bluuebunny/crossref_metadata_2025 huggingface dataset:
Enabling a service thinking mindset: practices for the global service ecosystem
Authors: Alkire Linda , Russell-Bennett Rebekah , Previte Josephine , Fisk Raymond P.
Published: December 2022

Purpose

Profound economic, social, political and environmental problems are cascading across modern civilization in the 21st century. Many of these problems resulted from the prevailing effects of rational economics focused on profit maximization. The purpose of this paper is to reframe the mindsets of scholars, firms and public policy decision-makers through enabling Service Thinking practices.

Design/methodology/approach

Marketing, service and allied discipline literature are synthesized, and Raworth's (2018) Doughnut Economics model is adapted to conceptualize and construct the Service Thinking framework.

Findings

Service Thinking is defined as a just, mutualistic and human-centered mindset for creating and regenerating service systems that meet the needs of people and the living planet. Service Thinking is enabled by five practices (service empathy, service inclusion, service respect, service integrity and service courage).

Practical implications

Actionable implications are presented for service ecosystem entities to uplift well-being, enhance sustainability and increase prosperity.

Originality/value

Service Thinking practices are shaped by influencing forces (marketing, education and law/policy) and operant service ecosystem resources (motivation–opportunity–ability or MOA), which makes Service Thinking applicable to four economic entities in the service ecosystem: the household, the market, the state and the commons.
Market selection and product positioning decisions’ implications for short- and long-term performance: evidence from the US music industry
Authors: Hoskins Jake David , Griffin Abbie
Published: December 2022

Purpose

This research paper aims to investigate detailed relationships between market selection and product positioning decisions and their associated short- and long-term product performance outcomes in the context of the music category: a cultural goods industry with high amounts of product introductions. Market selection decisions are defined by the size, competitiveness and age of market subcategories within an overall product category. Positioning decisions include where a product’s attributes are located spatially in the category (periphery versus the market center), whether a product resides within a single subcategory or spans multiple ones and what brand strategy (single versus co-branding) is used.

Design/methodology/approach

Data are from multiple sources for the US music industry (aka product category) from 1958 to 2019 to empirically test the hypotheses: genres (rock, blues, etc.) correspond to subcategories; artists to brands; and songs to products. Regression analyses are used.

Findings

A complex set of nuanced results are generated and reported, finding that key marketing decisions drive short-term new product success differently and frequently in opposing ways than long-term success. Launching into very new, well-established or very competitive markets leads to the strongest long-term success, despite less attractive short-run prospects. Positioning a product away from the market center and spanning subcategories similarly poses short-run challenges, but long-run returns. Brand collaborations have reverse effects. Short-run product success is found, overall, to be difficult to predict even with strong data inputs, which has substantial implications for how firms should manage portfolios of products in cultural goods industries. Long-run product success is considerably more predictable after short-run success is observed and accounted for.

Originality/value

While managers and firms in cultural goods industries have long relied on intuition to manage market selection and product positioning decisions, this research tests the hypothesis that objective data inputs and empirical modeling can better predict short- and long-run success of launched products. Specific insights on which song characteristics may be associated with success are found – as are more generalizable, industry-level results. In addition, by distinguishing between short- and long-run success, a more complete picture on how key decisions holistically affect product performance emerges. Many market selection and product positioning decisions have differential impacts across these two frames of reference.
Knowledge management in dairy production: a contribution to the competitiveness based on the value co-creation
Authors: Bonamigo Andrei , Rosa Louise Generoso , Guimarães Frech Camila , Andrade Herlandí de Souza
Published: December 2022

Purpose

The purpose of this study is to recognize the empirical inhibitors of knowledge management (KM)in value co-creation in the dairy production context.

Design/methodology/approach

This study undertook a qualitative multiple-case study strategy. The datas collected comes from five players in the dairy sector that jointly co-create value. In addition to in-depth interviews with the actors, this study considers complementary documents, with reports, management flowcharts. Content analysis was conducted based on Bardin (2011).

Findings

This study identified three empirical barriers for KM in managing value co-creation in dairy production. The inhibitors observed were related to ineffective communication among stakeholders, organizational culture and high competitiveness. This study identified that sharing and KM among actors is a way to stimulate innovative solutions via value co-creation in dairy production.

Research limitations/implications

This study explores the context in the Center-South of Brazil; therefore, it is not generalizable.

Practical implications

The findings help the managers to deal with the KM inhibitors in the value co-creation context and define actions based on the strategies listed to overcome the barriers identified in dairy production. This study can also help managers to change the mindset of organizations by adding KM to the organizational culture, as it identifies existing barriers in the sector and contributes by suggesting attitudes and tools capable of overcoming such difficulties.

Social implications

Professionals in the dairy sector, especially the small rural producer, can have access to knowledge and professional training through the value co-creation among actors in the dairy sector. In this sense, the milk quality, for example, the nutritional characteristics and traceability of the milk, can be improved for the final consumer.

