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Purpose: The purpose of this study is to investigate the link between downsizing cues and market performance prior to and after a major crisis. We use a recent exogenous shock – the COVID-19 pandemic – to test hypotheses on the nature of the relationship between downsizing cues and market performance within two distinct groups: pre and post-crisis. We purport that the sudden increase in uncertainty brought about by a major crisis widens information asymmetry between firms and their shareholders, and that top managers sending downsizing cues to the market with high levels of authenticity may be more likely to trigger positive market reactions. Design/methodology/approach: The authors rely on computer-assisted text analysis (CATA) methodology, event-study methodology and a data set of 952 pre- and post-crisis earnings conference calls held by 476 S&P 500 firms to test the hypotheses in this study. Findings: The authors find that downsizing cues have no effect on market performance in the pre-crisis group, but are negatively related to market performance in the post-crisis group. The authors also find that authenticity cues positively mitigate the relationship between downsizing cues and market performance relationship in the post-crisis group. Originality/value: This empirical study extends our knowledge of the influence of a major crisis on the relationship between downsizing and market performance by leveraging the revelatory power of an exogenous environmental shock. The authors also explore the role played by managerial authenticity and find that the market is more inclined to accept post-crisis downsizing efforts when top managers are perceived as authentic.

Purpose: This paper aims to investigate whether cues of morality can mitigate stock sell-offs in the face of earnings uncertainty prior to earnings conference calls and draws on moral foundations theory to study the effect of universal moral cues (harm/care and fairness/reciprocity rhetoric) and primarily conservative moral cues (ingroup/loyalty, authority/respect and purity/sanctity rhetoric) on market performance. Design/methodology/approach: The study relies on a longitudinal data set of 1,920 firm-quarter observations corresponding to calls held by firms listed on the S&P 500 in 2015 and relies on computer-assisted-text-analysis and event-study methodology to test hypotheses. Findings: The results suggest that cues of universal moral foundations have a mitigating effect on stock sell-offs and are able to create firm value; while cues primarily conservative moral foundations are not found to have an effect on market performance. Originality/value: This investigation highlights why earnings conference calls may serve as a valuable tool for communicating a firm’s moral inclination and why universal morality may appeal to a wider range of shareholders than primarily conservative morality.

In recent years, earnings conference calls have become a popular disclosure tool through which top managers can provide more information to the market regarding the quarterly earnings of their firms. Although some research has indicated that the tone of earnings conference calls is crucial in mitigating investors’ negative reactions to earnings surprises, relatively little is still known about other rhetorical tactics that may be available for managers to create value during times of heightened earnings uncertainty. This article contends that warm-glow rhetoric may be another way to mitigate investors’ negative reactions to earnings surprises, as warm-glow theory suggests that individuals are willing to make suboptimal economic choices when they receive warm-glow payouts. Hypotheses drawing on warm-glow theory and the incremental useful information perspective are developed and tested using computer-assisted text analysis (CATA) and event study methodology on a longitudinal sample of 1920 calls, and it is suggested that warm-glow rhetoric positively moderates the relationship between earnings surprises and financial performance (as measured through cumulated abnormal returns). The findings illustrate how the warm-glow effect can be used as an unconventional, yet effective tactic with which managers can create market value. A discussion of the findings and their implications for theory and practice concludes the study.

To document the experience of adult food insecurity in an urban context, a community-university research collaboration conducted a qualitative study of adults' personal experiences of food insecurity and its perceived effects on aspects of health, using individual interviews with food-insecure adults. The study was designed to gain understanding of experiential knowledge and to relate respondents' experiences to an extant conceptual model (Campbell, 1991). Respondents reported insufficient access to food and experienced personal distress, frustration, and despair, which they linked to food insecurity. Food insecurity affected participation in typical social activities and contributed to feelings of isolation and alienation.

