bluuebunny/crossref_metadata_2025 huggingface dataset:
299 Impact of a dedicated fracture liaison service candidate ANP on wait times in a geriatrician-led specialist bone health service
Authors: Steen G , Maher N , Fallon N , O'Carroll C , Carragher J , McCarroll K , Lannon R
Published: September 2023

Background

A specialist osteoporosis and bone health service was founded in 2003 in our institution. It sees a range of patients—providing DXA alone to giving specialist opinion on complex cases from all Ireland. Dedicated flow for hip fractures is well established however the advent of the fracture liaison database audit brought challenges providing DXA and reviewing specific acute fractures within the 12 week standard. Fracture liaison services target those who’ve just fractured with the aim of reducing risk of further imminent fracture by screening for osteoporosis and initiating bone protection measures.

Methods

Wait times for unselected direct review in the nurse led pre-assessment clinic with DXA were compared to the direct identification, review of DXA and subsequent follow up if indicated by a newly appointed candidate ANP (cANP).

Results

Average wait time for initial review of acute Colles/vertebral/humeral fractures prior to the cANP appointment was 10 months with further waits for consultant led bone clinic. Following the cANP appointment 318 relevant fractures were identified from September 2022 to May 2023. A 3 month lag was applied. Initial DXA took place on average 10 weeks post fracture (range 2–24). After this 169 patients were discharged back to GP with recommendations as scores above −2.0 on DXA as per locally agreed protocol for fractures and osteopenia; 111 seen in FLS by cANP for detailed assessment including bloods and risk factor review under supervision of their clinical mentor. 6 have not attended; the remainder await review. Average time from fracture to review by cANP is already 18 weeks.

Conclusion

Appointment of a dedicated cANP for fracture liaison has already streamlined bone health assessment for acute fractures attending our hospital as well as freed appointments in the specialist bone service. As the FLS service establishes we expect to reach the 12 week target consistently.
302 The educational experiences and perceived educational needs of multidisciplinary healthcare professionals in advanced care planning: a focus group study
Authors: Gannon E , Foley T , Creed S
Published: September 2023

Background

Advanced Care Planning (ACP) is the process by which patients, their families and healthcare professionals discuss and document patient preferences regarding future healthcare decisions if an individual loses decision making capacity regarding their care. ACP has been shown to reduce hospitalisations, admission to the intensive care unit, and increase patient and family satisfaction with medical care. Despite the benefits of quality ACP, healthcare professionals continue to report inadequate training and knowledge in this area. Using multidisciplinary healthcare professional focus groups, we intended to gather descriptions from different disciplines about their educational experiences in ACP both formal and informal, and their perceived educational needs.

Methods

We used a qualitative focus group methodology consisting of six focus groups in total. Two focus groups of each discipline were carried out—medical, nursing, Health and Social Care Practitioners (HSCPs) working in an acute tertiary hospital. We sought to explore the differing perspectives of multidisciplinary healthcare professionals’ involvement with ACP, their educational experiences, unique educational needs, and how multidisciplinary learning could be supported. Thematic analysis was used to analyse the findings.

Results

There was familiarity of ACP among multidisciplinary healthcare professionals, and a consensus that varied disciplines could have a role in ACP. Participants described a lack of formal education in ACP, with skills developed through informal means primarily through experience and learning from more senior colleagues. Concerns regarding the legal aspects of ACP was commonly stated as an educational need, as were communication skills, and ACP frameworks. Time was a perceived barrier to education in ACP, as well as lack of resources.

Conclusion

With the enactment of the Assisted Decision-Making Act formal education in advanced care planning and advanced health care directives is essential. This education should be multidisciplinary and needs to consider the perceived educational needs of its intended learners.
Silicone Shell Breast Implants in Patients Undergoing Risk-Reducing Mastectomy With a History of Breast-Conserving Surgery and Adjuvant Radiotherapy: A Long-term Study
Authors: Couto-González Ivan , Fernández-Marcos Adrián Ángel , Brea-García Beatriz , González-Giménez Nerea , Canseco-Díaz Francisco , García-Arjona Belén , Mato-Codesido Cristina , Taboada-Suárez Antonio
Published: September 2023

Background

Indications for breast-conserving surgery and adjuvant radiotherapy (BCSAR) in patients with breast carcinoma are increasing, as are indications for risk-reducing mastectomy (RRM) in healthy subjects. Most of these cases are reconstructed with silicone shell breast implants (SSBIs).

Objectives

The aim of this work was to study complications of SSBIs in breast reconstruction in patients undergoing RRM with previous BCSAR.

Methods

A prospective cohort study was designed. The study group included cases of RRM reconstructed with SSBI in patients who had previously undergone BCSAR in the same breast. The control group consisted of patients with high-risk breast cancer who had undergone RRM and immediate SSBI reconstruction without previous BCSAR.

