bluuebunny/crossref_metadata_2025_split huggingface dataset:
Worldviews in collision: conflict and collaboration across professional lines
Authors: Garman Andrew N. , Leach David C. , Spector Nancy 
Published: September 2006

AbstractThe process of providing health services in hospitals is inherently interdisciplinary; many of the challenges to enhancing quality and safety involve the human aspects of this interdisciplinary system. Each of the major disciplines—physicians, nurses, allied health providers, and health administrators—represent qualitatively distinct sets of goals and professional values, influencing not only current behavior but also who chooses these roles in the first place. Once a career is selected, the educational process further fortifies these differences, such that new professionals enter the workplace with fundamentally divergent perspectives on how care should be provided and how processes should be improved. These differences are in some ways functional but in other ways create work patterns that are both dysfunctional and very puzzling to outsiders. In this paper, we provide a guide to hospital organizational behavior through the lenses of professional preparation and interprofessional conflict. We review research on career choice, education, and cross‐disciplinary teamwork in healthcare, and end with a set of implications for organizational behavior researchers. Copyright © 2006 John Wiley & Sons, Ltd.
Reducing patient mortality in hospitals: the role of human resource management
Authors: West Michael A. , Guthrie James P. , Dawson Jeremy F. , Borrill Carol S. , Carter Matthew 
Published: September 2006

AbstractDeveloping effective health care organizations is increasingly complex as a result of demographic changes, globalization, and developments in medicine. This study examines the potential contribution of organizational behavior theory and research by investigating the relationship between systems of human resource management (HRM) practices and effectiveness of patient care in hospitals. Relatively little research has been conducted to explore these issues in health care settings. In a sample of 52 hospitals in England, we examine the relationship between the HRM system and health care outcome. Specifically, we study the association between high performance HRM policies and practices and standardized patient mortality rates. The research reveals that, after controlling for prior mortality and other potentially confounding factors such as the ratio of doctors to patients, greater use of a complementary set of HRM practices has a statistically and practically significant relationship with patient mortality. The findings suggest that managers and policy makers should focus sharply on improving the functioning of relevant HR management systems in health care organizations as one important means by which to improve patient care. Copyright © 2006 John Wiley & Sons, Ltd.
The challenges are organizational not just clinical
Authors: Ramanujam Ranga , Rousseau Denise M. 
Published: September 2006

AbstractContemporary hospitals fall far short in applying both state‐of‐the art clinical knowledge and management practices of known effectiveness. Organization and management practices in hospitals are shaped by four factors: their conflicting missions, a distinctive and largely professional workforce, demanding external environments, and a complex day‐to‐day task environment. This article identifies two critical organizing challenges that hospitals face: organizational learning and implementing effective high involvement management practices. It discusses how findings from organizational research, including articles in this special issue, identify solutions to the problems underlying these challenges. Copyright © 2006 John Wiley & Sons, Ltd.
Making it safe: the effects of leader inclusiveness and professional status on psychological safety and improvement efforts in health care teams
Authors: Nembhard Ingrid M. , Edmondson Amy C. 
Published: September 2006

AbstractThis paper introduces the construct of leader inclusiveness—words and deeds exhibited by leaders that invite and appreciate others' contributions. We propose that leader inclusiveness helps cross‐disciplinary teams overcome the inhibiting effects of status differences, allowing members to collaborate in process improvement. The existence of a professional hierarchy in medicine and the differential status accorded to those in different disciplines is well established in the health care literature, as is the need for quality improvement. We build on this foundation to suggest that profession‐derived status is positively associated with psychological safety (H1)—a key antecedent of speaking up and learning behavior—in health care teams. We hypothesize that this effect varies across teams (H2), and furthermore, that leader inclusiveness predicts psychological safety (H3) and moderates the relationship between status and psychological safety (H4). Finally, we suggest psychological safety predicts engagement in quality improvement work (H5) and mediates the relationship between leader inclusiveness and engagement (H6). Survey data collected in 23 neonatal intensive care units involved in quality improvement projects support our hypotheses. These results provide insight into antecedents of and strategies for fostering improvement efforts in health care and other sectors in which cross‐disciplinary teams engage in collaborative learning to improve products or services. Copyright © 2006 John Wiley & Sons, Ltd.
Notes from a small Island: researching organisational behaviour in healthcare from a UK perspective
Authors: Mark Annabelle L. 
Published: September 2006

