bluuebunny/crossref_metadata_2025 huggingface dataset:
Linking innovation and entrepreneurship to economic growth
Authors: Farinha Luis , Ferreira João J.M. , Nunes Sara
Published: June 2018

Purpose

The purpose of this paper is to study the linkage of innovation and entrepreneurship to economic growth in countries with different levels of development.

Design/methodology/approach

Following quantitative analysis, the authors carry out three empirical approaches to examine the effects of innovation and entrepreneurship on competitiveness. In accordance with their initial study framework, they test the conceptual model of competitiveness through applying descriptive statistics, structural equation modelling (SEM) and hierarchical cluster analysis. Descriptive statistics and SEM data sources from the Global Competitiveness Report of the World Economic Forum were analysed for 148 countries. The hierarchical cluster analysis furthermore analysed Global Entrepreneurship Monitor data on 67 different countries.

Findings

The study confirmed that innovation and sophistication factors are crucial to the competitiveness of economies. The study also revealed the definition of five clusters relative to the competitive performance of advanced economies following the introduction of new entrepreneurship variables.

Originality/value

This research aims to open up avenues for the development of regional competitiveness studies.
Post-disaster social capital: trust, equity,bayanihanand Typhoon Yolanda
Authors: Eadie Pauline , Su Yvonne
Published: June 2018

Purpose

The purpose of this paper is to explore the impact of disaster rehabilitation interventions on bonding social capital in the aftermath of Typhoon Yolanda.

Design/methodology/approach

The data from the project are drawn from eight barangays in Tacloban City, the Philippines. Local residents and politicians were surveyed and interviewed to examine perceptions of resilience and community self-help.

Findings

The evidence shows that haphazard or inequitable distribution of relief goods and services generated discontent within communities. However, whilst perceptions of community cooperation and self-help are relatively low, perceptions of resilience are relatively high.

Research limitations/implications

This research was conducted in urban communities after a sudden large-scale disaster. The findings are not necessarily applicable in the rural context or in relation to slow onset disasters.

Practical implications

Relief agencies should think more carefully about the social impact of the distribution of relief goods and services. Inequality can undermine community level cooperation.

Social implications

A better consideration of social as well as material capital in the aftermath of disaster could help community self-help, resilience and positive adaptation.

Originality/value

This study draws on evidence from local communities to contradict the overarching rhetoric of resilience in the aftermath of Typhoon Yolanda.
What’s new in leadership?
Authors: Marques Joan
Published: June 2018

Purpose

The purpose of this paper is to underscore the changing perceptions of leadership as a whole, and more specifically, what is appreciated in contemporary leadership practices.

Design/methodology/approach

This is a reflective paper based on observations on leadership skills and how these are perceived and valued today.

Findings

Leadership today demands qualities that are not merely to be reflected on others or situations, but that have to, first and foremost, make sense to the leader internally. Qualities and skills discussed are authenticity, wakefulness, agility, kindness, equilibrium, neuroticism, and eagerness.

Practical implications

This paper aims to provide food for thought to those who consider themselves leaders or aspire to become leaders, whether in formal or informal settings.

Social implications

The paper strives to instill deeper awareness in those who perform in leadership positions, toward treating themselves and others toward greater fulfillment and accomplishment.

Originality/value

The leadership qualities discussed in this paper demonstrate that leadership is not necessarily a practice in which followers and a situation have to be included. Each quality requires deep reflection and, first and foremost, pertains to self-leadership as a precursor to leadership onto others.
Certified Emission Reduction credits and the role of investments
Authors: Sabbaghi Omid , Li Jing , Sabbaghi Navid
Published: June 2018

Purpose

This study aims to investigate the cross-sectional and time-series dynamics of realized Certified Emission Reduction (CER) credits issued and the role of investments for a seminal sample of China’s Clean Development Mechanism (CDM) projects specializing in the wind sector.

Design/methodology/approach

The study investigates the dynamics of realized CER credits issued and the role of investments using traditional cross-sectional and time-series regression analysis.

Findings

The study results find that the level of investment per megawatt (MW) of power generation is an important predictor for the expected number of realized CER credits issued in the cross-section of China’s wind CDM projects. Additionally, the study finds evidence of time trends and seasonality when examining the time series of realized monthly CER credits: CER credits issued are lower in the summer and higher in the winter.

Originality/value

The study results highlight the importance of financing CDM projects and suggest guidelines in which investors are able to better assess how much to invest based on the anticipated CER credits in the Project Design Document. Additionally, the results suggest opportunities for the CDM Executive Board surrounding the Project Design Document and the anticipated CER credits contained therein. The present study contributes to the literature on strategic tools for addressing climate change and offer insights that narrow the gap between empirical finance and sustainable business practice in the context of CDM projects.
Towards a reference model for the cold chain
Authors: Bremer Peik
Published: June 2018

Purpose

Generic business process models for the supply chain do not cover the specific requirements of the cold chain catering to the needs of temperature-sensitive, perishable goods. The purpose of this paper is to draft a reference model specific to the cold chain.