OBJECTIVE:s To assess the effect of self monitoring of blood glucose concentrations on glycaemic control and psychological indices in patients with newly diagnosed type 2 diabetes mellitus. Design Prospective randomised controlled trial of self monitoring versus no monitoring (control). Setting Hospital diabetes clinics. Participants 184 (111 men) people aged <70 with newly diagnosed type 2 diabetes referred to the participating diabetes clinics. Major exclusion criteria were secondary diabetes, insulin treatment, previous self monitoring of blood glucose. Interventions Participants were randomised to self monitoring or no monitoring (control) groups for one year with follow-up at three monthly intervals. Both groups underwent an identical structured core education programme. The self monitoring group received additional education on monitoring. MAIN OUTCOME MEASURES: Between group differences in HbA1c, psychological indices, use of oral hypoglycaemic drugs, body mass index (BMI), and reported hypoglycaemia rates. RESULTS: 96 patients (55 men) were randomised to monitoring and 88 (56 men) to control. There were no baseline differences in mean (SD) age (57.7 (11.0) in monitoring group v 60.9 (11.5) in control group) or HbA1c(8.8 (2.1)% v 8.6 (2.3)%, respectively). Those in the monitoring group had a higher baseline BMI (34 (7) v 32 (6.2)). There were no significant differences between groups at any time point (12 months values given) in HbA1c(6.9 (0.8)% v 6.9 (1.2)%, P=0.69; 95% confidence interval for difference –0.25% to 0.38%), BMI (33.1 (6.4) v 31.8 (6.0); adjusted for baseline BMI, P=0.32), use of oral hypoglycaemic drugs, or reported incidence of hypoglycaemia. Monitoring was associated with a 6% higher score on the depression subscale of the well-being questionnaire (P=0.01). CONCLUSIONS: In patients with newly diagnosed type 2 diabetes self monitoring of blood glucose concentration has no effect on glycaemic control but is associated with higher scores on a depression subscale. Trial registration ISRCTN 49814766.

Large numbers of different bacterial species are resident in the lumen of the distal gastrointestinal tract. The normal intestinal host–microbial interactions are not well understood, but the relationship is generally believed to be either mutually beneficial or beneficial to one without disadvantage to the other. Animal model and clinical studies suggest that IBD (inflammatory bowel disease) may develop in a susceptible individual when the normal host–bacterial relationship is dysregulated. In addition to rodent models, this article reviews studies that have investigated the cellular and molecular mechanisms of interactions between intestinal mucosal cells and the resident luminal bacteria in healthy individuals and patients with ulcerative colitis and Crohn's disease. Mechanisms by which the intestinal mucosa is able to avoid pro-inflammatory responses to commensal bacteria (and their products) but able to respond appropriately to luminal pathogens is currently an area of active investigation. Such studies are beginning to provide important clues regarding possible alterations in the mucosa that lead to the development of pro-inflammatory responses to resident bacteria in patients with IBD. Approaches to alter the intestinal microflora for therapeutic purposes and their potential mechanisms of action are also discussed.

Carbon monoxide (CO), one of the products of heme oxygenase (HO) catalyzed heme degradation, is a vasodilator. The aim of the present study was to clarify the role of HO in blood flow maintenance in tumors. Male BD9 rats bearing subcutaneous transplants of the P22 carcinosarcoma tumor were treated intraperitoneally (ip) with either tin-protoporphyrin IX (SnPP; 45 μmol/kg), a selective inhibitor of HO or copper-protoporphyrin IX (CuPP; 45 μmol/kg), used as a negative control. The extent of HO activity inhibition was measured using a spectrophotometric assay of bilirubin production and blood flow rates to the tumor and a range of normal tissues were assessed using the uptake of the radiolabelled tracer, iodo-antipyrine (125I-IAP). The animals were cannulated under fentanyl citrate/fluanisone (Hypnorm)/midazolam anesthesia. In the P22 tumor, SnPP, but not CuPP, caused a complete inhibition of HO activity 15 min post-treatment. Administration of SnPP 15 min before blood flow measurements reduced tumor blood flow by 17%, with no effects in any of the normal tissues studied. However, CuPP induced a greater reduction in tumor blood flow than SnPP (45% decrease). Furthermore, CuPP caused a reduction in blood flow to the skin and small intestine but a significant increase to skeletal muscle. The current findings conclusively establish only a minor role played by the HO/CO system in the maintenance of blood flow in this tumor system, despite relatively high levels of HO-1 protein and HO activity. The results also highlight the potential usefulness of CuPP as a tumor blood flow modifier.

