bluuebunny/crossref_metadata_2025 huggingface dataset:
Load testing and health monitoring of monolithic bridges with innovative reinforcement
Authors: Zhang Kexin , Qi Tianyu , Li Dachao , Xue Xingwei , Zhu Zhimin
Published: August 2021

Purpose

The paper aims to investigate effectiveness of the strengthening method, the construction process monitoring, fielding-load tests before and after strengthening, and health monitoring after reinforcement were carried out. The results of concrete strain and deflection show that the flexural strength and stiffness of the strengthened beam are improved.

Design/methodology/approach

This paper describes prestressed steel strand as a way to strengthen a 25-year-old continuous rigid frame bridge. High strength, low relaxation steel strand with high tensile strain and good corrosion resistance were used in this reinforcement. The construction process for strengthening with prestressed steel strand and steel plate was described. Ultimate bearing capacity of the bridge after strengthening was discussed based on finite element model.

Findings

The cumulative upward deflection of the second span the third span was 39.7 mm, which is basically consistent with the theoretical value, and the measured value is smaller than the theoretical value. The deflection value of the second span during data acquisition was −20 mm–10 mm, which does not exceed the maximum deflection value of live load, and the deflection of the bridge is in a safe state during normal use. Thus, this strengthened way with prestressed steel wire rope is feasible and effective.

Originality/value

This paper describes prestressed steel strand as a way to strengthen a 25-year-old continuous rigid frame bridge. To investigate effectiveness of the strengthening method, the construction process monitoring, fielding-load tests before and after strengthening and health monitoring after reinforcement were carried out.
An interpretive structural model for factors affecting the tax compliance of professional athletes: a case study of football players
Authors: Memari Zhaleh , Rezaei Pandari Abbas , Bemanzadeh Fahimeh
Published: August 2021

Purpose

Tax revenues are becoming one of the crucial tax policy segments in developing countries. Governments intend to collect more funds in the budget. The study aimed to identify the dimensions and factors influencing tax compliance in Iranian professional football players.

Design/methodology/approach

Based on interpretive structural modelling (ISM), the required information was collected using a literature review and a pairwise comparison questionnaire from eleven sport academic and executive participants. Content validity index of the questionnaire was >0.7 and its inconsistency index was <0.1.

Findings

The influential factors put in six levels. Results showed “new technologies for implementing regulations” and “clear tax regulations” were the lowest level's most independent factors. Simultaneously, the “possibility of identifying violating taxpayers” and “transparency of the clubs' financial data” were the most dependent factors at the model's first level. Moreover, “legal” was the greatest, and “technological” dimensions had at least importance, and the “amount and manner of fines” was the influential factor. The findings can use for policymaking to improve the professional player's and society tax compliance.

Originality/value

The authors identified the most independent, dependent, influential and minor essential football players' tax compliance factors and the relations between these factors. Recognising each of the factors' role and level of importance can help governments and policymakers in tax legislation in sport.
Practical strategies and the need for psychological support: recommendations from nurses working in hospitals during the COVID-19 pandemic
Authors: Ralph Jody , Freeman Laurie A. , Ménard A. Dana , Soucie Kendall
Published: August 2021

Purpose

Nurses working during the coronavirus disease 2019 (COVID-19) pandemic have reported elevated levels of anxiety, burnout and sleep disruption. Hospital administrators are in a unique position to mitigate or exacerbate stressful working conditions. The goal of this study was to capture the recommendations of nurses providing frontline care during the pandemic.

Design/methodology/approach

Semi-structured interviews were conducted during the first wave of the COVID-19 pandemic, with 36 nurses living in Canada and working in Canada or the United States.