Design/methodology/approach

Following an object-oriented modeling approach, conceptual elements that have been synthesized from a literature review are transferred into the static view (object model) of the reference model. In addition, the reference model’s dynamic properties representing the business process view are outlined.

Findings

While a few atomic process steps are sufficient to model the cold chain’s dynamic properties, the complexity of the cold chain lies in the object model. The classes of the object model are highly interrelated and cover four domains: perishable product, information technology, infrastructure/equipment and regulatory framework. This technical approach is more adequate to the complex nature of cold chains than typical business process models.

Research limitations/implications

In the present draft status, the reference model is limited by the pure conceptual approach of this paper. As it is in the nature of things for a draft of a reference model, case studies to challenge the draft and a discourse of experts are required before detailed specifications can be added or any software implementation can be started. It is expected that the reference model is able to substantially support further research on cold chain design and optimization.

Practical implications

The cold chain reference model is intended to be a standard toolbox for planning and evaluating cold chains. By integrating the technical, information technology and regulatory objects behind the business processes, it allows to design and analyze cold chains from a more holistic perspective.

Originality/value

To the best knowledge of the author, this paper is the first to outline a reference model for the cold chain that goes beyond the business processes.
Explaining logistics social responsibility from a dynamic capabilities perspective
Authors: Gruchmann Tim , Seuring Stefan
Published: June 2018

Purpose

So far, most of the literature on logistics social responsibility (LSR) has prioritized the examination, classification of and adaption toward positive LSR practices instead of investigating necessary logistics service providers’ capabilities to implement LSR strategies. Therefore, the purpose of this paper is to contribute to theory by an assessment of LSR and its linkages to dynamic capabilities theory to gain insights into how logistics service providers can foster an enhanced application of LSR practices.

Design/methodology/approach

The paper is conceptual and grounded on dynamic capabilities theory. Relevant literature from logistics management, supply chain management and sustainable supply chain management (SSCM) as well as dynamic capabilities was examined to build upon existing theory by conceptualizing LSR from a dynamic capabilities perspective. In addition, propositions for future research are presented based on the conceptual model.

Findings

With regards to the controversial discussion in the literature about the direct link between dynamic capabilities and competitive advantage as well as the necessary degree of heterogeneity of dynamic capabilities, the conceptualization of LSR from a dynamic capabilities perspective adds new elements to this discussion. Considering long-term or even sustainable competitive advantage, the current degree of homogeneity across logistics services might hinder a sustainable advantage in the long run and demands for more advanced logistical capabilities. In this line, it is important to understand and utilize the causal relationships between different logistical resources and capabilities to achieve a unique long-term advantage allowing logistics service providers to further enhance LSR practices.

Practical implications

Due to the current role of logistics service providers, they should not just foster their resources focusing on the relationship to the focal firm, but they should also develop and implement new logistical capabilities derived from SSCM-related dynamic capabilities to design alternative service portfolio extensions and new business models.

Originality/value

Although dynamic capabilities have been studied intensively in the last two decades, the causal relationships between different logistical resources and necessary dynamic capabilities to achieve advantages by enhancing LSR practices still lack conceptualization. To build on the understanding of LSR, the paper at hand presents a conceptual framework explaining LSR and SSCM practices through the lens of dynamic capabilities theory.
Assessing service quality and customer behavioral responses in hospital outpatient services
Authors: Giovanis Apostolos , Pierrakos George , Rizomyliotis Ioannis , Binioris Spyridon
Published: June 2018

Purpose

In contrast to the reflective approach of service quality measurement, this paper aims to propose and validate a parsimonious multidimensional second-order formatively measured model of service quality for primary health-care services provided by hospital outpatient departments. The index’s empirical validity is examined by investigating the strength of its relationship with certain behavioral responses such as patient satisfaction and behavioral intentions.

Design/methodology/approach

Data were collected through a stratified random sampling from eight hospital outpatient departments in Greece. Covariance-based structural equation modeling techniques were used to validate the proposed service quality index and further investigate its effect on patient satisfaction and behavioral intention.

Findings

The data analysis indicated that the proposed formative index is fully functional with medical care being the factor and mostly contributes to service quality perception, followed by administrative service and staff performance, and facilities condition and nursing care. It, further, confirmed the partial mediating role of satisfaction, as it enhances the high impact of service quality on behavioral intentions.

Research limitations/implications

The relationships among hospital outpatient departments service quality, patient satisfaction and behavioral intentions were validated with data from one country and a health-care system which is state driven and funded.

