Adolescent-parent disagreement on health-related quality of life of food-allergic adolescents:who makes the difference?

Background: Food-allergic adolescents are at highest risk for food allergy fatalities, which may be partly due to compromised self-management behavior. Such behavior may be negatively influenced by conflictual situations caused by adolescent–parent disagreement on the adolescent’s health-related quality of life (HRQL). Comparisons of adolescent-self-reported and parent-proxy-reported HRQL of food-allergic adolescents have never extensively been studied. The aims of this study were to investigate disagreement in adolescent-self-reports and parent-proxy-reports on the HRQL of food-allergic adolescents and to investigate the factors influencing adolescent–parent disagreement. Methods: Teenager Form (TF) and Parent Form (PFA) of the Food Allergy Quality of Life Questionnaire (FAQLQ), Food Allergy Independent Measure (FAIM), and Brief-Illness Perception Questionnaire (Brief-IPQ) were sent to food-allergic Dutch adolescents (13–17 years) and their parents. ICCs, t-tests, and Bland–Altman plots were used to investigate adolescent–parent disagreement. Participant characteristics, illness expectations, and illness perceptions influencing adolescent–parent disagreement were studied using regression analysis. Results: Seventy adolescent–parent pairs were included. There were a moderate correlation (ICC = 0.61, P < 0.001) and no significant difference (3.78 vs 3.56, P = 0.103) between adolescent-self-reported and parent-proxy-reported HRQL at group level. However, Bland–Altman plots showed relevant differences (exceeding the minimal important difference) for 63% of all adolescent–parent pairs. Adolescent’s age (>15 years), poorer adolescent-reported illness comprehension (Brief-IPQ-TF, coherence), and higher adolescent-reported perceived disease severity (Food Allergy Independent Measure-Teenager Form & -Parent Form) were associated with adolescent–parent disagreement. Conclusions: Adolescent–parent disagreement on the adolescent’s HRQL was mainly associated with adolescents’ rather than parents’ perceptions and characteristics. Illness comprehension of the adolescent may be an important target for intervention aimed at reducing adolescent–parent disagreement.

Shell-side transfer in shell-and-tube heat exchangers

Local mass transfer coefficients were determined by using the electrochemical technique. A simple model of a heat exchanger with segmental nickel tube joined to p.v.c. rods replaced the exchanger tubes. Measurements were made for both no-Ieakage, semi-leakage and total leakage configurations. Baffle-spacings of 47.6 mm, 66.6 mm, 97 mm and 149.2 mm wer studied. Also studied were the overall exchanger pressure drops for each configuration. The comparison of the heat transfer data with this work showed good agreement at high flow rates for the no-leakage case, but the agreement became poor for lower flow rates and leakage configurations. This disagreement was explained by non-analogous driving forces existing in the two systems. The no-leakage data showed length-wise variation of transfer coefficients along the exchanger length. The end compartments showing transfer coefficients inferior by up to 26% compared to tbe internal compartments, depending on Reynolds number. With the introduction of leakage streams this variation however became smaller than the experimental accuracy. A model is outlined to show the characteristic behaviour of individual electrode segments within the compartment. This was able to discriminate between cross and window zones for the no- leakage case, but no such distinction could be made for the leakage case. A flow area was found which, when incorporated in the Reynolds number, enabled the correlation of baffle-cut and baffle-spacing parameters for the no-leakage case . This area is the free flow area determined at the baffle edge. Addition of the leakage area to this flow area resulted in correlation of all commercial leakage geometrical parameters. The procedures used to correlate the pressure drop data from a total of eighteen different configurations on a single curve are also outlined.

The measurements of neutron and gamma dose rates in mixed radiation fields, using a liquid scintillation counter

Measurements of neutron and gamma dose rates in mixed radiation fields, and gamma dose rates from calibrated gamma sources, were performed using a liquid scintillation counter NE213 with a pulse shape discrimination technique based on the charge comparison method. A computer program was used to analyse the experimental data. The radiation field was obtained from a 241Am-9Be source. There was general agreement between measured and calculated neutron and gamma dose rates in the mixed radiation field, but some disagreement in the measurements of gamma dose rates for gamma sources, due to the dark current of the photomultiplier and the effect of the perturbation of the radiation field by the detector. An optical fibre bundle was used to couple an NE213 scintillator to a photomultiplier, in an attempt to minimise these effects. This produced an improvement in the results for gamma sources. However, the optically coupled detector system could not be used for neutron and gamma dose rate measurements in mixed radiation fields. The pulse shape discrimination system became ineffective as a consequence of the slower time response of the detector system.