Findings

The following recommendations were identified from reflexive thematic analysis of interview transcripts: (1) The nurses emphasized the need for a leadership style that embodied visibility, availability and careful planning. (2) Information overload contributed to stress, and participants appealed for clear, consistent and transparent communication. (3) A more resilient healthcare supply chain was required to safeguard the distribution of equipment, supplies and medications. (4) Clear communication of policies related to sick leave, pay equity and workload was necessary. (5) Equity should be considered, particularly with regard to redeployment. (6) Nurses wanted psychological support offered by trusted providers, managers and peers.

Practical implications

Over-reliance on employee assistance programmes and other individualized approaches to virtual care were not well-received. An integrative systems-based approach is needed to address the multifaceted mental health outcomes and reduce the deleterious impact of the COVID-19 pandemic on the nursing workforce.

Originality/value

Results of this study capture the recommendations made by nurses during in-depth interviews conducted early in the COVID-19 pandemic.
Social capital, language and host country nationals (HCNs) as global talent
Authors: Kuki Maryam Bala , Kirk Susan , Ridgway Maranda
Published: August 2021

Purpose

In expatriate-reliant countries, the challenge of attracting and retaining overseas talent remains, despite the COVID-19 global pandemic restricting international travel. Expatriates depend on formal organizational and host country national (HCN) support to facilitate their adjustment when moving abroad. To date, there has been a limited focus on the centrality of language in spanning boundaries between HCNs and expatriates that enables bridges to be formed. This study explored how language influences the social capital accrual and the support received by expatriates from HCNs.

Design/methodology/approach

Rooted in social constructionism, the authors used semi-structured interviews with a purposive sample of 20 Nigerian HCNs from two Italian organizations in the construction industry.

Findings

The findings highlight how language is key to effective social capital bridging and show how HCNs act as boundary spanners between local talent and expatriates on assignment. In this study, HCNs have superior language skills and can thus fill the semantic void in communication between the two parties. It emerged that expatriates receive more significant support and higher levels of social capital accrual than HCNs from this relationship.

Practical implications

Consideration should be given to providing formal language training to both expatriates and HCNs. Embedding networking relationships, such as buddying schemes or reverse mentoring, would enhance the social capital of both parties and improve performance. In addition, global talent management policies should be adjusted to provide definitive career paths and clearer promotion criteria for HCNs.

Originality/value

The authors find that through their language ability, HCNs may have more power over expatriates than previously considered, repositioning their status from a talent perspective. The authors argue that expatriates should not be considered by organizations the only source of global talent in such a context, and that organizations need to offer more definitive talent policies and support that accounts for both expatriates and HCNs.
Dwelling in liminal spaces: twin moments of the same reality
Authors: Friesen Sharon Linda
Published: September 2021

Purpose

This paper is a thinking piece that examines, from the viewpoint of a Canadian pracademic, working through two definitions of pracademic, a collaborative relationship between academics and practitioners and a person engaged as a practitioner and researcher. Two aspects of a pracademics scholarship is discussed, wide awakeness and praxis. The purpose of the paper is to make the case that it is pracademics who are well suited and attuned to questioning, challenging, and disrupting the ordinariness of the everyday, to envision new possibilities, and who take responsibility for mobilizing the educational community to undertake meaningful social change within an education system. A case is provided to illustrate wide-awakeness and praxis in practice. A case is provide to illustrate how wide-awakeness and praxis present themselves in practice.

Design/methodology/approach

This paper considers the work of pracademics from Galileo Educational Network, located within a research-intensive university, who research and lead design-based professional learning. Drawing upon a design-based approach to guide design-based professional learning and design-based research, I highlight the ways in which wide-awakeness and praxis work themselves out in practice.

Findings

Drawing upon the two aspects of wide-awakeness and praxis, creates a liminal space for pracademics to engage with practitioners to undertake stubborn and persistent problems of practice to create important educational improvements. A key to engaging in transformational change through collaborative professionalism is to engage in sustained design-based professional learning led by pracademics.

