Sacral rootlet rhizotomy at the conus medullaris for hypertonic neurogenic bladder

1978 ◽  
Vol 48 (2) ◽  
pp. 193-196 ◽  
Author(s):  
Stanislaw K. Toczek ◽  
David C. McCullough ◽  
John S. Boggs
Keyword(s):  
Neurogenic Bladder ◽  
Smooth Muscle Contraction ◽  
Conus Medullaris ◽  
Detrusor Muscle ◽  
Urinary Frequency ◽  
Content Type ◽  
Bladder Activity ◽  
Root Stimulation

✓ Three patients with spastic neurogenic bladder underwent sacral root stimulation and appropriate section of motor rootlets to the detrusor at the level of the conus medullaris. Compared to the results obtained with rhizotomies at the sacral levels in a previous series of patients, urinary frequency and infection were inhibited for longer periods of time, but some uninhibited bladder activity recurred in all three patients. Analysis of anatomical and electrophysiological data serves to emphasize the complexity and asymmetry of efferent supply to detrusor muscle. The authors conclude that the role of selective rhizotomy for inhibition of the spastic bladder is inconclusive, and perhaps a combination of surgery and medications that inhibit smooth-muscle contraction may be required for long-term protection of urinary collection systems.

Selective sacral rootlet rhizotomy for hypertonic neurogenic bladder

1975 ◽  
Vol 42 (5) ◽  
pp. 567-574 ◽  
Author(s):  
Stanislaw K. Toczek ◽  
David C. McCullough ◽  
Guy W. Gargour ◽  
Rudolf Kachman ◽  
Roger Baker ◽  
...  
Keyword(s):  
Neurogenic Bladder ◽  
Conus Medullaris ◽  
Physiological Data ◽  
Detrusor Muscle ◽  
Lower Extremity Function ◽  
Accurate Identification ◽  
Content Type ◽  
Alternative Pathways ◽  
Bladder Detrusor ◽  
Stimulation Of

✓ The authors describe a highly selective transsacral microsurgical procedure for sacral nerve rootlet interruption in five patients with hypertonic neurogenic bladder. Magnification and systematic stimulation of sacral roots provided accurate identification of motor fibers supplying bladder detrusor muscle and differentiation of efferent components to the legs and anal sphincter. Although the technique prevented incontinence and adverse effects of nerve section on rectal and lower extremity function, improvement in voiding patterns and diminution of urinary sepsis was of brief duration in three of the five patients. Physiological data from these procedures reaffirms the importance of S-3 and S-4 motor roots in detrusor innervation, but clinical responses bring into question the possibility of sustained improvement from such a highly selective procedure at the sacral level. The authors suggest that alternative pathways, not apparent on initial stimulation, may develop after section of sacral root components, and that dissection and stimulation of fibers at the level of the conus medullaris should be investigated as an alternative procedure.

Long-term management of patients with multiple brain metastases after shaped beam radiosurgery

2004 ◽  
pp. 406-412
Author(s):  
Paul Okunieff ◽  
Michael C. Schell ◽  
Russell Ruo ◽  
E. Ronald Hale ◽  
Walter G. O'Dell ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Tumor Control ◽  
Content Type ◽  
Negative Results ◽  
Multiple Metastases ◽  
Extracranial Disease ◽  
Successful Control ◽  
The Brain

✓ The role of radiosurgery in the treatment of patients with advanced-stage metastatic disease is currently under debate. Previous randomized studies have not consistently supported the use of radiosurgery to treat patients with numbers of brain metastases. In negative-results studies, however, intracranial tumor control was high but extracranial disease progressed; thus, patient survival was not greatly affected, although neurocognitive function was generally maintained until death. Because the future promises improved systemic (extracranial) therapy, the successful control of brain disease is that much more crucial. Thus, for selected patients with multiple metastases to the brain who remain in good neurological condition, aggressive lesion-targeting radiosurgery should be very useful. Although a major limitation to success of this therapy is the lack of control of extracranial disease in most patients, it is clear that well-designed, aggressive treatment substantially decreases the progression of brain metastases and also improves neurocognitive survival. The authors present the management and a methodology for rational treatment of a patient with breast cancer who has harbored 24 brain metastases during a 3-year period.

