bluuebunny/crossref_metadata_2025 huggingface dataset:
Resilience, mental health and urban migrants: a narrative review
Authors: Coope Jonathan , Barrett Andy , Brown Brian , Crossley Mark , Raghavan Raghu , Sivakami Muthusamy
Published: June 2020

Purpose

The purpose of this paper is to provide a narrative review of the literature on mental health resilience and other positive mental health capacities of urban and internal migrants.

Design/methodology/approach

The methodology for this narrative review included a search of articles published up to 2017. The abstracts were screened and relevant articles studied and discussed. Literature on the particular mental health challenges of urban migrants in India was also studied. References found in the literature relating to neurourbanism were also followed up to explore broader historical and conceptual contexts.

Findings

Several key sources and resources for mental health resilience were identified – including familial and community networks and individual hope or optimism. Nevertheless, much of the literature tends to focus at the level of the individual person, even though ecological systems theory would suggest that mental health resilience is better understood as multi-layered, i.e. relevant to, and impacted by, communities and broader societal and environmental contexts.

Originality/value

This paper provides insight into an aspect of migrant mental health that has tended to be overlooked hitherto: the mental health resilience and positive mental health capacities of urban migrants. This is particularly relevant where professional “expert” mental health provision for internal migrant communities is absent or unaffordable. Previous work has tended to focus predominantly on mental health risk factors, despite growing awareness that focusing on risk factors along can lead to an over-reliance on top-down expert-led interventions and overlook positive capacities for mental health that are sometimes possessed by individuals and their communities.
The interplay of governance mechanisms in supply chain collaboration and performance in buyer–supplier dyads: substitutes or complements
Authors: Um Ki-Hyun , Oh Jae-Young
Published: June 2020

Purpose

This study seeks: (1) to identify whether the form of governance adopted (relational or contractual) drives suppliers' and buyers' collaboration in the same way; (2) to examine if both parties hold a similar view on the simultaneous use of both governance forms; and (3) to explore whether their perceptions on governance, collaboration and performance differ.

Design/methodology/approach

The study used data from a survey of 150 matched buyer–supplier dyads from South Korea, using structural equation modeling (SEM) for the analysis.

Findings

(1) While governance mechanisms assist collaboration and affect operational and innovation outcomes, the significance and relative strength of the proposed relationships are perceived differently by buyers and suppliers. (2) Contrasting results are found regarding the interaction effect of the governance mechanisms on collaboration: a complementary relationship for the buyer and a substitutive relationship for the supplier.

Originality/value

Studies on buyer–supplier relationships have yielded inconsistent results regarding whether the interactions of governance mechanisms function as substitutes or complements, because research has largely been conducted from the buyer's perspective, rather than the supplier's; this imbalanced view calls for integrated perspectives.
Desperately seeking happy chickens: producer dynamics and consumer politics in quality agricultural supply chains
Authors: Carter Elizabeth
Published: June 2020

Purpose

The purpose of this paper is to understand why the quality markets are expanding in some areas of food production, while struggling in others. Across agricultural markets in advanced industrialized economies, there are movements toward quality production and consumption. The author argues that the quality turn in beer, coffee, wine and other transformed artisanal food production are fundamentally different from the quality movements in primary food products. The heart of that difference lies in the nature of the supply chain advantages of transformed versus primary agricultural products.

Design/methodology/approach

The author applies convention theory to explain the dynamics within transformed agricultural quality markets. In these producer-dominant markets, networks of branded producers shape consumer notions of product quality, creating competitive quality feedback loops. The author contrasts this with the consumer-dominant markets for perishable foods such as produce, eggs, dairy and meat. Here, politically constructed short supply chains play a central role in building quality food systems.

Findings

The emergence of quality in primary food products is linked to the strength of local political organization, and consumers have a greater role in shaping quality in these markets.

Originality/value

Quality beer, coffee, wine and other transformed products can emerge without active political intervention, whereas quality markets for perishable foods are the outcome of political action.

Peer review

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-01-2020-0001.
Does mobile money promote financial inclusion in Eswatini?
Authors: Myeni Siphesihle , Makate Marshall , Mahonye Nyasha
Published: June 2020

Purpose

Mobile money, a service permitting monetary value to be digitally stored in a mobile phone and transacted to others through text messaging, is increasingly becoming available in several African countries including Eswatini. This study examines the factors associated with mobile money usage and the extent to which mobile money accelerates financial inclusion in Eswatini.

Design/methodology/approach

Data were collected from the nationally representative FinScope Consumer Survey for Eswatini conducted in 2014. The authors use a quasi-experimental method in propensity score matching (PSM) with bootstrapped standard errors to alleviate the possibility of selection bias associated with mobile money use and bank account ownership. As a sensitivity check, the authors calculate the average treatment effect (ATE) using kernel-based matching methods, as well as estimate a multilevel model that accounts for the hierarchical structure of data.

