bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing the objectives of dry ports: main issues, challenges and opportunities in Brazil
Authors: Rodrigues Thiago de Almeida , Mota Caroline Maria de Miranda , Ojiako Udechukwu , Dweiri Fikri
Published: November 2020

Purpose

The purpose is to identify the main characteristics of dry ports (DPs) in Brazil, discussing the role of this logistic player, challenges and opportunities. Furthermore, this study provides a structured framework to drive DP decision-makers, identifying and assessing a network of means–end objectives, which could be replicable to other contexts.

Design/methodology/approach

This article approached initially a literature review and exploratory research to discuss the main characteristics of DPs in Brazil. The second step was to conduct a qualitative analysis following the value-focused thinking (VFT) approach in two case studies in Pernambuco state to assess the achievement of the main objectives.

Findings

This article identified that the main characteristics of DPs in Brazil are offering additional services with a cheaper storage cost, handling mainly import cargo and being connected to seaports through highways. Moreover, this study resulted in a framework to assess the objectives of DPs, which could be replicable in other contexts, improving the current operations of DPs.

Practical implications

The framework to assess DPs' objectives bridged the gap between the literature and the practice working as a tool to drive decision-makers to improve the current performance of DPs in Brazil. Additionally, the main issues, challenges and opportunities discussed provide managers, policymakers and DPs operators with valuable insights into this theme.

Originality/value

This paper is the first study to present a framework to assess the objectives of DPs as a valuable tool to drive decision-makers to improve DPs operations. From this study, lessons could be learned and the process described could be replicable in other countries.
Using method analysis to improve productivity: case of a tap manufacturer
Authors: Sookdeo Barnes
Published: November 2020

Purpose

The purpose of this article is to demonstrate that basic interventions using method study investigations can improve productivity in the workplace. Continuous improvement of operational processes allows an organisation to develop its capabilities to keep it ahead of its competitors.

Design/methodology/approach

A mixed-methods approach was used as the research design of the study. It involved an intensive method study investigation at a tap manufacturer to improve productivity. Structured searches using keywords were carried to identify important contributors to research articles in the areas of work-study, method study and productivity.

Findings

The empirical results indicate the essential need for method study investigations to improve productivity in organisations. It can be concluded that the systematic implementation of this methodology will ensure that productivity is enhanced in organisations.

Research limitations/implications

The research is restricted to a single manufacturing organisation. Literature on method study was found to be limited.

Practical implications

This research is intended to support organisations by providing a methodology to address areas of inefficiency and also to assist with subsequent turnaround strategies to ensure organisational effectiveness and sustainability.

Originality/value

The essential contribution that this article makes is that it provides organisations with a universally accepted, user-friendly technique to improve organisational effectiveness and productivity with minimal capital outlay.
Direction of luxury fashion retailers' post-entry expansion – the evidence from China
Authors: Bai Huifeng , McColl Julie , Moore Christopher , He Weijing , Shi Jin
Published: November 2020

Purpose

This empirical study, from the international retailing perspective, examines the direction of retailers' further expansion after initial entry into overseas host market in the context of the luxury fashion retail market in China.

Design/methodology/approach

The research adopts qualitative multiple case studies.

Findings

After initial entry into China, luxury fashion retailers further expand their retail operations through three directional patterns: cautious, regional and countrywide expansions. The stepwise expansion from tier-1 to tier-2 and tier-3 cities remains popular; however, the importance of the tier system of Chinese cities has been weakened because tier-3 cities in affluent regions are perceived to have more potential than some tier-2 cities in less developed regions. The retailers assess a potential local market through interrelated criteria, including location and strategic importance, economic development, available store locations and staff, a high degree of urbanisation and tourism, debatable favourable policies and offers, and popularity of e- and m-commerce. There is a positive relationship between popularity of e- and m-commerce in a city and the potential of that city to run brick-and-mortar stores.

Originality/value

The paper offers an insight into the current international retailing literature by examining the direction of luxury fashion retailers' further expansion after their initial market entry. Particularly, the research considers a set of criteria which can be used to assess a potential local market, and the impact of e- and m-commerce on local market choices for brick-and-mortar stores.
Profitability and optimal debt ratio of the automobiles and parts sector in the Euro area
Authors: Basdekis Charalampos , Christopoulos Apostolos , Katsampoxakis Ioannis , Lyras Alexandros
Published: November 2020

Purpose

The goal of this paper is twofold: to assess the influence of specific corporate and market features on automobiles and parts sector's profitability in Euro area and to identify this particular sector's optimum debt level.

Design/methodology/approach

For the paper's purposes, the authors applied a panel data analysis on an annual basis for the period 2005–2017.