scholarly journals Sinabung volcano: how culture shapes community resilience

2019 ◽  
Vol 28 (3) ◽  
pp. 290-303
Author(s):  
Marta Mori ◽  
Ronan McDermott ◽  
Saut Sagala ◽  
Yasmina Wulandari
Keyword(s):  
Structured Interviews ◽  
Content Type ◽  
Aid Dependency ◽  
Relief Operations ◽  
Long Term Impact ◽  
Cultural Experts ◽  
Practical Implications

Purpose The purpose of this paper is to explore how culture, including traditions and social structures, can influence resilience and how culturally sensitive relief operations can put affected people and their context at the core of any interventions. Design/methodology/approach A case study of the Mt Sinabung volcano area in Indonesia was undertaken. As part of the case study, an analysis of interventions was conducted, which was complemented by semi-structured interviews with Karo cultural experts and humanitarian organisations. Findings Culture influences the manner in which the Karo people react to volcano eruptions with varying implications for recovery. In addition, relief organisations which understand people’s actions through a cultural lens have better managed to tailor programs with long-term impact, thereby avoiding aid dependency. Practical implications Practical examples of disaster management activities that adequately account for the beneficiaries’ way of living prior to the eruptions are provided. Aid actors are provided with guidance concerning how to better tailor their activities in line with a cultural lens. Originality/value The study provides empirical grounding for claims concerning the role of culture in planning interventions in Indonesia and other similar contexts.

Labor lawsuits and debt maturity

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Omer Unsal
Keyword(s):  
Chief Executive ◽  
Debt Maturity ◽  
Employee Relations ◽  
Short Term ◽  
Content Type ◽  
Negative Effect ◽  
Debt Market ◽  
Legal Fees

Purpose This paper aims to investigate how firms’ relationships with employees define their debt maturity. The authors empirically test the role of employee litigations in influencing firms’ choice of short-term versus long-term debt. The authors study employee relations by analyzing the importance of the workplace environment on capital structure. Design/methodology/approach The author’s test hypotheses using a sample of US publicly traded firms between 2000 and 2017, including 3,056 unique firms with 4,256 unique chief executive officer, adopting the fixed effect panel model. Findings The authors document that employee litigations have a significant negative effect on the use of short-term debt and a significant positive affect on long-term debt. Employee litigations, along with legal fees, outcomes and charging parties, matter the most in explaining debt maturity. In addition, frequently sued firms abandon the short-term debt market and use less shareholders’ equity to finance their operations while relying more on the longer debt market. Originality/value To the best of the authors’ knowledge, this is the first study to examine the role of employee mistreatment in debt maturity choice. The study extends the lawsuit and finance literature by examining unique, hand-collected data sets of employee lawsuits, allegations, violations, settlements, charging parties, case outcomes and case durations.

Forty years of rural reform in China: retrospect and future prospects

2019 ◽  
Vol 11 (3) ◽  
pp. 460-470 ◽  
Author(s):  
Xiwen Chen
Keyword(s):  
Rural Areas ◽  
Agricultural Policies ◽  
Timely Manner ◽  
Content Type ◽  
Rural Reform ◽  
Fields Of Study ◽  
The Future ◽  
The Government

Purpose Bottlenecked by rural underdevelopment, China’s overall development is bound to be inadequate and unbalanced. Through a brief retrospect of the reform directed against the “equalitarianism (egalitarianism)” in China’s rural areas, as well as the Chinese Government’s conceptual transformation and systemic construction and improvement thereof, the purpose of this paper is to clarify the panoramic significance of rural reform; the necessity, priority, and long-term nature of the current rural development; and the important role of public policy in doing so. It also looks ahead to consider the prospects for future rural reform. Design/methodology/approach This paper first reviews the rural reforms that were carried out in 1978. Second, it introduces the government’s conceptual change regarding rural reform and the establishment and improvement of the system that underlies it. Finally, the future of rural reform is envisaged. Findings The initial rural reforms brought extensive and profound changes to China’s rural areas. The experience of rural reform has been referred to and escalated by other fields of study. Hence, rural reforms have become something of global significance. Moreover, since the government can undertake reforms well beyond the reach of farmers, its views must be modified in a timely manner, and only then may it reasonably construct and improve the system pertaining to the “three rural issues (agriculture, rural areas, and farmers).” Originality/value This paper reviews the rural reforms carried out in 1978. It introduces the government’s change of concept with respect to rural reforms and the establishment and improvement of the system based on the “three rural issues,” thus looking forward to the future of rural reforms. The findings of this paper are of significance to the formulation of future agricultural policies.

