4,064 research outputs found
Combination of gastric atrophy, reflux symptoms and histological subtype indicates two distinct aetiologies of gatric cardia cancer.
<b>INTRODUCTION</b>
Atrophic gastritis is a risk factor for non-cardia gastric cancer, and gastro-oesophageal reflux
disease (GORD) for oesophageal adenocarcinoma. The role of atrophic gastritis and GORD in the
aetiology of adenocarcinoma of the cardia remains unclear. We have investigated the association
between adenocarcinoma of the different regions of the upper gastrointestinal tract and atrophic
gastritis and GORD symptoms.
<b>METHODS</b>
138 patients with upper GI adenocarcinoma and age and sex matched controls were studied.
Serum pepsinogen I/II was used as a marker of atrophic gastritis and categorised to five quintiles.
History of GORD symptoms, smoking and H.pylori infection was incorporated in logistic regression
analysis. Lauren classification of gastric cancer was used to subtype gastric and oesophageal
adenocarcinoma.
<b>RESULTS</b>
Non-cardia cancer was associated with atrophic gastritis but not with GORD symptoms; 55% of
these cancers were intestinal subtype. Oesophageal adenocarcinoma was associated with GORD
symptoms, but not with atrophic gastritis; 84% were intestinal subtype. Cardia cancer was positively
associated with both severe gastric atrophy [OR, 95% CI: 3.92 (1.77 ā 8.67)] and with frequent
GORD symptoms [OR, 95% CI: 10.08 (2.29 ā 44.36)] though the latter was only apparent in the nonatrophic
subgroup and in the intestinal subtype. The association of cardia cancer with atrophy was
stronger for the diffuse versus intestinal subtype and this was the converse of the association
observed with non-cardia cancer.
<b>CONCLUSION</b>
These findings indicate two distinct aetiologies of cardia cancer, one arising from severe atrophic
gastritis and being of intestinal or diffuse subtype similar to non-cardia cancer, and one related to
GORD and intestinal in subtype, similar to oesophageal adenocarcinoma. Gastric atrophy, GORD
symptoms and histological subtype may distinguish between gastric versus oesophageal origin of
cardia cancer
Early surgery versus initial conservative treatment in patients with traumatic intracerebral haemorrhage [STITCH(Trauma)] : the first randomized trial
Acknowledgements This project was funded by the NIHR Health Technology Assessment programme (project number 07/37/16). The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HTA programme, NIHR, NHS or the Department of Health.Peer reviewedPublisher PD
Professional service firms are relationship marketers: But does size matter?
There are few research-based insights into professional service firmsā (PSFs) contemporary marketing practices. This is unfortunate as the professional services sector is a key contributor to growth in Australian and other economies around the world. As professional services are unique in a number of ways and their operations and marketing activities inextricably intertwined, the present study investigated the extent to which PSFs practice marketing and whether this differs according to size. Depth interviews were held with thirty seven Australian senior managers in four key industries. We examined the extent of relationship marketing, conceptualised at an overall managerial level as well as four sub-practices identified in research by Coviello and colleagues. We found relationship management and interaction marketing were the most common practices, which is consistent with the inseparability concept, and that relationship management and database marketing were more common in larger firms, which is consistent with their relative resource strength
Reconceptualizing professional service firm innovation capability: Scale development
Building on capability theory, this paper presents a reconceptualization of the innovation capability construct within a knowledge-intensive service context, specifically, professional service firms (PSFs). Employing a rigorous multi-stage scale development process we interviewed 37 participants and surveyed 463 respondents across a wide range of PSFs including lawyers, accountants, consulting engineers and management consultants. The results of exploratory and confirmatory factor analyses highlight the multi-dimensional nature of innovation capability within this context. Three dimensions were identified: client-focused, marketing focused, and technology-focused innovation capability. We provide evidence of face validity, content validity, convergent and discriminant validity, nomological validity and reliability of our scale. Our scale offers a new way to measure innovation capability within PSFs and highlights the need to move beyond the narrow manufacturing mind-set focus of prior innovation research. Implications for theory and practice are discussed
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Gaining Customer Experience Insights that Matter
Contextualized in post-purchase consumption in B2B settings, the authors contribute to customer experience management theory and practice in three important ways. First, by offering a novel customer experience conceptual framework that integrates prior customer experience research to better understand, manage, and improve customer experiences - comprised of value cocreation elements (resources, activities, context, interactions and customer role), cognitive responses and discrete emotions at touchpoints across the customer journey. Second, by demonstrating the usefulness of a longitudinal customer experience analytic based on the conceptual framework that combines quantitative and qualitative measures. Third, by providing a step-by-step guide for implementing the text mining approach in practice, thereby showing that customer experience analytics that apply big data techniques to the customer experience can offer significant insights that matter. The authors highlight six key insights practitioners need in order to manage their customersā journey, through: (1) taking a customer perspective; (2) identifying root causes; (3) uncovering at-risk segments; (4) capturing customersā emotional and cognitive responses; (5) spotting and preventing decreasing sales; and (6) prioritizing actions to improve customer experience (CX). The article concludes with directions for future research
Acceptability of Financial Incentives for Health Behaviours: A Discrete Choice Experiment.