Originality/value

This study reveals the empirical inhibitors of KM presents in the value co-creation in the dairy production context. Additionally, insights to deal with the lack of sharing information and knowledge among multiple actors.
Exploring the challenges for medical tourism in the United Arab Emirates during the Covid-19 pandemic era: a stakeholder perspective
Authors: Okasha Ahmad A. , Haq Farooq , Medhekar Anita , Yasin Naveed
Published: December 2022

Purpose

This paper explores medical tourism development challenges in the United Arab Emirates (UAE) pre- and during Covid-19. Medical tourism is becoming a dynamic, rapid growth area and an engine of economic development.

Design/methodology/approach

In-depth interviews were conducted with medical tourism professionals. Fourteen medical tourism stakeholders were interviewed from 1 January to 31 January 2020. Qualitative thematic analysis was applied on medical tourism challenges before and during the pandemic.

Findings

The major themes indicated concerns for medical tourism in the UAE and they included higher medical services costs and a shortage of highly qualified medical expertise. The emerging themes related to the challenges of coping with Covid-19 and strategies to attract medical tourists.

Originality/value

This study contributes towards (1) the theory of medical tourism, (2) the related limited prior published work on this topic relating to the UAE and (3) the importance of medical tourism in today’s tourism industry. Additionally, there are theoretical and practical implications for medical tourism stakeholders in terms of attracting inbound medical tourists to the UAE from other countries during the Covid-19 crisis and in the post-pandemic situation.
Energy Disadvantage and Housing: Considerations Towards Establishing a Long Run Integrated Analysis Framework
Authors: Poruschi Lavinia , Gardner John
Published: December 2022

The relationship between housing quality and energy disadvantage over the long run is a complex interaction of growing interest. This work navigates through conceptual definitions and datasets to highlight gaps in monitoring and evaluating energy disadvantage, particularly the role of housing in perpetuating or mitigating energy disadvantage. We find that in Australia there is no agreed‐upon definition or metrics for energy poverty or energy hardship, nor a panel or longitudinal housing stock energy efficiency dataset and discuss options for remediating this.
Divine Struggles: Writing Histories of the Jewish Experience that Are Sensitive to Religious Sensitivities*
Authors: Cramsey Sarah A.
Published: December 2022

How can historians untangle the dynamics between intentional religious belief, inherited cultural practices and the numerous contexts (social, cultural, political) that outline relationships between religious majorities and religious minorities? This paper uses the exceptionally complex past of east central Europe in the modern period (and the 1930s/1940s in particular) as a laboratory to study how religious cleavages served as a basis for “everyday” interactions between Jews and Others. Drawing on the thinking of William Sewell and various narratives by historians of east central Europe, this paper isolates the concept of religious sensitivities (as opposed to racial, ethnic and national sensitivities) to explore how an awareness of believed rituals, ideas about perceived authority, notions of otherness and the contours of communal belonging illuminate four categories of historical actors. Religious sensitivities did and did not inspire rabbis, caregivers, “polite” anti‐Semites and “neighbours” to make decisions, live their lives alongside “Others” and construct their world views. This review of both published and original sources demands us to concede that historical context drives the production and articulation of religious sensitivities, even those that appear timeless.
History and the Study of Religion. Prophecy, Imagination and Religion in the Granadan Lead Books, the Works of Jacobus Palaeologus and of Nicholas of Cusa*
Authors: Wiegers Gerard
Published: December 2022

This article challenges the observation that historians and the discipline of History have not been helpful in addressing some of the important challenges in the Study of Religion by concentrating on “the local” and on deconstruction rather than on construction and “the global.” By undertaking a cross‐cultural case study — Medieval and Early Modern prophecies in the Muslim world and Europe — and focusing on the role and significance of the Granadan Sacromonte Lead Books (1588–1606) and the work of the radical Antitrinitarian Jacobus Paleologus (1520–1585), this paper argues that global and connected microhistorical approaches have been of great value to developing the promising trend of a relational approach in the Study of Religion.
Presence of Bacillus species in pasteurised milk and their phenotypic and genotypic antimicrobial resistance profile
Authors: Taher Eman M , Veltman Tania , Petrovski Kiro R
Published: December 2022

