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Stakeholder relations and sustainability practices of US small and medium-sized manufacturers
(2012)
Purpose: The purpose of this paper is to investigate the adoption of sustainability practices by small and medium-sized manufacturing (SMM) firms, the ways these firms work with their stakeholders for social and environmental purposes, and the relationships between the adoption of sustainability practices, stakeholder interaction, and product and process innovation.
Design/methodology/approach: This paper uses data from telephone interviews with 296 companies, a sustainability typology, and descriptive and statistical regression analysis.
Findings: The majority of the firms are adopting sustainability practices at least to some degree,stakeholders such as community advocacy groups, employees, suppliers, customers, and the localmedia are influencing the adoption of sustainability practices, and firms with high adoption rates of environmental practices are more successful in product and process innovation.Practical implications– The results of this research can help firms and stakeholder groups with their joint efforts to develop sustainability strategies. Community advocacy groups, employees,suppliers, customers, and the local media are capable of motivating firms to give something back tothe communities in which they conduct their business.
Originality/value: This paper contributes new understanding of the adoption of sustainabilitypractices by SMM firms, the ways these firms work with their stakeholders for social and environmental purposes, and the relationships between the adoption of sustainability practices,stakeholder interaction, and product and process innovation.
Fairness and Team Efficiency
(2013)
This study applies to the perception of fairness during teamwork. Students were assigned to work groups by lot and were instructed to prepare a course presentation. Groups were given no guidelines relating to allocation of tasks, but each group was graded as a whole. Since a real grade was given in a non-simulated experiment, it was possible to determine team efficiency, work satisfaction, and perception of fairness via a subsequent study. Results show a strong influence of fairness on team efficiency.
Detection and resolution of conflicting change operations in version management of process models
(2013)
Version management of process models requires that different versions of process models are integrated by applying change operations. Conflict detection between individually applied change operations and conflict resolution support are integral parts of version management. For conflict detection it is utterly important to compute a precise set of conflicts, since the minimization of the number of detected conflicts also reduces the overhead for merging different process model versions. As not every syntactic conflict leads to a conflict when taking into account model semantics, a computation of conflicts solely on the syntax leads to an unnecessary high number of conflicts. Moreover, even the set of precisely computed conflicts can be extensive and their resolution means a significant workload for a user. As a consequence, adequate support is required that guides a user through the resolution process and suggests possible resolution strategies for individual conflicts. In this paper, we introduce the notion of syntactic and semantic conflicts for change operations of process models. We provide a method how to efficiently compute conflicts precisely, using a term formalization of process models and consider the subsequent resolution of the detected conflicts based on different strategies. Using this approach, we can significantly reduce the number of overall conflicts and reduce the amount of work for the user when resolving conflicts.
Background: Continuous improvements of IT-performance in healthcare organisations require actionable performance indicators, regularly conducted, independent measurements and meaningful and scalable reference groups. Existing IT-benchmarking initiatives have focussed on the development of reliable and valid indicators, but less on the questions about how to implement an environment for conducting easily repeatable and scalable IT-benchmarks.
Objectives: This study aims at developing and trialling a procedure that meets the afore-mentioned requirements.
Methods: We chose a well established, regularly conducted (inter-) national IT-survey of healthcare organisations (IT-Report Healthcare) as the environment and offered the participants of the 2011 survey (CIOs of hospitals) to enter a benchmark. The 61 structural and functional performance indicators covered among others the implementation status and integration of IT-systems and functions, global user satisfaction and the resources of the IT-department. Healthcare organisations were grouped by size and ownership. The benchmark results were made available electronically and feedback on the use of these results was requested after several months.
Results: Fifty-ninehospitals participated in the benchmarking. Reference groups consisted of up to 141 members depending on the number of beds (size) and the ownership (public vs. private). A total of 122 charts showing single indicator frequency views were sent to each participant. The evaluation showed that 94.1% of the CIOs who participated in the evaluation considered this benchmarking beneficial and reported that they would enter again. Based on the feedback of the participants we developed two additional views that provide a more consolidated picture.
