Tuberculosis in an inflammatory bowel disease cohort from South Africa

Background. Potent immunosuppressive therapy is standard treatment for inflammatory bowel disease (IBD) but carries a risk of reactivating latent tuberculosis (TB). No data exist on the burden of TB in South African patients with IBD. Objective. To evaluate the burden of TB in IBD patients attending a large tertiary IBD clinic. Methods. A retrospective analysis was performed on data pertaining to patients attending the Groote Schuur Hospital IBD clinic. Data were extracted from an existing IBD database, patient notes, the National Health Laboratory Services database and chest X-ray analysis. Results. Of 614 patients, 72 (11.7%) were diagnosed with TB; 40 (55.6%) developed TB prior to the diagnosis of IBD. On regression analysis, coloured IBD patients were at increased risk for TB development (p=0.004, odds ratio (OR) 3.57, 95% confidence interval (CI) 1.49 - 8.56), as were patients with extensive Crohn’s disease (CD) compared with those with less extensive disease (p=0.001,OR 2.84, 95% CI 1.27 - 6.33). No other risk factors, including the use of immunosuppressive agents, were identified for the development of TB. Conclusions. Of over 600 patients, 12% had TB either before or after IBD diagnosis. The high rate of previous TB and positive association with ethnicity probably reflects the high burden of TB in a socio-economically disadvantaged community. We recommend that IBD patients should be screened actively and monitored for TB when immunosuppressive medications are used

Best practice in active surveillance for men with prostate cancer: a Prostate Cancer UK consensus statement.

OBJECTIVES:To develop a consensus statement on current best practice of active surveillance (AS) in the UK, informed by patients and clinical experts. SUBJECTS AND METHODS:A consensus statement was drafted on the basis of three sources of data: systematic literature search of national and international guidelines; data arising from a Freedom of Information Act request to UK urology departments regarding their current practice of AS; and survey and interview responses from men with localized prostate cancer regarding their experiences and views of AS. The Prostate Cancer UK Expert Reference Group (ERG) on AS was then convened to discuss and refine the statement. RESULTS:Guidelines and protocols for AS varied significantly in terms of risk stratification, criteria for offering AS, and protocols for AS between and within countries. Patients and healthcare professionals identified clinical, emotional and process needs for AS to be effective. Men with prostate cancer wanted more information and psychological support at the time of discussing AS with the treating team and in the first 2 years of AS, and a named healthcare professional to discuss any questions or concerns they had. The ERG agreed 30 consensus statements regarding best practice for AS. Statements were grouped under headings: 'Inclusion/Exclusion Criteria'; 'AS follow-up protocol' and 'When to stop AS'. CONCLUSION:Significant variation currently exists in the practice of AS in the UK and internationally. Men have clear views on the level of involvement in treatment decisions and support from their treating professionals when receiving AS. The Prostate Cancer UK AS ERG has developed a set of consensus statements for best practice in AS. Evidence for best practice in AS, and the use of multiparametric magnetic resonance imaging in AS, is still evolving, and further studies are needed to determine how to optimize AS outcomes

Publication Records of Faculty Promoted to Professor: Evidence from the UK Accounting and Finance Academic Community

This study investigates the publication profiles of 140 accounting and finance faculty promoted to the senior rank of professor at UK and Irish universities during the period 1992 to 2007. On average, approximately 9 papers in Association of Business Schools (ABS) (2008)-listed journals, with 5 at the highest 3*/4* quality levels in a portfolio of 20 outputs are required for promotion to professor. Multivariate analysis provides evidence that publication requirements in terms of ABS ranked journal papers have increased over time, an effect attributed to the government research assessment exercise. There is no evidence that requirements differ for: internal versus external promotion, male versus female candidates; accounting versus finance professors, research intensity of institution peer group; or government research ranking of unit. There is also no evidence of a substitution effect in relation to increased recent publication history, quantity of non-ABS outputs or sole-authorship, all of which show a significant complementary effect. It is noted that there is very limited overlap in the UK and US publication journal sets, suggesting underlying geographically-based paradigm differences. The benchmarks provided in this study are informative in a range of decision settings: recruitment; those considering making an application for promotion to a chair and those involved in promotion panels; cross-disciplinary comparisons; and resource allocation. The evidence presented also contributes to the emerging policy debates concerning the aging demographic profile of accounting faculty, the management of academic labour and the Research Excellence Framework