High‐temperature short‐time (HTST) pasteurisation is not sufficient for complete elimination of Bacillus sp. in milk. Hence, it is important to assess their prevalence, phenotypic and genetic antimicrobial resistance profiles in pasteurised milk. In this study, we investigated Bacillus prevalence and their phenotypic resistance to 25 antimicrobials and prevalence of five plasmid antimicrobial resistance genes. All isolates were resistant to β‐lactams; most isolates were susceptible to chloramphenicol (n = 52), ciprofloxacin, meropenem, sulphonamides, tetracycline and vancomycin (n = 56). Intriguingly, despite phenotypic sulphonamide and tetracycline sensitivity, Sul2 and tetA genes were detected in different Bacillus species, signifying a potential risk of horizontal gene transfer of these mobile resistance genes through pasteurised milk.
Genome‐wide association study analysis to resolve the key regulatory mechanism of biomineralization in Pinctada fucata martensii
Authors: Zheng Zhe , Hao Ruijuan , Yang Chuangye , Jiao Yu , Wang Qingheng , Huang Ronglian , Liao Yongshan , Jian Jianbo , Ming Yao , Yin Lixin , He Weiming , Wang Ziman , Li Chuyi , He Qi , Chen Kun , Deng Yuewen , Du Xiaodong
Published: December 2022

Biomineralization‐controlled exo‐/endoskeleton growth contributes to body growth and body size diversity. Molluscan shells undergo ectopic biomineralization to form the exoskeleton and biocalcified “pearl” involved in invading defence. Notably, exo‐/endoskeletons have a common ancestral origin, but their regulation and body growth are largely unknown. This study employed the pearl oyster, Pinctada fucata marntensii, a widely used experimental model for biomineralization in invertebrates, to perform whole‐genome resequencing of 878 individuals from wild and breeding populations. This study characterized the genetic architecture of biomineralization‐controlled growth and ectopic biomineralization. The insulin‐like growth factor (IGF) endocrine signal interacted with ancient single‐copy transcription factors to form the regulatory network. Moreover, the “cross‐phylum” regulation of key long noncoding RNA (lncRNA) in bivalves and mammals indicated the conserved genetic and epigenetic regulation in exo‐/endoskeleton growth. Thyroid hormone signal and apoptosis regulation in pearl oysters affected ectopic biomineralization in pearl oyster. These findings provide insights into the mechanism underlying the evolution and regulation of biomineralization in exo‐/endoskeleton animals and ectopic biomineralization.
Intranasal administration of Acinetobacter lwoffii in a murine model of asthma induces IL‐6‐mediated protection associated with cecal microbiota changes
Authors: Alashkar Alhamwe Bilal , Gao Zhan , Alhamdan Fahd , Harb Hani , Pichene Matthieu , Garnier Abel , El Andari Jihad , Kaufmann Andreas , Graumann Peter L. , Kesper Dörthe , Daviaud Christian , Garn Holger , Tost Jörg , Potaczek Daniel P. , Blaser Martin J. , Renz Harald
Published: December 2022

Background

Early‐life exposure to certain environmental bacteria including Acinetobacter lwoffii (AL) has been implicated in protection from chronic inflammatory diseases including asthma later in life. However, the underlying mechanisms at the immune‐microbe interface remain largely unknown.

Methods

The effects of repeated intranasal AL exposure on local and systemic innate immune responses were investigated in wild‐type and Il6−/−, Il10−/−, and Il17−/− mice exposed to ovalbumin‐induced allergic airway inflammation. Those investigations were expanded by microbiome analyses. To assess for AL‐associated changes in gene expression, the picture arising from animal data was supplemented by in vitro experiments of macrophage and T‐cell responses, yielding expression and epigenetic data.

Results

The asthma preventive effect of AL was confirmed in the lung. Repeated intranasal AL administration triggered a proinflammatory immune response particularly characterized by elevated levels of IL‐6, and consequently, IL‐6 induced IL‐10 production in CD4+ T‐cells. Both IL‐6 and IL‐10, but not IL‐17, were required for asthma protection. AL had a profound impact on the gene regulatory landscape of CD4+ T‐cells which could be largely recapitulated by recombinant IL‐6. AL administration also induced marked changes in the gastrointestinal microbiome but not in the lung microbiome. By comparing the effects on the microbiota according to mouse genotype and AL‐treatment status, we have identified microbial taxa that were associated with either disease protection or activity.

Conclusion

These experiments provide a novel mechanism of Acinetobacter lwoffii‐induced asthma protection operating through IL‐6‐mediated epigenetic activation of IL‐10 production and with associated effects on the intestinal microbiome.
Surveilling threat: The roles of ideology and threat perceptions in support for Islamophobic policy
Authors: Granger Aeleah M. , Kahn Kimberly B. , Steele Joel S.
Published: December 2022

After the attacks on 9/11, Muslims in the United States were the targets of increased surveillance by law enforcement on the basis of their religious identity, often resulting in mistreatment and unjustified imprisonment. The current study examined ideologies that are associated with Islamophobia and support for police surveillance of Muslims, as well as specific types of intergroup threat perceptions that mediate these relationships. Participants (N = 603) completed a survey measuring Social Dominance Orientation (SDO), Right‐wing Authoritarianism (RWA), Nationalism, intergroup threat perceptions, Islamophobia, and support for an anti‐Muslim police surveillance policy. Results demonstrated that higher levels of SDO, RWA, and Nationalism were each independently associated with Islamophobia through increased realistic, symbolic, and terroristic threat perceptions. Further, higher levels of Islamophobia mediated the relationships between each type of perceived threat and support for a Muslim surveillance policy. This comprehensive model of anti‐Muslim bias highlights the relative, independent effects of ideology and threat perceptions on anti‐Muslim prejudice and discrimination. Findings hold implications for the use of threat‐based language and stereotyping in policy decisions, particularly among those high in SDO, RWA, and Nationalism.
Dying to Work: Oʻahu Hotel Workers’ Efforts at Well‐being in the Face of Autoimmune Capitalism1
Authors: Rath Richard Cullen , Das Gupta Monisha
Published: December 2022

