Pre-term delivery and periodontal disease: a case-control study from Croatia

Aim: The aim of this report was to assess the strength and influence of periodontitis as a possible risk factor for pre-term birth (PTB) in a cohort of 81 primiparous Croatian mothers aged 18-39 years. Methods: PTB cases (n=17; mean age 25 +/- 2.9 years; age range 20-33 years) were defined as spontaneous delivery after less than 37 completed weeks of gestation that were followed by spontaneous labour or spontaneous rupture of membranes. Controls (full-time births) were normal births at or after 37 weeks of gestation (n=64; mean age 25 +/- 2.9 years; age range 19-39 years). Information on known risk factors and obstetric factors included the current pregnancy history, maternal age at delivery, pre-natal care, nutritional status, tobacco use, alcohol use, genitourinary infections, vaginosis, gestational age, and birth weight. Full-mouth periodontal examination was performed on all mothers within 2 days of delivery. Results: PTB cases had significantly worse periodontal status than controls (p=0.008). Multivariate logistic regression model, after controlling for other risk factors, demonstrated that periodontal disease is a significant independent risk factor for PTB, with an adjusted odds ratio of 8.13 for the PTB group (95% confidence interval 2.73-45.9). Conclusion: Periodontal disease represents a strong, independent, and clinically significant risk factor for PTB in the studied cohort. There are strong indicators that periodontal therapy should form a part of preventive prenatal care in Croatia.

Quality-of-life in children and adolescents with cystic fibrosis managed in both regional outreach and cystic fibrosis center settings in Queensland

To assess the health-related quality-of-life (HRQOL) of children/adolescents with cystic fibrosis (CF) and compare HRQOL in children managed by cystic fibrosis outreach service (CFOS) with those treated in a cystic fibrosis center (CFC). To compare HRQOL of children with CF in Queensland with previously published HRQOL data from the United States and examine the relationship between HRQOL scores and pulmonary function. Study design: Participants were children/adolescents with CF and their parents managed by the Royal Children’s Hospital Queensland at a CFC or CFOS. Two HRQOL surveys were used: PedsQL™ and Cystic Fibrosis Questionnaire (CFQ). Results: There were 91 CFC and 71 CFOS participants with similar demographics. PedsQL™ total summary score was statistically higher in CFOS, P = .05. There was no significant difference in CFQ scores between groups. Queensland parents reported lower HRQOL for their children compared with US parents (P

Solaria use in Queensland, Australia

Objective: To describe the demographics of solarium users and the correlates of solarium use in Queensland. Methods: A cross-sectional survey of 9,419 Queensland residents was conducted via an anonymous computer-assisted telephone interview. Results: Overall, 8.8% of the respondents had ever used a solarium and less than 1% had used a solarium in the previous year. Results indicated that users were more likely to be female and younger than non-users, and less than half of the users signed a consent form, suggesting that they had not been made aware of the associated risks by operators. Conclusions: The Queensland Cancer Risk Study was one of the first population-based studies to address solarium use in this State and highlights that the use of solariums in Queensland is low in comparison to other countries. Implications: There is no regulation of compliance with guidelines. It may become necessary to make compliance with the guidelines mandatory to effectively communicate the associated risks.

The psychosocial impact of caregiving on young people who have a parent with an illness or disability: Comparisons between young caregivers and noncaregivers

Objective: To investigate the psychosocial impact of young caregiving by empirically validating prominent qualitative themes.. This was achieved through developing an inventory called the Young Caregiver of Parents Inventory (YCOPI) designed to assess these themes and by comparing young caregivers and noncaregivers. Method: Two hundred forty-five participants between 10 and 25 years completed questionnaires: 100 young caregivers and 145 noncaregivers. In addition to the YCOPI, the following variables were measured: demographics, caregiving context, social support, appraisal, coping strategies, and adjustment (health, life satisfaction, distress, positive affect). Results: Eight reliable factors emerged from the YCOPI that described the diverse impacts of caregiving and reflected the key themes reported in prior research. The factors were related to most caregiving context variables and theoretically relevant stress and coping variables. Compared with noncaregivers, young caregivers reported higher levels of young caregiving impact, less reliance on problem-solving coping, and higher somatization and lower life satisfaction. Conclusions: Findings delineate key impacts of young caregiving and highlight the importance of ensuring that measures used in research on young caregivers are sensitive to issues pertinent to this population.

