Effects Of Positive Changes Research Articles

The effect of positive changes during intraoperative monitoring on the functional improvement in patients with cervical compressive myelopathy

Cervical compressive myelopathy (CCM) is a progressive, degenerative spine disease and the most common cause of spinal cord dysfunction in older individuals. Current clinical guidelines for spinal surgery strongly recommend multimodal intraoperative monitoring (IOM) during spinal surgery as a reliable and valid diagnostic adjunct to assess spinal cord integrity. The aim of this study was to evaluate the effect of positive changes during IOM on the functional status in patients with CCM. Patients who underwent spinal surgery with IOM due to CCM were enrolled. During the surgery, patients underwent IOM using motor evoked potential (MEP) and somatosensory evoked potential (SEP). MEP and SEP were checked before and immediately after decompression. A shortened in latency greater than 10% or an increase in amplitude greater than 50% was regarded as a ‘positive changes’. Subjects were divided according to the presence of positive changes. Motor scores of American Spinal Injury Association (ASIA) impairment scale and Korean version of modified Barthel index (K-MBI) were evaluated before and after operation. Twenty-nine patients underwent spinal surgery due to CCM. Among these patients, 11 showed positive changes in MEP during IOM. When the two groups were compared, improvement rate in the AISA motor score and K-MBI were significantly higher in patients with positive changes than in patients without positive changes at 1 month after surgery. The duration of hospital stay was significantly shortened in the ‘positive change’ group. Regardless of positive change, nearly all patients suffered from neuropathic pain after operation. Positive changes in MEP during IOM may affect better functional improvement 1 month after operation and early discharge without significant complications in CCM patients. However they do not affect the neuropathic pain. Thus, tailored, proper management is needed to achieve maximal functional recovery in each patient after cervical spinal decompression surgery.

Investigating the influence of intraindividual changes in perceived stress symptoms on injury risk in soccer.

Research has shown that high levels of stress and stress responsivity can increase the risk of injuries. However, most of the research that has supported this notion has focused on between-person relationships, ignoring the relationships at the within-person level. As a result, the objective of this study was to investigate if within-person changes in perceived stress symptoms over a 1-month time period could predict injury rates during the subsequent 3months. A prospective design with two measurement points (Time 1-at the beginning of the season and Time 2-1month into the season) was utilized. A total of 121 competitive soccer players (85 males and 36 females; Mage =18.39, SD=3.08) from Sweden and the United States completed the Kessler Psychological Distress Scale (KPDS) and a demographic sheet at Time 1. The KPDS was also completed at Time 2, and all acute injuries that occurred during the subsequent 3-month period were recorded. A Bayesian latent change scores model was used to determine whether within-person changes in stress symptoms could predict the risk of injury. Results revealed that there was a credible positive effect of changes in stress symptoms on injury rates, indicating that an increase in reported stress symptoms was related to an increased risk for injury. This finding highlights the importance of creating caring and supportive sporting environments and relationships and teaching stress management techniques, especially during the earlier portion of competitive seasons, to possibly reduce the occurrence of injuries.

Ključni izazovi pred sistemom obrazovanja u Srbiji

The Fourth Industrial Revolution is causing an accelerated transformation of economies and societies globally. Ways of production, consumption, service delivery and communication are changing. Labor market demands are changing dramatically. New occupations emerge and existing ones disappear. This opens up new opportunities, raises productivity, enables higher consumption, encourages growth, yet to reap the benefits from the positive effects of change, significant investment in human capital and knowledge and skills development of the population is essential. Such rapid changes result in high uncertainty as to the skills needed for the future. It is already obvious that even at lower education levels, preparing individuals to cope with a complex, digital environment becomes important. The emphasis in education is moving from memorization to developing analytical and critical thinking, problem solving, creativity, adaptability, team work, skills for lifelong learning. The education system needs to ensure people are equipped with the skills to adapt to technological changes to avoid the widening social gaps. The required knowledge and skills need to be developed before entering the labor market, and updated throughout the working life. Analysis of the Serbian education system outcomes at different levels shows that it fails to fulfill its social task. Students' results in international testing are below average, graduates are inadequately prepared for their first job requirements, the profile structure from secondary school level upwards is notably mismatched to the labor market needs. What is required is a radical, consistent reform of the education system at all levels. Solutions exist, what we need is to acknowledge the world around us.