The settler colonial state of Hawaii has fostered tourism as its primary economic activity, despite its being only one‐fifth to a quarter share of the economy. As a result, the push to reopen tourism in the face of COVID‐19 pandemic conditions, which ground the industry to a near halt in 2020, has been acute. Based on our long‐term involvement with UNITE HERE! Local 5 and our participation‐observation of union members’ activities since May 2020, we examine worker‐led safety protocols and practices to promote public health in the face of state and industry actors’ conscious exclusion of their expert knowledge in order to revive tourism. This exclusion put barriers in the way of hotel workers returning safely to their jobs and ultimately cost lives. We call this self‐destructive urge “autoimmune capitalism,” an autophagic assemblage that consumes the mostly immigrant and Indigenous workers integral to the operation of tourism in the state. As tourism returns, hotel workers continue to organize for life‐affirming practices even as their radical care to ensure community well‐being gets absorbed as an invisible and uncompensated component of the pandemic service economy.
The challenges and experiences of academics supporting psychological capital among students at the emergence of COVID‐19: A qualitative investigation of award‐winning educators at a British university
Authors: Morris Roseanne , Hoelterhoff Mark , Argyros Georgios
Published: December 2022

Background

Studies show that student mental health has continued to deteriorate over the years. Developing strengths‐based approaches could aid educators in the development of Psychological Capital (PsyCap) and positive protective factors in students to support their mental well‐being and aid in their success; however, little is known of the subject experience of educators who attempt this.

Aims

This study aims to understand the experience of award‐winning educators; both in their attempts to cultivate positive protective factors in students and in challenges to the pursuit of that goal during the shifting academic landscape at the emergence of COVID‐19.

Sample

Six award‐winning educators from a British university.

Methods

Participants were interviewed over video calls in this research design using semi‐structured interviews. Thematic analysis was used to analyse the data.

Results & Discussion

The results showed two major themes; pressures for academics and strength‐based approached to cultivating PsyCap. These themes reflected that educators saw an urgent need for students to develop resilience as they struggle to handle subjective failure and that students struggle with imposter syndrome. The educators identified the challenges as feeling taken for granted, having unmanageable workloads along high expectations placed on them.

Conclusion

COVID‐19 has added significantly to the workloads of educators and demonstrated students' need for resilience. This research identifies the experiences of educators trying to improve strengths‐based practice while identifying the challenges of pursuing that goal in the changing pedagogy post–COVID‐19.
Building personalised homework from a learning analytics based formative assessment: Effect on fifth‐grade students' understanding of fractions
Authors: Rodríguez‐Martínez José Antonio , González‐Calero José Antonio , del Olmo‐Muñoz Javier , Arnau David , Tirado‐Olivares Sergio
Published: December 2022

This study analyses the potential of a learning analytics (LA) based formative assessment to construct personalised teaching sequences in Mathematics for 5th‐grade primary school students. A total of 127 students from Spanish public schools participated in the study. The quasi‐experimental study was conducted over the course of six sessions, in which both control and experimental groups participated in a teaching sequence based on mathematical problems. In each session, both groups used audience response systems to record their responses to mathematical tasks about fractions. After each session, students from the control group were given generic homework on fractions—the same activities for all the participants—while students from the experimental group were given a personalised set of activities. The provision of personalised homework was based on the students' errors detected from the use of the LA‐based formative assessment. After the intervention, the results indicate a higher student level of understanding of the concept of fractions in the experimental group compared to the control group. Related to motivational dimensions, results indicated that instruction using audience response systems has a positive effect compared to regular mathematics classes.

Practitioner notes

What is already known about this topic

Developing an understanding of fractions is one of the most challenging concepts in elementary mathematics and a solid predictor of future achievements in mathematics.

Learning analytics (LA) has the potential to provide quality, functional data for assessing and supporting learners' difficulties.

Audience response systems (ARS) are one of the most practical ways to collect data for LA in classroom environments.

There is a scarcity of field research implementations on LA mediated by ARS in real contexts of elementary school classrooms.

What this paper adds

Empirical evidence about how LA‐based formative assessments can enable personalised homework to support student understanding of fractions.

Personalised homework based on an LA‐based formative assessment improves the students' comprehension of fractions.

Using ARS for the teaching of fractions has a positive effect in terms of student motivation.