Practical implications

An understanding of hospital primary health-care service quality formation is important to health-care decision makers because it offers them the opportunity to consider patients’ needs and wants, and takes the appropriate actions for improving the relevant underling procedures in a more efficient manner to achieve favorable behavioral responses.

Originality/value

The paper manages to propose and empirically evaluate a formatively measured approach of service quality and investigate the effects of the proposed index on patient satisfaction and behavioral intention, especially in the hospital outpatient services context in Greece.
They earn and send; we spend: consumption patterns of Pakistani migrant households
Authors: Ahmed Junaid , Mughal Mazhar , Martinez-Zarzoso Inmaculada
Published: June 2018

Purpose

The purpose of this paper is to analyze differential consumption patterns of Pakistani migrant households resulting from foreign and domestic remittances.

Design/methodology/approach

Using the Working-Leser model and a number of matching techniques, the authors analyze a representative household survey carried out in 2010–2011 to compare various expenditure categories of recipient and non-recipient households across different income brackets.

Findings

Results show that foreign remittances lead to significant consumption changes. Contrary to the widely held view, remittances do not raise the budget share on consumer goods and recreation, while allocation on education increases substantially. Households receiving domestic remittances also reflect strong focus on human capital with significantly higher shares of health and education. Recipients of international transfers living below one dollar a day spend proportionally more on food compared with their non-recipient counterparts whereas their education and health budget shares are not dissimilar.

Practical implications

The positive effect of remittances on expenditures on human capital coupled with a lack of evidence suggesting an increase in the share of conspicuous spending resulting from remittances highlights the beneficial role that remittances play in a developing country.

Originality/value

Extant literature lacks consensus on whether migrant remittances should be treated as a temporary or permanent source of household income. In this study, the authors argue and empirically show that the two need not be mutually exclusive, and may co-exist depending on the nature of remittances and household characteristics.
Could formalized State Business Relations lead to economic growth? Business participation, government representation and institutions
Authors: Sabry Mohamed Ismail
Published: June 2018

Purpose

The purpose of this paper is to investigate whether formal State Business Relations (F-SBR) lead to economic growth and which institutional variables are responsible for their success in achieving this.

Design/methodology/approach

Following a theoretical analysis, several hypotheses are presented, and a number of different regression models are being used to test the hypotheses.

Findings

The paper finds that F-SBR with high government representation and business participation are likely to increase investment flows as well as help overcome some burdensome institutional settings. This could be done thanks to building trust, enhancing information exchange and better policy formulation. Despite of its suggested trust-building capacity, F-SBR seem to fail to function in cultures where trust in governments is low, since trust is a key issue for cooperation as that expected in F-SBR. On the other hand, collective but also non-hierarchical cultures that foster cooperation seem to help in the success of F-SBR. Accountability to the public and openness to various societal groups as well as good regulatory quality would help F-SBR in leading to better economic outcomes.

Practical implications

This paper, thus, suggests supporting the establishment of F-SBR with high official representation and business participation because of their positive economic value. It also suggests that voice and accountability and regulatory quality are important institutions for the realization of better economic outcomes from F-SBR.

Originality/value

The theoretical and empirical approaches used in this paper are what make it a novel endeavor in this field. Much of the suggested hypotheses were hardly discussed thoroughly elsewhere in the literature on F-SBR. Moreover, the proxy used for F-SBR, constructed by the interaction term of government official representation and the level of business representation, made it possible to conduct empirical testing on a global level, something barely done in works on F-SBR experiences worldwide. The obtained results supported some of the arguments uttered in the literature while raising questions on others, opening the field for future research on the matter.
What did Ryan Lochte do? The double-edged sword of endorsers behaving badly
Authors: Vredenburg Jessica , Giroux Marilyn
Published: June 2018

Purpose

Endorsement deals are a key contributing factor for companies to gain brand recognition and positive brand associations from consumers. However, endorsement relationships can be risky for firms in the event of an endorser’s bad behavior or involvement in scandals. The purpose of this paper is to examine how brands can use endorsement exit strategies to minimize and even benefit from negative situations involving its endorser.

Design/methodology/approach

After a review of celebrity endorsement literature, the paper investigates the Rio Olympic Games robbery scandal involving American swimmer Ryan Lochte as a detailed case. By studying the timeline of sponsor-related activities, relevant theories and brand outcomes through Google Trends, indications of a calculated and strategic exit from the endorsement relationship emerge.

Findings

The case analysis establishes that sponsors can successfully leverage the negative associations toward a disgraced endorser. Based on the process of meaning transfer, this case proposes that sponsors can benefit from its public dissociation from the endorser and gain awareness from this separation.

