Work Related Communication, Environmental Uncertainty, and Subunit Effectiveness: A Second Look at the Information Processing Approach to Subunit Communication

The article discusses communication in organizations and looks at the effectiveness of contingency theory in analyzing operational research. The author critiques earlier research in this area, specifically by Boehm, Zedeck, and Tushman. She uses data from 90 of 100 subunits of a midwest state Extension Service. Questionnaires were sent out to assess work-related communications and information exchanges between the subunits, environmental conditions within each subunit, and the effectiveness of each office

Motor Carrier Scheduling Practices and Their Influence on Driver Fatigue

The primary objective of this report is to develop a better understanding of how the scheduling practices of motor carrier firms affect driver fatigue. The basis of this empirical research is a commercial driver fatigue model that includes driving environment (i.e., regularity of time, trip control, and quality of rest), economic pressures exerted on drivers (from customers, carriers, and the drivers themselves) and company safety practices as key factors in explaining driver fatigue. The model utilizes two measures of fatigue: frequency of close calls due to fatigue and driver perceptions of fatigue as a problem. Crash involvement is used to evaluate general safety performance. Three separate studies were conducted. First, the influence of driving environments alone on fatigue among over-the-road truck drivers was tested through a survey of 502 drivers at five geographically dispersed truck stops. A typology of driving environments was developed and the percent of drivers in each category was determined. It was found that a large number of drivers are in the “high fatigue risk” categories. Regression analysis identified starting the work week tired and longer than expected loading and unloading time as significantly related to both measures of fatigue. Regularity of time, regularity of route, and hours of uninterrupted sleep were each statistically significant factors for one fatigue measure. Next, the complete model was tested on a random sample of 279 drivers at 116 trucking companies and 122 drivers at 66 motor coach companies, which was then stratified on the basis of safety performance (i.e., SAFESTAT ratings). Data for these two studies were generated from surveys of drivers, safety directors, dispatchers, and top management at the sample firms. In the truck company study, starting the workweek tired was the single most significant factor related to fatigue. Other significant fatigue-influencing factors were difficulty in finding a place to rest and shippers’ and receivers’ scheduling requirements (including loading and unloading). Company safety practices that mitigated driver fatigue were carrier assistance with loading and unloading, carrier efforts to minimize nighttime driving, and driver voluntary attendance at corporate safety and training meetings. In the motor coach company study, the most significant factors related to driver fatigue were starting the work week tired, driving tired to make a good income, and pressure on drivers to accept trips. Two safety measures – drivers’ perceptions of their company’s safe drivingculture and policies, or attempts to minimize nighttime driving – mitigated some of the factors that adversely affect driver fatigue

Prospective Evaluation of Pregnancy-Associated Plasma Protein-A and Outcomes in Patients With Acute Coronary Syndromes

ObjectivesThis study sought to investigate whether pregnancy-associated plasma protein-A (PAPP-A) is useful for risk assessment in non–ST-segment elevation acute coronary syndrome (NSTE-ACS).BackgroundPAPP-A is a high molecular weight, zinc-binding metalloproteinase that is associated with vulnerable plaque and may be a predictor of cardiovascular disease and mortality.MethodsWe measured PAPP-A at baseline in 3,782 patients with non NSTE-ACS randomized to ranolazine or placebo in the MERLIN–TIMI 36 (Metabolic Efficiency With Ranolazine for Less Ischemia in Non-ST Elevation Acute Coronary Syndromes) trial and followed for an average of 1 year. A cut point of 6.0 μIU/ml was chosen from pilot work in this cohort.ResultsPAPP-A >6.0 μIU/ml at presentation was associated with higher rates of cardiovascular death (CVD) or myocardial infarction (MI) at 30 days (7.4% vs. 3.7%, hazard ratio [HR]: 2.01; 95% confidence interval [CI]: 1.43 to 2.82; p < 0.001) and at 1 year (14.9% vs. 9.7%, HR: 1.63; 95% CI: 1.29 to 2.05; p < 0.001). PAPP-A was also associated with higher rates of CVD (HR: 1.94; 95% CI: 1.07 to 3.52, p = 0.027) and myocardial infarction (HR: 1.82; 95% CI: 1.22 to 2.71, p = 0.003) individually at 30 days. There was no difference in the risk associated with PAPP-A stratified by baseline cardiac troponin I [Accu-TnI >0.04 μg/l], p interaction = 0.87). After adjustment for cardiac troponin I, ST-segment deviation, age, sex, diabetes, smoking, hypertension, and coronary artery disease, PAPP-A was independently associated with CVD/myocardial infarction at 30 days (adjusted HR: 1.62, 95% CI: 1.15 to 2.29; p = 0.006) and 1 year (adjusted HR: 1.35, 95% CI: 1.07 to 1.71; p = 0.012). PAPP-A also improved the net reclassification for CVD/MI (p = 0.003). There was no significant interaction with ranolazine.ConclusionsPAPP-A was independently associated with recurrent cardiovascular events in patients with NSTE-ACS. This finding supports PAPP-A as a candidate prognostic marker in patients with ACS and supports investigation of its therapeutic implications

Lactation and neonatal nutrition: defining and refining the critical questions.

This paper resulted from a conference entitled "Lactation and Milk: Defining and refining the critical questions" held at the University of Colorado School of Medicine from January 18-20, 2012. The mission of the conference was to identify unresolved questions and set future goals for research into human milk composition, mammary development and lactation. We first outline the unanswered questions regarding the composition of human milk (Section I) and the mechanisms by which milk components affect neonatal development, growth and health and recommend models for future research. Emerging questions about how milk components affect cognitive development and behavioral phenotype of the offspring are presented in Section II. In Section III we outline the important unanswered questions about regulation of mammary gland development, the heritability of defects, the effects of maternal nutrition, disease, metabolic status, and therapeutic drugs upon the subsequent lactation. Questions surrounding breastfeeding practice are also highlighted. In Section IV we describe the specific nutritional challenges faced by three different populations, namely preterm infants, infants born to obese mothers who may or may not have gestational diabetes, and infants born to undernourished mothers. The recognition that multidisciplinary training is critical to advancing the field led us to formulate specific training recommendations in Section V. Our recommendations for research emphasis are summarized in Section VI. In sum, we present a roadmap for multidisciplinary research into all aspects of human lactation, milk and its role in infant nutrition for the next decade and beyond