AbstractThis paper considers the development of research in organisational behaviour within the UK healthcare system since its foundation in 1948. It looks at the location and context of such work, given the unique setting provided in this national organisation. Contextual barriers that are both historical, political ontological and epistemological, are considered in the light of recent research developments in both academia, notably the bienniel international conference Organisational Behaviour in Healthcare (OBHC), where a search for comparative work has engaged with both the wider organisational and international communities, and government, notably the National Service Delivery and Organisation Research Programme. Confounding much of this is the absence of a way of understanding the complexity of the domain of healthcare in different contexts. The application of the Cynefin framework is then discussed as a way to aid understanding of both the organisational and research tasks, and to provide a forum for collaborative understanding to allow appropriate research and practice interventions to occur. Copyright © 2006 John Wiley & Sons, Ltd.
Leadership development in healthcare: a qualitative study
Authors: McAlearney Ann Scheck 
Published: September 2006

AbstractChallenges associated with leading a $1.7 trillion industry have created a need for strong leaders at all levels in healthcare organizations. However, despite growing support for the importance of leadership development practices across industries, little is known about leadership development in healthcare organizations. An extensive qualitative study comprised of 35 expert interviews and 55 organizational case studies included 160 in‐depth, semi‐structured interviews and explored this issue. Across interviews, several themes emerged around leadership development challenges that were particularly salient to healthcare organizations. Informants described how the relative newness of leadership development practices in a majority of healthcare organizations contributes to an overall perception of haphazard practices throughout the industry. In addition, respondents noted challenges associated with developing leaders who would be representative of the patient community served, and commented on the pressure to segregate different professional groups for leadership development. Framed by these challenges, I propose a conceptual model of commitment to leadership development in healthcare organizations as influenced by three factors—strategy, culture, and structure. These, in turn, influence program design decisions and can impact organizational effectiveness. In the context of inherently complex healthcare organizations where leaders must respond to multiple stakeholders and meet performance goals across multiple dimensions of effectiveness, addressing these reported challenges and considering the importance of organizational commitment to leadership development can help ensure that programs are effectively designed, delivered, and sustained. Copyright © 2006 John Wiley & Sons, Ltd.
Classifying and interpreting threats to patient safety in hospitals: insights from aviation
Authors: Tamuz Michal , Thomas Eric J. 
Published: September 2006

AbstractWe examine how the information gathered about patient safety‐related events is influenced by the interpretation and classification of these events in hospitals and by the context in which hospitals operate. Building on aviation safety studies, we developed research questions to guide a qualitative, interview‐based study of three hospitals. We found that having a specific (or general) definition of an event was important for aviation safety information systems, but was not salient for hospitals. In these hospitals, event classification was influenced by professional perspectives, perceived professional responsibility, event contingencies, and surveillance technology. In both contexts, decision makers avoided reporting potentially dangerous events by classifying them in non‐reportable categories. The importance of industry context for these results underscores the need for industry‐specific midlevel conceptual frameworks. Healthcare policy‐makers advocate standardizing event definitions to promote learning, but if organizational factors influence definitions and classification schemes, this may undermine the usefulness of centralized error reporting. Copyright © 2006 John Wiley & Sons, Ltd.
Hydrophilic Block Copolymer Aggregation in Solution Induced by Selective Threading of Cyclodextrins
Authors: Huang Jin , Ren Lixia , Zhu Hui , Chen Yongming 
Published: September 2006

AbstractSummary:The inclusion of polymer chains by cyclodextrins (CDs) may generate column‐like supramolecules. Herein, we report that the selective threading of cyclodextrin rings onto one segment of a double hydrophilic diblock copolymer in water generates spherical aggregates. Poly(ethylene oxide)‐block‐poly((dimethylamino)ethyl methacrylate) (PEO‐b‐PDMA) may dissolve in water to form a homogeneous solution. However, whenα‐CDs are introduced, they thread onto the PEO segments to form pseudopolyrotaxanes, which tend to aggregate. Instead of forming a precipitate, novel supramolecular particles are generated which are attributed to the stabilization of the soluble PDMA segments. The organization process and the assembly structure were characterized by dynamic light scattering, X‐ray diffraction, electron microscopy and 1D NOE NMR spectra. Such novel particles are biocompatible and could have potential applications as biomedical and stimulus‐response materials.Schematic presentation of the self‐assembly process.magnified imageSchematic presentation of the self‐assembly process.
Characteristic Features of Chitosan/Glycerol Blends Dynamics
Authors: Quijada‐Garrido Isabel , Laterza Benedetto , Mazón‐Arechederra José M. , Barrales‐Rienda José M. 
Published: September 2006