Application of Monte Carlo simulations to identify an appropriate dosage strategy for patients receiving a continuous intravenous infusion of enoxaparin

Aim: To identify an appropriate dosage strategy for patients receiving enoxaparin by continuous intravenous infusion (CII). Methods: Monte Carlo simulations were performed in NONMEM, (200 replicates of 1000 patients) to predict steady state anti-Xa concentrations (Css) for patients receiving a CII of enoxaparin. The covariate distribution model was simulated based on covariate demographics in the CII study population. The impact of patient weight, renal function (creatinine clearance (CrCL)) and patient location (intensive care unit (ICU)) were evaluated. A population pharmacokinetic model was used as the input-output model (1-compartment first order output model with mixed residual error structure). Success of a dosing regimen was based on the percent of Css that is between the therapeutic range of 0.5 IU/ml to 1.2 IU/ml. Results: The best dose for patients in the ICU was 4.2IU/kg/h (success mean 64.8% and 90% prediction interval (PI): 60.1–69.8%) if CrCL60ml/min, the best dose was 8.3IU/kg/h (success mean 65.4%, 90% PI: 58.5–73.2%). Simulations suggest that there was a 50% improvement in the success of the CII if the dose rate for ICU patients with CrCL

The politics of the new Germany

The Politics of the New Germany takes a new approach to understanding politics in the post-unification Federal Republic. Assuming only elementary knowledge, it focuses on debates and issues in order to help students understand both the workings of Germany's key institutions and some of the key policy challenges facing German politicians. Written in a straightforward style by four experts, each of the chapters draws on a rich variety of real-world examples. Packed with boxed summaries of key points, a guide to further reading and a range of seminar questions for discussion at the end of each chapter, this book highlights both the challenges and opportunities facing policy-makers in such areas as foreign affairs, economic policy, immigration, identity politics and institutional reforms. The book also takes a bird's-eye view of the big debates that define German politics over time, regardless of which party happens to be in power. It pinpoints three key themes that have characterised German politics over the last sixty years; reconciliation, consensus and transformation. Table of Contents: Introduction 1. Germany and the Burden of History 2. Germany’s Post-War Development, 1945-1989 3. Towards German Unity? 4. A Blockaded System of Government? 5. The Party System and Electoral Behaviour: The Path to Stable Instability? 6. Economic Management: The End of the German Model? 7. Citizenship and Demographics: A Country of Immigration? 8. The Reform of the Welfare State? 9. Germany and the European Union: A European Germany or a German Europe? 10. Foreign and Security Policy: A New Role for the Twenty-First Century? 11. Conclusion

A study of organizational citizenship behaviors in a retail setting

This study investigates the potential antecedents of organizational citizenship behaviors (OCBs) in a retail setting. Much remains unknown about the factors affecting OCBs in retail settings. Several characteristics of retail jobs, as compared with other organizational behavior contexts, suggest the need to examine antecedents of OCBs. Job attitudes (job satisfaction and organizational commitment) are proposed as direct predictors of OCBs. Leadership support, professional development, and empowerment are posited as indirect predictors of OCBs and direct predictors of job attitudes. The possible moderating impacts of employee demographics and job types on the modeled relationships are also examined. The research hypotheses are tested using data collected from 211 frontline employees who work in a retail setting. The employees have customer-contact roles in the upscale food and grocery retailer that participated in the study. The pattern of results is more complex than hypothesized. Job attitudes are related to OCBs but the mediating role of job attitudes is not supported. The relationships between leadership support, professional development, and empowerment, and OCBs and job attitudes differ systematically. Evidence of how employee demographics can alter the modeled relationships is also presented. The findings have significant implications for the theory and practice of managing frontline employees. Limitations of the study are discussed and a program of further research is sketched. © 2003 Elsevier Inc. All rights reserved.