Results

There was a history of BCSAR in 15.8% of cases. The first SSBI used in immediate reconstruction after RRM was replaced in 51.5% of cases with a mean [standard deviation] survival of 24.04 [28.48] months. BCSAR was significantly associated with pathological capsular contracture (P = .00) with this first SSBI (37.5% vs 5.9%). Of the cases requiring the replacement of the first SSBI, 44.23% suffered failure of the second SSBI, with a mean survival of 27.95 [26.53] months. No significant association was found between the consecutive development of capsular contracture in the second SSBI and a previous history of BCSAR (P = .10).

Conclusions

BCSAR prior to RRM reconstructed with an SSBI is associated with a significant increase in pathological capsular contracture. Patients should be warned of the high rate of SSBI complications and reconstruction failure. Polyurethane-coated implants may provide an alternative in cases in which alloplastic reconstruction is considered in patients with previous BCSAR.

Level of Evidence: 3
Early-life behavior, survival, and maternal personality in a wild marsupial
Authors: Menário Costa Weliton , King Wendy J , Bonnet Timothée , Festa-Bianchet Marco , Kruuk Loeske E B
Published: September 2023

Individual behavior varies for many reasons, but how early in life are such differences apparent, and are they under selection? We investigated variation in early-life behavior in a wild eastern gray kangaroo (Macropus giganteus) population, and quantified associations of behavior with early survival. Behavior of young was measured while still in the pouch and as subadults, and survival to weaning was monitored. We found consistent variation between offspring of different mothers in levels of activity at the pouch stage, in flight initiation distance (FID) as subadults, and in subadult survival, indicating similarity between siblings. There was no evidence of covariance between the measures of behavior at the pouch young versus subadult stages, nor of covariance of the early-life behavioral traits with subadult survival. However, there was a strong covariance between FIDs of mothers and those of their offspring tested at different times. Further, of the total repeatability of subadult FID (51.5%), more than half could be attributed to differences between offspring of different mothers. Our results indicate that 1) behavioral variation is apparent at a very early stage of development (still in the pouch in the case of this marsupial); 2) between-mother differences can explain much of the repeatability (or “personality”) of juvenile behavior; and 3) mothers and offspring exhibit similar behavioral responses to stimuli. However, 4) we found no evidence of selection via covariance between early-life or maternal behavioral traits and juvenile survival in this wild marsupial.
E-values as unnormalized weights in multiple testing
Authors: Ignatiadis Nikolaos , Wang Ruodu , Ramdas Aaditya
Published: September 2023

We study how to combine p-values and e-values, and design multiple testing procedures where both p-values and e-values are available for every hypothesis. Our results provide a new perspective on multiple testing with data-driven weights: while standard weighted multiple testing methods require the weights to deterministically add up to the number of hypotheses being tested, we show that this normalization is not required when the weights are e-values that are independent of the p-values. Such e-values can be obtained in meta-analysis where a primary dataset is used to compute p-values, and an independent secondary dataset is used to compute e-values. Going beyond meta-analysis, we showcase settings wherein independent e-values and p-values can be constructed on a single dataset itself. Our procedures can result in a substantial increase in power, especially if the nonnull hypotheses have e-values much larger than one.
Global epidemiology of atopic dermatitis: a comprehensive systematic analysis and modelling study
Authors: Tian Jingru , Zhang Dingyao , Yang Yi , Huang Yaqing , Wang Lu , Yao Xu , Lu Qianjin
Published: September 2023

Background

Atopic dermatitis (AD) is the leading cause of the global burden from skin disease; no study has provided global and country-specific epidemiological estimates of AD.

Objectives

To quantify global, regional and country-specific estimates of the epidemiology of AD.

Methods

A comprehensive search for epidemiological studies in AD was conducted in four electronic databases (PubMed, Embase, Web of Science and China National Knowledge Infrastructure). A Bayesian hierarchical linear mixed model was constructed to calculate epidemiological estimates of AD considering the heterogeneity of regions, countries, type of diagnoses and age strata.

Results

In total, 344 studies met the inclusion criteria. Incidence varied substantially with the location and age of the surveyed participants. The global prevalence of AD and the population affected by AD were estimated to be 2.6% [95% uncertainty interval (UI) 1.9–3.5] and 204.05 million people, respectively. Around 101.27 million adults and 102.78 million children worldwide have AD, corresponding to prevalence rates of 2.0% (95% UI 1.4–2.6) and 4.0% (95% UI 2.8–5.3), respectively. Females were more likely to suffer from AD than males: the global prevalence of AD in females was 2.8% (95% UI 2.0–3.7%) and affected 108.29 million people, while in males the corresponding estimates were 2.4% (95% UI 1.7–3.3%) and 95.76 million people.