Implications for practice and/or policy

Teachers should be given LA/ARS tools that allow them to quickly provide students with personalised mathematical instruction.

Researchers should continue exploring these potentially beneficial educational implementations in other areas.
Behavioural clusters characteristic of cardiovascular reactivity profiles relate to poorer health outcomes
Authors: Keogh Tracey M. , Howard Siobhán , Gallagher Stephen
Published: December 2022

Objectives

Blunted cardiovascular reactivity is associated with a distinct behavioural profile of greater exposure to early life adversity, coupled with higher levels of behavioural disengagement and symptoms of depression. The present study sought to extend on this work by investigating if behavioural clusters with distinct patterns of reactivity were related to health and behavioural outcomes at baseline and at a 4‐year follow‐up.

Methods

Hierarchical cluster analyses were conducted using longitudinal data drawn from the Midlife Development in the United States (MIDUS 2) Biomarker Project and the MIDUS 3 follow‐up 4 years later. During MIDUS, 2 participants (N = 513) underwent a standardized stress testing protocol and had their blood pressure and heart rate monitored throughout. In addition, hierarchical cluster analyses were conducted on responses from measures of early life adversity, behavioural disengagement and depression. Binary logistic regressions were conducted to determine whether cluster membership was related to health and behavioural outcomes which were taken at both time points.

Results

Three behavioural clusters emerged with statistically different blood pressure reactivity patterns. The cluster characterized by greater exposure to early life adversity, higher levels of behavioural disengagement and depressive symptoms, had relatively lower blood pressure reactivity patterns compared with both the exaggerated reactivity cluster and the cluster similar to the sample mean. In fully adjusted models, this cluster was associated with hypertension (p = .050) and depressed affect (p = .033), while Cluster 1 characteristic of an exaggerated blood pressure reactivity profile was associated with depressed affect (p < .001). Cluster membership did not significantly predict future health status.

Conclusion

This study extends research on behavioural clusters characteristic of reactivity profiles to demonstrate how they relate to health and behavioural outcomes during MIDUS 2.
Talking to talkers: Infants' talk status, but not their gender, is related to language input
Authors: Dailey Shannon , Bergelson Elika
Published: December 2022

Prior research points to gender differences in some early language skills, but is inconclusive about the mechanisms at play, providing evidence that both infants' early input and productions may differ by gender. This study examined the linguistic input and early productions of 44 American English‐learning infants (93% White) in a longitudinal sample of home recordings collected at 6–17 months (in 2014–2016). Girls produced more unique words than boys (Cohen's d = .67) and this effect grew with age, but there were no significant gender differences in language input (d = .22–.24). Instead, caregivers talked more to infants who had begun to talk (d = .93–.97), regardless of gender. Therefore, prior results highlighting gender‐based input differences may have been due, at least partly, to this talking‐to‐talkers effect.
Does the fixture thread depth affect the accuracy of implant placement during fully guided immediate implant placement?: A human cadaver study
Authors: Song Young Woo , Park Jin‐Young , Jung Ji‐Young , Kim Joo‐Nyeon , Hu Kyung‐Seok , Lee Jung‐Seok
Published: December 2022

Background

The fixture thread depth reportedly influences the primary stability of dental implant, but its effect on the positional accuracy in immediate implant placement has not been reported previously.

Materials and Methods

Fifty‐six single‐rooted, anterior and premolar teeth were extracted from six human cadavers, followed by installing either regular‐threaded implants (RT group, N = 30) or deep‐threaded implants (DT group, N = 26) completely relying on the surgical guide. Optical impressions taken after osteotomy and fixture installation were superimposed with the preoperative virtual planning data to measure the vertical, angular, platform and apex deviations that occurred during osteotomy and installation.

Results

While the osteotomy deviations were similar between the two groups, the angular and apex deviation of the DT group (2.67 ± 2.56°; 1.04 ± 0.49 mm, respectively) were significantly larger than those of the RT group (1.61 ± 1.04°; 0.67 ± 0.41 mm, respectively) during installation (p < .05). When the installation deviations were analysed in the anterior and premolar areas separately, the angular, platform and apex deviations of the DT group (3.05 ± 3.26°; 0.75 ± 0.32 mm; 1.08 ± 0.56 mm, respectively) were significantly larger than those of the RT group (1.56 ± 0.73°, 0.59 ± 0.28 mm; 0.62 ± 0.38 mm, respectively) in the anterior site (p < .05), whereas there was no significant intergroup difference in the premolar site.

Conclusion

In immediate‐implant surgery, using an implant with a deeper thread might increase the deviations during installation, especially in the anterior area.
Intraoperative cytological diagnosis of brain tumours: A preliminary study using a deep learning model
Authors: Ozer Erdener , Bilecen Ali Enver , Ozer Nur Basak , Yanikoglu Berrin
Published: December 2022

Background

Intraoperative pathological diagnosis of central nervous system (CNS) tumours is essential to planning patient management in neuro‐oncology. Frozen section slides and cytological preparations provide architectural and cellular information that is analysed by pathologists to reach an intraoperative diagnosis. Progress in the fields of artificial intelligence and machine learning means that AI systems have significant potential for the provision of highly accurate real‐time diagnosis in cytopathology.