Adverse drug reaction teaching in UK undergraduate medical and pharmacy programmes

Objectives: To assess the extent of teaching about the Committee on Safety of Medicine's Yellow Card scheme and adverse drug reactions within UK Schools of Medicine and Pharmacy. Methods: A self-completed questionnaire sent to all heads of undergraduate schools of medicine and pharmacy within the UK. Results: The majority of undergraduate syllabuses feature the Yellow Card Scheme. Knowledge of the Yellow Card Scheme was assessed in 79% of pharmacy programmes and 57% of medical schools. Specialist speakers on the Yellow Card Scheme were infrequently used. Fewer than half of respondents provided students with a guide to reporting ADRs (43% pharmacy and 43% medical). There is some disagreement about the value of supplying students with printed material about the Yellow Card Scheme. Half of medical Schools did not think that supplying 'Current Problems In Pharmacovigilance' would be useful. Conclusions: It was found that in both medicine and pharmacy, courses differed substantially in teaching about the Yellow Card Scheme and adverse drug reactions (ADRs). There is scope for increased involvement of the Medicines and Healthcare products Regulatory Agency in undergraduate education, in line with recommendations from the National Audit Office.

Political parties and public policy in the German Länder:when parties matter

When Parties Matter looks at the extent to which political parties can make a difference to public policy, focusing on the regional level in Germany. Politicians of the left and the right sometimes have radically different views, but inevitably the combined forces of legal and financial constraints, bureaucracy, public expectations and the 'weight of history' restrict their ability to translate political disagreement into policy change. Giving a detailed examination of education policy, childcare and family policy, and labour market policy in three German regions between 1999 and 2006, this book provides insights into what politicians can and cannot achieve, in particular at the level below the nation-state.

Control of antibiotic prescribing in UK NHS hosptials. Available in 2 volumes.

This thesis is an evaluation of practices to control antibiotic prescribing in UK NHS hospitals. Within the past ten years there has been increasing international concern about escalating antibiotic resistance, and the UK has issued several policy documents for pmdent antibiotic prescribing. Chief Pharmacists in 253 UK NHS hospitals were surveyed about the availability and nature of documents to control antibiotic prescribing (formularies, policies and guidelines), and the role of pharmacists and medical microbiologists in monitoring prescribers' compliance with the recommendations of such documents. Although 235 hospitals had at least one document, only 60% had both an antibiotic formulary and guidelines, and only about one-half planned an annual revision of document(s). Pharmacists were reported as mostly checking antibiotic prescribing on every ward whilst medical microbiologists mostly visited selected units only. Response to a similar questionnaire was obtained from the Chief Medical Microbiologists in 131 UK NHS hospitals. Comparisons of the questionnaires indicated areas of apparent disagreement about the roles of pharmacists and medical microbiologists. Eighty three paired-responses received from pharmacists and medical microbiologists in the same hospital revealed poor agreement and awareness about controls. A total of 205 institutional prescribing guidelines were analysed for recommendations for the empirical antibiotic prescribing of Community-Acquired Pneumonia (CAP). Variation was observed in recommendations and agreement with national guidance from the British Thoracic Society (BTS). A questionnaire was subsequently sent to 235 Chief Pharmacists to investigate their awareness of this new guidance from the BTS, and subsequent revision of institutional guidelines. Documents had been revised in only about one-half of hospitals where pharmacists were aware of the new guidance. An audit of empirical antibiotic prescribing practices for CAP was performed at one hospital. Although problems were experienced with retrieval of medical records, diagnostic criteria were poorly recorded, and only 57% of prescribing for non-severe CAP was compliant with institutional guidelines. A survey of clinicians at the same hospital identified that almost one-half used the institutional guidelines and most found them useful. However, areas for improvement concernmg awareness of the guidelines and ease of access were identified. It is important that hospitals are equipped to react to changes in the hospital environment including frequent movement of junior doctors between institutions, the employment of specialist "infectious diseases pharmacists" and the increasing benefits offered by information technology. Recommendations for policy have been suggested.