The persistent effect of banking crises on investment and the role of financial markets

2014 ◽  
Vol 6 (1) ◽  
pp. 64-77 ◽  
Author(s):  
Felix Rioja ◽  
Fernando Rios-Avila ◽  
Neven Valev
Keyword(s):  
Financial Markets ◽  
Financial Development ◽  
Banking Crisis ◽  
Banking Crises ◽  
Output Growth ◽  
Long Term Effects ◽  
Content Type ◽  
Negative Effect

Purpose – While the literature studying the effect of banking crises on real output growth rates has found short-lived effects, recent work has focused on the level effects showing that banking crises can reduce output below its trend for several years. This paper aims to investigate the effect of banking crises on investment finding a prolonged negative effect. Design/methodology/approach – The authors test to see whether investment declines after a banking crisis and, if it does, for how long and by how much. The paper uses data for 148 countries from 1963 to 2007. Econometrically, the authors test how banking crises episodes affect investment in future years after controlling for other potential determinants. Findings – The authors find that the investment to GDP ratio is on average about 1.7 percent lower for about eight years following a banking crisis. These results are robust after controlling for credit availability, institutional characteristics, and a host of other factors. Furthermore, the authors find that the size and duration of this adverse effect on investment varies according to the level of financial development of a country. The largest and longer-lasting decrease in investment is found in countries in a middle region of financial development, where finance plays its most important role according to theory. Originality/value – The authors contribute by finding that banking crisis can have long-term effects on investment of up to nine years. Further, the authors contribute by finding that the level of development of the country's financial markets affects the duration of this decrease in investment.

The role of service fairness in the service quality – relationship quality – customer loyalty chain

2015 ◽  
Vol 25 (6) ◽  
pp. 744-776 ◽  
Author(s):  
Apostolos Giovanis ◽  
Pinelopi Athanasopoulou ◽  
Evangelos Tsoukatos
Keyword(s):  
Service Quality ◽  
Relationship Quality ◽  
Customer Loyalty ◽  
Higher Order ◽  
Equation Modeling ◽  
Content Type ◽  
Order Construct ◽  
Service Fairness

Purpose – The purpose of this paper is to extend the well-established nomological network of service quality-relationship quality-customer loyalty by introducing service fairness – a distinct service evaluation concept. Specifically, the study aims to investigate the impact of service fairness on relationship quality as a complementary to service quality driver, and the direct and indirect effect of service fairness on customer loyalty in the presence of service quality and relationship quality in a no failure/recovery effort service context. Design/methodology/approach – A telephone survey of a random sample of 408 customers of auto repair and maintenance services was implemented using a structured questionnaire with established scales. Data were analyzed with partial least squares path methodology, a structural equation modeling methodology. Findings – Interactional fairness is the most important formative determinant of customers’ overall fairness perception, followed by procedural and distributive fairness. Relationship quality measured as a higher order construct, made of satisfaction; trust; affective and calculative commitment, is the main determinant of customer loyalty. Also, it partially mediates, along with service quality, the relationship between service fairness and customer loyalty and fully mediates the effect of service quality on customer loyalty. Finally, service fairness has the highest overall effect on customer loyalty. Research limitations/implications – The sample is industry-specific and this may affect generalizability of findings. Also, the cross-sectional design adopted does not reflect temporal changes. Practical implications – Interactional fairness is of utmost importance to customers of the investigated industry. So, customers should be fairly treated at every point of contact. Also, service quality is heavily affected by service fairness. Thus, fair service leads to high-perceived service quality. Third, service quality affects customer loyalty only through relationship quality. Only when service quality is coupled by long-term quality relationships, signs of customer loyalty appear. Finally, service fairness influences customer loyalty mainly through service and relationship quality and has the highest overall effect on customer loyalty. So, fairly treating customers is crucial for developing long-term relationships that lead to customer loyalty. Originality/value – The role of service fairness in the service quality-relationship quality-customer loyalty chain is investigated and using a higher order construct for relationship quality.