Objective

To investigate the efficiency of machine‐learning models in the intraoperative cytological diagnosis of CNS tumours.

Materials and Methods

We trained a deep neural network to classify biopsy material for intraoperative tissue diagnosis of four major brain lesions. Overall, 205 medical images were obtained from squash smear slides of histologically correlated cases, with 18 high‐grade and 11 low‐grade gliomas, 17 metastatic carcinomas, and 9 non‐neoplastic pathological brain tissue samples. The neural network model was trained and evaluated using 5‐fold cross‐validation.

Results

The model achieved 95% and 97% diagnostic accuracy in the patch‐level classification and patient‐level classification tasks, respectively.

Conclusions

We conclude that deep learning‐based classification of cytological preparations may be a promising complementary method for the rapid and accurate intraoperative diagnosis of CNS tumours.
“I think that comes with experience”: A thematic analysis exploring how dental students at a transitional stage of training understand and engage with reflection
Authors: Penlington Chris , Lyttle Ross , Dillon Megan , Ali Adam , Waterhouse Paula
Published: December 2022

Introduction

Reflection is an important skill for dentists but there is little consensus about how reflection can most usefully be integrated into dental education. The aim of this study was to conduct focus groups to explore how students at a transitional point of dental education in one UK dental school had experienced, and conceptualised reflection.

Methods

Students at the beginning of their clinical studies were recruited by email and invited to attend a single focus group. Focus groups were co‐facilitated by a team of staff and student researchers and analysed using thematic analysis. Students acted as research partners in planning a topic guide, recruiting students, conducting focus groups and considering the implications of research findings for the curriculum, and contributed their perspectives to other aspects of the research.

Results

Students primarily associated reflection with their clinical learning and valued the skill highly in this context. They were less familiar with the potential for reflection to support personal development and deeper learning. Themes were identified of learning, uncertainty, emotions and wellbeing, community and challenges and are discussed in detail.

Conclusion

Reflection is highly valued within our dental education setting but many students may be missing out on using it to its' full potential. Changes to the undergraduate curriculum, including offering reflection from an early stage of education may be warranted.
Irrigation effects on elephant grass morphology, and its genotype‐dependent responses
Authors: Ribeiro Robson Elpídio Pereira , de Mello Alexandre Carneiro Leão , da Cunha Márcio Vieira , de Miranda Costa Suellen Brandão , Coelho Janerson José , de Souza Rayanne Thalita de Almeida , dos Santos Mércia Virginia Ferreira
Published: December 2022

This study hypothesised that different elephant grass genotypes respond differently in terms of their morphological development to irrigation. The objective of this study was to evaluate how water availability could affect the morphological development of different genotypes of elephant grass. The treatments consisted of four genotypes of elephant grass [Cenchrus purpureus (Schumach.) Morrone], managed under irrigation or not, during a two‐year field trial. The experiment was arranged in a randomised block design in a split‐plot, with four replicates per treatment (n = 4). Between the genotypes, two of them were classified as tall‐sized (IRI 381 and Elephant B), and two as dwarfs (Taiwan A‐146 2.37 and Mott). A three‐way interaction between season, irrigation, and genotype affected the variables plant height, stem diameter, number of dead tillers, light interception (LI), and leaf area index (LAI) (p < .05). The morphological development of all genotypes was negatively impacted by the dry season. All genotypes grew taller during the rainy season (p < .05) and had a greater light interception (62%–80%) compared to the dry period (28%–59%). The genotype Mott, showed comparable LI and LAI to the tall‐sized genotypes, whilst Taiwan A‐146 2.37 was characterized by the lowest values, despite being the genotype with the greatest tiller density (60 tillers m−2) (p < .05). The use of irrigation mitigated the negative effects of the dry season on the plants, however, the type and size (tall vs. dwarf) of the elephant grass genotypes defined the extent of the responses to the use of the irrigation during the dry period.
Current role of tailored therapy in treating Helicobacter pylori infections. A systematic review, meta‐analysis and critical analysis
Authors: Rokkas Theodore , Ekmektzoglou Konstantine , Graham David Y.
Published: December 2022

Background and Aims

Recent guidelines dictate that all Helicobacter pylori (H. pylori) infected subjects should receive curative therapy. The efficacy of empirical regimens for H. pylori eradication might decline with bacterial, drug, and host factors. The necessity of a tailored therapy still remains controversial. Here we provide a meta‐analysis of the current status of susceptibility‐based (tailored) therapy in which susceptibility‐based therapies were compared to the currently accepted choice of empiric therapy. In this rapidly closing era, neither the susceptibility nor empiric therapies were routinely optimized, such that we report the outcome of comparisons on the efficacy of unoptimized tailored vs. locally preferred empiric treatments.