Findings

There is a strong statistical significance of debt ratio, growth domestic product per capita growth, E.C.'s economic sentiment index (ESI), the European Central Bank key interest rate and the Euro area crisis on sector's profitability, while weak statistical significance appears to emerge for the firm's size. Moreover, the authors find average 14.4% profitability for the entire sector of the Euro area, without significant fluctuations among firms and/or during the examined time period. Another interesting finding of this study is that results are consistent with the theory of Modigliani Miller that financial leverage at a “low” level is beneficial for the firm, but beyond a turning point, it becomes counterproductive. This turning point for the automobiles and parts sector in Euro area has been computed at 47.3%.

Originality/value

The paper focuses on issues of profitability, capital structure and optimal debt ratio of an important sector of the economy, the automotive sector. As regards the Euro area automotive sector, it is a dynamic sector with a significant multiplier effect for the European economy as it is strongly correlated with other industrial sectors as chemicals, steel, textiles, information technology and so forth, having an outstanding multiplier effect on the economy.
Technological capabilities, open innovation and perceived operational performance in SMEs: the moderating role of environmental dynamism
Authors: Taghizadeh Seyedeh Khadijeh , Nikbin Davoud , Alam Mirza Mohammad Didarul , Rahman Syed Abidur , Nadarajah Gunalan
Published: November 2020

Purpose

In the current dynamic environment, technological capabilities and open innovation play vital roles in operational performance of small and medium enterprises (SMEs). Thus, the purpose of this paper is to explore the influence of technological capabilities on open innovation and consequent impact on perceived operational performance of the SMEs in Malaysia by considering the moderating effect of environmental dynamism.

Design/methodology/approach

This study is quantitative in nature and used a survey questionnaire to gather responses from 202 SME owners in Malaysia. The data were analyzed with SmartPLS software, as it used structural equation modeling.

Findings

The results show that technological capabilities significantly influence open innovation whereas open innovation plays an instrumental role to achieve operational performance of the SMEs. Interestingly, environmental dynamism was found to have a negative moderating role in the relationship between open innovation and perceived operational performance.

Practical implications

This paper will assist SME managers in making effective decisions while using technological capabilities and open innovation practices. Managers need to be aware of the vital role of technological capabilities to build external and internal collaboration and incorporate their knowledge that is necessary for open innovation practices. The results also assist managers in a way that in the dynamic and competitive environment SMEs should take further proactive actions to compete in the market to survive.

Originality/value

This study provides new insights by dismantling technological capabilities and open innovation to understand further the effects of technological capabilities on open innovation and its consequence on a firm’s operational performance.
A reflective evaluation of the Bradford positive behaviour support – in reach service
Authors: Hodder Matthew , Syson Tom , Aziz Zobia , Handy Anthony , Khan Hafsa , Lancaster Julie
Published: November 2020

Purpose

Without effective support and intervention, young people with learning disabilities and severe challenging behaviour are at risk of placement in out-of-area residential settings or highly specialist child and adolescent mental health service (CAMHS) units. Such placements may be inappropriate and result in significant reductions to the quality of life of young people and their families. This paper aims to evaluate the effectiveness of the Bradford positive behaviour support (PBS) service model in terms of its aims to improve quality of life, develop skills and maintain children living with their families in their own homes.

Design/methodology/approach

A service evaluation using quantitative and qualitative data from a range of sources to review the effectiveness of the PBS model being applied in Bradford and Calderdale was the methodology used.

Findings

When consistently implemented, the Bradford positive behaviour support–in reach service may improve quality of life, facilitate skill development in young people and their carers and reduce placements in residential and CAMHS inpatient units. Avoidance of such placements is likely to reduce the overall costs of service commissioning in Bradford.

Originality/value

This paper evaluates a novel approach being applied by a third sector agency to implement effective PBS with a small group of children, their families and networks. There is scope for this model to be successfully implemented in other areas.
Underwater video and still‐image dataset of fishes and other aquatic animals in Lake Biwa, Japan, observed via carp‐mounted video loggers
Authors: Yoshida Makoto A. , Totsu Kumiko , Sato Katsufumi , Mabuchi Kohji
Published: November 2020

This is the first large dataset of underwater videos from which species occurrence and behavioral records of aquatic organisms were identified in Lake Biwa, the largest lake in Japan. We compiled 109 videos and 122 still‐images of fishes, diving birds and shrimps. The images were cropped from videos taken underwater with animal‐borne video cameras which were mounted on the backs of common carp (Cyprinus carpio). The attribute of each image and its occurrence of organisms were formatted according to the Darwin Core Archive which was developed by the Biodiversity Information Standards (TDWG), and the dataset is available via the Global Biodiversity Information Facility. Our dataset includes records of 10 species, 4 genera, 2 families and 1 infraorder which includes mostly fishes, several birds and a crustacean. The fish records include a threatened endemic fish, the “gengorou‐buna” crucian carp (Carassius cuvieri), and two alien fishes, largemouth bass (Micropterus salmoides) and bluegill sunfish (Lepomis macrochirus). We confirmed several types of intraspecific and interspecific relationships between video‐mounted carp and other organisms; for example, most video‐mounted carp frequently approached or chased conspecifics upon encountering, which sometimes led to two carp feeding side by side. At least three avian species also appeared in the dataset: Eurasian coot (Fulica atra), little grebe (Tachybaptus ruficollis), great crested grebe (Podiceps cristatus), but there was no apparent interaction between carp and these birds. Our underwater videos reveal and highlight the rich biodiversity of the lake today, providing clear evidence for behavior of aquatic organisms under natural conditions.