Conclusions

Epidemiological AD data are lacking in 41.5% of countries worldwide. The epidemiology of AD varies substantially with age and sex and is distributed unequally across geographical regions.
Evaluating the usefulness of the Atopic Dermatitis Control Tool for assessing disease control in individuals with atopic dermatitis in Japan
Authors: Nakahara Takeshi , Fujita Hiroyuki , Tajima Yuki , Arima Kazuhiko
Published: September 2023

An online questionnaire assessed atopic dermatitis (AD)-related patient-reported outcome measures [including the Atopic Dermatitis Control Tool (ADCT)] in 5546 patients with AD. Spearman’s rank correlation coefficients showed that total ADCT scores had strong correlations with established AD assessment tools (including the DLQI, POEM and WI-NRS). ADCT subitem scores also had moderate correlations with the other AD assessment tools, except for Q4 (sleep) with the Global Questions assessment tool. This demonstrates that ADCT scores can effectively characterize multidimensional AD disease burden.
Angiosarcoma in the breast: a population-based cohort from Sweden
Authors: Olander Susanne , Wennstig Anna-Karin , Garmo Hans , Holmberg Lars , Nilsson Greger , Blomqvist Carl , Karlsson Fredrik , Wickberg Åsa , Wärnberg Fredrik , Sund Malin , Wadsten Charlotta
Published: September 2023

Background

Breast angiosarcoma is a rare disease mostly observed in breast cancer (BC) patients who have previously received radiotherapy (RT). Little is known about angiosarcoma aetiology, management, and outcome. The study aim was to estimate risk and to characterize breast angiosarcoma in a Swedish population-based cohort.

Methods

The Swedish Cancer Registry was searched for breast angiosarcoma between 1992 and 2018 in three Swedish healthcare regions (population 5.5 million). Information on previous BC, RT, management, and outcome were retrieved from medical records.

Results

Overall, 49 angiosarcomas located in the breast, chest wall, or axilla were identified, 8 primary and 41 secondary to BC treatment. Median age was 51 and 73 years, respectively. The minimum latency period of secondary angiosarcoma after a BC diagnosis was 4 years (range 4–21 years). The cumulative incidence of angiosarcoma after breast RT increased continuously, reaching 1.4‰ after 20 years. Among 44 women with angiosarcoma treated by surgery, 29 developed subsequent local recurrence. Median recurrence-free survival was 3.4 and 1.8 years for primary and secondary angiosarcoma, respectively. The 5-year overall survival probability for the whole cohort was 50 per cent (95 per cent c.i., 21 per cent–100 per cent) for primary breast angiosarcoma and 35 per cent (95 per cent c.i., 23 per cent–54 per cent) for secondary angiosarcoma.

Conclusion

Breast angiosarcoma is a rare disease strongly associated with a history of previous BC RT. Overall survival is poor with high rates of local recurrences and distant metastasis.
Mental health interventions for atopic dermatitis: knowledge gaps, pilot programmes and future directions
Authors: Chatrath Sheena , LeBovidge Jennifer , Jack Carolyn , Abuabara Katrina , Schneider Lynda C , Capozza Korey , Kelley Keri , Silverberg Jonathan I
Published: September 2023

Atopic dermatitis (AD) is associated with high levels of psychosocial burden, often resulting in poor mental health outcomes. Despite this association, few studies have evaluated the efficacy of mental health interventions within this population. Utilization of multidisciplinary and peer-led support, in addition to equipping patients with psychological tools, may be beneficial in improving mental health outcomes. Future research is needed to determine which interventions and formats are desired by, effective in and accessible to patients and caregivers with AD.
Effects of probiotic supplementation in adult with atopic dermatitis: a systematic review with meta-analysis
Authors: Husein-ElAhmed Husein , Steinhoff Martin
Published: September 2023

Background

Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases. The effect of probiotic administration on the severity of AD in adults has shown inconsistent results.

Objectives

To determine the effectiveness of probiotic supplementation as a therapeutic tool for adult AD.

Methods

PubMed, Scopus and Embase were systematically searched to collect data from studies in which probiotics were administered to treat adult AD.

Results

Out of 413 publications, 9 papers were included in the meta-analysis. Significant differences in the ScORing Atopic Dermatitis tool favouring probiotics were observed [relative risk (RR) –5.93, 95% confidence interval (CI) –8.43 to –3.43]. Lactobacillus salivarius presented with largest effect size (RR –9.79, 95% CI –13.04 to –6.54), followed by L. acidophilus (RR –5.77, 95% CI –10.82 to –0.72) and L. plantarum (RR –3.76, 95% CI –6.36 to –1.16). No benefit was observed with L. fermentum. Based on the severity of AD, probiotics showed better results in people with moderate-to-severe AD (RR –9.12, 95% CI –12.17 to –6.08) than in individuals with mild disease (RR –2.67, 95% CI –4.67 to –0.66). Serum levels of IgE and eosinophil count remained significantly unchanged after the probiotic intervention (RR 0.25, 95% CI –0.10 to 0.60; RR –0.27, 95% CI –0.68 to 0.13, respectively).