Methods

PubMed, Medline, and Embase databases were searched using suitable keywords. Individual and pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using the fixed‐ or random‐effects model as appropriate. Heterogeneity was calculated employing the Cochrane Q test and I2 values, whereas the possibility of publication bias was examined by constructing funnel plots. Additionally, subgroup and sensitivity analyses were performed.

Results

Thirty‐four studies were included with a total of 9613 patients. Tailored therapy proved superior to empiric treatment [OR 2.07 (95% CI 1.53–2.79)]. However, tailored therapy achieved eradication rates >90% in only 15 (44%) studies and >95% in only 6 (17.6%).

Conclusions

Although tailored therapy performed better than empiric treatment, the lack of optimization of therapies failed to reliably achieve high cure rates (>90%). These results emphasize that H. pylori infection, like other infectious diseases, should utilize the principles of antimicrobial stewardship in relation to treatment guidance.
Association of Geriatric Emergency Department post‐discharge referral order and follow‐up with healthcare utilization
Authors: Simpson Michelle , Sergi Clinton , Malsch Aaron , Ryer Suzanne , Rubach Christopher , Singh Maharaj
Published: December 2022

Background

Compared with younger adults who receive care in the emergency department (ED), older patients who are discharged home have greater risk of adverse health outcomes. Connecting older adults with outpatient care following ED discharge are among the guidelines of the Geriatric Emergency Department (GED). The objective of this study was to examine the association between referral order placed during the ED visit for older adults and post‐discharge follow‐up to the outcomes of 72‐h ED revisit, 30‐day ED revisit, and 30‐day all cause and unplanned hospital admission.

Methods

We conducted a retrospective cohort study. Ten accredited GEDs within one midwestern health system and all ED encounters of older adults aged 65 years and older who were discharged home from the ED between July 2019 and December 2020 were included. Predictor variables included age, sex, race, ISAR©, ED Length of Stay, post‐ED referral order, and follow‐up.

Results

Among the older adults discharged home from the ED, 17% of older adult encounters had an outpatient referral ordered in the ED, 48.4% attended a follow‐up appointment. Referrals were ordered for 69 referral order types with orthopedic, family practice, and urology referrals as the top 3. In mixed‐effect regression models, compared with older adults with follow‐up, those with a referral order but no follow‐up had 19% higher odds of having a 30‐day ED revisit (OR = 1.19; 95% CI = 1.07–1.31) and 11% higher odds of having 30‐day unplanned hospital admission (OR = 1.11; 95% CI = 0.98–1.26).

Conclusions

Older adults who had an outpatient referral ordered prior to ED discharge and followed up had lower odds of a 30‐day ED revisit and 30‐day subsequent unplanned hospital admission. However, less than half of patients with a referral order attended a follow‐up appointment. Designing interventions for older adults aimed at improving follow‐up after an ED visit is needed.
Barriers to and recommendations for integrating the age‐friendly 4‐Ms framework into electronic health records
Authors: Southerland Lauren T. , Presley Carolyn J. , Hunold Katherine M. , Caterino Jeffrey M. , Collins Courtney E. , Walker Daniel M.
Published: December 2022

Background

The Institute for Healthcare Improvement's 4‐Ms framework of care for older adults recommends a multidisciplinary assessment of a patient's Medications, Mentation, Mobility, and What Matters Most. Electronic health record (EHR) systems were developed prior to this emphasis on the 4‐Ms. We sought to understand how healthcare providers across the healthcare system perceive their EHRs and to identify any current best practices and ideas for improvement regarding integration of the 4‐Ms.

Methods

Anonymous survey of healthcare providers who care for older adults. The survey aimed to evaluate efficiency, error tolerance, and satisfaction (usefulness and likeability). The survey was distributed through organizational list serves that focus on the care of older adults and through social media.

Results

Sixty‐six respondents from all geographic segments of the U.S. (n = 62) and non‐U.S. practices (n = 4) responded. Most (82%) were physicians. Respondents used a range of EHRs and 82% had >5 years of experience with their current EHR. Over half of respondents agreed that their EHR had easy to find contact information (56%) and advance directives. Finding a patient's prior cognitive status (26% agreement), goals of care (24%), functional status (14%), and multidisciplinary geriatric assessments (27%) was more difficult. Only 3% were satisfied with how their EHR handles geriatric syndromes. In free text responses, respondents (79%) described three areas that the EHR assists in the care of older adults: screening tied to actions or orders; advance care planning, and medication alerts or review. Common suggestions on how to improve the EHR included incorporating geriatric assessments in notes, establishing a unified place to review the 4‐Ms, and creating age‐specific best practice alerts.