Findings

The authors found that higher education, entrepreneurship, being female, improvement in work situation in the past year and living in urban area and in the Lubombo region all positively influence the probability to use mobile money. The results also show that individuals who use mobile money are 19% more likely to own a bank account at a formal financial institution with a higher probability estimate observed amongst rural residents.

Originality/value

This study examines whether mobile money accelerates financial inclusion in Eswatini. On analysing data from the 2014 FinScope Consumer Survey, the results show that mobile money does not seem to be accelerating the reach of financial services to those who are structurally excluded from the formal financial system and suggest the need for ongoing review of the financial inclusion strategies of the country to enhance access to financial services in underserved areas.

Peer review

The peer review history for this article is available at:https://publons.com/publon/10.1108/IJSE-12-2019-0723
Advocacy in authoritarian contexts: the case of disability NGOs in Russia
Authors: Toepler Stefan , Fröhlich Christian
Published: June 2020

Purpose

The growing trend towards closing the political space for civil society in authoritarian regimes has primarily targeted NGOs focused on rights-based advocacy. Drawing on a study of disability NGOs in Russia, this paper seeks to contribute to a better understanding of the advocacy options that nonprofit organizations have even in repressive political contexts. The authors first review the extant literature to identify common actors, types and tactics and then trace what types of advocacy Russian NGOs are engaged in and what tactics they are able to utilize.

Design/methodology/approach

The empirical part of this paper is based on 20 interviews conducted among active participants in disability NGOs in Moscow, St. Petersburg, Perm and Nizhniy Novgorod. Despite not being a representative sample of organizations, the selection of cities and organizations was intended to reflect spatial and structural factors of the field.

Findings

The authors find that NGOs are able to pursue a broad range of advocacy activities despite a generally restrictive legal environment for civil society.

Research limitations/implications

Research on advocacy in authoritarian countries is often focused on NGOs that are primarily engaged in these activities. This has overshadowed the considerable leeway that nonprofit service providers have to engage in advocacy.

Practical implications

Service-providing NGOs should not forsake advocacy activities, even in authoritarian contexts, but can find access points in the political system and should seek to utilize their voice on behalf of their clients.

Social implications

Despite general restrictions, NGOs can still find ways to successfully secure social rights, justice and solidarity, provided they accept the supremacy of the state in social policy and appeal to the state's responsibility for the welfare of its citizens without directly questioning the overall status quo too heavily.

Originality/value

We develop a broad framework for various advocacy forms and activities and apply it to nonprofit service providers.
Relevance and challenges of wine tourism in Germany: a winery operators’ perspective
Authors: Tafel Maximilian Carl , Szolnoki Gergely
Published: June 2020

Purpose

This paper aims to put Germany on par with other countries in terms of academic research on the topic of wine tourism from a producers’ perspective.

Design/methodology/approach

For this study, 199 in-depth interviews and 703 online questionnaires with winery operators in Germany were collected and analyzed according to a mixed-methods framework.

Findings

The results indicate that wine tourism is highly relevant not only for wineries but also for the families behind the predominantly small companies. The respondents reported increased demand for wine tourism activities, particularly those that are close to large cities. The findings show that the main challenges in the German wine tourism sector are to achieve a coordinated collaboration among stakeholders and to stop the ongoing concentration process in the restaurant industry.

Social implications

Appropriate strategic decisions backed by governmental support may help to enhance Germany’s developing wine tourism industry, thereby preserving cultural heritage and strengthening some of the country’s structurally disadvantaged rural areas.

Originality/value

To the best of the authors’ knowledge, this work is the first mixed-methods framework study in the research field of wine tourism that includes producers from all wine regions in one country.
Halal food credence: do the Malaysian non-Muslim consumers hesitate?
Authors: Wibowo Mas Wahyu , Permana Dudi , Hanafiah Ali , Ahmad Fauziah Sh , Ting Hiram
Published: June 2020

Purpose

The purpose of this paper is to introduce the variable of halal food knowledge (HFK) into the theory of planned behavior framework to investigate Malaysian non-Muslim consumers’ decision-making process in purchasing halal food.

Design/methodology/approach

Data were collected through 350 distributed questionnaires toward non-Muslim consumers on five most visited grocery stores (hypermarket-based) in Kuala Lumpur and Selangor. The collected data was analyzed by using Statistical Package for Social Sciences and SmartPLS.

Findings

Purchasing halal food remain an uneasy task for the non-Muslim consumers, thus rely on their personal evaluation and closest relative’s approval.

Research limitations/implications

This study is focusing only on two halal food credence attributes namely health attribute and animal-friendly attributes.