The complete data set for this abstract published in the Data Paper section of the journal is available in electronic format in MetaCat in JaLTER at http://db.cger.nies.go.jp/JaLTER/metacat/metacat/ERDP-2020-18.1/jalter-en.
Acceptance of group‐based dominance and climate change denial: A cross‐cultural study in Hong Kong, New Zealand, and Sweden
Authors: Jylhä Kirsti M. , Tam Kim‐Pong , Milfont Taciano L.
Published: November 2020

Despite the importance of overcoming the persistent delay in climate action, almost no research has investigated the psychological underpinnings of climate change denial in Asian countries. Addressing this research gap, our study compares results obtained in Hong Kong with those of samples from New Zealand and Sweden regarding correlations of climate change denial with acceptance of dominance between social groups (Social Dominance Orientation), acceptance of two additional forms of group‐based dominance (humans over nature, and humans over animals), and empathic concern. Results showed that only acceptance of human dominance over nature and animals predicted climate change denial in Hong Kong. In New Zealand and Sweden, however, the results resembled those found in previous research: The strongest predictor was Social Dominance Orientation, followed by acceptance of human dominance over nature. Low empathic concern predicted climate change denial only in Sweden. Results in Hong Kong differ from previous findings and indicate that climate change denial in this East Asian society is motivated more by hierarchical attitudes related to nature than social groups. We discuss possible reasons for these distinct findings and conclude that there is a need for cross‐cultural research to further investigate the psychological and culture‐specific motivations to dismiss climate change.
aEEG as a useful tool for neuromonitoring in critically ill children – Current evidence and knowledge gaps
Authors: Bruns Nora , Felderhoff‐Müser Ursula , Dohna‐Schwake Christian
Published: November 2020

Aim

Amplitude‐integrated electroencephalography (aEEG) is used in children beyond neonatal age, but systematic investigations have been lacking. This mini‐review summarised aEEG studies on children aged one month to 18 years, evaluated the usefulness of aEEG and identified knowledge gaps or limitations.

Methods

We searched the PubMed database for articles published in English up to September 2020, and 23 papers were identified.

Results

aEEG was frequently used to compensate for the absence of continuous full‐channel EEG monitoring, particularly for detecting seizures. Interpreting background patterns was based on neonatal classifications, as reference values for older infants and children are lacking. It is possible that aEEG could predict outcomes after paediatric cardiac arrests and other conditions. Gaps in our knowledge exist with regard to normal values in healthy children and the effects of sedation on aEEG background patterns in children.

Conclusion

The main application of aEEG was detecting and treating paediatric seizures. Further research should determine reference values and investigate the potential to predict outcome after critical events or in acute neurological disease. It is likely that aEEG will play a role in paediatric critical care in the future.
Gendered constraints on a strategy of regional mobility: Latino/a migration to post‐Katrina New Orleans
Authors: Blue Sarah A.
Published: November 2020

In August 2005, rising waters from Hurricane Katrina compromised several of New Orleans’ levees, causing extensive flooding that, in the face of government inaction, resulted in the deaths of 1,400 people and a large‐scale evacuation of the city. As long‐term residents of the city evacuated, New Orleans witnessed an influx of new Latino/a immigrants who arrived to demolish irreparable structures, clear toxic debris, and rebuild. Disaster recovery work draws on construction and low‐skilled service sectors, which are already niches for undocumented Latino/a labour in the USA. Migration to disaster recovery sites is a potentially lucrative strategy for undocumented migrants, who use their mobility to seek better employment. By highlighting differences in gendered labour experiences in a neoliberal disaster‐recovery context, this study illustrates how migrant‐labour niches and a lack of reproductive support systems constrain opportunities and shape migrants’ mobility strategies. Through a perspective of constrained agency, it considers how migrants’ experiences differ according to gender as they negotiate labour and care possibilities. The constraints on migrant aspirations are explored through interview and survey data collected from 256 Latino/a migrants to post‐Katrina New Orleans who were working between 2006 and 2008. The paper argues that while disaster recovery sites create opportunity for some of the most vulnerable workers, gendered immigrant employment niches and the absence of reproductive support constrain women’s success.
Quantifying the relationship between soil seed bank and plant community assemblage in sites harboring the threatened Ivesia webberi in the western Great Basin Desert
Authors: Borokini Israel T. , Weisberg Peter J. , Peacock Mary M.
Published: November 2020

Questions

The soil seed bank is an important ecosystem component that can be pivotal for long‐term persistence of many plant species, especially after disturbances followed by the invasion of alien weeds. However, many Great Basin Desert perennials produce relatively few viable seeds, while large areas of the Great Basin are currently invaded by alien weeds. This could result in dissimilarity in floristic composition between the above‐ground vegetative community and the soil seed bank, causing abrupt plant community shifts following disturbance. Therefore, we asked what is the relationship in the floristic composition between the above‐ground communities and the soil seed bank in sites where the threatened Ivesia webberi occurs?