Conclusions

The majority of healthcare providers were not satisfied with how their EHR handles multidisciplinary geriatric assessment and geriatric care. EHR modifications would aide in reporting, communicating, and tracking the 4‐Ms in EHRs.
The impact of nursing on health outcomes of people receiving medication for opioid use disorder: An integrative review
Authors: Alexander Karen , Smith Jamie M. , Gerolamo Angela , Bernhardt Jean
Published: December 2022

Introduction

This integrative review aimed to understand the impact of nursing on the health outcomes of people with opioid use disorder (OUD).

Methods

Whittemore and Knafl's (2005) integrative review methodology guided the review process. The authors searched PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and OVID databases for peer‐reviewed, English language articles describing nursing care for people receiving medications for OUD. The literature search followed the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) guidelines.

Results

A total of 773 articles were identified through the database searches after duplicates were removed; 15 articles met inclusion criteria and were included in the final review from the United States, Canada, Ireland, England, and the Netherlands. Two themes emerged: (1) The effect of nurse‐led care on patient outcomes and (2) Nursing roles and the environment of care. Studies emphasized the aspects of nursing care that promote patient‐centeredness and patient satisfaction.

Conclusions

The importance of the registered nurse in providing quality care for people receiving medications for OUD is clear from the literature reviewed. The studies in the review highlighted important aspects of the registered nurses' role in affecting outcomes for people receiving medications for OUD including communication and care coordination.

Clinical relevance

This review highlights the need for role delineation and further development of nurse‐sensitive indicators in the OUD treatment setting.
Introduction and overview of radiofrequency treatments in aesthetic dermatology
Authors: Delgado Axel R. , Chapas Anne
Published: December 2022

In this introductory article to this special supplement in radiofrequency (RF), we aim to summarize the scientific foundation of RF therapy and its role in aesthetic dermatology. Monopolar, bipolar, and multipolar RF systems are described in detail, along with the different delivery methods such as stamping, dynamic or continuous movement, fractional, fractionated (FR) needling, and non‐contact devices as well as the minimally invasive platforms that use subdermal probes. The characteristics of different tissues and the technical parameters that influence the effect of RF therapy, such as the penetration of energy, are summarized. This article expands on the various treatment applications for these devices and the mechanism of action behind skin and adipose tissue remodeling, and also discussed are safety concerns, treatment endpoints, and specific considerations when using RF therapy to provide effective treatment outcomes with reduced patient downtime.
Reviewing the employee spinout literature: A cross‐disciplinary approach
Authors: Yeganegi Sepideh , Dass Parshotam , Laplume André O.
Published: December 2022

Increasing research on spinouts highlights the key role that employees play in new business creation, knowledge diffusion, and economic development. However, this research conflicts on many points, including on definitions of key concepts. In this paper, we review the theoretical and empirical literatures on private sector employee spinouts and integrate insights spanning multiple academic disciplines. We address definitional ambiguity and propose a cross‐disciplinary conceptual framework that adequately captures the extant literature on this phenomenon. Doing so allows us to organize the selected academic articles on employee spinouts into six themes: antecedents at the individual, organizational (parent firm), and external environmental levels, and consequences of spinouts for spinout founder(s), parent firms, and external environments. For each theme, we summarize the key research questions, theories, and evidence to date, and refer to potential integration points that could help to expand our knowledge. We conclude our review of each major theme with targeted suggestions for future research.
Cerebral cavernous malformations: Typical and atypical imaging characteristics
Authors: Kuroedov Danila , Cunha Bruno , Pamplona Jaime , Castillo Mauricio , Ramalho Joana
Published: December 2022

Cavernous malformations (CMs) are benign vascular malformations that maybe seen anywhere in the central nervous system. They are dynamic lesions, growing or shrinking over time and only rarely remaining stable. Size varies from a few millimeters to a few centimeters. CMs can be sporadic or familial, and while most of them are congenital, de novo and acquired lesions may also be seen. Etiology is still unknown. A genetic molecular mechanism has been proposed since a cerebral cavernous malformation gene loss of function was found in both familial and sporadic lesions. Additionally, recent studies suggest that formation of CMs in humans may be associated with a distinctive bacterial gut composition (microbioma). Imaging is fairly typical but may vary according to age, location, and etiology. Follow‐up is not well established because CMs patients have a highly unpredictable clinical course. Angiogenic and inflammatory mechanisms have been implicated in disease activity, as well as lesional hyperpermeability and iron deposition. Imaging and serum biomarkers of these mechanisms are under current investigation. Treatment options, including surgery or radiosurgery, are not well defined and are dependent upon multiple factors, including clinical presentation, lesion location, number of hemorrhagic events, and medical comorbidities. Our purpose is to review the imaging features of CMs based on their size, location, and etiology, as well as their differential diagnosis and best imaging approach. New insights in etiology will be briefly considered. Follow‐up strategies, including serum and imaging biomarkers, and treatment options will also be discussed.