Practical implications

Both health and animal friendly credence attributes of halal food should be the main message to be conveyed to the non-Muslim consumers. In addition, the inclusion of non-Muslim consumers within the Malaysian halal ecosystem might provide a solution to tackle the resistance of halal food from foreign countries.

Originality/value

The value of this study is the finding of halal food credence attributes of health and animal friendly, which are the dimensions of HFK.
Antecedent consumer factors, consequential branding outcomes and measures of online consumer engagement: current research and future directions
Authors: Vander Schee Brian A. , Peltier James , Dahl Andrew J.
Published: June 2020

Purpose

The purpose of this study is to summarize the findings of consumer factor research and to suggest future lines of inquiry connected to branding outcomes. Consumers are comfortable with social media and accept firms occupying the same digital space. However, some consumers more readily engage with firms online than others. Consumer factor antecedents are numerous and yet not fully explored. Online consumer engagement has also been defined and measured in various ways. The resultant outcomes related to branding also have implications for future consumer engagement. Summarizing the findings of consumer factor research and suggesting future lines of inquiry connected to branding outcomes will enhance the understanding of consumer engagement and branding strategies to maximize marketing return on investment.

Design/methodology/approach

The authors review literature examining key constructs and sub-dimensions on how consumer factors impact brand engagement and brand outcomes.

Findings

Three major research areas specific to consumer factors were identified: consumer status, consumer disposition, personality trait, intrinsic motivation, extrinsic motivation and cultural dimensions. Brand engagement was explored relative to affective, cognitive and behavioral engagement. Lastly, six brand outcomes were explored: brand status, disposition, attitude, affirmation connection and aversion.

Practical implications

This review contributes to the literature through a deeper understanding of consumer factors that lead to consumer engagement and the resultant branding factors of consumer engagement. The authors offer framework that both identifies future research needs, and insights into how firms may create, grow and enhance consumer–brand engagement.

Originality/value

Given the dearth of comprehensive brand engagement frameworks in the literature, the authors offer insights into how consumer factors serve as antecedents to brand engagement and identify a research agenda for advancing the field.
Users' perceived level of service at the African Union Court on Human and Peoples' Rights library in Arusha, Tanzania
Authors: Mutisya Fidelis , Onyancha Omwoyo Bosire
Published: June 2020

Purpose

The study examined users' perceived level of service at the African Union Court on Human and Peoples' Rights (AUCHPR) library in Arusha, Tanzania.

Design/methodology/approach

The study adopted a quantitative approach in line with the tenets of the LibQUAL and SERVQUAL protocols, which were used as theoretical lenses and informed the development of questionnaires which were used to collect data. The target population consisted of 94 library users.

Findings

The study found that the library's best services, in terms of their quality and as perceived by users, lie in its human resources (i.e. affect of service, assurance and responsiveness). On the other hand, the lowest perceived level of services was recorded in the aspects related to information collection and physical facilities (i.e. library as a place and tangibles).

Research limitations/implications

This study was based on the African Court on Human and Peoples' Rights library in Arusha, Tanzania. The study covered both internal and external users of the library.

Practical implications

The study identified strengths and weaknesses of the African Court library as far as the perceived level of service is concerned, and the findings can therefore be used to inform decisions on the improvement of quality of the library services. In so doing, the library will be in a stronger position to offer quality services and assist the court in attaining its objectives of promoting and protecting human rights in Africa. With improved library service quality, the non-judicial staff, external users and society in general will stand to benefit from the library.

Originality/value

While drawing lessons from previous service quality studies, this study is the first quality assessment study to be done in the African Court library. It is also the first to use a combination of LibQUAL and SERVQUAL models in the context of the African Court library services.
Open research data in African academic and research libraries: a literature analysis
Authors: Chiware Elisha R.T.
Published: June 2020

Purpose

The paper presents a literature review on research data management services in African academic and research libraries on the backdrop of the advancing open science and open research data infrastructures. It provides areas of focus for library to support open research data.

Design/methodology/approach

The literature analysis and future role of African libraries in research data management services were based on three areas as follows:open science, research infrastructures and open data infrastructures. Focussed literature searches were conducted across several electronic databases and discovery platforms, and a qualitative content analysis approach was used to explore the themes based on a coded list.

Findings

The review reports of an environment where open science in Africa is still at developmental stages. Research infrastructures face funding and technical challenges. Data management services are in formative stages with progress reported in a few countries where open science and research data management policies have emerged, cyber and data infrastructures are being developed and limited data librarianship courses are being taught.

Originality/value

The role of the academic and research libraries in Africa remains important in higher education and the national systems of research and innovation. Libraries should continue to align with institutional and national trends in response to the provision of data management services and as partners in the development of research infrastructures.
Exploring the common factors affecting the strategic plans in Iranian academic libraries
Authors: Panahi Sirous , Ghalavand Hossein , Sedghi Shahram , Nabiolahi Abdolahad , Khani Sedigheh
Published: June 2020

Purpose

One of the important processes for success or failure of strategic plans in academic libraries is identifying different dimensions and factors affecting library activities and services. However, more previous studies focusing on strategic planning processes and few research have explored perspectives of academic library managers in factors affecting designed strategic plans. This article aims to identify the common factors affecting the strategic plans in Iranian academic libraries.