Conclusions

Current evidence supports a role for some probiotics as a therapeutic tool for the treatment of adult AD, particularly in patients with severe AD. The efficacy of probiotics is strain specific, with L. salivarius and L. acidophilus having the largest clinical benefit. Such benefit is apparently independent of IgE levels and eosinophil count. Despite these encouraging results, the decrease in AD severity did not translate into a clinically meaningful better quality of life as assessed by the Dermatology Life Quality Index. There currently is not enough reliable data to reach conclusions about the optimal dose and duration for probiotic treatment.
Applications of Artificial Intelligence in Urinalysis: Is the Future Already Here?
Authors: De Bruyne Sander , De Kesel Pieter , Oyaert Matthijs
Published: September 2023

Background

Artificial intelligence (AI) has emerged as a promising and transformative tool in the field of urinalysis, offering substantial potential for advancements in disease diagnosis and the development of predictive models for monitoring medical treatment responses.

Content

Through an extensive examination of relevant literature, this narrative review illustrates the significance and applicability of AI models across the diverse application area of urinalysis. It encompasses automated urine test strip and sediment analysis, urinary tract infection screening, and the interpretation of complex biochemical signatures in urine, including the utilization of cutting-edge techniques such as mass spectrometry and molecular-based profiles.

Retrospective studies consistently demonstrate good performance of AI models in urinalysis, showcasing their potential to revolutionize clinical practice. However, to comprehensively evaluate the real clinical value and efficacy of AI models, large-scale prospective studies are essential. Such studies hold the potential to enhance diagnostic accuracy, improve patient outcomes, and optimize medical treatment strategies. By bridging the gap between research and clinical implementation, AI can reshape the landscape of urinalysis, paving the way for more personalized and effective patient care.
Evolution of the viral genomes of SARS-CoV-2 in association with the changes in local condition: a genomic epidemiological study of a suburban city of Japan
Authors: Kashima Yukie , Mizutani Taketoshi , Okimoto Yuki , Maeda Minami , Musashino Kaoru , Nishide Ryo-ichi , Matsukura Akira , Nagase Jison , Suzuki Yutaka
Published: September 2023

Understanding the factors driving the spread and evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at the local, regional, national, and international levels is important in protecting against future pandemics. By exploring their viral genomes, we attempted to analyse the spread of SARS-CoV-2 and its evolutionary convergence in Kashiwa City, as an example of a representative commuter town in Japan. From September 2020 to January 2023, a total of 47,134 nasopharyngeal swab and saliva specimens were collected from patients in 47 local clinics and hospitals, covering the vast majority of healthcare facilities. All SARS-CoV-2-positive samples were subjected to whole genome sequencing. Based on the analysis of 5,536 identified genomes, all major strains were represented. Unique regional mutations were occasionally identified in each strain. Inspection of these mutations revealed that the overall base substitution rate increased with progressive waves of the pandemic, at an overall rate of 2.56 bases/year. Interestingly, the spread and evolutionary patterns appeared to be distinct between regions and between individual clinics. Further analysis of the synonymous base substitution rate showed that the speed of viral evolution accelerated coincident with the beginning of public vaccination. Comprehensive genomic epidemiological studies, as presented here, should be useful in precisely understanding the pandemic and preparing for possible future pandemics.
Deliberate Surrender? The Impact of Interwar Indian Protection
Authors: Arthi Vellore , Lampe Markus , Nair Ashwin , O’Rourke Kevin Hjortshøj
Published: September 2023

What is the role of trade policy in promoting intra-Empire trade? We address the question in the context of interwar India, whose trade policies have been accused of harming British export interests. We quantify the impact of trade policy on the value and composition of Indian imports, using novel disaggregated data on both trade policies and imports for 114 commodity categories coming from 42 countries. We find that, even though Indian protection lowered total imports, it substantially boosted imports from the United Kingdom. Despite the rising tariff barriers facing British exporters, trade diversion from other countries ensured that Indian trade policy benefited them overall.
Moodle as online platform for cardiac nurses’ competency: nursing staff experiences
Authors: El-Khatib Mohamed , Helmy Ibrahim , Eltayyeb Mahmoud
Published: September 2023

Background

Aswan Heart Centre competency project were started in 2017, nurse’s competency were tillered and implemented within the nursing units.

Self-assessment and preceptor grading ideationally to constrictive comment should be documented in the competency tool for every staff, was no unified way to keep tracking these documentations and very hard to secure the hard copy.

Aim

Is to establish an online platform where the competencies are accessible and high secured that also controls and facilitates the use of nursing competencies.

Process

Moodle as a cloud-based learning management system (LMS) selected to be the new Online competency platform. Moodle expert were contacted by the nursing education department to assist and support the process. Online could server to host and upload the platform were established by the information technology department. After competencies and users uploaded pilot phase were started to identify the gap in the Moodle platform. After 4 months of use survey were conducted to get a clear view from the staff.

Data analysis

Most of the staff were satisfied about Moodle use, but the form still need farther support from the information technology department to host the Moodle cloud in stable server to avoid the browser render.