The anti‐vascular effects of the tubulin binding agent, disodium combretastatin A‐4 3‐O‐phosphate (CA‐4‐P), have been investigated in the rat P22 carcinosarcoma by measurements of radiolabelled iodoantipyrine uptake and dynamic contrast‐enhanced MRI. The iodoantipyrine estimates of absolute tumour blood flow showed a reduction from 0.35 to 0.04 ml g−1min−16 h after 10 mg kg−1CA‐4‐P and to <0.01 ml g−1min−1after 100 mg kg−1. Tumour blood flow recovered to control values 24 h after 10 mg kg−1CA‐4‐P, but there was no recovery by 24 h after the higher dose. Dynamic contrast‐enhanced MR images were obtained at 4.7 T, following injection of 0.1 mmol kg−1Gd‐DTPA and analysed assuming a model arterial input function. A parameter, Ktrans, which is related to blood flow rate and permeability of the tumour vasculature to Gd‐DTPA, was calculated from the uptake data. Ktransshowed a reduction from 0.34 to 0.11 min−16 h after 10 mg kg−1CA‐4‐P and to 0.07 min−1after 100 mg kg−1. Although the magnitude of changes in Ktranswas smaller than that in tumour blood flow, the time course and dose‐dependency patterns were very similar. The apparent extravascular extracellular volume fraction, νe, showed a four‐fold reduction 6 h after 100 mg kg−1CA‐4‐P, possibly associated with vascular shutdown within large regions of the tumour. These results suggest that Ktransvalues for Gd‐DTPA uptake into tumours could be a useful non‐invasive indicator of blood flow changes induced by anti‐vascular agents such as combretastatin. Copyright © 2002 John Wiley & Sons, Ltd.

Currently, nurses are under great pressure to demonstrate effective, evidence-based patient care. In this article a single case study will be used to demonstrate that care can be based on recent research within a palliative care setting to produce effective outcomes. Research-based interventions, which were used to provide care for a patient who will be referred to as Maria, will be discussed and evaluated to illustrate the contribution that evidence-based practice made to her nursing care. Although it is a single case study and the findings cannot be generalized, it is suggested that this article can be used to demonstrate the need for accurate interpretation of assessment data, illustrate the use of research to support nursing interventions in pain management, constipation and skin pressure damage, and show that empirical evidence alone may not be a sufficient basis for care and that moral issues must be taken into account.

Modification of blood flow by endothelin-1 (ET-1) was examined in the s.c. HSN fibrosarcoma and compared to normal tissues of anaesthetised CBH/CBi rats. The ET receptor subtypes involved in the response were investigated using the ETA and ETB receptor antagonists BQ-610 and BQ-788, respectively. Blood flow and vascular resistance were determined using the uptake of radiolabelled iodo-antipyrine (¹²⁵I-IAP). BQ-610 or BQ-788 was infused for 30 min prior to blood flow determination. ET-1 was administered 15 min into the infusion time. BQ-610 and BQ-788 infused alone did not modify any vascular parameters. Tumour blood flow increased slightly following ET-1, contrasting with most normal tissues, in which blood flow was reduced. Vascular resistance increased in all tissues, including the tumour. Neither antagonist significantly modified the ET-1-induced changes in tumour blood flow or vascular resistance, whereas in the majority of normal tissues BQ-610 attenuated and BQ-788 potentiated the vascular resonse to ET-1. Our results show that the HSN tumour vasculature is only weakly responsive to ET-1 and antagonism of its effects by BQ-610 and BQ-788. This contrasts with the majority of normal tissues, in which ET-1 induces an intense vasoconstriction. Int. J. Cancer 73:283–289, 1997. © 1997 Wiley-Liss, Inc.