Care of patients with dementia in an acute trauma and orthopaedics unit

Aim To increase awareness of the needs of patients with dementia in the trauma and orthopaedics unit of one acute hospital, and to collaborate with staff on the unit to identify ways of improving the care experienced by these patients and their families. Method An action research approach was used and three action research cycles were completed. Data were obtained retrospectively for 20 patients with dementia who were admitted to the unit for treatment. Deficiencies in the care of these patients were identified and related to communication, pain management and the recognition of delirium. In response, a dementia toolkit was developed by nurses and implemented on the unit to improve the care of patients with dementia. Findings Comparison of pre-implementation and post-implementation audit results indicated a significant improvement in all aspects of care for patients with dementia in the trauma and orthopaedics unit, as a result of the implementation of the dementia toolkit. Education and training were provided to staff on the ward to ensure the toolkit was implemented appropriately. Conclusion It is important to consider the specific needs of patients with dementia in acute care settings, not only the primary reason for their admission. The involvement and inclusion of staff in determining what change was needed on the unit, how change would be undertaken and the positive effects of change, demonstrates how action research can inform and improve clinical practice.

Quality of Life and Psychological Adjustment of Women Living with 46,XY Differences of Sex Development.

Progressive care improvement for differences of sex development (DSD), regarding diagnosis communication, psychological, medical and surgical management has been claimed. To assess clinical management, quality of life (QoL) and the general psychosocial adjustment of individuals with 46,XY DSD. Some differences related to age at diagnosis are investigated. Cross-sectional study using standardized questionnaires. Forty-three Caucasian females with 46,XY DSD (self declared diagnoses: complete androgen insensitivity syndrome, n = 34; complete gonadal dysgenesis, n = 1; 5α-reductase deficiency, n = 4; Leydig cell hypoplasia, n = 1; unknown diagnosis, n = 3; age years: 31.5 ± 9.6 [range 18-57 years]). University Hospitals. Subjects were required to fill in questionnaires (ABCL, WHOQOL, dedicated 17-item questionnaire). Academic and socioeconomic data were compared with those of the Italian population. QoL and psychological data were compared with those of a comparison group (46,XX healthy females: n = 43; age, years: 34.5 ± 9.7, range 22-51 years). Present sample of women living with 46,XY DSD were well adapted and were higher achievers than controls, both in educational and professional life. They showed good QoL, but they appeared less satisfied in psychological and social areas. They had borderline mean scores and statistically higher scores than the comparison group for depression, anxiety, internalizing and externalizing problems. Younger persons living with a 46,XY DSD showed better psychosocial adjustment than older ones. Younger women showed lower age at diagnosis communication. Psychological support was more often proposed at the time of diagnosis communication to younger individuals, and they undertook it more frequently than older ones. Italian people living with 46,XY DSD were well adapted and successful; they reported a good QoL but showed higher degree of psychological distress than the comparison group. Lower psychological distress in younger women could indicate some positive effects of changes in management.

Testing the scaling effects and mechanisms of N‐induced biodiversity loss: evidence from a decade‐long grassland experiment

Summary Although extensive studies demonstrate that nitrogen (N) enrichment frequently reduces plant diversity within small quadrats (0.5–4 m2), only a few studies have evaluated N effects on biodiversity across different spatial scales. We conducted the first experimental test of the scale dependence of N effects on species richness from a 10‐year N treatment (1.75–28 g N m−2 year−1) in a typical steppe. We used species–area relationship (SAR) to analyse the scale dependence of species loss with power model S = cAz (S is species number, A is area, c is intercept, and z is slope). Absolute species loss decreased at sampling area > 8 m2. Proportional species loss (compared to control) decreased and critical threshold (Ncrit) for biodiversity losses increased with sampling areas. These scale dependences were quantified as increasing slope (z‐value) of SAR with N addition. Through SAR decomposition, we found that this overall positive effect was in response to positive effects of changes to the species abundance distribution over negative effects of overall species richness losses. Synthesis. As nitrogen (N) enrichment typically occurs at scales much larger than individual plots, understanding how N enrichment affects the scaling patterns of biodiversity is necessary for biodiversity conservation and ecosystem management in response to anthropogenic N deposition.

Customer Referral Behavior

In today’s highly competitive market environment, service providers are beginning to recognize that customer referral plays an important role in enhancing firm value through cost-effective acquisition of new customers. While a significant body of research has focused on exploring customer referral, surprisingly limited research to date has addressed how customer referral may vary for different customer groups, particularly among switchers and stayers. This article examines the moderating effect of switchers and stayers on the relationships between service quality and perceived value on customer referral behavior. Actual referral data were collected from 441 customers of an Internet Service Provider in two waves for this study. The results show that the effects of positive changes in service quality and perceived value on customer referral behavior are stronger for recently acquired customers (switchers) than for long-term customers (stayers). The findings of the study suggest that investment in service quality and value improvements yield significantly higher returns (through greater customer referrals) for switchers than for stayers. Based on the findings, the authors recommend that service managers should identify and target newly acquired customers, who have switched from different service providers, right from the outset of the relationship with service offerings that signify higher quality and value in order to maximize customer referrals.