AbstractSummary: The phase relaxation behavior of chitosan and its blends with glycerol has been studied by dynamic mechanical thermal analysis (DMTA) and differential scanning calorimetry (DSC) techniques. The analysis of DMTA spectra of chitosan leads to recognition of two molecular relaxations in chitosan and its blends. The analysis of enthalpic and entropic contributions suggest that both processes involve a large degree of cooperativity. At high temperature, the α‐relaxation has been assigned to its glass transition temperature Tg on the basis of the stiffness of the chitosan backbone, the high activation energy, and the plasticization with glycerol. Tg may be originated by torsional oscillations between two glucopyranose rings across a β‐1,4‐glycosidic oxygen and a cooperative hydrogen bond reordering. The other is a low temperature β‐relaxation that, in chitosan, has been associated to motions of lateral pendant groups in the glucopyranose rings and in the blends to the movements of a glycerol hydrogel bonded to the lateral groups of chitosan. Its composition dependence has been modeled by means of the Schneider‐Riegel‐Penzel equation in which the interactions among functional groups when a glass‐forming liquid is adsorbed to a stiff, highly functionalized macromolecule such as chitosan are taken into account.A three‐dimensional plot representing the tan δ for a series of chitosan and chitosan/glycerol blends as a function of temperature and composition.magnified imageA three‐dimensional plot representing the tan δ for a series of chitosan and chitosan/glycerol blends as a function of temperature and composition.
Effect of Functionalized Carbon Nanotubes on Molecular Interaction and Properties of Polyurethane Composites
Authors: Sahoo Nanda Gopal , Jung Yong Chae , Yoo Hye Jin , Cho Jae Whan 
Published: September 2006

AbstractSummary: Functionalized MWNTs were incorporated into PU by solution mixing to improve the mechanical and thermal properties of composites. A homogeneous dispersion of MWNTs was successfully achieved in PU matrix as evidenced by scanning electron microscopy. It may be attributed to the hydrogen bonds existing between CO groups of hard segments of PU chains and COOH groups of the MWNT‐COOH. The incorporation of the MWNTs effectively enhanced the crystallization of the PU matrix through heterogeneous nucleation, and the nucleation effect was more evident at 10 wt.‐% functionalized MWNTs as compared to other composite systems. Mechanical properties of the PU‐MWNTs composites were assessed as a function of MWNT concentration and dispersion of MWNT in PU matrix. The most significant improvement in mechanical properties was obtained, e.g., 740% increase in modulus and 180% increase in tensile strength over pure PU with 20% MWNT content. The thermal stability of composites due to thermal gravimetric measurements was significantly improved.A possible interaction of H‐bonding existed between PU chain and MWNT‐COOH.magnified imageA possible interaction of H‐bonding existed between PU chain and MWNT‐COOH.
Association of olfactory dysfunction with incidental Lewy bodies
Authors: Ross G. Webster , Abbott Robert D. , Petrovitch Helen , Tanner Caroline M. , Davis Daron G. , Nelson James , Markesbery William R. , Hardman John , Masaki Kamal , Launer Lenore , White Lon R. 
Published: September 2006