Originality/value

This paper is the first study to examine the positive impact of a celebrity endorsement scandal. It highlights the need for managers to actively prepare endorsement exit strategies in the event of negative associations or endorser actions. The timing and scope of the exit strategy can both limit negative meaning transfer, and leverage the situation creating positive perceptions of integrity and ethics for the sponsor.
Psychological engagement of university students
Authors: Timms Carolyn , Fishman Tracey , Godineau Alexander , Granger Jamie , Sibanda Tariro
Published: June 2018

Purpose

The purpose of this paper is to investigate the relationship of undergraduate university students’ course experience (learning community (LC), clear goals and standards, student support, study-family affect (SF affect) and autonomy) to their well-being, as measured by psychological engagement (dedication, absorption and vigour) and burnout (exhaustion and disengagement/cynicism).

Design/methodology/approach

First-year psychology students (n=128) were surveyed using previously validated measures of their well-being and experiences at university.

Findings

Belonging to a LC (where students were encouraged to develop fluidity with the subject matter and share insights) was positively related to students’ psychological engagement. By contrast, the provision of ready access to course materials did not predict student engagement. Knowledge of goals and standards predicted that students would find course work energising (vigour). Respondents reported that SF affect (where participation at university enhances family life) was related to their engagement at university. In addition, mature age students (over the age of 25 years) reported higher levels of engagement in their study than did younger students.

Research limitations/implications

The dominant predictor of student well-being (LC) was redolent of two important psychological human needs (affiliation and mastery). The central nature of this variable to student well-being is therefore currently undifferentiated and calls for the application of more finely tuned instruments to predict student well-being.

Originality/value

The current research applied measures from the widely validated Course Experience Questionnaire (Ramsden, 1991) as predictors of students’ psychological engagement and burnout. It highlights the value of personal relationships and community in university students’ mastery of difficult course material.
Successfully mobilizing for employee board representation
Authors: Gomez Pierre-Yves , Wirtz Peter
Published: June 2018

Purpose

The equal representation of employees on codetermined supervisory boards is one of the distinctive features of the German corporate governance system. This study aims to examine the relevance of the frequent assumption according to which this system is rooted in a typically “German culture”.

Design/methodology/approach

This research applies Davis and Thompson’s (1994) mobilization theory as an interpretive grid to historical sources to reveal the determinants of the institutionalization of equal board representation in post-war Germany.

Findings

The present contribution reveals that the supposedly “German tradition” of board representation is a myth. The specific regime of codetermined supervisory boards is instead the outcome of the dramatic political and institutional circumstances of the late 1940s, which saw fierce struggles and the mobilization of various actors ranging from politicians and industrialists to trade unionists.

Originality/value

The German Catholic Church is shown to have played a significant, albeit seldom recognized, role in this search for institutional consensus. It acted as a broad-based “supporting institution”, positively influencing mobilization efforts in favor of board codetermination and ultimately enabling an agreement to be reached.
Technological constraints to firm performance
Authors: Kolade Oluwaseun , Obembe Demola , Salia Samuel
Published: June 2018

Purpose

Manufacturing and services SMEs in Africa face challenges and constraints exacerbated by ineffectual government policies, environmental turbulence and the near absence of institutional support. The purpose of this paper is to investigate if informal linkages and formal cooperation are helping firms to overcome constraints to uptake of technological innovations in Nigeria.

Design/methodology/approach

The paper is based on quantitative data obtained from structured interviews of 631 Nigerian firms. These firms were selected using stratified random sampling from a total population of 18,906 manufacturing and services companies in the national database obtained from the National Bureau of Statistics.

Findings

The result of the binary logistic regression indicates that while informal linkages appear to be insignificant, formal inter-firm cooperation is an effective moderator of barriers to technological innovations.

Research limitations/implications

The paper focusses only on technological, rather than non-technological, innovations.

Practical implications

The paper recommends that, in addition to other interventions to promote diffusion of technological innovations, governments should give priority to interventions that support formal cooperation among SMEs.

Originality/value

Previous studies have generally looked at the impact of cooperative networks on firms’ innovation uptake. This paper provides original insights into the “how” of cooperative impact, specifically with respect to helping SMEs to overcome constraints. The paper also delineates formal cooperation from informal linkages.
Eco-capability role in healthcare facility’s performance
Authors: Maleki Minbashrazgah Morteza , Shabani Atefeh
Published: June 2018

Purpose

With the exponential growth of problems linked to the natural environment, healthcare facilities are increasingly faced with ecological challenges in their operations. In this regard, they progressively need to improve their environmental performance like other industries in recent years. Applying the natural-resource-based view (NRBV) and dynamic capabilities literature, the purpose of this paper is to investigate this eco-capability which fully leverages human, relationship, and technology resources.