Activation of endothelin receptors on the vasculature can produce a variety of responses from potent vasoconstriction to mild vasodilation, depending on the receptor complement within the tissue. To elucidate the potential role of endothelin analogues as tumour blood flow modifiers, we have evaluated the effect of the ETB receptor agonist, IRL 1620 ([Suc-(Glu⁹, Ala^11,15)-ET-1(8-21)]) in CBH/CBi rats bearing an HSN fibrosarcoma. Tissue blood flow and vascular resistance were determined, 20 min following administration of IRL 1620 (bolus intravenous), using the uptake of radiolabelled iodoantipyrine (¹²⁵I-IAP). Blood flow was unchanged in most tissues. However, at doses ≥1.0 nmol kg⁻¹ IRL 1620, blood flow in the brain and heart was increased, whereas in the small intestine it was reduced. Blood flow in the skeletal muscle was reduced at 1.0 nmol kg⁻¹ only. Tumour blood flow was significantly reduced at 3.0 and 5.0 nmol kg⁻¹. Vascular resistance was unchanged in most tissues although it was increased in the skeletal muscle at 1.0 nmol kg⁻¹, in the kidney at 1.0 and 3.0 nmol kg⁻¹ and in the brain and heart, it was reduced at 5.0 nmol kg⁻¹ IRL 1620. Vascular resistance was significantly increased in the tumour and the small intestine at doses ≥1 nmol kg⁻¹ IRL 1620. Pretreatment of rats with BQ-788, an ETB receptor antagonist, selectively attenuated the tumour vascular response to 3 nmol kg⁻¹ IRL 1620 with no changes observed in the normal tissue responses. Our results demonstrate that the HSN tumour vasculature is selectively responsive to IRL 1620 at doses >1 nmol kg⁻¹ compared with the majority of normal tissues with the exception of the small intestine, and that only the tumour response is highly sensitive to BQ-788 antagonism, under the experimental dosing regime investigated. These differences may be exploitable for therapeutic benefit. Int. J. Cancer 80:295–302, 1999. © 1999 Wiley-Liss, Inc.

The De'il cam fiddling thro' the town,And danced awa wi' the Exciseman;And ilka wife cried, ‘Auld Mahoun,We wish you luck o' your prize, man.’We'll mak our maut, and brew our drink,We'll dance, and sing, and rejoice, man;And mony thanks to the muckle black De'ilThat danced awa wi' the Exciseman.There's threesome reels, and foursome reels,There's hornpipes and strathspeys, man;But the ae best dance e'er came to our Ian',Was-the De'il's awa' wi' the Exciseman.(Robert Burns, The De'il's awa' wi' the Exciseman, 1792)In 1823 the English government introduced a new Act reducing the outrageous excise tax to levels that made it possible for enterprising Scots to come out of hiding and legally produce and sell their beloved whisky. (Bottle of Glenlivet malt whisky, 1990)In late December 1783, a desperate king took a seemingly desperate political step. With all of his other options exhausted, George III asked William Pitt, then only twenty-four years old, to form a government. In recognition of both the king's remarkable choice and the time of year, Pitt's critics, eagerly expecting the new administration to be short-lived, dubbed it the “mincepie administration.” The critics were of course wrong; Pitt survived not only that Christmas season but another twenty in office. Yet they had reason to be skeptical. For one of the “presents” delivered to the young chancellor of the Exchequer that first Christmas Eve was the preliminary report of a parliamentary committee, appointed under Lord Shelburne, “to enquire into the illicit practices used in defrauding the revenue.”

Changes in healthcare provision introduced in the early 1990s raised awareness of the issue of quality in health care. Quality, currently a fashionable topic, is an abstract concept and attempts to define and measure its properties have proved controversial and challenging. An equally challenging aspect of nursing care is the satisfactory delivery of health education to patients. This paper focuses on patient education and quality assurance in nursing. The results of a study concerning 20 young adults with insulin-dependent diabetes mellitus (IDDM) are reported. The findings indicate deficiencies in their experiences of patient education at initial diagnosis, discharge home after first hospital admission and when needing further information. It is contended that patient education is an area which requires qualitative as well as quantitative measurements of quality in order to capture the unique experience of information needs.