AbstractOlfactory dysfunction is found in early Parkinson's disease (PD) and in asymptomatic relatives of PD patients. Incidental Lewy bodies (ILB), the presence of Lewy bodies in the brains of deceased individuals without a history of PD or dementia during life, are thought to represent a presymptomatic stage of PD. If olfactory dysfunction were associated with the presence of ILB, this would suggest that olfactory deficits may precede clinical PD. The purpose of this study was to determine the association of olfactory dysfunction during late life with ILB in the substantia nigra or locus ceruleus. Olfaction was assessed during the 1991–1994 and 1994–1996 examinations of elderly Japanese–American men participating in the longitudinal Honolulu–Asia Aging Study. Among those who later died and underwent a standardized postmortem examination, brains were examined for Lewy bodies in the substantia nigra and the locus ceruleus with hematoxylin and eosin stain. Lewy bodies in the brains of individuals without clinical PD or dementia were classified as ILB. There were 164 autopsied men without clinical PD or dementia who had olfaction testing during one of the examinations. Seventeen had ILB. The age‐adjusted percent of brains with ILB increased from 1.8% in the highest tertile of odor identification to 11.9% in the mid‐tertile to 17.4% in the lowest tertile (P = 0.019 in test for trend). Age‐adjusted relative odds of ILB for the lowest versus the highest tertile was 11.0 (P = 0.02). Olfactory dysfunction is associated with ILB. If incidental Lewy bodies represent presymptomatic stage of PD, olfactory testing may be a useful screening tool to identify those at high risk for developing PD. © 2006 Movement Disorder Society
Study of possible factors associated with age of onset in essential tremor
Authors: Louis Elan D. , Ottman Ruth 
Published: September 2006

AbstractFactors associated with the age of onset of essential tremor (ET) have not been studied in detail. Identification of modifiable factors could lead to strategies to delay disease onset and identification of nonmodifiable factors would be useful while counseling at risk individuals. The objective of this study was to identify factors associated with age of onset of tremor in ET. One hundred ninety‐five ET cases were enrolled in an environmental epidemiological study. Clinical questionnaires included questions on age of onset, demographics (age, sex, race, education), early‐life exposures (birth order, childhood household size), exposures prior to tremor onset (head trauma, well water, rural living, estrogen replacement therapy), and family history. In unadjusted analyses, age of onset was associated with family history of tremor (40.9 ± 22.0 years for cases with a family history of tremor vs. 57.3 ± 18.4 years for cases without a history; P < 0.001), history of head trauma, younger current age, greater tremor severity, and white race. Ninety‐one percent of cases with onset before age 20 years had a family history of tremor. Age ofonset was not associated with other variables of interest (e.g., sex, well water, rural living). In an adjusted linear regression model, age of tremor onset was strongly associated with family history of tremor (P < 0.001). The familial form of ET is characterized by an earlier age of onset than the sporadic form. This study did not detect any other exposures that modified the age of onset of ET. Follow‐up studies are needed to examine additional factors of potential interest. © 2006 Movement Disorder Society
Antiparkinsonian effects of the novel D3/D2dopamine receptor agonist, S32504, in MPTP‐lesioned marmosets: Mediation by D2, not D3, dopamine receptors
Authors: Hill Michael P. , Ravenscroft Paula , McGuire Steven G. , Brotchie Jonathan M. , Crossman Alan R. , Rochat Catherine , Millan Mark J. 
Published: September 2006

AbstractL‐dopa remains the most common treatment for Parkinson's disease. However, there is considerable interest in D3/D2receptor agonists such as the novel agent S32504, since they exert antiparkinsonian properties in the absence of dyskinesia. An important question concerns the roles of D2vs. D3receptors, an issue we addressed with the 1‐methyl‐4‐phenyl‐1,2,3,6‐tetrahydropyridine (MPTP)–lesioned nonhuman primate model of Parkinson's disease. InL‐dopa–primed animals, S32504 (0.16–2.5 mg/kg p.o.) dose‐dependently enhanced locomotor activity. This action was abolished by the D2antagonist, L741,626 (2.5 mg/kg), but potentiated by the D3antagonist, S33084 (0.63 mg/kg). Both antagonists were inactive alone. In drug‐naive animals, a maximally effective dose of S32504 (2.5 mg/kg p.o.) displayed pronounced antiparkinsonian properties from the third day of administration, and its actions were expressed rapidly and durably. Thus, on day 33, antiparkinsonian properties of S32504 were apparent within 5 minutes and present for > 4 hours. Moreover, they were associated with neither wearingoffnor significant dyskinesia. In conclusion, the novel D3/D2agonist S32504 may offer advantages overL‐dopa in the treatment of newly diagnosed parkinsonian patients. Its actions are expressed primarily by activation of D2, not D3, receptors. © 2006 Movement Disorder Society
15N NMR chemical shifts of ring substituted benzonitriles
Authors: Žáček Petr , Dransfeld Alk , Exner Otto , Schraml Jan 
Published: September 2006