Conclusion: The results demonstrate that establishing an independent, easily repeatable and scalable IT-benchmarking procedure is possible and was deemed desirable. Based on these encouraging results a new benchmarking round which includes process indicators is currently conducted.
Introduction: Establishing continuity of care in handovers at changes of shift is a challenging endeavor that is jeopardized by time pressure and errors typically occurring during synchronous communication. Only if the outgoing and incoming persons manage to collaboratively build a common ground for the next steps of care is it possible to ensure a proper continuation. Electronic systems, in particular electronic patient record systems, are powerful providers of information but their actual use might threaten achieving a common understanding of the patient if they force clinicians to work asynchronously. In order to gain a deeper understanding of communication failures and how to overcome them, we performed a systematic review of the literature, aiming to answer the following four research questions: (1a) What are typical errors and (1b) their consequences in handovers? (2) How can they be overcome by conventional strategies and instruments? (3) electronic systems? (4) Are there any instruments to support collaborative grounding?
Methods: We searched the databases MEDLINE, CINAHL, and COCHRANE for articles on handovers in general and in combination with the terms electronic record systems and grounding that covered the time period of January 2000 to May 2012.
Results: The search led to 519 articles of which 60 were then finally included into the review. We found a sharp increase in the number of relevant studies starting with 2008. As could be documented by 20 studies that addressed communication errors, omission of detailed patient information including anticipatory guidance during handovers was the greatest problem. This deficiency could be partly overcome by structuring and systematizing the information, e.g. according to Situation, Background, Assessment and Recommendation schema (SBAR), and by employing electronic tools integrated in electronic records systems as 23 studies on conventional and 22 articles on electronic systems showed. Despite the increase in quantity and quality of the information achieved, it also became clear that there was still the unsolved problem of anticipatory guidance and presenting “the full story” of the patient. Only a small number of studies actually addressed how to establish common ground with the help of electronic tools.
Discussion: The increase in studies manifests the rise of great interest in the handover scenario. Electronic patient record systems proved to be excellent information feeders to handover tools, but their role in collaborative grounding is unclear. Concepts of how to move to joint information processing and IT-enabled social interaction have to be implemented and tested.
There is clinical evidence that cervical lateral glide (CLG) improves neurodynamics and alleviates pain in patients who suffer from neurogenic arm pain. Cervical lateral flexion (CLF) is also a treatment method and a means of testing neurodynamics. However, for both techniques nerve movement has not yet been investigated using ultrasound imaging (US). The purpose of this study was to quantify median nerve movement in the arm during CLG and CLF. For this study 27 healthy participants were recruited. Longitudinal movement of the median nerve was measured using US during CLG and CLF with the shoulder in 30° abduction in the middle and distal forearm (Fad). Data could be obtained from 11 participants (6 women and 5 men, average age 25.6 years, ±2.25) at the middle forearm (Fam) and from 9 participants (5 women and 4 men, average age 27.2 years, ±2.75) at the Fad. When applying CLF, the median nerve moved 2.3 mm (SEM ± 0.1 mm) at the Fam. At the same measuring point the median nerve moved 3.3 mm (SEM ± 0.3 mm, p = 0.005) by applying CLG. At the Fad the difference between CLF and CLF amounted to 0.6 mm (CLF: 1.9 mm (SEM ± 0.2 mm, CLG: 2.5 mm (SEM ± 0.2 mm, p ≤ 0.05). The movements during CLG are larger than during CLF. This difference is statistically significant. However, the statistical relevance cannot be extrapolated to a clinical relevance.