Location

The Great Basin Desert, United States.

Methods

We used Dice–Sorensen's similarity index to estimate similarity between the standing vegetation and the soil seed bank. Redundancy analysis and variation partitioning were used to quantify the relationship between the total abundance of the sampled above‐ground flora and the soil seed bank, accounting for effects of spatial processes and environmental variables describing climate, soils, and vegetation in the 10 sites.

Results

Findings reveal high dissimilarity in species assemblage and abundance between the above‐ground plant communities and the soil seed bank. Most of the dominant native plant species sampled in the standing vegetation were absent in the soil seed bank, and the soil seed bank was dominated by invasive alien weeds.

Conclusions

Divergence in the floristic composition between the above‐ground communities and the soil seed bank in Ivesia webberi habitat indicates low resilience and high risk of native species loss following perturbation. Post‐disturbance succession in these plant communities may be largely dominated by invasive annual species; therefore, reduction of invasive species and native plant seeding may be necessary to sustain the ecological legacies of the desert ecosystem.
Mapping the experiences of people with achalasia from initial symptoms to long‐term management
Authors: Kalantari Melika , Hollywood Amelia , Lim Rosemary , Hashemi Majid
Published: November 2020

Background

Achalasia is a rare motility disorder affecting the oesophagus, which is associated with a range of symptoms and different treatment strategies. Currently, little is known about people's experiences with achalasia and its management. This study aimed to understand the experiences of people living with achalasia, from the initial onset of symptoms to long‐term management.

Method

This qualitative study explored the journey of people living with achalasia and outlined the care pathway using a process map. Ten female and five male participants living with achalasia (age range: 40‐73) took part, and all aspects of their diagnosis, treatment and management were discussed. A process map showing people's experiences by separating the management of their condition into a series of steps was developed to present the pathway in the participants’ journey. The analysis involved discussing the process map within the research team.

Results

The process map comprised of 10 steps, which occurred before and after diagnosis. The developed map indicates that most participants managed their on‐going symptoms through stress management techniques and dietary changes. Key issues that participants highlighted about their journey managing achalasia were misdiagnosis, delay in diagnosis and lack of support in the long‐term management of achalasia.

Conclusions

This research was a novel study exploring patients’ experiences and management of achalasia and mapping their journey. Two distinct phases to their journeys were identified: before and after diagnosis. Areas highlighted by this study can provide a basis for future research, in particular behaviour change to support the long‐term management of achalasia.
Cognitive function in toddlers with congenital heart disease: The impact of a stimulating home environment
Authors: Bonthrone Alexandra F. , Chew Andrew , Kelly Christopher J. , Almedom Leeza , Simpson John , Victor Suresh , Edwards A. David , Rutherford Mary A. , Nosarti Chiara , Counsell Serena J.
Published: November 2020

Infants born with congenital heart disease (CHD) are at increased risk of neurodevelopmental difficulties in childhood. The extent to which perioperative factors, cardiac physiology, brain injury severity, socioeconomic status, and home environment influence early neurodevelopment is not clear. Sixty‐nine newborns with CHD were recruited from St Thomas’ Hospital. Infants underwent presurgical magnetic resonance imaging on a 3‐Tesla scanner situated on the neonatal unit. At 22 months, children completed the Bayley Scales of Infant and Toddler Development‐3rd edition and parents completed the cognitively stimulating parenting scale to assess cognitive stimulation at home. Level of maternal education and total annual household income were also collected. Hospital records were reviewed to calculate days on the intensive care unit post‐surgery, time on bypass during surgery, and days to corrective or definitive palliative surgical intervention. In the final analysis of 56 infants, higher scores on the cognitively stimulating parenting scale were associated with higher cognitive scores at age 22 months, correcting for gestational age at birth, sex, and maternal education. There were no relationships between outcome scores and clinical factors; socioeconomic status; or brain injury severity. Supporting parents to provide a stimulating home environment for children may promote cognitive development in this high‐risk population.
Magnet hospital attributes in nursing work environment and its relationship to nursing students’ clinical learning environment and satisfaction
Authors: Rodríguez‐García M. Carmen , Márquez‐Hernández Verónica V. , Granados‐Gámez Genoveva , Aguilera‐Manrique Gabriel , Gutiérrez‐Puertas Lorena
Published: November 2020

Aims

To analyse nursing students’ perception of the Magnet hospital attributes of the work environment at the hospitals where they perform their clinical placement and the relationship of this factor to their clinical learning environment and supervision, satisfaction and intention to stay in those hospitals once graduated.