Abstract15N chemical shifts in an extensive series of para (15) and meta (15) as well as ortho (8) substituted benzonitriles, XC6H4CN, were measured in deuteriochloroform solutions, using three different methods of referencing. The standard error of the average chemical shift was less than 0.03 ppm in most cases. The results are discussed for both empirical correlations with substituent parameters and quantum chemical calculations. The 15N chemical shifts calculated at the GIAO/B3LYP/6–31 + G*//B3LYP/6–31 + G* level reproduce the experimental values well, and include nitrogen atoms in the substituent groups (range of 300 ppm with slope 0.98 and R = 0.998, n = 43). The 15N shifts in hydroxybenzonitriles are affected by interaction with the OH group. Therefore, these derivatives are excluded from the correlation analysis. The resultant 15N chemical shift correlates well with substituent constants, both in the simple Hammett or DSP relationships and the 13C substituent‐induced chemical shifts of the CN carbon. Copyright © 2006 John Wiley & Sons, Ltd.
The NMR studies on two new furostanol saponins from Agave sisalana leaves
Authors: Zou Peng , Fu Jing , Yu He‐shui , Zhang Jie , Kang Li‐ping , Ma Bai‐ping , Yan Xian‐zhong 
Published: September 2006

AbstractThe detailed NMR studies and full assignments of the 1H and 13C spectral data for two new furostanol saponins isolated from Agave sisalana leaves are described. Their structures were established using a combination of 1D and 2D NMR techniques including 1H, 13C, 1H1H COSY, TOCSY, HSQC, HMBC and HSQC‐TOCSY, and also FAB‐MS spectrometry and chemical methods. The structures were established as (25S)‐26‐(β‐D‐glucopyranosyl)‐22 ξ‐hydroxyfurost‐12‐one‐3β‐yl‐O‐α‐L‐rhamnopyranosyl‐(1→4)‐β‐D‐glucopyranosyl‐(1→3)‐O‐[O‐β‐D‐glucopyranosyl‐(1→2)]‐O‐β‐D‐glucopyranosyl‐(1→4)‐β‐D‐galacto‐ pyranoside (1) and (25S)‐26‐(β‐D‐glucopyranosyl)‐22ξ‐hydroxyfurost‐5‐en‐12‐one‐3β‐yl‐O‐α‐L‐rhamno‐ pyranosyl‐(1→4)‐β‐D‐glucopyranosyl‐(1→3)‐O‐[O‐β‐D‐glucopyranosyl‐(1→2)]‐O‐β‐D‐glucopyranosyl‐ (1→4)‐β‐D‐galactopyranoside (2). Copyright © 2006 John Wiley & Sons, Ltd.
Localized short‐echo‐time proton MR spectroscopy with full signal‐intensity acquisition
Authors: Mlynárik Vladimír , Gambarota Giulio , Frenkel Hanne , Gruetter Rolf 
Published: September 2006

AbstractWe developed a short‐echo‐time (TE) sequence for proton localized spectroscopy by combining a 1D add‐subtract scheme with a doubly slice‐selective spin‐echo (SE) sequence. The sequence preserves the full magnetization available from the selected volume of interest (VOI). By reducing the number of radiofrequency (RF) pulses acting on transverse magnetization, we were able to minimize the TE to the level that is achievable with the stimulated echo acquisition mode (STEAM) technique, and also gained a twofold increase in sensitivity. The use of an adiabatic pulse in the add‐subtract localization improved the efficiency of excitation in spatially inhomogeneous RF fields, which are frequently encountered at high magnetic fields. The localization performance and sensitivity gains of this method, which is termed SPin ECho, full Intensity Acquired Localized (SPECIAL) spectroscopy, were demonstrated in vivo in rat brains. In conjunction with spectroscopic imaging, a 2‐μl spatial resolution was accomplished with a signal‐to‐noise ratio (SNR) above 30, which is usually sufficient for reliable quantification of a large number of metabolites (neurochemical profile). Magn Reson Med, 2006. © 2006 Wiley‐Liss, Inc.
Can a federal regulator become a civic enabler?: Watersheds at the U.S. Environmental Protection Agency
Authors: Sirianni Carmen 
Published: September 2006

AbstractIn addition to the works listed in the References, I have drawn on interviews conducted with EPA staff in 2005–2006, as well as with watershed leaders. At the request of some EPA staff, however, I have not named individuals at the agency unless they are clearly identified in published writings or in interviews with watershed leaders.