ diversified needs for food under the process of economic growth.Design/methodology/approachVarious kinds of methodologies are employed such as the interview analysis, food tasting investigation, group discussion, retail price investigation and the questionnaire survey, etc. for the case study from Shanghai.FindingsFood policy for China in the current stage should be considered to supply food with a constant quality to the poorest segment of the population at cheap price and to correspond to the diversified needs of the general public for food (including high quality and safety intention of top‐tier population).Originality/valueNot only the existence of income gap but also the realities of the difference in the food consumption among the poorest segment, the general public and the rich layer of the population are clarified. The food policy which attempts to correspond to the diversified needs for food and to realize a sustainable development of the society is proposed.
Access flexibility, trust and performance in achieving competitiveness
Authors: Hua Song , Ranjan Chatterjee Samir , Kang‐kang Yu 
Published: January 2009

PurposeThis paper aims to advance research in the challenging area of achieving competitiveness through supply chain flexibility fit and trust development.Design/methodology/approachA structured survey questionnaire was administered to a potential list of 773 participants resulting in 348 valid responses. An empirical study was conducted on these responses.FindingsLeveraging of flexibility in supply chain access structures and improving of trust relationships can ensure significant performance improvement.Research limitations/implicationsThe research relies on the use of cross sectional data instead of longitudinal data, thereby limiting the generalisibility of the findings.Practical implicationsThe strong evidence of relationship between improved performance and capability of supply chain linkages provides Chinese business managers with practical guidelines for improving competitive edge.Originality/valueThe value of the paper lies in the originality of the data and context‐relevant findings. No previous study of this nature had been undertaken in China.
Building Chinese global brands through soft technology transfer
Authors: Ille Francis R. 
Published: January 2009

PurposeThe purpose of this paper is to examine the different strategies implemented by a number of successful Chinese firms currently striving to build global brands in order to improve their export capabilities. A particular emphasis is put on the transfer of marketing technology for brand engineering in order to achieve this goal.Design/methodology/approachThe analysis uses case study methodology to understand what many prominent Chinese exporting firms have achieved, and develops a theory about their general strategy. Five firms have been chosen: Lenovo, Haier, Cosco, Tsingtao, Geely. Aside from these five, information is also given on the branding strategy of Li Ning and Suntech Power. A great part of the information collected is coming from “desk research”, except for Haier, Lenovo and Tsingtao for which personal contacts and visits took place in 2005 and 2006.FindingsThe findings suggest that some of the most successful Chinese firms in the field of development of brand image either use some marketing tools, such as increasing their communication spending, improving quality control, emphasizing their corporate social responsibility visibility, or by seeking a partnership through mergers/acquisition with successful foreign brands. A basic global branding model has been defined as consistent with Chinese firms’ experience.Research limitations/implicationsThe study was limited to seven firms to be considered among the most successful Chinese businesses. It does not intend to be perceived as statistically representative. The period of observation of the effect of the strategy which was implemented was short and during a time of booming Chinese economy. It was impossible to isolate the extraneous variables linked to the economic or competitive situation, knowing that they could affect the observations on the firms that were studied.Originality/valueThough the entry strategies on the Chinese market as well as inbound foreign direct investments have been the object of a great number of publications, the outbound strategies of Chinese exporting firms, as well as the impact of technology transfer, has been covered less frequently. Therefore, this paper can have value for candidates for the improvement of global branding.
Effect of proton pump inhibition on the gastric volume: assessed by magnetic resonance imaging
Authors: BABAEI A. , BHARGAVA V. , AALAM S. , SCADENG M. , MITTAL R. K. 
Published: January 2009