Design/methodology/approach

Applying the NRBV and dynamic capabilities literature, this paper investigates this eco-capability which fully leverages human, relationship, and technology resources. Using survey data from staffs across 15 hospitals in north of Iran, researchers estimated a latent moderated structural model that provides support for these three resource components.

Findings

Results obtained from structural equation analysis revealed that human, technology, and relationship resources have positive impact on eco-capability. Also eco-capability has positive impact on market and financial performance and the perceived quality of the hospital’s offering.

Research limitations/implications

As the model consist just of three kinds of resources, future studies could include examining the effect of additional resources and other internal and external factors on eco-capability.

Practical implications

This paper includes suggestions for facility’s managers to develop environmental strategy in three areas: human, technology, and relationship resources.

Originality/value

The role of eco-resources has been used only rarely to investigate organization capability and performance. This paper includes suggestions for facility’s managers to develop environmental strategy in three areas: human, technology, and relationship resources.
Replacement service decisions for disruption recovery in light rail systems
Authors: Fang Yan , Jiang Yiping
Published: June 2018

Purpose

Attracting commuters from driving to light rail systems has a good potential for reducing carbon emissions. However, the light rail system is interrupted by disruptions frequently, which reduces its attraction to passengers. Therefore, how to provide a quick replacement service during disruptions is of vital importance to avoid passengers change to other higher emission vehicles. The purpose of this paper is to focus on the decision analysis of the replacement tool for disruption recovery service in urban public light rail systems from the perspective of environmental effect.

Design/methodology/approach

The traditional approach – bus replacement service – and the new approach – taxi replacement service – which has been recently adopted by several cities, are examined individually and compared. The benefit of the light rail company is formulated by balancing between carbon emission and financial cost. The involving parties’ decision functions taking the passengers’ behaviors as well as numerous other important factors into account are formulated.

Findings

Both theoretical and numerical sensitivity analyses are conducted to shed light for light rail systems to better coping with disruptions, increasing service level, and attracting more passengers to the environmental transit system to reduce carbon emission.

Originality/value

It is worth mentioning that this research is a successful application for disruption recovery in a public transit system considering the environmental effect. To the authors’ knowledge, this research is one of the first of such applications in this area and can be used not only in the public light rail systems, but also in other urban public transport network components such as the subway and rail systems.
Diversity, corporate governance and CSR reporting
Authors: El-Bassiouny Dina , El-Bassiouny Noha
Published: June 2018

Purpose

Taken from an institutional theory perspective, the purpose of this paper is to explore the effects of organizational-level factors, specifically diversity and corporate governance structure, on the corporate social responsibility (CSR) reporting practices of corporations operating in developing and developed country contexts, namely, Egypt, Germany and the USA. Since developed countries are exposed to different settings, the paper argues that there is likely to be a difference in the organizational-level drivers of CSR reporting in developed vs developing countries.

Design/methodology/approach

The sample consists of companies listed on the Egyptian EGX 30 index, the German DAX 30 index and the US Dow Jones 30 index. Governance- and diversity-related data are gathered from multiple sources including the BoardEx and Orbis databases. Content analysis is used to analyze the CSR information of sample companies using the software package MAXQDA. To examine the relationship between the explanatory variables of the study and CSR disclosures, multiple regression analysis is used.

Findings

The results are mostly consistent with institutional theory where the effects of diversity and governance structure, observed mainly by foreign BOD, board independence and institutional ownership, are found to be significant on the CSR disclosure levels of sample Egyptian companies only. On the other hand, no significant influence of tested factors was observed on the level of CSR reporting in the USA and Germany. The results thus indicate that the influence of organizational-level factors on CSR is highly dependent on the institutional context where companies operate.

Originality/value

The influence of diversity and corporate governance on CSR has been separately studied in the management literature. Yet, the potential effects of both variables on CSR have received limited attention. In addition, no study combining such explanatory variables of CSR was carried out in the specific context of developing Middle Eastern countries. Also, illustrating how institutional contexts can influence the dynamics of interaction between organizational-level variables and CSR is still understudied. This kind of multi-level research can help broaden the understanding of the drivers and practices of CSR in developing vs developed countries that have distinct institutional environments.
The effectiveness of celebrity endorsement in aspiring new celebrities
Authors: Freire Otávio , Quevedo-Silva Filipe , Senise Diego , Scrivano Pedro
Published: June 2018

Purpose

Celebrity endorsement is a phenomenon widely used by companies and studied by researchers. Despite the generally positive aspects of endorsement on the evaluation of products, in some cases, celebrities cannot substantially help promote products. The purpose of this paper is to analyze the effectiveness of celebrity endorsement effect in an aspiring new celebrity.