BACKGROUND: Healthy behaviours are important determinants of health and disease, but many people find it difficult to perform these behaviours. Systematic reviews support the use of personal financial incentives to encourage healthy behaviours. There is concern that financial incentives may be unacceptable to the public, those delivering services and policymakers, but this has been poorly studied. Without widespread acceptability, financial incentives are unlikely to be widely implemented. We sought to answer two questions: what are the relative preferences of UK adults for attributes of financial incentives for healthy behaviours? Do preferences vary according to the respondents' socio-demographic characteristics? METHODS: We conducted an online discrete choice experiment. Participants were adult members of a market research panel living in the UK selected using quota sampling. Preferences were examined for financial incentives for: smoking cessation, regular physical activity, attendance for vaccination, and attendance for screening. Attributes of interest (and their levels) were: type of incentive (none, cash, shopping vouchers or lottery tickets); value of incentive (a continuous variable); schedule of incentive (same value each week, or value increases as behaviour change is sustained); other information provided (none, written information, face-to-face discussion, or both); and recipients (all eligible individuals, people living in low-income households, or pregnant women). RESULTS: Cash or shopping voucher incentives were preferred as much as, or more than, no incentive in all cases. Lower value incentives and those offered to all eligible individuals were preferred. Preferences for additional information provided alongside incentives varied between behaviours. Younger participants and men were more likely to prefer incentives. There were no clear differences in preference according to educational attainment. CONCLUSIONS: Cash or shopping voucher-type financial incentives for healthy behaviours are not necessarily less acceptable than no incentives to UK adults.This work is produced under the terms of a Career Development Fellowship research training fellowship issued by the National Institute of Health Research to JA (grant number NIHR-CDF-2011-04-17; http://www.nihr.ac.uk/funding/fellowship-programme.htm). The views expressed are those of the authors and not necessarily those of the NHS, The National Institute for Health Research or the Department of Health. JA is currently funded in full by the Centre for Diet & Activity Research (CEDAR), and the FFS is funded in full by Fuse: the Centre for Translational Research in Public Health. CEDAR and Fuse are UKCRC Public Health Research Centres of Excellence (http://www.ukcrc.org/research-coordination/joint-funding-initiatives/public-health-research/). Funding for CEDAR (grant number MR/K023187/1) and Fuse (grant number MR/K02325X/1) from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged.This is the final version of the article. It first appeared from PLOS via http://dx.doi.org/10.1371/journal.pone.015740
Library Buildings And The Building Of A Collaborative Research Collection At The Tri-College Library Consortium
This report is the product of a planning grant awarded by The Andrew W. Mellon Foundation in 2001 to the Tri-College Library Consortium, which comprises the libraries of Bryn Mawr, Haverford and Swarthmore Colleges. The grant proposal, entitled āLibrary Buildings and the Building of a Collaborative Research Collection at the Tri-Colleges,ā set out a research agenda designed to address two central questions. The first question was a challenge: How could the three libraries come to terms with space problems caused by ever-growing collections and increasing demands to accommodate media, teaching, and student study areas in an environment in which library building expansion was a remote possibility? The second question was an opportunity: Could the libraries take advantage of their history of cooperation and the powerful tool of a unified online catalog to create a single research-quality collection out of the combined holdings of three strong liberal arts colleges? Working with a consultant, a seven-member Planning Group representing the three colleges and the consortium gathered data on the collections, convened focus groups of faculty and students, and engaged three publishing industry experts to assess the state of electronic publishing. After analyzing the data, the Planning Group studied alternatives for maximizing collection space and made recommendations for new models and strategies to be pursued by the Tri-Colleges consortium
The Gestational Obesity Weight Management: Implementation of National Guidelines (GLOWING) study: a pilot cluster randomised controlled trial
\ua9 The Author(s) 2024.Background: Pregnancy weight management interventions can improve maternal diet, physical activity, gestational weight gain, and postnatal weight retention. UK guidelines were published in 2010 but health professionals report multiple complex barriers to practice. GLOWING used social cognitive theory to address evidence-based barriers to midwivesā implementation of weight management guidelines into routine practice. This paper reports the pilot trial outcomes relating to feasibility and acceptability of intervention delivery and trial procedures. Methods: GLOWING was a multi-centre parallel-group pilot cluster RCT comparing the delivery of a behaviour change intervention for midwives (delivered as training workshops) with usual practice. The clusters were four NHS Trusts in Northeast England, randomised to intervention or control arms. Blinding of allocation was not