Design/methodology/approach

After adopting a qualitative survey design, 28 Iranian academic library managers were interviewed. Purposive snowball sampling method was used to select the libraries’ managers, and the data analysis was done using the thematic analysis method by MAXQDA 10.

Findings

The study revealed three main themes including personal, professional and organizational factors that effect on academic libraries’ strategic plans. Users' expectations and librarians' personality characteristics were identified as two sub-themes for personal factors. In term of professional factors, scientific achievement of libraries and communication skills are the most important factors. Academicals factors, managerial factors and budget alignment are most important organizational factors that affect the Iranian academic libraries’ strategic plans.

Originality/value

Iranian academic libraries use different approaches for developing their strategic plans. However, by revealing the common affecting factors by academic library managers, the study provides an opportunity for better controlling the academic libraries' strategic plans progresses.
Estimation of GDP from public library usage: Turkey sample
Authors: Öztemiz Semanur , Tekindal Mustafa Agah
Published: June 2020

Purpose

Public libraries are institutions that provide information services to all citizens in a country and support the development of lifelong learning, awareness and creativity. All these provide an advantage for having a developed economy and being a developed society. This study aims to reveal the interaction between the gross domestic product (GDP) and public library usage in Turkey. The study also purposed to increase awareness of the economic benefits of public libraries.

Design/methodology/approach

In the study, a vector autoregression (VAR) model and co-integration techniques were used. Johansen co-integration test was used examining the long-term relationship between the variables. Due to the variables moving together in the long term, the vector error-correction model was preferred instead of the VAR model, as a result.

Findings

According to the causality test results, GDP was found to be affected when there was a change in the number of library users. According to the Granger causality test result, a change in GDP was also found to have a significant effect on the number of library users. All these indicate an interaction between GDP and public library usage in Turkey between 2001 and 2017.

Social implications

The revealed interaction between GDP and the number of public library users can be useful for policymakers who are making decisions to develop public library services and to increase GDP.

Originality/value

The interaction between public library usage and GDP can be seen such as an unlikely combination. However, this study presented a mutual interaction between public library usage and GDP. The findings of the study will be of a great importance in developing countries to be motivated to make public library services better.
US academic libraries' staffing and expenditure trends (1996–2016)
Authors: Hoffman Starr , Godbey Samantha
Published: June 2020

Purpose

This paper explores trends over time in library staffing and staffing expenditures among two- and four-year colleges and universities in the United States.

Design/methodology/approach

Researchers merged and analyzed data from 1996 to 2016 from the National Center for Education Statistics for over 3,500 libraries at postsecondary institutions. This study is primarily descriptive in nature and addresses the research questions: How do staffing trends in academic libraries over this period of time relate to Carnegie classification and institution size? How do trends in library staffing expenditures over this period of time correspond to these same variables?

Findings

Across all institutions, on average, total library staff decreased from 1998 to 2012. Numbers of librarians declined at master’s and doctoral institutions between 1998 and 2016. Numbers of students per librarian increased over time in each Carnegie and size category. Average inflation-adjusted staffing expenditures have remained steady for master's, baccalaureate and associate's institutions. Salaries as a percent of library budget decreased only among doctoral institutions and institutions with 20,000 or more students.

Originality/value

This is a valuable study of trends over time, which has been difficult without downloading and merging separate data sets from multiple government sources. As a result, few studies have taken such an approach to this data. Consequently, institutions and libraries are making decisions about resource allocation based on only a fraction of the available data. Academic libraries can use this study and the resulting data set to benchmark key staffing characteristics.
Exploring entrepreneurial characteristics, motivations and behaviours in equity crowdfunding: some evidence from Italy
Authors: Troise Ciro , Tani Mario
Published: June 2020

Purpose

This study explores entrepreneurial decision-making in the equity crowdfunding (ECF) context, and it aims to shed some light on the relationship among three aspects: entrepreneurial characteristics (i.e. entrepreneurial alertness and entrepreneurial self-efficacy), entrepreneurial motivations (i.e. promotion, improvement of networking and acquisition of product and market knowledge) and entrepreneurial behaviours (i.e. campaign characteristics in terms of communication and offerings).

Design/methodology/approach

The hypotheses testing and analysis were conducted using the partial least squares approach to structural equation modelling, and data were collected from the overall population of Italian ECF platforms.

Findings

Our results highlight that entrepreneurial characteristics may be central in ECF because of their significant impact on some motivation entrepreneurs have to adopt ECF, which in turn have an impact on meaningful campaign characteristics that can influence ECF performance.