Recommendation

The use of cloud-based learning management system like Moodle will maintain the easy accessibility and the high security of the data also will facilitate the data audit for further plans.
Comparison of in-hospital outcomes and complications of leadless pacemaker and traditional transvenous pacemaker implantation
Authors: Alhuarrat Majd Al Deen , Kharawala Amrin , Renjithlal Sarath , Magdi Eid Mohamed , Varrias Dimitrios , Mohammed Moghniuddin , Grushko Michael , Di Biase Luigi
Published: September 2023

Aims

Since their introduction in 1958, traditional cardiac pacemakers have undergone considerable upgrades over the years, but they continue to have a complication rate of ∼3.8%–12.4%. There are no randomized controlled trials comparing outcomes of leadless pacemakers (LPM) with single-chamber transvenous pacemakers (TV-VVI). The aim is to assess the differences in the procedural complications and in-hospital outcomes between LPM and TV-VVI implants.

Methods and results

We queried the national inpatient database from 2016 to 2019 to include adult patients undergoing LPM and TV-VVI. Admissions for leadless and single-lead transvenous pacemakers were identified by their appropriate ICD-10 codes. Complications were identified using ICD-10 codes that mostly represent initial encounter. The difference in outcomes was assessed using multivariable logistic regression and 1:1 propensity score matching between the two cohorts. Thirty-five thousand four hundred thirty expanded samples of admissions were retrieved of which 27 650 (78%) underwent TV-VVI with a mean age 81.3 ± 9.4 years and 7780 (22%) underwent LPM with a mean age of 77.1 ± 12.1 years. The LPM group had a higher likelihood of in-hospital mortality [adjusted odds ratio (aOR): 1.63, 95% CI (1.29–2.05), P < 0.001], vascular complications [aOR: 7.54, 95% CI (3.21–17.68), P < 0.001], venous thromboembolism [aOR: 3.67, 95% CI (2.68–5.02), P < 0.001], cardiac complications [aOR: 1.79, 95% CI (1.59–2.03), P < 0.001], device thrombus formation [aOR: 5.03, 95% CI (2.55–9.92), P < 0.001], and need for a blood transfusion [aOR: 1.54, 95% CI (1.14–2.07), P < 0.005]. The TV-VVI group had higher likelihood of in-hospital pulmonary complications [aOR:0.68, 95% CI (0.54–0.87), P < 0.002] and had a need for device revisions [aOR:0.42, 95% CI (0.23–0.76), P < 0.004].

Conclusion

There is a higher likelihood of all-cause in-hospital mortality and complications following LPM implantation in comparison to TV-VVI. This could be related to higher co-morbidities in the LPM group. Clinical trials aimed to accurately compare these two groups should be undertaken.
Cardiac muscle–restricted partial loss of Nos1ap expression has limited but significant impact on electrocardiographic features
Authors: Smith Alexa , Auer Dallas , Johnson Morgan , Sanchez Ernesto , Ross Holly , Ward Christopher , Chakravarti Aravinda , Kapoor Ashish
Published: September 2023

Genome-wide association studies have identified sequence polymorphisms in a functional enhancer of the NOS1AP gene as the most common genetic regulator of QT interval and human cardiac NOS1AP gene expression in the general population. Functional studies based on in vitro overexpression in murine cardiomyocytes and ex vivo knockdown in zebrafish embryonic hearts, by us and others, have also demonstrated that NOS1AP expression levels can alter cellular electrophysiology. Here, to explore the role of NOS1AP in cardiac electrophysiology at an organismal level, we generated and characterized constitutive and heart muscle–restricted Nos1ap knockout mice to assess whether NOS1AP disruption alters the QT interval in vivo. Constitutive loss of Nos1ap led to genetic background-dependent variable lethality at or right before birth. Heart muscle–restricted Nos1ap knockout, generated using cardiac-specific alpha-myosin heavy chain promoter-driven tamoxifen-inducible Cre, resulted in tissue-level Nos1ap expression reduced by half. This partial loss of expression had no detectable effect on the QT interval or other electrocardiographic and echocardiographic parameters, except for a small but significant reduction in the QRS interval. Given that challenges associated with defining the end of the T wave on murine electrocardiogram can limit identification of subtle effects on the QT interval and that common noncoding NOS1AP variants are also associated with the QRS interval, our findings support the role of NOS1AP in regulation of the cardiac electrical cycle.
S
Hmax orientation in the Alpine region from observations of stress-induced anisotropy of nonlinear elasticity
Authors: Aiman Y A , Delorey A A , Lu Y , Bokelmann G
Published: September 2023