Originality/value

This thinking piece offers the perspective of one Canadian pracademic who shows how pracademics are uniquely positioned to take on the work of transformation, agency, and social change.
Current value as relational becoming: the case of goodwill impairment testing
Authors: Hartmann Berit
Published: August 2021

Purpose

The purpose of this study is to shed light on the tools, processes and negotiations involved in the formation of acceptable current values in the context of goodwill impairment testing. The study raises the questions of how a current value for goodwill becomes a faithful representation and how one expectation about the future becomes more convincing than other expectations.

Design/methodology/approach

Drawing on the study of associations, the analysis presents a case study of a large, internationally active organisation. By combining field notes, interview transcripts and a variety of documents, the qualitative analysis focusses on strategies and mechanisms of persuasion.

Findings

The findings reveal how epistemological objectivity of current values forms in three moments of relational becoming that codify, depersonalise and proceduralise the valuation task. Further, the study suggests that a convincing argument forms with the help of four enablers: a bricolage of inscriptions, methodological mystification, transformed professional identities and a practical need for closure.

Originality/value

The study contributes with an analysis and illustration of financial accounting as practice, elaborating on the meaning and construction of faithful representation in cases of measurement uncertainty.
Soft-tissue-mimicking using silicones for the manufacturing of soft phantoms by fresh 3D printing
Authors: Tejo-Otero Aitor , Colly Arthur , Courtial Edwin-Joffrey , Fenollosa-Artés Felip , Buj-Corral Irene , A. Marquette Christophe
Published: September 2021

Purpose

The purpose of this study is to use the Freeform Reversible Embedding of Suspended Hydrogels (FRESH) additive manufacturing (AM) technique for manufacturing a liver phantom which can mimic the corresponding soft living tissue. One of the possible applications is surgical planning.

Design/methodology/approach

A thermo-reversible Pluronic® F-127-based support bath is used for the FRESH technique. To verify how three-dimensional (3D)-printed new materials can mimic liver tissue, dynamic mechanical analysis and oscillation shear rheometry tests are carried out to identify mechanical characteristics of different 3D printed silicone samples. Additionally, the differential scanning calorimetry was done on the silicone samples. Then, a validation of a 3D printed silicone liver phantom is performed with a 3D scanner. Finally, the surface topography of the 3D printed liver phantom was fulfiled and microscopy analysis of its surface.

Findings

Silicone samples were able to mimic the liver, therefore obtaining the first soft phantom of the liver using the FRESH technique.

Practical implications

Because of the use of soft silicones, surgeons could practice over these improved phantoms which have an unprecedented degree of living tissue mimicking, enhancing their rehearsal experience before surgery.

Social implications

An improvement in surgeons surgery skills would lead to a bettering in the patient outcome.

Originality/value

The first research study was carried out to mimic soft tissue and apply it to the 3D printing of organ phantoms using AM FRESH technique.
The interaction between servant leadership and organizational culture: an NCAA Division III case study
Authors: Dahlin Sean , Schroeder Pete
Published: August 2021

Purpose

Servant leadership is primarily focused on the empowerment and moral development of followers (Burtonet al., 2017). Within sports research, little is known about how servant leadership interacts with organizational culture in teams. Thus, the purpose of this study is to assess the servant leadership of one head baseball coach and examine the degree to which servant leadership affects the program's culture.

Design/methodology/approach

Data were collected for this case study of an NCAA Division III head baseball coach throughout one academic year. Sources included 12 interviews (ranging from four minutes to 92 min), observation of practices and games, textual analysis of documents and websites, as well as the coach's reflection journal. Data were analyzed using a six-phase process of thematic analysis (Braun and Clarke, 2006).

Findings

The participant exhibited the following servant leadership behaviors: empowering, helping subordinates grow and succeed, behaving ethically, and conceptual skills (Lidenet al., 2015, 2008). In addition, the program maintained a culture featuring a few distinct artifacts, very clear espoused values, and three deeply held basic assumptions. The findings suggest that the head coach used servant leadership not to create or change culture but instead to amplify the existing culture of the baseball program.