Premium e-grocery:exploring value in logistics integrated service solutions

E-grocery is gradually becoming viable or a necessity for many families. Yet, most e-supermarkets are seen as providers of low value "staple" and bulky goods mainly. While each store has a large number of SKU available, these products are mainly necessity goods with low marginal value for hedonistic consumption. A need to acquire diverse products (e.g., organic), premium priced products (e.g., wine) for special occasions (e.g., anniversary, birthday), or products just for health related reasons (e.g., allergies, diabetes) are yet to be served via one-stop e-tailers. In this paper, we design a mathematical model that takes into account consumers' geo-demographics and multi-product sourcing capacity for creating critical mass and profit. Our mathematical model is a variant of Capacitated Vehicle Routing Problem with Time Windows (CVRPTW), which we extend by adding intermediate locations for trucks to meet and exchange goods. We illustrate our model for the city of Istanbul using GIS maps, and discuss its various extensions as well as managerial implications.

Workplace gender discrimination and the implicit association test

Women are under-represented at senior levels within organisations. They also fareless well than their male counterparts in reward and career opportunities. Attitudestoward women in the workplace are thought to underpin these disparities and moreand more organisations are introducing attitude measures into diversity and inclusioninitiatives to: 1) raise awareness amongst employees of implicit attitudes, 2) educateemployees on how these attitudes can influence behaviour and 3) re-measure theattitude after an intervention to assess whether the attitude has changed. TheImplicit Association Test (IAT: Greenwald, et al., 1998) is the most popular tool usedto assess attitudes. However, questions over the predictive validity of the measurehave been raised and the evidence for the real world impact of the implicit attitudes islimited (Blanton et al., 2009; Landy, 2008; Tetlock & Mitchell, 2009; Wax, 2010).Whilst there is growing research in the area of race, little research has explored theability of the IAT to predict gender discrimination. This thesis addresses thisimportant gap in the literature. Three empirical studies were conducted. The firststudy explored whether gender IATs were predictive of personnel decisions thatfavour men and whether affect- and cognition-based gender IATs were equallypredictive of behaviour. The second two studies explored the predictive validity ofthe IAT in comparison to an explicit measure of one type of gender attitude,benevolent sexism. The results revealed implicit gender attitudes were stronglyheld. However, they did not consistently predict behaviour across the studies.Overall, the results suggest that the IAT may only predict workplace genderdiscrimination in a very select set of circumstances. The attitude component that anIAT assesses, the personnel decision and participant demographics all impact thepredictive validity of the tool. The interplay between the IAT and behaviour thereforeappears to be more complex than is assumed.

Meta-analytic model comparisons of surface- and deep-level relational diversity effects on social integration and individual effectiveness

While diversity might give an organization a competitive advantage, individuals have a tendency to prefer homogenous group settings. Prior research suggests that group members who are dissimilar (vs. similar) to their peers in terms of a given diversity attribute (e.g. demographics, attitudes, values or traits) feel less attached to their work group, experience less satisfying and more conflicted relationships with their colleagues, and consequently are less effective. However, prior empirical findings tend to be weak and inconsistent, and it remains unclear when, how and to what extent such differences affect group members’ social integration (i.e. attachment with their work group, satisfaction and conflicted relationships with their peers) and effectiveness. To address these issues the current study conducted a meta-analysis and integrated the empirical results of 129 studies. For demographic diversity attributes (such as gender, ethnicity, race, nationality, age, functional background, and tenure) the findings support the idea that demographic dissimilarity undermines individual member performance via lower levels of social integration. These negative effects were more pronounced in pseudo teams – i.e. work groups in which group members pursue individual goals, work on individual tasks, and are rewarded for their individual performance. These negative effects were however non-existent in real teams - i.e. work groups in which groups members pursue group goals, work on interdependent tasks, and are rewarded (at least partially) based on their work group’s performance. In contrast, for underlying psychological diversity attributes (such as attitudes, personality, and values), the relationship between dissimilarity and social integration was more negative in real teams than in pseudo teams, which in return translated into even lower individual performance. At the same time however, differences in underlying psychological attributes had an even stronger positive effect on dissimilar group member’s individual performance, when the negative effects of social integration were controlled for. This implies that managers should implement real work groups to overcome the negative effects of group member’s demographic dissimilarity. To harness the positive effects of group members’ dissimilarity on underlying psychological attributes, they need to make sure that dissimilar group members become socially integrated.