The orientation of SHmax is commonly estimated from in situ borehole breakouts and earthquake focal mechanisms. Borehole measurements are expensive, and therefore sparse, and earthquake measurements can only be made in regions with many well-characterized earthquakes. Here, we derive the stress-field orientation using stress-induced anisotropy in nonlinear elasticity. In this method, we measure the strain derivative of velocity as a function of azimuth. We use a natural pump-probe (NPP) approach which consists of measuring elastic wave speed using empirical Green’s functions (probe) at different points of the earth tidal strain cycle (pump). The approach is validated using a larger data set in the Northern Alpine Foreland region where the orientation of maximum horizontal compressive stress is known from borehole breakouts and drilling-induced fractures. The technique resolves NNW-SSW to N-S directed SHmax which is in good agreement with conventional methods and the recent crustal stress model. We confirm that the NPP method can be applied to dense large-scale seismic arrays. The technique is then applied to the Southern Alps to understand the contemporary stress pattern associated with the ongoing deformation due to counterclockwise rotation of the Adriatic plate with respect to the European plate. Our results explain why the two major faults in Northeastern Italy, the Giudicarie Fault and the Periadriatic Line (Pustertal–Gailtal Fault) are currently inactive, while the currently acting stress field allows faults in Slovenia to deform actively. We have demonstrated that the pump-probe method has the potential to fill in the measurement gap left by conventional approaches, both in terms of regional coverage and in depth.
Creating healthy food environments in recreation and sport settings using choice architecture: a scoping review
Authors: Prowse Rachel , Lawlor Natasha , Powell Rachael , Neumann Eva-Marie
Published: September 2023

Recreation and sport settings (RSS) are ideal for health promotion, however, they often promote unhealthy eating. Choice architecture, a strategy to nudge consumers towards healthier options, has not been comprehensively reviewed in RSS and indicators for setting-based multi-level, multi-component healthy eating interventions in RSS are lacking. This scoping review aimed to generate healthy food environment indicators for RSS by reviewing peer-reviewed and grey literature evidence mapped onto an adapted choice architecture framework. One hundred thirty-two documents were included in a systematic search after screening. Data were extracted and coded, first, according to Canada’s dietary guideline key messages, and were, second, mapped onto a choice architecture framework with eight nudging strategies (profile, portion, pricing, promotion, picks, priming, place and proximity) plus two multi-level factors (policy and people). We collated data to identify overarching guiding principles. We identified numerous indicators related to foods, water, sugary beverages, food marketing and sponsorship. There were four cross-cutting guiding principles: (i) healthy food and beverages are available, (ii) the pricing and placement of food and beverages favours healthy options, (iii) promotional messages related to food and beverages supports healthy eating and (iv) RSS are committed to supporting healthy eating and healthy food environments. The findings can be used to design nested, multipronged healthy food environment interventions. Future research is needed to test and systematically review the effectiveness of healthy eating interventions to identify the most promising indicators for setting-based health promotion in RSS.
Harnessing citizen science in health promotion: perspectives of policy and practice stakeholders in Australia
Authors: Laird Yvonne , Marks Leah , Smith Ben J , Walker Pippy , Garvey Kate , Jose Kim , O’Rourke Sean , Pontifex Katherine , Wardle Karen , Rowbotham Samantha
Published: September 2023

Citizen science is rapidly gaining momentum as a means of involving members of the public in research and decision-making in disease prevention and health promotion. However, citizen science projects have predominantly been led by academic researchers and there is limited understanding of how to support the application of citizen science approaches in policy and practice settings. This study aimed to understand the perceptions, motivations and early experiences of applying citizen science approaches in policy and practice settings. Semi-structured interviews were conducted with policy and practice stakeholders who were leading citizen science projects (project partners, n = 7), and their implementation partners (project implementers, n = 11). Participants viewed citizen science as an opportunity to access hard-to-reach data and to enhance engagement with community members to support policy and practice change. Barriers and facilitators of citizen science in policy and practice settings included navigating collaborative relationships, team capacity and resources available to deliver projects, recruitment and engagement of citizen scientists and ethical considerations in the design and implementation of citizen science projects. Findings support the feasibility and wider application of citizen science approaches in health promotion and are being used to inform the development of tools and resources to build capacity in these approaches in policy and practice settings.
A qualitative study of children’s experiences with school-based divorce groups led by teachers in Denmark
Authors: Rose Pernelle , Ness Ottar
Published: September 2023

New interventions are offered to children of divorced parents in Danish schools. Establishing conversation groups can be seen as part of this overall effort to increase pupils’ well-being. This new practice leads to new professional challenges when teachers facilitate group processes and call for in-depth studies of children’s own perspectives on their participation in these interventions. This article is based on ethnographic fieldwork and asks the following research question: ‘How do children make sense of the professionals’ double role as both group leader and teacher when facilitating the conversation-groups in schools?’ The study draws on 23 interviews with children and observations in four conversation groups in Denmark. Theory of social representations is used as an analytical tool to explore the dilemmas of school interventions for children of divorced parents. The analysis presents three dominant themes: the group leader’s problematic double role, balancing the duty of confidentiality and trusting the group members. The analysis shows that children struggle to express feelings about their home situation in the school context. The importance of balancing the duty of confidentiality as a group leader is clearly reflected as a key factor, seen from the perspective of the child.
Interpreting Strategy
Authors: Mackay Dave , Arevuo Mikko , Meadows Maureen
Published: September 2023