Pediatric headache is an increasingly reported phenomenon. Cervicogenic headache (CGH) is a subgroup of headache, but there is limited information about cervical spine physical examination signs in children with CGH. Therefore, a cross-sectional study was designed to investigate cervical spine physical examination signs including active range of motion (ROM), posture determined by the craniovertebral angle (CVA), and upper cervical ROM determined by the flexion–rotation test (FRT) in children aged between 6 and 12 years. An additional purpose was to determine the degree of pain provoked by the FRT. Thirty children (mean age 120.70 months [SD 15.14]) with features of CGH and 34 (mean age 125.38 months [13.14]) age-matched asymptomatic controls participated in the study. When compared to asymptomatic controls, symptomatic children had a significantly smaller CVA (p < 0.001), significantly less active ROM in all cardinal planes (p < 0.001), and significantly less ROM during the FRT (p < 0.001), especially towards the dominant headache side (p < 0.001). In addition, symptomatic subjects reported more pain during the FRT (p < 0.001) and there was a significant negative correlation (r = −0.758, p < 0.001) between the range recorded during the FRT towards the dominant headache side and FRT pain intensity score. This study found evidence of impaired function of the upper cervical spine in children with CGH and provides evidence of the clinical utility of the FRT when examining children with CGH.
There is evidence that temporomandibular disorder (TMD) may be a contributing factor to cervicogenic headache (CGH), in part because of the influence of dysfunction of the temporomandibular joint on the cervical spine. The purpose of this randomized controlled trial was to determine whether orofacial treatment in addition to cervical manual therapy, was more effective than cervical manual therapy alone on measures of cervical movement impairment in patients with features of CGH and signs of TMD. In this study, 43 patients (27 women) with headache for more than 3-months and with some features of CGH and signs of TMD were randomly assigned to receive either cervical manual therapy (usual care) or orofacial manual therapy to address TMD in addition to usual care. Subjects were assessed at baseline, after 6 treatment sessions (3-months), and at 6-months follow-up. 38 subjects (25 female) completed all analysis at 6-months follow-up. The outcome criteria were: cervical range of movement (including the C1-2 flexion-rotation test) and manual examination of the upper 3 cervical vertebra. The group that received orofacial treatment in addition to usual care showed significant reduction in all aspects of cervical impairment after the treatment period. These improvements persisted to the 6-month follow-up, but were not observed in the usual care group at any point. These observations together with previous reports indicate that manual therapists should look for features of TMD when examining patients with headache, particularly if treatment fails when directed to the cervical spine.
International research on a construct presupposes that the same measurement instruments are implemented in different countries. Only then can the results of the studies be directly compared to one another. We report on a study in which the English-language original of the Organizational Commitment Questionnaire (OCQ) as well as a German-language version of the OCQ was adapted into four further languages (Polish, Hungarian, Spanish, Malay) and validated. The employees of an international company were surveyed in seven countries (USA, Canada, Germany, Poland, Spain, Hungary and Malaysia). For purposes of validation, the job satisfaction, the self-rated job performance and the support of the employees in implementing the company values were used. The results show that the translations proceeded successfully. In all cases, a reliable scale emerges, which correlates positively with the validity criteria.
After foundation of the Wadden Sea National Park, grazing and artificial drainage was ceased or reduced on large areas of the salt marshes at the Schleswig-Holstein mainland coast (Northern Germany). The effect of grazing cessation versus intensive and moderate grazing on vegetation diversity was studied on small (plant species richness on plots between 0.01 and 100 m2) and large scale (vegetation type richness per hectare) over 18 to 20 years by analysing data from long-term monitoring programs. Plant species richness and vegetation type richness increased strongly over time in all management regimes, because grazing-sensitive species increased first in ungrazed marshes and later dispersed to and established in intensively grazed marshes. Dominance of the tall, late-successional grass Elymus athericus on 7% to 52% of all moderately and ungrazed (primarily high marsh) plots led to a decrease in species richness. After 18 to 20 years, species richness was highest in moderately and intensively grazed high marshes. Differences were significant only on small plots of up to 4 m2. On the large scale, vegetation type richness in the low marsh was higher without grazing, while no differences were found in the high marsh. Our results indicate that grazing effects differ between spatial scales and that different spatial scales have to be considered for monitoring and evaluation of vegetation diversity in salt marshes. To conserve vegetation diversity on all scales, a large-scale mosaic of different management regimes should be maintained.