The role of manufacturing and market managers in strategy development:lessons from three companies

According to researchers and managers, there is a lack of agreement between marketing and manufacturing managers on critical strategic issues. However, most of the literature on the subject is anecdotal and little formal empirical research has been done. Three companies are investigated to study the extent of agreement/disagreement between manufacturing and marketing managers on strategy content and process. A novel method permits the study of agreement between the two different functional managers on the process of developing strategy. The findings consistently show that manufacturing managers operate under a wider range of strategic priorities than marketing managers, and that manufacturing managers participate less than marketing managers in the strategy development process. Further, both marketing and manufacturing managers show higher involvement in the strategy development process in the latter stages of the Hayes and Wheelwright four-stage model of manufacturing’s strategic role.

Avoiding measurement dogma:a response to Rossiter

Purpose – This paper aims to respond to John Rossiter's call for a “Marketing measurement revolution” in the current issue of EJM, as well as providing broader comment on Rossiter's C-OAR-SE framework, and measurement practice in marketing in general. Design/methodology/approach – The paper is purely theoretical, based on interpretation of measurement theory. Findings – The authors find that much of Rossiter's diagnosis of the problems facing measurement practice in marketing and social science is highly relevant. However, the authors find themselves opposed to the revolution advocated by Rossiter. Research limitations/implications – The paper presents a comment based on interpretation of measurement theory and observation of practices in marketing and social science. As such, the interpretation is itself open to disagreement. Practical implications – There are implications for those outside academia who wish to use measures derived from academic work as well as to derive their own measures of key marketing and other social variables. Originality/value – This paper is one of the few to explicitly respond to the C-OAR-SE framework proposed by Rossiter, and presents a number of points critical to good measurement theory and practice, which appear to remain underdeveloped in marketing and social science.

Professionals' awareness of operational antibiotic prescribing controls in UK NHS hospitals

In recent years, there have been increasing recommendations for multidisciplinary collaboration between clinical pharmacists and medical microbiologists in an attempt to control the quality (and quantity) of antibiotic prescribing. A questionnaire addressing the utilization of antibiotic prescribing controls was sent to the chief pharmacist and medical microbiologist in UK NHS hospitals. Responses were received from both the chief pharmacist and the medical microbiologist employed in the same hospital from 83 hospitals (a 30% response rate from two independent studies). A high level of disagreement and poor awareness was identified between the interprofessional staff groups regarding the existence of antibiotic formulary (with disagreement between the two groups, or not known by one or both respondents, in 46% of the paired hospitals, N=38) and guideline documents (13%, N=11), performance of antibiotic prescribing audits (40%, N=33), and whether pharmacists (52%, N=43) and medical microbiologists (77%, N=64) monitored physician compliance with antibiotic prescribing control documents. This study has identified poor knowledge of the existence of basic antibiotic prescribing control mechanisms and the role of professional colleagues. It is suggested that there is some way to go before 'Agenda for Change' principles of flexible and collaborative roles are met. © 2004 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.

A firm's capability to calibrate supply chain knowledge-antecedents and consequences

This paper proposes a conceptual model for a firm's capability to calibrate supply chain knowledge (CCK). Knowledge calibration is achieved when there is a match between managers' ex ante confidence in the accuracy of held knowledge and the ex post accuracy of that knowledge. Knowledge calibration is closely related to knowledge utility or willingness to use the available ex ante knowledge: a manager uses the ex ante knowledge if he/she is confident in the accuracy of that knowledge, and does not use it or uses it with reservation, when the confidence is low. Thus, knowledge calibration attained through the firm's CCK enables managers to deal with incomplete and uncertain information and enhances quality of decisions. In the supply chain context, although demand- and supply-related knowledge is available, supply chain inefficiencies, such as the bullwhip effect, remain. These issues may be caused not by a lack of knowledge but by a firm's lack of capability to sense potential disagreement between knowledge accuracy and confidence. Therefore, this paper contributes to the understanding of supply chain knowledge utilization by defining CCK and identifying a set of antecedents and consequences of CCK in the supply chain context.