Originality/value

There is strong evidence of a link between servant leadership and team culture, which is context-bound. At the Division III level, servant leadership behaviors can be used to embody a program's culture. Furthermore, through this embodiment, servant leaders can perpetuate an effective, functioning team culture, particularly within intercollegiate athletics.
Spatial structure and dispersal dynamics in a house sparrow metapopulation
Authors: Ranke Peter S. , Araya‐Ajoy Yimen G. , Ringsby Thor Harald , Pärn Henrik , Rønning Bernt , Jensen Henrik , Wright Jonathan , Sæther Bernt‐Erik
Published: August 2021

The effects of spatial structure on metapopulation dynamics depend upon the interaction between local population dynamics and dispersal, and how this relationship is affected by the geographical isolation and spatial heterogeneity in habitat characteristics.

Our aim is to examine how emigration and immigration of house sparrowsPasser domesticusin a Norwegian archipelagic metapopulation are affected by key factors predicted by classic metapopulation models to affect dispersal—spatial and temporal variation in population size, inter‐island distance, local demography and habitat characteristics.

This metapopulation can be divided into two major habitat types: (a) islands closer to the mainland where sparrows breed in colonies on farms, and (b) islands without farms, situated farther away from the mainland where sparrows are exposed to harsher environmental conditions.

Dispersal was spatially structured within the metapopulation; there was proportionally and numerically less emigration and immigration involving farm islands, as compared to non‐farm islands. Furthermore, emigration and immigration occurred mostly between nearby islands. Moreover, emigration in response to spatial differences in mean population size differed between the habitat types, but populations with large mean received more immigrants in both habitat types. The number of emigrants and immigrants was negatively related to long‐term recruit production, which was not the case in non‐farm islands. The proportion and number of emigrants was positively related to temporal increases in recruit production on farm islands, however not on non‐farm islands.

Our results demonstrate that spatial heterogeneity in environmental conditions influences how spatial variation in long‐term mean population size, and temporal and spatial variation in recruit production, affects dispersal dynamics. The spatial structure of this metapopulation is therefore best described by a spatially explicit model in which the exchange of individuals within each habitat type is strongly affected by the degree of geographical isolation, population size and recruit production. However, these relationships differed between the two habitat types; non‐farm islands showing similarities to a mainland‐island model type of structure, whereas farm islands showed features more associated with source–sink or balanced dispersal models. Such differential dispersal dynamics between habitat types are expected to have important consequences for the ecological and evolutionary dynamics within this metapopulation.
Optimal stopover model: A state‐dependent habitat selection model for staging passerines
Authors: Domer Adi , Vinepinsky Ehud , Bouskila Amos , Shochat Eyal , Ovadia Ofer
Published: August 2021

During their seasonal migration, birds stage in areas comprising stopover sites of varying quality. Given that migrating birds have a limited information about their environment, they may land at a low‐quality stopover site in which their fuel deposition rate (FDR) is low. Birds landing at such sites should decide either to extend their stopover duration or to quickly depart in search for a better site. These decisions, however, strongly depend on their body condition upon landing.

To understand the decision‐making process of passerines within a stopover area, comprising stopover sites of varying quality, prior to the crossing of a large ecological barrier, we constructed a state‐dependent habitat selection model. The model assumes that even if migrating birds have an expectation of encountered area quality, they cannot control for their initial landing site. Once landing, movement between low‐ and high‐quality stopover sites will occur only if the body condition of these birds is high to the extent that they can entail the energetic cost of movement. Birds in the model aim to maximize their fuel load at the end of the stopover period, to suffice for successfully crossing a large ecological barrier.