A floodplain-restoration project along the Danube between Neuburg and Ingolstadt (Germany) aims to bring back water and sediment dynamic to the floodplain. The accompanied long-term monitoring has to document the changes in biodiversity related to this new dynamics. Considerations on and results of the vegetation monitoring concept are documented in this paper. In a habitat rich ecosystem like a floodplain different habitats (alluvial forest, semi-aquatic/aquatic sites) have different demands on the sampling methods.
Therefore, different monitoring designs (preferential, random, systematic, stratified random and transect sampling) are discussed and tested for their use in different habitat types of the floodplain. A stratified random sampling is chosen for the alluvial forest stands, as it guarantees an equal distribution of the monitoring plots along the main driving factors, i.e. influence of water. The parameters distance to barrage, ecological flooding, height above thalweg and distance to the new floodplain river are used for stratifying and the plots are placed randomly into these strata, resulting in 117 permanent plots. Due to small changes at the semi-aquatic/aquatic sites a transect sampling was chosen. Further, a rough stratification (channel bed, river bank adjacent floodplain) was implemented, which was only possible after the start of the restoration project. To capture the small-scale changes due to the restoration measures on the vegetation, 99 additional plots completed the transect sampling. We conclude that hetereogenous study areas need different monitoring approaches, but, later on, a joint analysis must be possible.
Atopic dermatitis, STAT3- and DOCK8-hyper-IgE syndromes differ in IgE-based sensitization pattern
(2014)
Background
The continuous rise in caesarean rates across most European countries raises multiple concerns. One factor in this development might be the type of care women receive during childbirth. ‘Supportive care during labour’ by midwives could be an important factor for reducing fear, tension and pain and decreasing caesarean rates. The presence and availability of midwives to support a woman in line with her needs are central aspects for ‘supportive care during labour’.
To date, there is no existing research on the influence of effective ‘supportive care’ by German midwives on the mode of birth. This study examines the association between the attendance and workload of midwives with the mode of birth outcomes in a population of low-risk women in a German multicentre sample.
Methods
The data are based on a prospective controlled multicentre trial (n = 1,238) in which the intervention ‘midwife-led care’ was introduced. Four German hospitals participated between 2007 and 2009.
Secondary analyses included a convenience sample of 999 low-risk women from the primary analyses who met the selection criterion ‘low-risk status’. Participation was voluntary. The association between the mode of birth and the key variables ‘attendance of midwives’ and ‘workload of midwives’ was assessed using backward logistic regression models.
Results
The overall rate of spontaneous delivery was 80.7% (n = 763). The ‘attendance of midwives’ and the ‘workload of midwives’ did not exhibit a significant association with the mode of birth. However, women who were not satisfied with the presence of midwives (OR: 2.45, 95% CI 1.54-3.95) or who did not receive supportive procedures by midwives (OR: 3.01, 95% CI 1.50-6.05) were significantly more likely to experience operative delivery or a caesarean. Further explanatory variables include the type of hospital, participation in childbirth preparation class, length of stay from admission to birth, oxytocin usage and parity.
Conclusion
Satisfaction with the presence of and supportive procedures by midwives are associated with the mode of birth. The presence and behaviour of midwives should suit the woman’s expectations and fulfil her needs. For reasons of causality, we would recommend experimental or quasi-experimental research that would exceed the explorative character of this study.
Background: We see a growing number of older adults receiving long-term care in industrialized countries. The Healthcare Utilization Model by Andersen suggests that individual need characteristics influence utilization. The purpose of this study is to analyze correlations between need characteristics and service utilization in home care arrangements.
Methods: 1,152 respondents answered the questionnaire regarding their integration of services in their current and future care arrangements. Care recipients with high long-term care needs answered the questionnaire on their own, the family caregiver assisted the care recipient in answering the questions, or the family caregiver responded to the questionnaire on behalf of the care recipient. They were asked to rank specific needs according to their situation. We used descriptive statistics and regression analysis.