Design

This study had a cross‐sectional, correlational, design.

Methods

Data were collected using self‐reported questionnaires from 180 nursing students at a university in southeast Spain between September–October 2018. Nursing work environment and clinical learning environment were measured using the Practice Environment Scale of the Nursing Work Index and Clinical Learning Environment, Supervision and Nurse Teacher scale, respectively. Students’ satisfaction with the work environment and with the clinical learning process were measured using a four‐point Likert scale developed by the researchers. Percentages, frequencies, mean, standard deviation, χ2 test, Mann–Whitney U test, Spearman and phi correlation were used to analyse the data.

Results

Nursing students’ perception of greater Magnet‐like features at work environment was associated with better clinical learning environment (Spearman rs = |0.22–0.54|; p < .01) and satisfaction with the work environment (Spearman rs = 0.18; p = .01) and with their learning process (Spearman rs = 0.21; p < .01). Greater intention to stay working in the hospital after graduation was significantly associated with greater satisfaction with the learning process (phi = 0.31; p < .01) and the work environment (phi = 0.23; p = .02).

Conclusion

Magnet‐like features at the work environment lead to superior clinical learning environment and higher students’ satisfaction, two factors that play a decisive role in their decision to stay at hospitals where they performed clinicals after graduation.

Impact

In the face of a global nurse shortage, nursing managers and faculty leaders should consider the improvement of nursing workplaces as a strategic alliance to promote satisfactory clinical learning experience and aid recruitment of nurses.
The effect of delaying first bathing on skin barrier function in late preterm infants: A study protocol for multi‐centre, single‐blind RCT
Authors: Taşdemir Halil İbrahim , Efe Emine
Published: November 2020

Aims

The study aims to examine the effect of delaying first bathing on skin barrier function, body temperature, and neonatal comfort of late preterm infants.

Design

This study is a multi‐centre, single‐blind, prospective randomized controlled trial.

Methods

We attempt to report this randomized controlled trial to comply with the SPIRIT. The study population will consist of 80 late preterm infants born at three centres (hospitals) in Turkey. The study, between September 2020–September 2021 will be held in the Neonatal Intensive Care Unit. The participants will be randomly divided into two groups, each with different bathing times. The first group (N = 40) will be bathed between 24–48 hr after birth and the second group (N = 40) will be bathed between 48–72 hr after birth. Each group's intervention will be performed by a blinded researcher. The infants’ transepidermal water loss, body temperature, and comfort level will be measured before the bath and again at three times after the bath. The measurements will be taken by a blinded researcher and blinded nurse.

Discussion

The benefits of infant bathing are known. However, the effect of delaying first bathing of late preterm infants on skin barrier function is unknown. At the same time, the effect of delaying bathing on maintaining body temperature and neonatal comfort is unknown.

Impact

This study is expected to provide a piece of credible evidence of the delay of first bathing and benefit of neonatal care in this population. It is thought that postponing bathing time of late preterm infants to 48–72 hr after birth will lead to a protective effect on skin barrier and temperature. It will be performed in clinical practice if it can effectively improve transepidermal water loss and heat loss.

Trial registration

It was registered at ClinicalTrials.gov in January 2020 (NCT04231799).
Credit constraints, labor productivity, and the role of regional institutions: Evidence from manufacturing firms in Europe
Authors: Rodríguez‐Pose Andrés , Ganau Roberto , Maslauskaite Kristina , Brezzi Monica
Published: November 2020

This paper examines the relationship between credit constraints—proxied by the investment‐to‐cash flow sensitivity—and firm‐level economic performance— defined in terms of labor productivity—during the period 2009–2016, using a sample of 22,380 manufacturing firms from 11 European countries. It also assesses how regional institutional quality affects productivity at the level of the firm both directly and indirectly. The empirical results highlight that credit rationing is rife and represents a serious barrier for improvements in firm‐level productivity and that this effect is far greater for micro and small than for larger firms. Moreover, high‐quality regional institutions foster productivity and help mitigate the negative credit constraints–labor productivity relationship that limits the economic performance of European firms. Dealing with the European productivity conundrum thus requires greater attention to existing credit constraints for micro and small firms, although in many areas of Europe access to credit will become more effective if institutional quality is improved.
Achillea millefolium antagonism to Pratylenchus brachyurus
Authors: Baldisera Sephora Serrano , Schwengber Raiane Pereira , Ferreira Paulo Giliard da Silva , Jacomassi Ezilda , Gazim Zilda Cristiani , Santana‐Gomes Simone de Melo
Published: November 2020