This chapter introduces strategy, which is a mainstay in the management of
organizational, civic, and personal life. It is rare to find an organization that
doesn't have a strategy either explicitly or implicitly. It looks at industrial
strategies at a country level that are intended to grow economies and increase
productivity of nations, citing companies that vie to help with the development of
personal financial strategies to save for later life. The chapter reviews the role
of political strategies in determining the outcome of elections and influencing
public opinion. This is becoming increasingly important. It explores how strategy
can be interpreted in many ways according to the experience and perspective of
individuals.
The sustainable strategic organization
Authors: Mackay Dave , Arevuo Mikko , Meadows Maureen
Published: September 2023

This chapter talks about how strategists can build knowledge of internal
organizational context as an aid to effective strategizing. It considers the
difference between organizational purpose and organizational direction and how these
concepts matter to those managing strategy. The chapter then looks at shareholders
and stakeholders, their sometimes conflicting interests and raises the question of
who the organization serves. The chapter then moves on to discuss sustainability,
its influence on strategy and whether it can be considered a megatrend that is
shaping how we do business. From a process-practice perspective, sustainability is
considered as a feature of the macro-context that will increasingly drive
strategizing episodes in the future.
External Environment
Authors: Mackay Dave , Arevuo Mikko , Meadows Maureen
Published: September 2023

This chapter argues that individuals and organizations do not exist in a vacuum but
are embedded in relationships, systems, and structures that inform and constrain
their activity and which are, in turn, sustained or changed by organizational
activity. It examines methods and theories that can be used to build an
understanding of the external context. It considers how the external context
influences and is influenced by strategy activities now and in the future. The
chapter highlights the market-based view (MBV), also known as the outside-in
approach, which is a well-known theoretical perspective in strategy literature, and
an ecosystems perspective, which is a contemporary view of an external context in
which organizations are an active part.
Internal Environment
Authors: Mackay Dave , Arevuo Mikko , Meadows Maureen
Published: September 2023

This chapter talks about resources and capabilities: what an organization has
available to use, and what it can do with those resources. The chapter is focused on
exploring theories and methods that can assist managers in building their knowledge
of resources and capabilities, and crucially, the options that are available to
improve the effectiveness of how resources are deployed through activity. These
considerations are part of the internal context. It emphasizes how distinctive
resources might enable competitive advantage using what is known as the
resource-based view (RBV). This discussion is then extended to include the dynamic
capabilities view. The chapter includes an analysis of several key tools that
managers can use, including: VRIO analysis, capability audit, dynamic capability
analysis, and value chain analysis. The chapter concludes by critically assessing
the value of internally focused analytical tools in strategy work.
Functional Strategy and Performance
Authors: Mackay Dave , Arevuo Mikko , Meadows Maureen
Published: September 2023

This chapter discusses strategic management which often focuses on the level of the
corporate, or the whole organization. However, strategizing can occur within
different elements of an organization. In this context, the goals and activities of
the rest of the organization form part of the context influencing what people do in
relation to strategy. The chapter refers to the application of the dynamic
frameworks of strategy which involves practitioners that make and realize decisions
on specific functional concerns. The chapter considers the functional strategies
which, particularly in medium and large organizations, will need to be in place to
support the organizational strategy and help to ensure that it is delivered as
intended. It recognizes functional strategy as the organizational strategies and
plans prepared for various functional areas of the organization, such as financial
strategy, human resources management (HRM) strategy, marketing strategy, operations
strategy, and information technology (IT) strategy.
Strategies for Growth
Authors: Mackay Dave , Arevuo Mikko , Meadows Maureen
Published: September 2023

This chapter reviews strategies for growth, establishing a distinction between
corporate strategy and competitive strategy. Corporate strategy occurs at a higher
level than business or competitive strategy; it involves choices such as which
industries, markets, or segments an organization should compete in, and whether and
how an organization should collaborate with another organization. The chapter also
mentions how organizations reach a point in their development or life cycle when
they want to consider whether and how to expand, which may be about a desire to
increase profits, or to serve more clients. The chapter addresses some classic
questions of corporate strategy and highlights the role of the ‘corporate parent’ in
supporting strategy. This is often an important corporate strategy issue, as the
‘headquarters’ of a large organization is typically responsible for high-level
decisions around what business the organization participates in.
Competing in a Globalized World
Authors: Mackay Dave , Arevuo Mikko , Meadows Maureen
Published: September 2023

This chapter highlights global strategy development. Traditionally, companies built
their international presence gradually, taking their best products and services to
markets where foreign customers share similar needs and characteristics as the home
market customers. With the increasing connectivity and digitization of business,
some firms, both small and large, are beginning to explore new ways of launching
international ventures. The chapter asserts that business-model-grounded
globalization will increase compared with the more traditional product- and
service-led global expansion. The chapter describes traditional multinational
enterprises (MNEs) that have become global entities and developed their
international operations over decades. Examples of MNEs include firms such as
Siemens, Toyota, and Rolls-Royce Engines, among many other well-known
enterprises.
Leading Strategic Change Initiatives
Authors: Mackay Dave , Arevuo Mikko , Meadows Maureen
Published: September 2023