Results: Respondents are widely informed about services. Nursing services and counseling are the most used services. Short-term care and guidance and training have a high potential for future use. Day care, self-help groups, and mobile services were the most frequently rejected services in our survey. Women use more services than men and with rising age utilization increases. Long waiting times and bad health of the primary caregiver increases the chance of integrating services into the home care arrangements.
Conclusion: The primary family caregiver has a high impact on service utilization. This indicates that the whole family should be approached when offering services. Professionals should react upon the specific needs of care dependents and their families.
Background
To offer vaginal birth after cesarean (VBAC) in a hospital setting is recommended in international guidelines, but offering VBAC in out‐of‐hospital settings is considered controversial. This study describes neonatal and maternal outcomes in mothers who started labor in German out‐of‐hospital settings.
Method
In a retrospective analysis of German out‐of‐hospital data from 2005 to 2011, included were 24,545 parae II with a singleton pregnancy in a cephalic presentation at term (1,927 with a prior cesarean and 22,618 with a prior vaginal birth).
Result
The overall VBAC rate was 77.8 percent. The intrapartum transfer rate to hospital was 38.3 percent (prior cesarean) versus 4.6 percent (prior vaginal) (p < 0.05), and the 10‐minute Apgar < 7 rate was 0.6 versus 0.2 percent (p < 0.05), and the nonemergency intrapartum transfer rate was 91.5 versus 85.0 percent (p < 0.05). Prolonged first stage of labor was the most common reason for intrapartum transfer in both groups. The leading reason for postpartum transfer was retained placenta.
Discussion
There was a high rate of successful VBAC in this study. The high nonemergency transfer rate for women with VBAC might mean that midwives are more cautious when attending women with a prior cesarean in out‐of‐hospital settings. Further studies are necessary to evaluate which women are suitable for VBAC in out‐of‐hospital settings.
The candidate list of substances subject to authorisation is an instrument provided by the EU chemicals regulation (REACH) to publicly announce and prioritize chemical substances of very high concern (SVHC) as a first step of imposing an obligation of authorisation on them, i.e. including them into the authorisation list (Annex XIV of REACH). As a consequence of inclusion into the “candidate list”, a variety of obligations concerned with intensifying risk communication apply. Article producers, importers and distributors of articles have to communicate information about SVHCs contained in articles and necessary risk management measures to the recipients of the articles and provide this information to consumers on request (Art. 33 REACH). This research paper analyzes the reputational mechanism of the candidate list showing a potential to stigmatize not only the substances as such but also various actors of the supply chain associated with these substances and their brands. Drawing on behavioral psychology theories, hypotheses on the reputational impacts of the candidate list on substance manufacturers, downstream users (including formulators and manufacturers of articles) and distributors are derived. These are discussed on the basis of current empirical data surveyed by the European Commission.
Alexithymia, or a lack of emotional awareness, is prevalent in some chronic pain conditions and has been linked to poor recognition of others' emotions. Recognising others' emotions from their facial expression involves both emotional and motor processing, but the possible contribution of motor disruption has not been considered. It is possible that poor performance on emotional recognition tasks could reflect problems with emotional processing, motor processing or both. We hypothesised that people with chronic facial pain would be less accurate in recognising others' emotions from facial expressions, would be less accurate in a motor imagery task involving the face, and that performance on both tasks would be positively related. A convenience sample of 19 people (15 females) with chronic facial pain and 19 gender-matched controls participated. They undertook two tasks; in the first task, they identified the facial emotion presented in a photograph. In the second, they identified whether the person in the image had a facial feature pointed towards their left or right side, a well-recognised paradigm to induce implicit motor imagery. People with chronic facial pain performed worse than controls at both tasks (Facially Expressed Emotion Labelling (FEEL) task P < 0·001; left/right judgment task P < 0·001). Participants who were more accurate at one task were also more accurate at the other, regardless of group (P < 0·001, r2 = 0·523). Participants with chronic facial pain were worse than controls at both the FEEL emotion recognition task and the left/right facial expression task and performance covaried within participants. We propose that disrupted motor processing may underpin or at least contribute to the difficulty that facial pain patients have in emotion recognition and that further research that tests this proposal is warranted.