Design/methodology/approach

Four studies involving 664 respondents were conducted to analyze the effectiveness of the endorsement. In addition to verifying the existence of the effect (Study 1), studies were conducted focusing on contextual variables with the potential to modify effect. Study 2 analyzes the brand and charisma effects, Study 3 analyzes the congruence between celebrities and Study 4 analyzes the exposure level of the endorser celebrity.

Findings

The results demonstrate the effectiveness of this celebrity endorsement, as well as the effect of different contexts on endorsement, demonstrating that although new celebrities are less affected by acclaimed celebrities, as they become better known, to use the endorsement of celebrities with charisma and who relating in some way to the aspiring celebrity, can be an effective strategy, especially for the beginners in the career.

Originality/value

This research contributes to the knowledge of celebrity endorsement to fill the lack pointed out in previous studies in the field over the effectiveness of this effect and, above all, the moderator variables that can influence or even annul this effect. In addition, by developing its own image and reputation, the aspiring new celebrity receives less influence from the endorser.
Does Decentralization Improve Health System Performance and Outcomes in Low‐ and Middle‐Income Countries? A Systematic Review of Evidence From Quantitative Studies
Authors: DWICAKSONO ADENANTERA , FOX ASHLEY M.
Published: June 2018

Policy Points:

For more than 3 decades, international development agencies have advocated health system decentralization to improve health system performance in low‐ and middle‐income countries.

We found little rigorous evidence documenting the impact of decentralization processes on health system performance or outcomes in part due to challenges in measuring such far‐reaching and multifaceted system‐level changes.

We propose a renewed research agenda that focuses on discrete definitions of decentralization and how institutional factors and mechanisms affect health system performance and outcomes within the general context of decentralized governance structures.

Context

Despite the widespread adoption of decentralization reforms as a means to improve public service delivery in developing countries since the 1980s, empirical evidence of the role of decentralization on health system improvement is still limited and inconclusive. This study reviewed studies published from 2000 to 2016 with adequate research designs to identify evidence on whether and how decentralization processes have impacted health systems.

Methods

We conducted a systematic review of peer‐reviewed journal articles from the public health and social science literature. We searched for articles within 9 databases using predefined search terms reflecting decentralization and health system constructs. Inclusion criteria were original research articles, low‐ and middle‐income country settings, quantifiable outcome measures, and study designs that use comparisons or statistical adjustments. We excluded studies in high‐income country settings and/or published in a non‐English language.

Findings

Sixteen studies met our prespecified inclusion and exclusion criteria and were grouped based on outcomes measured: health system inputs (n= 3), performance (n= 7), and health outcomes (n= 7). Numerous studies addressing conceptual issues related to decentralization but without any attempt at empirical estimation were excluded. Overall, we found mixed results regarding the effects of decentralization on health system indicators with seemingly beneficial effects on health system performance and health outcomes. Only 10 studies were considered to have relatively low risks of bias.

Conclusions

This study reveals the limited empirical knowledge of the impact of decentralization on health system performance. Mixed empirical findings on the role of decentralization on health system performance and outcomes highlight the complexity of decentralization processes and their systemwide effects. Thus, we propose a renewed research agenda that focuses on discrete definitions of decentralization and how institutional factors and mechanisms affect health system performance and outcomes within the general context of decentralized governance structures.
Emerging Trends in Clinical Research With Implications for Population Health and Health Policy
Authors: CHIN‐YEE BENJAMIN , SUBRAMANIAN S.V. , VERMA AMOL A. , LAUPACIS ANDREAS , RAZAK FAHAD
Published: June 2018

Policy Points:

Significant advances in clinical medicine that have broader societal relevance may be less accessible to population health researchers and policymakers because of increased specialization within fields.

We describe important recent clinical advances and discuss their broader societal impact. These advances include more expansive strategies for disease prevention, the rise of precision medicine, applications of human microbiome research, and new and highly successful treatments for hepatitis C infection.

These recent developments in clinical research raise important issues surrounding health care costs and equitable resource allocation that necessitate an ongoing dialogue among the fields of clinical medicine, population health, and health policy.

Context

Developments in clinical medicine have important implications for population health, and there is a need for interdisciplinary engagement among clinical medicine, the social sciences, and public health research. The aim of this article is to help bridge the divide between these fields by exploring major recent advances in clinical medicine that have important implications for population health.

Methods

We reviewed the most cited articles published from 2010 to 2015 in 5 high‐impact clinical journals and selected 5 randomized controlled trials and 2 related clinical practice guidelines that are broadly relevant to population health and policy.