Documentation of antibiotic prescribing controls in UK NHS hospitals

Objectives: To identify the types, prevalence and nature of antibiotic prescribing control documents within NHS hospitals in the UK. Methods: A self-completion postal questionnaire was sent to each Chief Pharmacist at 465 NHS hospitals in 2001/2002. This contained questions covering hospital demographics, and hospital antibiotic prescribing control documentation, including format, dissemination, approval and review processes. Results: In total, 253 (54%) completed questionnaires were returned. Of these, 168 respondents' hospitals had an antibiotic formulary, 107 had a policy for antibiotic prescribing and 216 had guidelines on antibiotic use. All three types of antibiotic prescribing documents were used by 82 hospitals but 18 did not have any documents; 44% of formularies, 45% of policies and 35% of guidelines were available electronically. The Drug and Therapeutics Committee was the most frequently cited body for document approval and approximately one-third of documents had been approved during the current year of the questionnaire. Only about one-half of responding hospitals had an annual review of documents. Conclusions: Despite publication of high-profile national guidance in response to growing concerns regarding antimicrobial resistance, there has been little increase in the use of antibiotic prescribing control documents in NHS hospitals over the past decade. It is clear that appropriate controls for antibiotic prescribing are not yet universally applied in the UK and recommendations for action have been proposed. © The British Society for Antimicrobial Chemotherapy 2004; all rights reserved.

Correlates of spontaneous reporting of adverse drug reactions within primary care: the paradox of low prescribers who are high reporters

AIM(S) To examine Primary Care Trust (PCT) demographics influencing general practitioner (GP) involvement in pharmacovigilance. METHODS PCT adverse drug reaction (ADR) reports to the Yellow Card scheme between April 2004 and March 2006 were obtained for the UK West Midlands region. Reports were analysed by all drugs, and most commonly reported drugs (‘top drugs’). PCT data, adjusted for population size, were aggregated. Prescribing statistics and other characteristics were obtained for each PCT, and associations between these characteristics and ADR reporting rates were examined. RESULTS During 2004–06, 1175 reports were received from PCTs. Two hundred and eighty (24%) of these reports were for 14 ‘top drugs’. The mean rate of reporting for PCTs was 213 reports per million population. A total of 153 million items were prescribed during 2004–06, of which 33% were ‘top drugs’. Reports for all drugs and ‘top drugs’ were inversely correlated with the number of prescriptions issued per thousand population (rs = -0.413, 95% CI -0.673, -0.062, P < 0.05, and r = -0.420, 95% CI -0.678, -0.071, P < 0.05, respectively). Reporting was significantly negatively correlated with the percentages of male GPs within a PCT, GPs over 55 years of age, single-handed GPs within a PCT, the average list size of a GP within a PCT, the overall deprivation scores and average QOF total points. ADR reports did not correlate significantly with the proportion of the population over 65 years old. CONCLUSIONS Some PCT characteristics appear to be associated with low levels of ADR reporting. The association of low prescribing areas with high ADR reporting rates replicates previous findings.