Pratylenchus brachyurus is a phytonematode species mostly damaging crops. It is mainly controlled by agrochemicals which are harmful to the environment and public health. Such outcomes encourage the development of research on products and/or processes to control this phytonematode and to contribute to the sustainability of agricultural systems. Thus, the aim of the current study was to assess host suitability of Achillea millefolium to P. brachyurus, as well as the nematicidal potential of its essential oil and root exudates. We conducted two experiments with two different plant species—Glycine max (soya bean) and Achillea millefolium (yarrow)—based on a 2 × 3 factorial arrangement to assess host suitability. Plants were assessed 5, 10 and 15 days after inoculation through the fuchsine acid staining technique. Based on the results, A. millefolium was an unfavourable host to this phytonematode. Therefore, it can be recommended for crop rotation and/or succession systems in small areas. We tested the nematicidal activity of the essential oil and exudates of A. millefolium at concentrations of 0, 25, 50, 100, 200, 300, 400 and 500 µg/ml in a BOD incubator at 26°C for 48 hr. The essential oil showed increasing linear regression, that is the higher was the concentration, the higher was the mortality rate. Exudates showed a quadratic behaviour (p ≤ .05), leading to 60.83% nematode mortality. Therefore, the essential oil and root exudates of A. millefolium have the potential to control P. brachyurus. The essential oil showed antagonistic properties likely because of the presence of germacrene D (39.55%), (E,E)‐α‐farnesene (25.70%) and chamazulene (8.91%).
A Systematic Review of Factors Impacting Suicide Risk Among Rural Adults in the United States
Authors: Mohatt Nathaniel V. , Kreisel Carlee J. , Hoffberg Adam S. , MPH Leah Wendleton , Beehler Sarah J.
Published: November 2020

Purpose

Suicide rates continue to be significantly higher in rural compared to urban communities in the United States, with the suicide rate disparity continuing to grow since 1999. This systematic review synthesizes rural‐specific factors related to increased suicide risk.

Methods

OVID Medline, EMBASE, OVID PsycINFO, Web of Science, SocINDEX, Cochrane Library, and Google Scholar were searched for articles published after 2003 investigating rural adult suicide in the United States. Selection criteria were: (1) study participants > 18 years old; (2) included rural participants or communities; (3) included suicidal self‐directed violence outcomes; (4) within the United States; (5) published after 2003; (6) presented peer‐reviewed original data; (7) identified rural‐specific risk or protective factors for suicide or barriers to treatment.

Findings

Of the 1,058 records screened, 34 studies were included. The strength of evidence was relatively stronger for individual level factors including lethal means, alcohol and substance use.

Conclusions

Access to firearms is strongly related to elevated rural US suicide rates, with substance use, economic stress, and behavioral health care utilization as additional individual level factors that may contribute to the disparity. At the community level, economic distress and access to care were commonly identified factors. Future research should better quantify how risk factors contribute to rural suicide and examine interdependence across social‐ecological levels. Suicide prevention efforts for the rural United States must address access to lethal means, in particular the use of firearms, and navigate limited access to quality behavioral health care.
Exceptional Survival Among Kentucky Stage IV Non‐small Cell Lung Cancer Patients: Appalachian Versus Non‐Appalachian Populations
Authors: Pravosud Vira , Vanderford Nathan L. , Huang Bin , Tucker Thomas C. , Arnold Susanne M.
Published: November 2020

Purpose

To determine differences in exceptional survival (ES)—survival of 5 years or more past diagnosis—between stage IV non‐small cell lung cancer (NSCLC) patients residing in the Appalachian versus non‐Appalachian regions of Kentucky.

Methods

This was a population‐based, retrospective case‐control study of Kentucky patients, diagnosed with stage IV NSCLC between January 1, 2000, and December 31, 2011. The data were drawn from the Kentucky Cancer Registry.

Findings

Findings from the multivariable logistic regression revealed no significant differences in the odds of ES between patients who resided in Appalachian versus non‐Appalachian Kentucky. Being female and undergoing surgery only as the first course of treatment were associated with higher odds of ES. Increasing age, unspecified histology, having poorly differentiated or undifferentiated carcinomas, and receiving radiation therapy only as the first course of treatment were associated with decreased odds of ES.