Findings

We discuss the following themes: (1) expanding indications for drug therapy and the inherent medicalization of the population as highlighted by studies and clinical guidelines supporting lower blood pressure targets or widespread statin use; (2) the tension in nutritional research between quantifying the impact of isolated nutrients and studying specific foods and dietary patterns, for example, the role of the Mediterranean diet in the primary prevention of cardiovascular disease; (3) the issue of high medication costs and the challenge of providing equitable access raised by the development of new and effective treatments for hepatitis C infection; (4) emerging clinical applications of research on the human microbiome as illustrated by fecal transplant to treat Clostridium difficile infections; and (5) the promise and limitations of precision medicine as demonstrated by the rise of novel targeted therapies in oncology.

Conclusions

These developments in clinical science hold promise for improving individual and population health and raise important questions about resource allocation, the role of prevention, and health disparities.
An Analysis of the Australian Superannuation System's Taxes and Transfers
Authors: Evans John , Razeed Abdul
Published: June 2018

The Council of Superannuation Custodians () indicated that one of the objectives of the Superannuation Guarantee Levy (SGL) was to relieve pressure on the cost of the Age Pension system. This paper uses a life cycle approach together with a model that introduces volatility in the drivers that affect theSGLaccumulations in the pre‐retirement and post‐retirement phases to establish the effective tax and transfers expected from theSGLand Age Pension components of the Australian retirement system. The analysis shows that for higher income earners, the Australian Government will gain from theSGLsystem, but for others, theSGLsystem will remain a net cost to the Australian Government. The net costs to the Australian government will vary over time and will be particularly affected by the return on investment earned onSGLassets.
Comparison of carboplatin plus etoposide with amrubicin monotherapy for extensive‐disease small cell lung cancer in the elderly and patients with poor performance status
Authors: Igawa Satoshi , Shirasawa Masayuki , Ozawa Takahiro , Nishinarita Noriko , Okuma Yuriko , Ono Taihei , Sugimoto Ai , Kurahayashi Shintaro , Sugita Keisuke , Sone Hideyuki , Fukui Tomoya , Mitsufuji Hisashi , Kubota Masaru , Katagiri Masato , Sasaki Jiichiro , Naoki Katsuhiko
Published: June 2018

Background

Carboplatin plus etoposide (CE) is a standard treatment for elderly patients with extensive‐disease small cell lung cancer (ED‐SCLC). However, amrubicin monotherapy (AMR) may be a feasible alternative. We compared the efficacies and safety profiles of CE and AMR for ED‐SCLC in elderly patients and chemotherapy‐naive patients with poor performance status (PS).

Methods

The records of SCLC patients who received CE or AMR as first‐line chemotherapy were retrospectively reviewed and their treatment outcomes evaluated.

Results

Eighty‐four patients (median age 72 years; 42 each received CR and AMR) were analyzed; 34 patients had a PS score of 2. There were no significant differences in patient characteristics between the treatment groups. The median progression‐free survival rates of patients in the CE and AMR groups were 5.8 and 4.8 months, respectively (P = 0.04); overall survival was 14.0 and 8.5 months, respectively (P = 0.089). Twenty‐three CE group patients received AMR as second‐line chemotherapy; their median overall survival from first‐line chemotherapy was 18.5 months. Grade 3 or higher neutropenia occurred more frequently in patients treated with AMR (64% vs. 40%; P = 0.02), as did febrile neutropenia (14% vs. 7%).

Conclusions

CE remains a suitable first‐line treatment for ED‐SCLC in elderly patients or those with poor PS in comparison with AMR.
Comparison of tumor related signaling pathways with known compounds to determine potential agents for lung adenocarcinoma
Authors: Xu Song , Liu Renwang , Da Yurong
Published: June 2018

Background

This study compared tumor‐related signaling pathways with known compounds to determine potential agents for lung adenocarcinoma (LUAD) treatment.

Methods

Kyoto Encyclopedia of Genes and Genomes signaling pathway analyses were performed based on LUAD differentially expressed genes from The Cancer Genome Atlas (TCGA) project and genotype‐tissue expression controls. These results were compared to various known compounds using the Connectivity Mapping dataset. The clinical significance of the hub genes identified by overlapping pathway enrichment analysis was further investigated using data mining from multiple sources. A drug‐pathway network for LUAD was constructed, and molecular docking was carried out.

Results

After the integration of 57 LUAD‐related pathways and 35 pathways affected by small molecules, five overlapping pathways were revealed. Among these five pathways, the p53 signaling pathway was the most significant, with CCNB1, CCNB2, CDK1, CDKN2A, and CHEK1 being identified as hub genes. The p53 signaling pathway is implicated as a risk factor for LUAD tumorigenesis and survival. A total of 88 molecules significantly inhibiting the five LUAD‐related oncogenic pathways were involved in the LUAD drug‐pathway network. Daunorubicin, mycophenolic acid, and pyrvinium could potentially target the hub gene CHEK1 directly.