The model is based on empirical data on autumn migrating BlackcapsSylvia atricapilla, collected at two important stopover sites in the Negev desert of Israel. Migrating passerines staging at these two sites differ in their FDR and body condition. The model shows that the optimal behaviour when arriving at a low‐quality stopover site is to abandon it quickly. However, as lean individuals cannot entail the costs of searching for an alternative site, they have no other choice but to stay there even if their chances to successfully cross the Sahara Desert ahead are low.

Our model can be applied to other ecological systems. Proper use of this model may allow good assessment of stopover site quality, as indicated by the bird's FDR, regardless of specific site characteristics. Hence, it can help applying targeted management decisions regarding the maintenance of stopover sites or establishment of new ones.
The efficacy of soy isoflavones combined with soy protein on serum concentration of interleukin‐6 and tumour necrosis factor‐α among post‐menopausal women? A systematic review and meta‐analysis of randomized controlled trials
Authors: Gholami Ali , Mollanoroozy Ensiyeh , Reza Baradaran Hamid , Hariri Mitra
Published: August 2021

The post‐menopausal stage in women’s life is associated with the enhancement of inflammation that may be reduced using soy isoflavones or soy protein. The present study aimed to summarize the effect of soy isoflavones plus soy protein on circulating interleukin‐6 (IL‐6) and tumour necrosis factor‐α (TNF‐α) in post‐menopausal women. The English‐language articles were identified from the databases such as Cochrane Library, clinicaltrials.gov, Web of Science, PubMed, and Scopus until December 2020. The mean change from baseline and its standard deviation (SD) for intervention and comparison groups were used to calculate the effect size. The statistical heterogeneity of the intervention effects was computing by Cochran's Q test and I2 statistic. Nine and seven studies were selected for systematic review and meta‐analysis, respectively. The results of our meta‐analysis indicated a non‐significant effect on the serum concentrations of IL‐6 and TNF‐α (weighted mean differences [WMD] = 0.07 pg/mL; 95% confidence interval [CI] = −0.03, 0.17 pg/mL; P = 0.190; WMD =0.05 pg/mL; 95% CI = −0.01, 0.12 pg/mL; P = 0.092; respectively). In subgroup analysis, soy isoflavones plus soy protein could increase the serum concentration of IL‐6 in studies with soy isoflavones dose ≤87 mg/days, cross‐over design, weak quality, and studies on participants who had health risk factors or diseases. The serum concentration of TNF‐α increased in studies with cross‐over design, intervention duration ≤56 days, and body mass index (BMI) >27, and in studies that were conducted on at‐risk or sick participants. In conclusion, our meta‐analysis did not confirm any significant effect on serum concentration of IL‐6 and TNF‐α among post‐menopausal women.
Proactive changes in clinical practice as a result of the COVID‐19 pandemic: Survey on use of telepractice by Quebec speech‐language pathologists
Authors: Macoir J. , Desmarais C. , Martel‐Sauvageau V. , Monetta L.
Published: August 2021

Background

The coronavirus disease2019 (COVID‐19) pandemic has led to important challenges in health and education service delivery.

Aims

The present study aimed to document: (i) changes in the use of telepractice by speech‐language pathology (SLP) professionals in Quebec since the start of the COVID‐19 outbreak; (ii) perceptions of the feasibility of telepractice by SLPs; (iii) barriers to the use of telepractice; and (iv) the perceptions of SLP professionals regarding the main issues of telepractice.

Methods & Procedures

An online survey with closed and open, Likert scale and demographic questions was completed by 83 SLPs in Quebec in June and July 2020.

Outcomes & Results

The survey responses showed that within the cohort responding, telepractice use has increased significantly as a response to the COVID‐19 pandemic. Most respondents planned to continue using telepractice after the pandemic ends. In addition, the respondents considered telepractice to be adequate for many clinical practices but less so for others (e.g., swallowing disorders, hearing impairment). Most of the reported barriers to the use of telepractice concerned technological problems and a lack of clinical materials for online use. Confidentiality and privacy issues were also raised.