Change management in the entrepreneurial Latin‐American organizations: an overview

Purpose – The purpose of this article is to provide an introduction to the papers presented in the special issue.Design/methodology/approach – Six papers are included in the special issue and an overview of their content is given.Findings – Alteration in markets that is brought about by economic, political and cultural changes often makes it difficult for business organizations to adapt to new circumstances. The papers focus, in a Latin American context, on how technological networks are changing the business world, the role of entrepreneurialism, and the positive effects of change management.Originality/value – The article introduces the six original and well‐presented papers.

Vegetation Restoration and Its Effects on Carbon Balance in Guangdong Province, China

Abstract The significance of the regional carbon (C) balance of vegetation restoration to global change was studied in Guangdong Province, one of the most populated provinces in China. The percentage of the province in forestland cover increased steadily from 26.23% in 1979 to 50.11% in 1998 owing to restoration of forests. During this period, the area increase in the conifer forest was 424.83 × 104 ha, whereas the area in broad‐leaved, mixed, and other forests increased by 68.82 × 104, 18.94 × 104, and 60.46 × 104 ha, respectively. C sequestration by forest soils from 1979 to 1998 was 389.36 Mt, equivalent to 1.43 Pg fixed carbon dioxide (CO2). The total annual CO2 sequestration by forests and the soils was 118.05 Mt, which was about half of the annual CO2 emission in Guangdong. The role of forest management and restoration in improving the carbon balance is discussed.

Realities of forest landscape restoration: The case of Barobbob watershed, Philippines

This paper described the experience in the restoration of the Barobbob Watershed and the implementation of an integrated watershed management approach through community‐based forest management, assessed the land use and associated cover changes in the watershed, and determined the indicators of effectiveness of forest protection strategies based on stakeholders perspectives. The decentralization of 868.79 hectares of Barobbob Watershed including 439‐hectare project managed by the Provincial Government of Nueva Vizcaya and Barobbob Watershed Occupants Association, Inc. (BWOA) lead to the successful restoration of the forest through people's participation and community ownership approach. The current land use as a result of enhanced participation between LGU and the community is far better compared to the previous land use because of the increase in productive farm favoring planting of trees. Positive effect of changes in the land use were apparent such as decline in the incidence of grassland and bush fire, sustainable supply of quality or potable water in the Barobbob Watershed due to the maintenance of the remaining secondary forest by the association, and increased livelihood opportunities. The result of interview conducted in determining the importance of watershed as perceived by the people showed that socio‐economic (39%) ranked first followed by biophysical (34%) and institutional framework (27%). This is due to the fact that the current good condition of the watershed largely depends on the management and concern of the residents for the area and its resources. The study found out that the issuance of security of tenure and certificate of land ownership strengthened the motivation of the farmers to participate in the conservation program. The co‐management arrangement in Barobbob Watershed proved appropriate with the help of the community in the management of its land, timber and water resources. The call for watershed forest restoration and protection is best displayed by enabling social mechanism, community's positive perceptions, and democratic and participatory governance.

POLICING, DRUGS, AND THE HOMICIDE DECLINE IN NEW YORK CITY IN THE 1990s*

This research reassesses the role of policing and drugs in the sharp homicide decline in New York City in the 1990s. Drawing on theoretical arguments about “broken windows” policing and lethal violence associated with the diffusion of crack cocaine, we estimate the effects of measures of misdemeanor arrests and cocaine prevalence on homicide rates with pooled, cross‐sectional time‐series data for 74 New York City precincts over the 1990–1999 period. The results of mixed regression models reveal a significant negative effect of changes in misdemeanor arrests and a significant positive effect of changes in cocaine prevalence on changes in total homicide rates. Additional analyses of homicide disaggregated by weapon indicate that the effects of misdemeanor arrests and cocaine prevalence emerge for gun‐related but not for non‐gun‐related homicides. Overall, the research generally supports influential interpretations of the homicide decline in New York City but also raises questions about underlying mechanisms that warrant more inquiry in future research.