OBJECTIVE: To report a case of intravenous streptomycin sulfate use in a patient infected with high-level, gentamicin-resistant Streptococcus faecalis.CASE SUMMARY: A 37-year-old woman with a history of schizoaffective disorder, diabetes insipidus possibly induced by lithium, chronic renal insufficiency, and anemia presented with a two-day history of decreased responsiveness, decreased verbalization, and tremulousness. Her hospital course was complicated by polymicrobial sepsis (S. faecalis, coagulase-negative staphylococci, Citrobacter diversus, Enterobacter aerogenes, and unidentified gram-negative bacilli #2) requiring vancomycin and gentamicin therapy. Gentamicin was discontinued after two doses because she developed acute-on-chronic renal insufficiency. Subsequent susceptibility data showed the enterococcus to be highly resistant to gentamicin. The patient deteriorated clinically when treated only with vancomycin. She remained septic with a blood pressure of 80/40 mm Hg; streptomycin was added to her regimen. We were concerned that streptomycin concentrations obtained following intramuscular administration would not be adequate because of possible hypoperfusion. Based on limited published literature, streptomycin was administered intravenously via a central intravenous catheter.DISCUSSION: A review of high-level aminoglycoside-resistant S. faecalisand treatment with intravenous streptomycin therapy are discussed. The availability and monitoring of streptomycin therapy are also described.CONCLUSIONS: Streptomycin is an antimicrobial agent that must be used with vancomycin in serious infections to eradicate high-level, gentamicin-resistant S. faecalis. Its unique administration and monitoring concerns require individual patient assessment.

The etiological agents that cause human babesiosis (Babesia microti) and Lyme disease (Borrelia burgdorferi) share a common tick vector (Ixodes scapularis Say) and rodent reservoir (Peromyscus leucopus), but because the geographical distribution of babesiosis is more restricted than Lyme disease, it was not considered a nationally notifiable disease until 2011. Although recent studies have shown dramatic increases in the number of cases of babesiosis and expansion of its range, little is known about infection and coinfection prevalence of these pathogens in the primary tick vector. Of the 478 I. scapularis nymphs collected within six Monmouth County, NJ, municipalities between 2004 and 2006, 4.0 and 10.0% were infected with B. microti and B. burgdorferi, respectively, while 2.9% were coinfected. Analysis of the 610 I. scapularis adults collected during the same period yielded an infection prevalence of 8.2% for B. microti and 45.2% for B. burgdorferi, while 6.2% were coinfected. The potential public health importance of these findings is discussed.

To evaluate their potential importance in the transmission of ixodid tick-borne borrelioses in Monmouth County, NJ, we collected host-seeking Ixodes scapularis Say and Amblyomma americanum (L.) (Acari: Ixodidae) adults and nymphs to determine relative encounter frequencies and the infection prevalence of selected Borrelia spp. in their respective tick vectors. We also reviewed records of all ticks submitted for identification by the public in Monmouth County during 2001–2005. Relative abundance of the two species varied markedly among sites. Adult encounter frequencies for the two species were similar; however, A. americanum nymphs were encountered 3 times more frequently than I. scapularis nymphs. Of 435 ticks submitted by the public, 50.1 and 38.9% were I. scapularis and A. americanum, respectively. However, during May through August, the peak Lyme disease transmission season in New Jersey, significantly more submitted ticks were A. americanum (55.9%), compared with I. scapularis (34.1%). Polymerase chain reaction analysis of 94 I. scapularis and 103 A. americanum adults yielded infection prevalences of 31.9% for B. burgdorferi and 5.8% for B. lonestari, respectively. Although the infection prevalence of B. burgdorferi in I. scapularis was considerably higher than the infection prevalence of B. lonestari in A. americanum, the higher encounter frequencies for A. americanum compared with I. scapularis observed in this and other studies may result in increased risk of acquiring exposure to A. americanum-transmitted pathogens. The potential public health implications of these results are discussed.