This chapter talks about leading strategic change initiatives within an
ever-changing environment, wherein organizations need to be able to manage and
reconcile their current activities to protect their current market position while
simultaneously adapting to the future. Any adaptation from the way the organization
operates currently will entail change, and any change is bound to encounter
resistance. The chapter refers to the composition of organizations of people that
are highly resistant to any change in their routines as well as protective of their
positions, spheres of influence, and power. The chapter shows how strategists can
approach the strategic change management process in organizations as a consequence
of the changes in the external environment. It reviews the concept of organizational
ambidexterity, the tension between managing for the short term within the current
competitive environment while at the same time developing longer-term organizational
capabilities to be able to compete successfully in the future.
Strategic Leadership for an Ever-Changing World
Authors: Mackay Dave , Arevuo Mikko , Meadows Maureen
Published: September 2023

This chapter explains how strategy happens through the actions and interactions of
practitioners and stakeholders. People's history, skills, relationships, and
motivations shape strategy outcomes to the extent that they are included and engaged
in strategy activity. It identifies and explores the concept of leadership, looking
in specific depth at strategic leadership. It examines the challenges of strategic
leadership in a global contemporary context and considers ways of building strategic
leadership capacities.
Exploring Leadership
Authors: Bolden Richard , Gosling Jonathan , Hawkins Beverley
Published: September 2023

Exploring Leadership aims to support the personal and professional development of both aspiring and experienced leaders. Investigating the complex dynamics of power, identity, and purpose in organizations and wider society, it critically examines significant global issues such as diversity and inclusion, the environmental crisis, and the recent Covid-19 pandemic to reveal the systemic nature of leadership in a complex and ever-changing world. Examples and case studies include: ancestral leadership in Maori communities; consideration of Ukrainian president Volodymyr Zelensky as a transformational leader; and leadership paradoxes in the Singaporean Civil Service. The book is made up of five parts. The first part is concerned with framing leadership and the leader. The second part looks at leadership traits, styles, and the dynamics of leadership. The next part is about leadership within the organization. The fourth part is about ethics and alternatives to leaderships. The final part looks at emerging perspectives and enduring dilemmas. The final question is, where next for leadership theory and practice?
Introduction: Exploring leadership
Authors: Bolden Richard , Gosling Jonathan , Hawkins Beverley
Published: September 2023

This introductory chapter provides an overview of how this book contributes to the already vast literature on leadership theory and practice. It outlines the changing perspectives on how leadership has been conceptualized and researched, including the common distinction between leadership and management. The chapter then considers why it is an 'essentially contested' concept. Understanding why the topic of ‘leadership’ has proven so hard to pin down is a key step towards developing a richer, more nuanced appreciation and understanding of what can be done to improve leadership practice as individuals, in organizations and in societies. The chapter concludes with a call to 'reframe' leadership in terms of the relative focus on individual and collective approaches; the ways in which we recognize, reward, and develop leaders and leadership; and methodologies and approaches for studying and researching leadership.
Leadership traits, styles, and competencies
Authors: Bolden Richard , Gosling Jonathan , Hawkins Beverley
Published: September 2023

This chapter focuses on leadership as an individual phenomenon. It explores how leadership can be understood as the property of an individual's traits (their psychological make-up), skills (their capacities in different kinds of activity), and competencies (the success or otherwise of their behaviour in context). The chapter then looks at different ‘styles’ of leadership, focusing on the metaphors describing the patterns of behaviour associated with individual leaders (teachers, stewards, and designers). It also considers leadership skills and competencies—what they are and what they might become, as well as limitations to this approach. Finally, the chapter discusses the skills and behaviours of effective ‘followers’ and the similarities these bear to those of ‘leaders’.
Gender and Inclusion, Digital Disruption, and Ethics
Authors: Bolden Richard , Gosling Jonathan , Hawkins Beverley
Published: September 2023

This chapter begins by exploring the relationship between gender and leadership and what can be done to create more inclusive environments where people are supported and encouraged to contribute to leadership no matter what their demographic characteristics or background. It argues that systemic inequalities continue to privilege particular forms of ‘leadership’ and not others and that in order to make progress on these issues we need to fundamentally shift narratives, culture, and expectations. The chapter then considers the impact of digital transformation on leadership and both the opportunities and challenges this poses. It concludes by returning to the question of ethics and the fundamental and enduring dilemmas this poses around practicing and developing ‘good’ leadership. Arguably, many large corporations have the potential to negatively impact on the democratic process and calls are increasing for responsible and ethical leadership in all areas of business and society.
Marketing Strategy
Authors: Baines Paul , Rosengren Sara , Antonetti Paolo
Published: September 2023

This chapter focuses on the strategic marketing planning process. It explains that the strategic planning process commences at the corporate level, where the organization sets out its overall mission, purpose, and values. To help understand the marketing strategy process, the SWOT analysis generates a series of checklists, although the analyst should be ranking the key strengths and weaknesses and the key opportunities and threats in terms of importance. Meanwhile, the five main types of strategic marketing goals are niche, hold, harvest, diverse, and growth. The chapter then discusses how to frame strategic marketing, which can be written for not-for-profit, public-sector, and private-sector organizations.