Conclusion

Differences in the odds of ES among stage IV NSCLC patients were not related to residence in Appalachian versus non‐Appalachian Kentucky. ES was associated with other nongenetic and treatment factors that warrant further investigations.
Extensions of Rosenblatt's results on the asymptotic behavior of the prediction error for deterministic stationary sequences
Authors: Babayan Nikolay M. , Ginovyan Mamikon S. , Taqqu Murad S.
Published: November 2020

One of the main problem in prediction theory of discrete‐time second‐order stationary processes X(t) is to describe the asymptotic behavior of the best linear mean squared prediction error in predicting X(0) given X(t), −n ≤ t ≤ −1, as n goes to infinity. This behavior depends on the regularity (deterministic or non‐deterministic) of the process X(t). In his seminal article ‘Some purely deterministic processes’ (J. of Math. and Mech., 6(6), 801–10, 1957), Rosenblatt has described the asymptotic behavior of the prediction error for deterministic processes in the following two cases: (i) the spectral density f of X(t) is continuous and vanishes on an interval, (ii) the spectral density f has a very high order contact with zero. He showed that in the case (i) the prediction error behaves exponentially, while in the case (ii), it behaves like a power as . In this article, using an approach different from the one applied in Rosenblatt's article, we describe extensions of Rosenblatt's results to broader classes of spectral densities. Examples illustrate the obtained results.
Hydroxychloroquine Controversies: Clinical Trials, Epistemology, and the Democratization of Science
Authors: Berlivet Luc , Löwy Ilana
Published: November 2020

The claim that anti‐malaria drugs, chloroquine and hydroxychloroquine, can cure COVID‐19 became a focus of fierce political battles that pitted promoters of these pharmaceuticals, Presidents Bolsonaro and Trump among them, against “medical elites.” At the center of these battles are different meanings of effectiveness in medicine, the complex role of randomized clinical trials (RCTs) in proving such effectiveness, the task of medical experts and the state in regulating pharmaceuticals, patients’ activism, and the collective production of medical knowledge. This article follows the trajectory of chloroquine and hydroxychloroquine as anti‐COVID‐19 drugs, focusing on the reception of views of their main scientific promoter, the French infectious disease specialist, Didier Raoult. The surprising career of these drugs, our text proposes, is fundamentally a political event, not in the narrow sense of engaging specific political fractions, but in the much broader sense of the politics of public participation in science.
Congenital dermoid sinus of the anterior chest region
Authors: Shin Hyun Beak , Park Ho Sung , Park Eun Hae , Jeong Yeon Jun
Published: November 2020

Background

Congenital dermoid sinus of the anterior chest region (CDACR) is a rare developmental anomaly. Therefore, the aim of our study was to draw attention to this underrecognized lesion.

Methods

From 2011 to 2019, our study group included 11 patients who presented to our hospital with pits and masses of their anterior chest walls. All lesions were surgically excised with histologic confirmation of the diagnosis of CDACR. The medical records of these patients were reviewed for the following data: patient age, gender, clinical characteristics of the lesion and site of involvement, department first visited, diagnostic evaluation, management, postoperative complications, and histopathological findings.

Results

There was a clear left‐sided predominance, with 10/11 cases occurring on the left and a female predominance of eight cases out of 11. Although the pits were present at birth, the mean age at presentation was 19.7 months. All patients showed clinical signs of infection at the time of presentation and were treated with antibiotics. Seven patients had a history of abscess formation treated with incision and drainage. Ultrasound was performed in eight patients. In all cases, the lesions, including pit and sinus, were completely excised.

Conclusions

Congenital dermoid sinus of the anterior chest region is likely underrecognized. We encountered a high frequency of complications such as infections or abscesses prior to surgical excision. Complete excision of CDACR is not technically difficult. Therefore, surgical removal should be considered, even for asymptomatic lesions, to avoid future complications and for cosmesis.
Retributivism and the proportionality dilemma
Authors: Ryberg Jesper
Published: November 2020

‘Retributivism’ covers a wide range of theories which, even though they differ in various ways, all give some room for proportionality considerations with regard to the question of how severely offenders should be punished. This article addresses the question—well‐known from traditional ethical theory—as to whether proportionality constraints should be given an absolutist or a non‐absolutist interpretation. It is argued that both absolutist and some non‐absolutist accounts of proportionality constraints have counter‐intuitive implications and, more generally, that the non‐absolutist interpretation, to which most retributivists seem to subscribe, faces serious challenges with regard to how the thresholds of such constraints should be determined. It is concluded that, given the aspiration of providing genuine action guidance for penal practice, the retributivist faces a dilemma that is not easily resolved.
Medication management in dialysis: Barriers and strategies
Authors: Cardone Katie E. , Parker Wendy M.
Published: November 2020

People with end‐stage kidney disease (ESKD) who require chronic dialysis are often reliant on complicated medication regimens to manage their health conditions. Due to the complexities of the advanced kidney disease, underlying comorbidities, and special instructions, medication regimens for patients on dialysis put patients at high risk for medication therapy problems related to safety, effectiveness, appropriateness, and adherence. This article explores the factors that affect optimal medication use for people on dialysis, including the broader drug use system, and offers recommendations around medication reconciliation, medication review, deprescribing, and considering social determinants of health to improve medication management among patients with ESKD.
Barriers to home dialysis: Unraveling the tapestry of policy
Authors: Fissell Rachel B. , Cavanaugh Kerri L.
Published: November 2020