Originality/value

The current literature is mainly focused on investors' decisions, while a neglected perspective until now has been that of entrepreneurs. This study is among the first to focus on entrepreneurs in the ECF context, and, to the best of our knowledge, it is the first study to investigate the entrepreneurial decision-making process. The added value of this research lies in the analysis of the entrepreneurial aspects underlying entrepreneurial decisions to use ECF.
Impacts of Cittaslow philosophy on sustainable tourism development
Authors: Ince Ecem , Iscioglu Deniz , Ozturen Ali
Published: June 2020

Purpose

Sustainability concept exists in the soul of the Cittaslow (slow city) philosophy. This protest movement is mainly based on the philosophy of sustainability by promoting the “slowness” perspective and the concept of sustainable development at the local level. The purpose of this paper is to analyze the impacts of Cittaslow (slow city) philosophy on support for sustainable tourism development in North Cyprus. In this context, this research study is concentrated on the influences of Cittaslow practices on support for sustainable tourism development with dimensions in terms of socio-cultural, economic and ecological aspects.

Design/methodology/approach

This study was based on a quantitative research approach to observe the significant effects and meet the objectives. The data were collected randomly by self-administrated questionnaires from residents who are living in the slow cities (Yeni Bogaziçi, Mehmetçik, Lefke, Geçitkale and Tatlisu) at North Cyprus.

Findings

The partial least squares approach to the structural equation model was used to analyze the data. The research results were discussed the critical issues and consequences in the management of slow cities.

Originality/value

The slow city concept is a very significant movement that emphasizes the importance of local differences and sustainability. There is a lack of knowledge about the effects of Cittaslow membership and efforts on sustainable tourism development in North Cyprus. The critical factors and implications were pinpointed for enhancing sustainable tourism development in slow cities.
Effects of metallic system components on marine electromagnetic loop data
Authors: Reeck Konstantin , Müller Hendrik , Hölz Sebastian , Haroon Amir , Schwalenberg Katrin , Jegen Marion
Published: June 2020

Electromagnetic loop systems rely on the use of non‐conductive materials near the sensor to minimize bias effects superimposed on measured data. For marine sensors, rigidity, compactness and ease of platform handling are essential. Thus, commonly a compromise between rigid, cost‐effective and non‐conductive materials (e.g. stainless steel versus fibreglass composites) needs to be found. For systems dedicated to controlled‐source electromagnetic measurements, a spatial separation between critical system components and sensors may be feasible, whereas compact multi‐sensor platforms, remotely operated vehicles and autonomous unmanned vehicles require the use of electrically conductive components near the sensor. While data analysis and geological interpretations benefit vastly from each added instrument and multidisciplinary approaches, this introduces a systematic and platform‐immanent bias in the measured electromagnetic data. In this scope, we present two comparable case studies targeting loop‐source electromagnetic applications in both time and frequency domains: the time‐domain system trades the compact design for a clear separation of 15 m between an upper fibreglass frame, holding most critical titanium system components, and a lower frame with its coil and receivers. In case of the frequency‐domain profiler, the compact and rigid design is achieved by a circular fibreglass platform, carrying the transmitting and receiving coils, as well as several titanium housings and instruments. In this study, we analyse and quantify the quasi‐static influence of conductive objects on time‐ and frequency‐domain coil systems by applying an analytically and experimentally verified 3D finite element model. Moreover, we present calibration and optimization procedures to minimize bias inherent in the measured data. The numerical experiments do not only show the significance of the bias on the inversion results, but also the efficiency of a system calibration against the analytically calculated response of a known environment. The remaining bias after calibration is a time/frequency‐dependent function of seafloor conductivity, which doubles the commonly estimated noise floor from 1% to 2%, decreasing the sensitivity and resolution of the devices. By optimizing size and position of critical conductive system components (e.g. titanium housings) and/or modifying the transmitter/receiver geometry, we significantly reduce the effect of this residual bias on the inversion results as demonstrated by 3D modelling. These procedures motivate the opportunity to design dedicated, compact, low‐bias platforms and provide a solution for autonomous and remotely steered designs by minimizing their effect on the sensitivity of the controlled‐source electromagnetic sensor.
Comparing biocontrol and herbicide for managing an invasive non‐native plant species: Efficacy, non‐target effects and secondary invasion
Authors: Peterson Paul G. , Merrett Merilyn F. , Fowler Simon V. , Barrett Douglas Paul , Paynter Quentin
Published: June 2020

Globally, invasive non‐native plants are an increasing threat to indigenous biodiversity and ecosystems, but management can be compromised by poor efficacy of control methods, harmful non‐target effects or secondary invasions by other non‐native plant species.