possible due to the nature of the intervention. We aimed to deliver the intervention to all eligible midwives in the intervention arm, in groups of 6 midwives per workshop, and to pilot questionnaire data collection for a future definitive trial. Intervention arm midwivesā acceptability of GLOWING content and delivery was assessed using a mixed methods questionnaire, and pregnant womenās acceptability of trial procedures by interviews. Quantitative data were analysed descriptively and qualitative data thematically. Results: In intervention arm Trusts, 100% of eligible midwives (n = 67) were recruited to, and received, the intervention; however, not all workshops had the planned number of attendees (range 3ā8). The consent rate amongst midwives randomised (n = 100) to complete questionnaires was 74% (n = 74) (95% CI 65%, 83%), and overall completion rate 89% (n = 66) (95% CI 82%, 96%). Follow-up response rate was 66% (n = 49) (95% CI 55%, 77%), with a marked difference between intervention (39%, n = 15) and control (94%, n = 34) groups potentially due to the volume of research activities. Overall, 64% (n = 47) (95% CI 53%, 75%) completed both baseline and follow-up questionnaires. Midwives viewed the intervention as acceptable and directly relevant to routine practice. The least popular components related to scripted role-plays. Pregnant women viewed the recruitment and trial processes to be acceptable. Conclusions: This rigorously conducted pilot study demonstrated feasibility intervention delivery and a high level of acceptability amongst participants. It has provided information required to refine the intervention and trial protocol, enhancing confidence that a definitive trial could be carried out. Trial registration: ISRCTN46869894; retrospectively registered 25th May 2016, www.isrctn.com/ISRCTN46869894
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Questionnaire study to gain an insight into the manufacturing and fitting process of artificial eyes in children: an ocularist perspective
Purpose
To gain an insight into the manufacturing and fitting of artificial eyes in children and potential improvements to the process.
Method
An online qualitative survey was distributed to 39 ocularists/prosthetists in Europe and Canada. Participants were recruited through purposive sampling, specifically maximum variation sampling from the researcherās contacts and an online search.
Results
The findings highlighted the current impression technique as being the most difficult yet most important part of the current process for both the ocularist and child patient. Negatively affecting obtaining a good impression, the child patients distress can be reduced by their parents by providing encouragement, reassurance, practicing the insertion and removal of the artificial eye and being matter of fact. Whilst improvements to the current process provided mixed views, the incorporation of current technology was perceived as not being able to meet the requirements to produce aesthetically pleasing artificial eyes.
Conclusion
The current artificial eye process can be seen as an interaction with its success being dependent on the child patientās acceptance and adjustment which is dependent on the factors associated to the process. Investigation into the needs of the patient and whether technology can improve the process are the next steps in its advancement
Cost-effectiveness of child caries management: a randomised controlled trial (FiCTION trial)
Background: A three-arm parallel group, randomised controlled trial set in general dental practices in England, Scotland, and Wales was undertaken to evaluate three strategies to manage dental caries in primary teeth. Children, with at least one primary molar with caries into dentine, were randomised to receive Conventional with best practice prevention (C + P), Biological with best practice prevention (B + P), or best practice Prevention Alone (PA). Methods: Data on costs were collected via case report forms completed by clinical staff at every visit. The coprimary outcomes were incidence of, and number of episodes of, dental pain and/or infection avoided. The three strategies were ranked in order of mean cost and a more costly strategy was compared with a less costly strategy in terms of incremental cost-effectiveness. Costs and outcomes were discounted at 3.5%. Results: A total of 1144 children were randomised with data on 1058 children (C + P n = 352, B + P n = 352, PA n = 354) used in the analysis. On average, it costs Ā£230 to manage dental caries in primary teeth over a period of up to 36 months. Managing children in PA was, on average, Ā£19 (97.5% CI: -Ā£18 to Ā£55) less costly than managing those in B + P. In terms of effectiveness, on average, there were fewer incidences of, (ā 0.06; 97.5% CI: ā 0.14 to 0.02) and fewer episodes of dental pain and/or infection (ā 0.14; 97.5% CI: ā 0.29 to 0.71) in B + P compared to PA. C + P was unlikely to be considered cost-effective, as it was more costly and less effective than B + P. Conclusions: The mean cost of a child avoiding any dental pain and/or infection (incidence) was Ā£330 and the mean cost per episode of dental pain and/or infection avoided was Ā£130. At these thresholds B + P has the highest probability of being considered cost-effective. Over the willingness to pay thresholds considered, the probability of B + P being considered cost-effective never exceeded 75%. Trial registration: The trial was prospectively registered with the ISRCTN (reference number ISRCTN77044005) on the 26th January 2009 and East of Scotland Research Ethics Committee provided ethical approved (REC reference: 12/ES/0047)
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