A quasi‐experimental study on a community‐based stroke prevention programme for clients with minor stroke

The aim of this study was to determine the effectiveness of a community-based stroke prevention programme in (1) improving knowledge about stroke; (2) improving self-health-monitoring practice; (3) maintaining behavioural changes when adopting a healthy lifestyle for stroke prevention. People with minor stroke (or transient ischaemic attack) tend to under-estimate the long-term impact of this on their health. The challenge for nurses is to prevent subsequent strokes by finding ways to promote and sustain appropriate behaviours. Educational intervention is of paramount importance in equipping those at risk with relevant knowledge and self-care strategies for secondary stroke prevention. This study adopted a quasi-experimental design. One hundred and ninety subjects were recruited, of whom 147 (77 in the intervention group and 70 in the control group) completed the study. Data were obtained at three time points: baseline (T0); one week after (T1) and three months after (T2) the intervention. The intervention programme consisted of eight weekly two-hour sessions, with the aims of improving the participants' awareness of their own health signals and of actively involving them in self-care management of their own health for secondary stroke prevention. Significant positive changes were found among participants of the intervention group in the knowledge on stroke warning signs (P < 0.001); treatment seeking response in case of a stroke (P < 0.001); medication compliance (P < 0.001); self blood pressure monitoring (P < 0.001) as well as lifestyle modification of dietary habits (reduction in salted food intake, P = 0.004). No significant improvement was found in walking exercise participation in the intervention group, yet a significant decrease was detected among the control group. This study found a three-month-sustained effect of positive changes in knowledge and skill from participants who undertook a nurse-led community-based stroke prevention programme. Effective educational intervention by professional nurses helped clients integrate their learned knowledge into their real-life practice. This empowering, that is, the taking of responsibility by clients for their own self-care management on a daily basis, affirms that patient education has moved beyond teaching people facts.

Reassessing the Cross-National Relationship Between Income Inequality and Homicide Rates: Implications of Data Quality Control in the Measurement of Income Distribution

A significant positive relationship between income inequality and homicide rates has been found in a large number of cross-sectional studies and a few longitudinal analyses; a theoretically interesting interaction effect between income inequality and social welfare has also been found. For the most part researchers have been willing to use generous quality criteria in collecting income-distribution data, to maximize sample size and thereby enhance statistical power and representativeness. In the present paper we use a recently developed data set with explicit quality ratings for the income-distribution data, which permits systematic assessment of the consequences of relying on income-distribution measures of varying quality in examining the inequality-homicide relationship. Our analyses reveal that the income inequality-homicide relationship is remarkably robust in cross-sectional analyses. Regardless of the quality of income-distribution data, we observe significant positive effects of the Gini coefficient on homicide rates in cross-sectional multivariate models. Consistent results are also observed when an interaction term for income inequality and decommodification is examined. The results of longitudinal analyses differ; we observe a significant positive effect of changes in inequality on changes in homicide rates only when income-distribution measures of low quality are used.

Is the Local Business Tax a User Tax? An Empirical Investigation for Germany / Ist die Gewerbesteuer eine Äquivalenzsteuer? Eine empirische Analyse für Deutschland

Summary The theory of fiscal federalism argues that local governments should only tax mobile tax bases for the purpose of charging user taxes which correct for congestion effects. Empirically, we observe that local governments do levy taxes on mobile bases. In Germany, this is the local business tax (Gewerbesteuer). Since such taxes are efficient only if they are raised to cover congestion effects, the justification for these taxes usually put forward is that they serve as user taxes. This paper tests empirically whether that justification holds for the case of German local business taxes. Our findings do not support the user tax argument. Instead, our results suggest that local governments use the local business tax as a source of revenue for general public expenditures. Our empirical analysis finds statistically significant positive effects of changes in expenditures for social assistance and interest payments on subsequent tax rate changes. Our results are thus consistent with the view prevailing in the literature according to which local business tax rates are set in response to general financial pressure in local government budgets.

Partitioning Growth in Queensland Tourism Expenditure

The Queensland state economy has been one of the fastest growing in Australia over the past decade. Tourism is widely recognised as being one of the driving forces behind that growth. Total expenditure in the host economy by tourists is dependent not only on the number of visitors, but also on their behaviour. At the broad level, “behaviour” covers such things as length of stay and expenditure per day. Purpose of visit and usual place of residence may contribute to variability in these measures. It is found that length of stay is changing in the opposite direction to the positive effects of changes in average expenditure and numbers of visitors. Partitioning of changes in tourism expenditure into these components enables policy makers to better understand the changes that are occurring in aggregate tourism expenditure.