Semantic annotation support in the absence of consensus

We are interested in the annotation of knowledge which does not necessarily require a consensus. Scholarly debate is an example of such a category of knowledge where disagreement and contest are widespread and desirable, and unlike many Semantic Web approaches, we are interested in the capture and the compilation of these conflicting viewpoints and perspectives. The Scholarly Ontologies project provides the underlying formalism to represent this meta-knowledge, and we will look at ways to lighten the burden of its creation. After having described some particularities of this kind of knowledge, we introduce ClaimSpotter, our approach to support its ‘capture’, based on the elicitation of a number of recommendations which are presented for consideration to our annotators (or analysts), and give some elements of evaluation.

Mixed methods research:don't "just do it"

Purpose The purpose of this paper is to identify some of the dilemmas involved in the debate on the how, when and why of mixed methods research. Design/methodology/approach The authors' starting point is formed by developments in the philosophy of science literature, and recent publications on mixed methods research outside of the management accounting domain. Findings Contrary to recent claims made in the management accounting literature, the authors assert that uncovering points of disagreement between methods may be as far as researchers can go by combining them. Being reflexive can help to provide a deeper understanding of the research process and the researcher's role in this process. Research limitations/implications The paper should extend the debate among management accounting researchers about mixed methods research. One of the lessons drawn is that researchers are actively immersed in the research process and cannot purge their own interests and views. Accepting this lesson casts doubt on what the act of research may imply and achieve. Practical implications The paper shows that combinations of research methods should not be made based on a "whatever works" attitude, since this approach ultimately is still infused with ontological and epistemological considerations that researchers have, and should try to explicate. Originality/value The value of this paper lies in the provision of philosophical underpinnings that have not been widely considered in the management accounting literature on mixed methods to date. © 2011 Emerald Group Publishing Limited. All rights reserved.

Breaking out of the silo mentality

The return to methods focusing on language and experience following the dominance of experimental methods has in the last few decades led to debate, dialogue, and disagreement regarding the status of qualitative and quantitative methods. However, a recent focus on impact has brought an air of pragmatism to the research arena. In what ways, then, is psychology moving from entrenched mono methods approaches that have epitomised its development until recently, to describing and discussing ways in which mixed and pluralistic research can advance and contribute to further, deeper psychological understanding?.

Are tumoral factors responsible for host tissue wasting in cancer cachexia?

Both cytokines and tumor factors have been implicated in tissue loss in cancercachexia. Loss of adipose tissue is most likely due to the tumor (and host) factorzinc-α2-glycoprotein because of its direct lipolytic effect, ability to sensitizeadipocytes to lipolytic stimuli and increased expression in cachexia. TNF-α andthe tumor factor proteolysis-inducing factor are the major contenders for skeletalmuscle at rophy; both increase protein degradat ion through theubiquitin-proteasome pathway and depres s protein synthesis throughphosphorylation of eukaryotic initiation factor 2α. However, while most studiesreport proteolysis-inducing factor levels to correlate with the appearance ofcachexia, there is some disagreement regarding a correlation between serumlevels of TNF-α and weight loss. Furthermore, only antagonists to proteolysisinducingfactor prevent muscle loss in cancer patients, suggesting that tumorfactors are the most important. © 2010 Future Medicine Ltd.

A European competence framework for industrial pharmacy practice in biotechnology

Project Report: The PHAR-IN ("Competences for industrial pharmacy practice in biotechnology") looked at whether there is a difference in how industrial employees and academics rank competences for practice in the biotechnological industry. A small expert panel consisting of the authors of this paper produced a biotechnology competence framework by drawing up an initial list of competences then ranking them in importance using a three-stage Delphi process. The framework was next evaluated and validated by a large expert panel of academics (n = 37) and industrial employees (n = 154). Results show that priorities for industrial employees and academics were similar. The competences for biotechnology practice that received the highest scores were mainly in: . "Research and Development", . "Upstream" and "Downstream" Processing', " . "Product development and formulation", " . "Aseptic processing", ."Analytical methodology", . "Product stability", and . "Regulation". The main area of disagreement was in the category "Ethics and drug safety" where academics ranked competences higher than did industrial employees.