A 5‐year field trial compared two stakeholder‐selected control methods for heather, a European plant invading native ecosystems in and adjoining Tongariro National Park in New Zealand. The control methods were a selective herbicide (Pasture Kleen®; 2,4‐D ester) and biocontrol with an introduced beetle Lochmaea suturalis (Coleoptera: Chrysomelidae).

Biocontrol reduced mean heather cover by 97%, slightly more than herbicide at 87%, compared with a 20% increase in heather under no management.

Cover of native dicots, the most species‐rich plant group, increased following biocontrol. In contrast, herbicide application had major non‐target effects on native dicots, reducing their percentage cover and species richness. Native monocot cover and species richness increased following both herbicide and biocontrol treatments.

A similar eightfold increase in non‐native monocots occurred following both biocontrol and herbicide treatments. Overall, secondary invasion was greatest with biocontrol because non‐native dicot cover also increased, whereas herbicide almost eliminated non‐native dicots.

Synthesis and applications. Biocontrol and herbicide treatments both controlled heather but herbicide application was associated with severe non‐target impacts on native dicots. Benefits to the native flora were consequently greatest in the biocontrol treatment, despite greater secondary invasion. Control strategies for management of widespread non‐native plants to optimize ecosystem outcomes should include more consideration of biocontrol.
Evaluation of a Novel Protocol for Assessment and Treatment of Alcohol Withdrawal Syndrome in Psychiatric Inpatients
Authors: Butterfield Michael , Thorne‐Humphrey Lucas , Suzuki Joji , Herschenhous Nicole
Published: June 2020

Background and Objectives

Despite the high incidence of alcohol withdrawal syndrome (AWS) in psychiatric inpatients, standardized methods for assessing and treating AWS have been studied only once before in this population. We evaluated a novel AWS assessment and treatment protocol designed for psychiatric inpatients.

Methods

This retrospective cohort study evaluated outcomes before and after implementation of the protocol. We collected consecutive data on patients (N = 138) admitted to inpatient psychiatric units at a single center. Participants were patients admitted for nonsubstance‐related psychiatric reasons, who were also at risk for developing AWS. Those who developed AWS were treated with either (a) treatment as usual (TAU) or (b) a novel standardized protocol. The primary outcome was duration of benzodiazepine treatment for symptoms of alcohol withdrawal. Secondary outcomes included cumulative benzodiazepine dose administered, treatment duration, and incidence of complications.

Results

Of 138 participants, 83 received TAU and 55 were assessed and treated with the novel protocol. Median duration of benzodiazepine treatment following protocol implementation was 19.7 hours (interquartile range [IQR], 0‐46) prior to implementation (TAU) and 0 hours (IQR, 0‐15) following protocol implementation (protocol group) (P < .0001). Median benzodiazepine dose (in diazepam equivalents) administered to participants was 30 mg (IQR, 0‐65) for TAU and 5 mg (IQR, 0‐30) for the protocol group (P < .001). Adverse events before and after implementation occurred in 4.8% and 0%, respectively (P = .15).

Conclusion and Scientific Significance

This study provides preliminary evidence for the efficacy and safety of a novel standardized AWS protocol for psychiatric inpatients. This is the first known study assessing an AWS assessment and treatment protocol designed for psychiatric inpatients. (Am J Addict 2020;29:500–507)
Winning Hearts and Minds in Civil Wars: Governance, Leadership Change, and Support for Violent Groups in Iraq
Authors: Mikulaschek Christoph , Pant Saurabh , Tesfaye Beza
Published: June 2020

The “hearts and minds” model of combating rebellions holds that civilians are less likely to support violent opposition groups if the government provides public services and security. Building on this model, we argue that a political event that raises popular expectations of future public service and security provision increases support for the government and decreases sympathy for violent opposition groups. To test this argument, we leverage a unique research design opportunity that stems from the unforeseen announcement of the resignation of Iraq's divisive prime minister in August 2014 while an original survey was being administered across the country. We show that the leadership transition led Iraq's displeased Sunni Arab minority to shift support from the violent opposition to the government. In line with our argument, this realignment was due to rising optimism among Sunni Arabs that the new government would provide services and public goods—specifically security, electricity, and jobs.
Misgovernance and Human Rights: The Case of Illegal Detention without Intent
Authors: Slough Tara , Fariss Christopher
Published: June 2020

Existing explanations of human rights abuses emphasize a strategic logic of repression. Yet certain classes of abuses may arise absent the intent to repress because of the misaligned bureaucratic incentives of state agents. To separate accounts of strategic repression from bureaucratic incentives, we study the responses of state agents working within the Haitian criminal justice system to a randomized, free legal assistance intervention for detainees held in illegal pretrial detention. Legal assistance addresses moral hazard problems of the bureaucrats responsible for processing cases. We demonstrate that legal assistance accelerates case advancement and liberation, in line with the view that large‐scale human rights abuses in the justice system can result from poor governance and not repressive intent.
Surgical cancellation rates due to peri‐operative hypertension: implementation of multidisciplinary guidelines across primary and secondary care
Authors: Soni S. , Shah S. , Chaggar R. , Saini R. , James E. , Elliot J. , Stephens J. , McCormack T. , Hartle A.
Published: June 2020