Best practice in active surveillance for men with prostate cancer: a Prostate Cancer UK consensus statement

Objectives To develop a consensus statement on current best practice of active surveillance (AS) in the UK, informed by patients and clinical experts. Subjects and Methods A consensus statement was drafted on the basis of three sources of data: systematic literature search of national and international guidelines; data arising from a Freedom of Information Act request to UK urology departments regarding their current practice of AS; and survey and interview responses from men with localized prostate cancer regarding their experiences and views of AS. The Prostate Cancer UK Expert Reference Group (ERG) on AS was then convened to discuss and refine the statement. Results Guidelines and protocols for AS varied significantly in terms of risk stratification, criteria for offering AS, and protocols for AS between and within countries. Patients and healthcare professionals identified clinical, emotional and process needs for AS to be effective. Men with prostate cancer wanted more information and psychological support at the time of discussing AS with the treating team and in the first 2 years of AS, and a named healthcare professional to discuss any questions

A resource-advantage perspective on the orchestration of ambidexterity

This is an Accepted Manuscript of an article published by Taylor & Francis in Service Industries Journal on 31 Jul 2014, available online: http://dx.doi.org/10.1080/02642069.2014.942655Strategic resources are key inputs to strategy that can form the basis of superior service performance, yet there is scarce research on the strategic resources used by managers to realise ambidexterity: the simultaneous pursuit of alignment and adaptability. In this article, we draw on a qualitative case study of a leading European airline and examine the resource bundles used by managers in their orchestration of ambidexterity. Adopting a resource-advantage perspective, the study illustrates elements of human, organisational, and informational capital that are mobilised by managers in their incorporation of alignment-oriented and adaptability-oriented activities. By moving beyond a linear association between strategic resources and ambidextrous organisations, we argue that managers' orchestration of ambidexterity is central to how service organisations manage their strategic resources and enhance competitiveness. Overall, we highlight the micro managerial level as an important point of observation to extend current thinking on the ‘how’ of ambidexterity in service organisations

Re-engineering of South Africa’s primary health care system: where is the pharmacist?

South Africa’s transition towards a district-based health system (DHS) aims to offer health promotion and prevention services at community level, through re-engineered primary health care (PHC) services. Along with pharmacy workforce shortages and service delivery challenges, health reform is a clarion call to strategically re-position the pharmacist’s role in DHS strengthening. The pharmacist’s involvement in the three DHS streams, namely the clinical specialist support teams, school health services and municipal ward-based PHC outreach teams, is pertinent. This paper contextualises pharmacists’ current peripheral role in the health system, discusses a team-based approach and identifies opportunities to integrate pharmacy students into the re-vitalised PHC framework. Re-positioning of pharmacists within district clinical specialist support and school health teams could create opportunities for community-based and population-based services whereby a range of clinical and pharmaceutical services could materialise. Pharmacy training institutions could strengthen the DHS through established partnerships with the community and health services. Academic service learning programmes could integrate pharmacy students as part of the PHC outreach teams to promote community health. Interdependence between the health services, pharmacy schools and the community would create a platform to contextualise learning and dismantle existing silos between them. Multi-sectoral engagement could enable pharmacy schools to design strategies to optimise pharmaceutical service delivery and align their activities towards social accountability.DHE

Business capabilities for industrial firms: A bibliometric analysis of research diffusion and impact within and beyond Industrial Marketing Management

An extensive body of work investigates business phenomena from the capability perspective introduced by Teece, Pisano, and Shuen (1997). While several literature reviews on capabilities exist, research is still fragmented with ongoing debates between those trying to foster relevance and passionate critics in favour of rigour. This study contributes to the conversation by looking at how the community of scholars gathered around Industrial Marketing Management (IMM) has engaged with this body of work and, in turn, influenced other sub-communities. Specifically, using the CitNetExplorer software, we analyse all IMM capabilities-related publications and their direct influence on other journals. The findings unveil seven thematic clusters that highlight how IMM scholars have expanded capability research by deepening the understanding of its relational foundations. Our data not only reinforce prior warnings about weak validity but also uncover signs that suggest that the IMM community is on a path of theoretical consolidation with potential benefits for the broader conversation