Conclusion

Our study highlights the critical pathways that should be targeted in the search for potential LUAD treatments, most importantly, the p53 signaling pathway. Some compounds, such as ciclopirox and AG‐028671, may have potential roles for LUAD treatment but require further experimental verification.
Synergistic effects of TGFβ2, WNT9a, and FGFR4 signals attenuate satellite cell differentiation during skeletal muscle development
Authors: Zhang Weiya , Xu Yueyuan , Zhang Lu , Wang Sheng , Yin Binxu , Zhao Shuhong , Li Xinyun
Published: June 2018

Satellite cells play a key role in the aging, generation, and damage repair of skeletal muscle. The molecular mechanism of satellite cells in these processes remains largely unknown. This study systematically investigated for the first time the characteristics of mouse satellite cells at ten different ages. Results indicated that the number and differentiation capacity of satellite cells decreased with age during skeletal muscle development. Transcriptome analysis revealed that 2,907 genes were differentially expressed at six time points at postnatal stage. WGCNA and GO analysis indicated that 1,739 of the 2,907 DEGs were mainly involved in skeletal muscle development processes. Moreover, the results of WGCNA and protein interaction analysis demonstrated that Tgfβ2, Wnt9a, and Fgfr4 were the key genes responsible for the differentiation of satellite cells. Functional analysis showed that TGFβ2 and WNT9a inhibited, whereas FGFR4 promoted the differentiation of satellite cells. Furthermore, each two of them had a regulatory relationship at the protein level. In vivo study also confirmed that TGFβ2 could regulate the regeneration of skeletal muscle, as well as the expression of WNT9a and FGFR4. Therefore, we concluded that the synergistic effects of TGFβ2, WNT9a, and FGFR4 were responsible for attenuating of the differentiation of aging satellite cells during skeletal muscle development. This study provided new insights into the molecular mechanism of satellite cell development. The target genes and signaling pathways investigated in this study would be useful for improving the muscle growth of livestock or treating muscle diseases in clinical settings.
Girdling increases survival and growth of emerald ash borer larvae on Manchurian ash
Authors: Rigsby Chad M. , Villari Caterina , Peterson Donnie L. , Herms Daniel A. , Bonello Pierluigi , Cipollini Don
Published: June 2018

In its native range in Asia, emerald ash borer (EAB; Agrilus planipennis Fairmaire) is a secondary colonizer of its coevolved hosts, including Manchurian ash (Fraxinus mandschurica Ruprecht). However, why larval performance is enhanced on stressed trees remains to be determined.

We examined the mechanisms that may reduce the resistance of stressed Manchurian ashes. Trees in a common garden were girdled or left untreated as controls and both treatments were inoculated with EAB eggs. Larvae and bark tissue were harvested after feeding and larval performance so that the defensive mechanisms and nutritional quality of bark tissue could be assessed.

Larval survival and mass was twice as high on girdled trees, although girdling had no effect on bark phenolics. The activity of two enzymes involved in wound repair and lignification (peroxidase and cinnamic alcohol dehydrogenase) was increased by girdling in bark tissue. Starch and total protein levels declined in girdled stems, although sugar content was unchanged. Total disulphide levels, a measure of protein oxidative damage, were increased by girdling, although no difference in lipid oxidative damage in ash phloem tissue was detected.

Girdling ash increased larval performance even though it elevated some wound repair mechanisms and decreased some indices of plant nutritional quality. Other tree responses to girdling also were poor predictors of larval performance. It appears that mechanisms of stress‐induced variation in resistance of Manchurian ash to EAB differ from those that may explain interspecific variation in resistance.
Bayesian Optimal Interval Design with Multiple Toxicity Constraints
Authors: Lin Ruitao
Published: June 2018

Most phase I dose-finding trials are conducted based on a single binary toxicity outcome to investigate the safety of new drugs. In many situations, however, it is important to distinguish between various toxicity types and different toxicity grades. By minimizing the maximum joint probability of incorrect decisions, we extend the Bayesian optimal interval (BOIN) design to control multiple toxicity outcomes at prespecified levels. The developed multiple-toxicity BOIN design can handle equally important, unequally important as well as nested toxicity outcomes. Interestingly, we find that the optimal interval boundaries with non-nested toxicity outcomes under the proposed method coincide with those under the standard single-toxicity BOIN design by treating the multiple toxicity outcomes marginally. We establish several desirable properties for the proposed interval design. We additionally extend our design to address trials with combined drugs. The finite-sample performance of the proposed methods is assessed according to extensive simulation studies and is compared with those of existing methods. Simulation results reveal that, our methods are as accurate and efficient as the more complicated model-based methods, but are more robust and much easier to implement.