Relational diversity, social integration and individual effectiveness: a social self-regulation perspective

Relational demographers and dissimilarity researchers contend that group members who are dissimilar (vs. similar) to their peers in terms of a given diversity attribute (e.g. demographics, attitudes, values or traits) feel less attached to their work group, experience less satisfying and more conflicted relationships with their colleagues, and consequently are less effective. However, qualitative reviews suggest empirical findings tend to be weak and inconsistent (Chattopadhyay, Tluchowska and George, 2004; Riordan, 2000; Tsui and Gutek, 1999), and that it remains unclear when, how and to what extent such differences (i.e. relational diversity) affect group members social integration (i.e. attachment with their work group, satisfaction and conflicted relationships with their peers) and effectiveness (Riordan, 2000). This absence of meta-analytically derived effect size estimates and the lack of an integrative theoretical framework leave practitioners with inconclusive advice regarding whether the effects elicited by relational diversity are practically relevant, and if so how these should be managed. The current research develops an integrative theoretical framework, which it tests by using meta-analysis techniques and adding two further empirical studies to the literature. The first study reports a meta-analytic integration of the results of 129 tests of the relationship between relational diversity with social integration and individual effectiveness. Using meta-analytic and structural equation modelling techniques, it shows different effects of surface- and deep-level relational diversity on social integration Specifically, low levels of interdependence accentuated the negative effects of surface-level relational diversity on social integration, while high levels of interdependence accentuated the negative effects of deep-level relational diversity on social integration. The second study builds on a social self-regulation framework (Abrams, 1994) and suggests that under high levels of interdependence relational diversity is not one but two things: visibility and separation. Using ethnicity as a prominent example it was proposed that separation has a negative effect on group members effectiveness leading for those high in visibility and low in separation to overall positive additive effects, while to overall negative additive effects for those low in visibility and high in separation. These propositions were sustained in a sample of 621 business students working in 135 ethnically diverse work groups in a business simulation course over a period of 24 weeks. The third study suggests visibility has a positive effect on group members self-monitoring, while separation has a negative effect. The study proposed that high levels of visibility and low levels of separation lead to overall positive additive effects on self-monitoring but overall negative additive effects for those low in visibility and high in separation. Results from four waves of data on 261 business students working in 69 ethnically diverse work groups in a business simulation course held over a period of 24 weeks support these propositions.

Knowledge engineering for mental-health risk assessment and decision support

Mental-health risk assessment practice in the UK is mainly paper-based, with little standardisation in the tools that are used across the Services. The tools that are available tend to rely on minimal sets of items and unsophisticated scoring methods to identify at-risk individuals. This means the reasoning by which an outcome has been determined remains uncertain. Consequently, there is little provision for: including the patient as an active party in the assessment process, identifying underlying causes of risk, and eecting shared decision-making. This thesis develops a tool-chain for the formulation and deployment of a computerised clinical decision support system for mental-health risk assessment. The resultant tool, GRiST, will be based on consensual domain expert knowledge that will be validated as part of the research, and will incorporate a proven psychological model of classication for risk computation. GRiST will have an ambitious remit of being a platform that can be used over the Internet, by both the clinician and the layperson, in multiple settings, and in the assessment of patients with varying demographics. Flexibility will therefore be a guiding principle in the development of the platform, to the extent that GRiST will present an assessment environment that is tailored to the circumstances in which it nds itself. XML and XSLT will be the key technologies that help deliver this exibility.

Service quality of frontline employees:a profile deviation analysis

Using a configuration theory approach, this paper conducts a comparative study between frontline employees in phone and face-to-face service encounters for a retail bank. The study compares the top performers in service quality in relation to three components of organizational commitment and their demographics by applying a profile deviation analysis. The results show that the profile deviation for face-to-face employees is significantly negative, while for call center employees nonsignificant. Although the study finds no significant differences in the three components of commitment, significant differences exist in the total experience and age of the best performers. Also, affective commitment dominates the profile of high performers, while poor service providers seem to exhibit a higher level of continuance commitment. This study demonstrates the utility of profile deviation approaches in designing internal marketing strategies.