Patients with uncontrolled hypertension are at increased risk of complications during general anaesthesia but the number of patients whose surgery is delayed or cancelled due to hypertension remains unknown. Prospective, regional multicentre service evaluations were performed on consecutive patients undergoing elective surgery before and after the publication of new guidelines from the Association of Anaesthetists and the British Hypertensive Society. The aim was to quantify the number of operations cancelled due to hypertension alone and to assess impact of the guidelines on cancellation rates. In October 2013 (before the publication of the guidelines), 1.37% (95%CI 0.69–2.11%) of patients listed for elective surgery were cancelled solely due to raised blood pressure. This reduced significantly to 0.54% (95%CI 0.20–0.92%, p < 0.001) in 2018. There was a significant reduction in inappropriate cancellations for stage 1 or 2 hypertension from 2013 to 2018 (72 vs. 14, respectively, p < 0.001) in keeping with the recommendations in the guidelines. Furthermore, the number of patients being referred back to primary care for the management of hypertension reduced from 2013 to 2018 (85 vs. 30, respectively, p < 0.001). Our data suggest achievement of three major outcomes: reduced surgical cancellations due to hypertension alone; improved detection of significant hypertension before elective surgery; and reduced referral back to primary care from hospital for hypertension management. To the best of our knowledge, this is the first time the successful implementation of guidelines from the Association of Anaesthetists has been assessed on such a broad scale. Our data indicate that these guidelines have been effectively implemented in both primary and secondary care, which is likely to have made a positive psychosocial, physical and economic impact on patients and the NHS.
The incidence of symptomatic remnant gall bladder: a population study
Authors: Bradshaw Luke , Lau Lawrence , Knowles Brett , Fox Adrian , Banting Simon W.
Published: June 2020

Background

Subtotal cholecystectomy is utilized in conditions of high risk to critical structures, like the common bile duct. However, the remnant gall bladder may become symptomatic and require a completion cholecystectomy for treatment. This second procedure can itself be a risk to critical structures. To establish the incidence of redo‐cholecystectomy and identify risk factors that lead to subtotal cholecystectomy and repeat operation in a review of state‐based practices for cholecystectomy.

Methods

A search of state coding records relating to cholecystectomy from 1998 to 2016. Patients who were coded for cholecystectomy‐related procedures on different dates were identified. Patients who underwent the procedures within 6 months were excluded to avoid acute post‐operative complications and gall bladder malignancy.

Results

210 719 cholecystectomies were performed. 1133 required repeat procedure. 616 were excluded, leaving 516 (0.25%) cholecystectomy patients requiring a second cholecystectomy. The subsequent operation was more likely to be an emergency procedure; involve transcystic bile duct exploration, adhesiolysis and require intensive care unit admission post‐operatively. A repeat cholecystectomy was more likely to occur after having the primary procedure at a public hospital and when an intra‐operative cholangiogram was not performed. Over the study period, the rate of repeat cholecystectomy increased from 0.02% to 0.6%. Incidentally, the rate of intra‐operative cholangiogram during a primary cholecystectomy increased from 43% to 73%.

Conclusions

Repeat cholecystectomy is an uncommon procedure. A second cholecystectomy is a more complex and likely to require intensive care unit support. Referral to a tertiary hepatobiliary unit is recommended.
Pregnancy in metabolic healthy and unhealthy obese women
Authors: Pétursdóttir Maack Heidrun , Larsson Anders , Axelsson Ove , Olovsson Matts , Wikström Anna‐Karin , Sundström Poromaa Inger
Published: June 2020

Introduction

Obesity‐associated adverse obstetric outcomes are well‐known but still relatively rare and difficult to predict. Not all obese individuals are unhealthy; some have metabolically healthy obesity (MHO) and others have metabolic unhealthy obesity (MUO). Our aim was to investigate whether the MHO and MUO classification could be used for prediction of obesity‐associated complications in pregnancy.

Material and methods

We included 547 pregnant women with obesity, 2302 pregnant women with overweight and 5852 normal weight pregnant women. The women with obesity were classified as MUO (n = 181, 33.1%) or MHO (n = 366, 66.9%) based on first trimester blood pressure, lipoprotein levels and nonfasting glucose levels. The risk of obstetric outcomes was evaluated by multivariable logistic regression. We compared cardiovascular risk markers in blood between obese pregnant women with MUO and MHO.