Home dialysis use as a treatment for end‐stage kidney disease varies locally, nationally, and internationally. There is a call to action in the United States to significantly increase access and uptake of home dialysis as the preferred dialysis treatment option. Although most do not object to patient choice in modality selection, the reality is that there are multilevel barriers both obvious and subtle that interfere with expanding home dialysis access. Financial barriers and how payment is structured continue to be key drivers, although new models of care are emerging that include for the first time incentives rather than penalties regarding home dialysis. Resources to support implementation include expert personnel requiring educational training. Policies requiring training curriculum content that is not only specified within nephrology but also for these multidisciplinary providers requisite for successful home dialysis to ensure professional expertise is ready and available, and also to cultivate champions of home modality within the broader nephrology community. Perhaps most importantly, innovation through expanded investment in research is necessary to advance practices, elevate quality, and improve outcomes. Policy in a variety of sectors at local, regional, national, and international levels has the potential to drastically drive expansion and increasing success of home dialysis.
Costs associated with transfusion therapy in patients with myelodysplastic syndromes in Sweden: a nationwide retrospective cohort study
Authors: Zhao Jingcheng , Dahlén Torsten , Edgren Gustaf
Published: November 2020

Background and objectives

Blood transfusion is a cornerstone therapy for many patients with myelodysplastic syndromes (MDS), but ranges from few to no transfusions to intensive transfusion therapy. To date, no large studies have described transfusion use or costs for patients with MDS, accounting for the range of disease severity.

Materials and methods

A nationwide cohort study was conducted with all patients diagnosed with MDS in Sweden between 2008 and 2017, based on the Swedish MDS register and the Swedish part of the Scandinavian Donations and Transfusions Database 3 (SCANDAT3‐S). Patients were followed from diagnosis until death, emigration, allogeneic hematopoietic stem cell transplantation or end of follow‐up. Average cumulative transfusion count and costs over time were calculated, stratified by the revised international prognostic scoring system (IPSS‐R) and age at diagnosis. Costs calculations used data on incident transfusions and laboratory testing and were divided into: direct material costs, direct labour costs and laboratory costs.

Results

In total, 2311 patients were included in the cohort. In the first four years after diagnosis, patients in the very low IPSS‐R category received on average 25 red cell (95% confidence interval, 20–32) and 4 (3–7) platelet transfusions. Conversely, patients in the very high‐risk category received on average 171 (135–200) red cell and 66 (51–78) platelet transfusions. Correspondingly, transfusion costs ranged from $8805 ($6482–$11 625) to $80 106 ($61 460–$95 792).

Conclusion

Transfusion count and costs for patients with MDS increased markedly with IPSS‐R risk category, but were similar across age groups. Transfusion costs were considerable for the highest IPSS‐R risk categories.
Use of Evidence‐Based Practice Among Healthcare Professionals After the Implementation of a New Competency‐Based Curriculum
Authors: Engels Cynthia , Boutin Emmanuelle , Boussely Fabien , Bourgeon‐Ghittori Irma , Couturier Bérengère , Fromantin Isabelle , Lafuente‐Lafuente Carmelo , Canoui‐Poitrine Florence
Published: November 2020

Background

Although evidence‐based practice (EBP) has been spreading since the 1990s, it has not yet been sufficiently implemented.

Aim

Following the reform of initial training for healthcare professions in France 2012, we sought to determine whether the new curriculum was associated with more frequent use of EBP.

Methods

We performed an online, cross‐sectional survey of nurses, occupational therapists, and podiatrists (divided into pre‐ and post‐reform groups) in June 2018. The questionnaire covered demographic data, use of EBP, and the perception of EBP. As holding a master’s degree may enhance knowledge and use of EBP, we adjusted for this variable. Categories to analyze qualitative data were created regarding the five steps in EBP and its definition.

Results

The total sample was N = 595 (pre‐reform group n = 301; post‐reform group n = 294). The proportion of respondents who frequently read the professional literature was lower in the post‐reform group than in the pre‐reform group (33% vs. 54%, respectively; OR [95% CI] = .52 [.37–.73]; p < .001). The main stated reasons for reading the professional literature were “keeping up to date with practice” and “making clinical decisions.” Respondents in both groups mentioned a lack of time as the most frequent barrier to reading the literature (82%), a lack of access to bibliographical resources, and that EBP was not encouraged. Most professionals limited their definition of EBP to reading the literature and implementing research results.

Linking Evidence to Action

There is a need to teach the five steps of EBP more explicitly and to embed its position into daily practice, for example, through reflective analysis practice. Professional trainings about EBP should be offered on a regular basis. Guidance coming from the healthcare directorate should include expected daily practice time for reading and journal club and giving more access to international healthcare literature.