Investment opportunities for student housing in Europe

2018 ◽  
Vol 36 (6) ◽  
pp. 578-584 ◽  
Author(s):  
Nick French ◽  
Geetha Bhat ◽  
Gurpreet Matharu ◽  
Filipe Ortigão Guimarães ◽  
David Solomon
Keyword(s):  
Student Housing ◽  
European Countries ◽  
Content Type ◽  
Market Requirements ◽  
Investment Opportunities ◽  
Property Markets ◽  
Practical Implications ◽  
Insight Into

Purpose The purpose of this paper is to provide an insight into how the demographic of international and home students in the major university cities in three European countries (France, Spain and Germany) offers investors an opportunity to provide students housing. This paper looks at how a mobile and demanding student clientele now demands, well priced, good quality and purpose built accommodation during their studies at University. This offers a good property investment opportunity. Design/methodology/approach This practice briefing is an overview of the demand factors that are creating opportunities in France, Spain and Germany. Findings This paper analyses the link between the under provision of purpose built student housing and an opportunity to develop a long-term cash flow producing investment asset. Practical implications The role of the property developers and investors is to successfully identify trends and demands and provide the assets that meet the market requirements. This paper looks at the meeting point in three major European countries for this latent and, currently, poorly served demand. Originality/value This provides guidance on how investment opportunities develop in non-traditional property markets.

Paradoxical tensions of the COVID-19 pandemic: a paradox theory perspective on the role of management control systems in helping organizations survive crises

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ralph Kober ◽  
Paul J. Thambar
Keyword(s):  
Control Systems ◽  
Management Control ◽  
Management Control Systems ◽  
Short Term ◽  
Content Type ◽  
Strategic Objectives ◽  
Paradox Theory ◽  
Practical Implications

PurposeThis paper presents paradox theory as a useful theoretical lens for researchers exploring crises such as coronavirus disease 2019 (COVID-19). The authors argue that paradox theory, which emphasizes a “both/and” as opposed to an “either/or” approach, is ideally suited for management control systems (MCS) research on crises.Design/methodology/approachThe authors adopt a revelatory case approach to provide empirical examples of the insights that paradox theory can provide.FindingsThis paper highlights how MCS can be used to simultaneously manage short-term/operational and long-term/strategic objectives to navigate a crisis. Furthermore, it highlights how MCS can be mobilized during crises to identify and embrace opportunities.Practical implicationsThis paper illustrates the importance of MCS focusing on not just the short-term, but also the long-term, and managing multiple objectives in assisting organizations to survive crisis.Originality/valueThis paper highlights the benefits of using paradox theory to understand the role of MCS in helping organizations manage crises and to use a crisis as a source of opportunity.

Study shows significant influence of HRD to shape and inspire CSR and sustainability initiatives

2021 ◽  
Vol 29 (2) ◽  
pp. 37-39
Keyword(s):  
Performance Management ◽  
Design Methodology ◽  
Life Balance ◽  
Content Type ◽  
The World ◽  
Sustainability Initiatives ◽  
Campbell Soup ◽  
Equity And Inclusion

Purpose The authors wrote their study in response to the pressures businesses face today to behave responsibly. More than 90% of the largest 250 MNCs in the world, they said, disclose information about various aspects of their CSR and sustainability. Meanwhile, HRD practices play a significant role in the design and effectiveness of these initiatives. Design/methodology/approach The authors conducted an analysis of the contents of CR reports to detect themes. They used a list of the top 100 CSR companies in the 2016 Global CSR Rep Trak 100. Overall, 55 reports were included from 23 large MNCs in 17 industries and 10 countries across Europe, Asia and North America. Household names included BMW, Campbell Soup, Dell, FedEx, Nike, Visa, Sony, Honda, Samsung, LEGO, Air Canada, Hilton Worldwide, and Fujifilm. Findings Initial analysis showed that seven areas of HRD work were the most important in supporting CSR and sustainability agendas. They were (1) Diversity, equity and inclusion. (2) Community engagement. (3) Work-life balance. (4) Employee long-term growth and development. (5) Performance management. (6) Business ethics and ethical culture and (7) Raising CSR awareness. Originality/value The study addressed two fundamental questions: First, what is the role of HRD in CSR and sustainability as portrayed in CR reports? Second, what areas of HRD work are highlighted in CR reports as important in the context of CSR and sustainability?

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