SummaryBackground Proton pump inhibitor (PPI) therapy is known to suppress gastric acid secretion. Thus PPI therapy may decrease gastric volume and gastric contents available for gastro‐oesophageal reflux by decreasing acid secretion.Aim To determine the effect of PPI therapy on the gastric volume after a standard meal.Methods A total of nine healthy subjects were studied using magnetic resonance imaging, before and after a standard liquid meal mixed with a paramagnetic contrast to help demarcate the gastric region. Images were acquired for a total of 90 min after the meal. Studies were conducted before and following esomeprazole twice daily for 7 days. Images were analysed to determine the gastric liquid volume.Results Gastric volume, 15 min after the meal peaked to 611 ± 37 mL on the control day and 539 ± 30 mL following the PPI administration (P < 0.001). Average gastric volume remained significantly lower (56 ± 9 mL, P < 0.05) on the PPI therapy from 5 to 75 min after the meal.Conclusions Proton pump inhibitor therapy causes a significant reduction in the gastric contents volume during first 75 min after the meal. In addition to increasing the gastric pH, PPI therapy may decrease the frequency of gastro‐oesophageal reflux by decreasing the volume of gastric contents.
Distinct regulatory roles of transforming growth factor‐β and interleukin‐4 in the development and maintenance of natural and induced CD4+ CD25+ Foxp3+ regulatory T cells
Authors: Prochazkova Jana , Fric Jan , Pokorna Katerina , Neuwirth Ales , Krulova Magdalena , Zajicova Alena , Holan Vladimir 
Published: January 2009

SummaryThe development and function of CD4+ CD25+ Foxp3+ regulatory T cells (Tregs) are strictly regulated by cytokines. Here we show that transforming growth factor‐β (TGF‐β) and interleukin‐4 (IL‐4) play a crucial and antagonistic role in the development of Tregs. Additionally, these cytokines also have distinct effects on the maintenance of natural (nTregs) and antigen‐induced (iTregs) Tregs. Using double‐staining and tracking of proliferation of purified and carboxyflourescein succinimidyl ester (CFSE)‐labelled mouse T‐cell subpopulations we demonstrated that CD4+ CD25+ Foxp3+ iTregs develop upon alloantigenic stimulation in the presence of TGF‐β exclusively from CD4+ CD25− Foxp3− precursors. Both the induction of Foxp3 expression and Treg proliferation were prevented when the cells were stimulated in the presence of IL‐4. By contrast, nTregs did not proliferate in the presence of the antigen and TGF‐β, and partially lost their Foxp3 expression. IL‐4 not only prevented the development of iTregs, but also down‐regulated the level of Foxp3 mRNA and decreased the number of Foxp3+ cells in a population of iTregs. Further analyses proved that IL‐4 decreased the expression of Foxp3 only in a population of iTregs, whereas it substantially supported the survival of nTregs. Functional experiments showed that Tregs induced in the presence of alloantigen and TGF‐β inhibited, on a per‐cell basis, cell proliferation comparably to nTregs, and their suppressive capacity was not modulated by IL‐4. These data suggest that TGF‐β and IL‐4 differentially regulate the development of Tregs and distinctly sustain Foxp3 expression and the number of nTregs and iTregs, but have no influence on the suppressive activity of Tregs on a per‐cell basis.
Body mass index and risk of all‐cause and cardiovascular mortality in hospitalized elderly patients with diabetes mellitus
Authors: Weiss A. , Boaz M. , Beloosesky Y. , Kornowski R. , Grossman E. 
Published: January 2009

AbstractAims  Obesity is linked to increased morbidity and mortality risk in both the general population and in patients with diabetes mellitus; however, recent reports suggest that, in hospitalized elderly individuals, the association between body mass index (BMI) and mortality may be inverse. The present study sought to investigate the association between BMI and survival in hospitalized elderly individuals with diabetes mellitus.Methods  The medical records of 470 patients (226 males, mean age of 81.5 ± 7.0 years) admitted to an acute geriatric ward between 1999 and 2000 were reviewed. Of the 140 patients with diabetes mellitus, 122 had more than 6 months of follow‐up and were included in this analysis. Patients were followed up until 31 August 2004. Mortality data were extracted from death certificates.Results  During a mean follow‐up of 3.7 ± 1.6 years, 69 (56.6%) subjects died, 31 (25.4%) from cardiovascular causes. Those who died from any cause had lower baseline BMI than those who survived (24.0 ± 4.0 vs. 27.1 ± 4.3 kg/m2; P < 0.0001). Similarly, those who died of cardiovascular causes had lower baseline BMI than those who did not (23.7 ± 3.6 vs. 25.9 ± 4.5, P = 0.01). BMI was inversely associated with all‐cause [relative risk (RR) 0.89, 95% confidence interval (CI) 0.83–0.96, P = 0.002] and cardiovascular death (RR 0.83, 95% CI 0.74–0.93, P = 0.002) even after controlling for age, sex, smoking, dyslipidaemia and reason for hospital admission.Conclusions  In very elderly subjects with diabetes mellitus, increased BMI was associated with reduced mortality risk.