Results

Overall, 45.9% of women with MUO developed at least one adverse obesity‐associated obstetric outcome, whereas corresponding proportions in women with MHO, overweight and normal weight were 35.0%, 27.6% and 21.2%, respectively. Following adjustment, the overall risk of at least one obesity‐associated obstetric or perinatal complication in women with MUO, vs women with MHO, was increased (adjusted odds ratio 1.49, 95% confidence interval 1.03‐2.15), but the predictive value of the model was low. Women with MUO had altered levels of cardiovascular risk markers such as cathepsin S, adiponectin, and cystatin C in comparison with women with MHO.

Conclusions

Women with MUO had an overall increased risk of adverse obstetric outcomes in comparison to women with MHO, but the classification had little relevance for risk prediction beyond that of body mass index.
Vegetation change over a period of 46 years in a Mediterranean mountain massif (Penyagolosa, Spain)
Authors: Merle Hugo , Garmendia Alfonso , Hernández Héctor , Ferriol María
Published: June 2020

Questions

The Mediterranean mountain massifs are biodiversity hotspots threatened by climate change and land use transformations, among other factors. Did vegetation composition and α‐ and β‐diversities change in mid‐ and high‐elevation Mediterranean ecosystems over the last 46 years? Can these changes be explained by climate change or land use?

Location

Medium and high altitudes of the Penyagolosa Massif, Castellón, Eastern Spain.

Methods

In 2014, we resurveyed 92 vegetation plots sampled in 1968, belonging to nine plant communities distributed on basic and acid soils. We performed estimates of α‐ and β‐diversity, multidimensional ordination of species composition, ecological characterisation of species and non‐parametric tests to identify vegetation change over time.

Results

We observed different patterns of vegetation change depending on the plant community; an increase in α‐diversity, especially in high‐altitude habitats, and a homogenisation of species composition among plant communities. Seral communities and forests increased particularly in locations on basic soils that used to be occupied by pastures and communities of degraded successional stages. Higher Ellenberg indicator values of temperature and light, and loss of temperate taxa, which are usually rare in the region, were found in the climax forest of high altitudes and some acidophilous communities. However, altitudinal shifts of species distributions were detected only in 14% of plant species, both upwards and downwards. An increase of nitrophily at medium altitudes was also observed.

Conclusions

The results suggested that land use change related with abandonment of agro‐sylvo‐pastoral systems was the major driving force of vegetation dynamics in most of the seral plant communities, while thermophilisation was more evident in the high‐altitude climax forest.
Effect of low‐dose aspirin on health outcomes: An umbrella review of systematic reviews and meta‐analyses
Authors: Veronese Nicola , Demurtas Jacopo , Thompson Trevor , Solmi Marco , Pesolillo Gabriella , Celotto Stefano , Barnini Tommaso , Stubbs Brendon , Maggi Stefania , Pilotto Alberto , Onder Graziano , Theodoratou Evropi , Vaona Alberto , Firth Joseph , Smith Lee , Koyanagi Ai , Ioannidis John P.A. , Tzoulaki Ioanna
Published: June 2020

Aims

This study aimed to use an umbrella review methodology to capture the range of outcomes that were associated with low‐dose aspirin and to systematically assess the credibility of this evidence.

Methods

Aspirin is associated with several health outcomes, but the overall benefit/risk balance related to aspirin use is unclear. We searched three major databases up to 15 August 2019 for meta‐analyses of observational studies and randomized controlled trials (RCTs) including low‐dose aspirin compared to placebo or other treatments. Based on random‐effects summary effect sizes, 95% prediction intervals, heterogeneity, small‐study effects and excess significance, significant meta‐analyses of observational studies were classified from convincing (class I) to weak (class IV). For meta‐analyses of RCTs, outcomes with random effects P‐value < .005 and a moderate/high GRADE assessment, were classified as strong evidence. From 6802 hits, 67 meta‐analyses (156 outcomes) were eligible.

Results

Observational data showed highly suggestive evidence for aspirin use and increased risk of upper gastrointestinal bleeding (RR = 2.28, 95% CI: 1.97–2.64). In RCTs of low‐dose aspirin, we observed strong evidence for lower risk of CVD in people without CVD (RR = 0.83; 95% CI: 0.79–0.87) and in general population (RR = 0.83; 95% CI: 0.79–0.89), higher risk of major gastrointestinal (RR = 1.47; 95% CI: 1.26–1.72) and intracranial bleeding (RR = 1.34; 95% CI: 1.18–1.53), and of major bleedings in people without CVD (RR = 1.62; 95% CI: 1.26–2.08).

Conclusion

Compared to other active medications, low‐dose aspirin had strong evidence for lower risk of bleeding, but also lower comparative efficacy. Low‐dose aspirin significantly lowers CVD risk and increases risk of bleeding. Evidence for multiple other health outcomes is limited.