Conclusions & Implications

SLP professionals rapidly took advantage of existing technologies in their clinical settings to cope with the pandemic's effects on service delivery. The discrepancy between their perceptions and the evidence in the literature for some practices and populations strengthens the need for more information and education on telepractice.

What this paper adds

What is already known on the subject

The proportion of speech‐language pathologists (SLPs) in Canada who use telepractice for clinical activities is unknown. Knowing this information became crucial in the context of the coronavirus disease 2019 (COVID‐19) pandemic because non‐essential activities were interrupted to halt the spread of the disease.

What this paper adds to existing knowledge

The findings from this survey study confirmed that the use of telepractice in SLP in Quebec increased significantly during the COVID‐19 pandemic. Moreover, the majority of the respondents began using telepractice because of the pandemic, and most planned to continue doing so after it ends. This demonstrates how SLP professionals rapidly took advantage of existing technologies in their clinical settings to cope with the pandemic's effects on service delivery.

What are the potential or actual clinical implications of this work?

Although the SLPs expressed an overall positive perception of telepractice, they also highlighted barriers to its optimal use. The findings of this study should help employers and regulatory bodies in Quebec to bring down those barriers and make telepractice in SLP a durable, effective and efficient service delivery model.
Maternal morbidity and mortality: an iceberg phenomenon
Authors: Leitao S , Manning E , Greene RA , Corcoran P ,   the Maternal Morbidity Advisory Group*
Published: August 2021

Objective

To apply the iceberg model, quantifying absolute and relative incidence, to the four main causes of maternal morbidity and mortality in Ireland: haemorrhage, hypertension, sepsis and thrombosis.

Design

Secondary analysis of national data on maternal morbidity and mortality.

Setting

Republic of Ireland.

Population or sample

Approximately 715 000 maternities, 1 200 000 maternal hospitalisations, 2138 cases of severe maternal morbidity (SMM) and 54 maternal deaths.

Methods

Incidence rates and case‐fatality ratios were calculated.

Main outcome measures

Maternal death, SMM and hospitalisation.

Results

At the ‘tip of the iceberg’, the incidence of maternal death per 10 000 maternities was 0.09 (95% CI 0.03–0.20) due to thrombosis and 0.03 (95% CI 0–0.11) due to haemorrhage, hypertension disorders or sepsis. For one death due to thrombosis there were 35 cases of pulmonary embolism and 257 thrombosis hospitalisations. For one death due to eclampsia, there were 58 eclampsia cases, 13 040 hospitalisations with pre‐existing hypertension and 40 781 hospitalisations with gestational hypertension. For one death due to pregnancy‐related sepsis, there were 92 cases of septicaemic shock and 9005 hospitalisations with obstetric sepsis. For one maternal death due to haemorrhage, there were 1029 cases of major obstetric haemorrhage and 53 715 maternal hospitalisations with haemorrhage. For every 100 maternities, there were approximately 16 hospitalisations associated with haemorrhage, 12 associated with hypertension disorders, three with sepsis and 0.2 with thrombosis.

Conclusions

Haemorrhage and hypertension disorders are leading causes of maternal morbidity in Ireland but they have very low case fatality. This indicates that these morbidities are managed effectively but their prevention requires more focus.

Tweetable abstract

Study shows that haemorrhage and hypertension are main causes of #maternalmorbidity in Ireland. Timely interventions for #maternalhealth and focus on prevention of severe and non‐severe morbidities are needed.

@NPEC #maternityservices #clinicalaudit #qualityimprovement.
The relationship between hepatitis B virus serum DNA, RNA and quantitative hepatitis B surface antigen, and the predictive value for mother‐to‐child transmission: an observational cohort study
Authors: Wang C , Pan Y‐C , Jia Z‐F , Chi X‐M , Wang Y‐Q , Yang N , Wu Y‐H , Niu J‐Q , Jiang J
Published: August 2021

Objective

To explore the relationships between hepatitis B virus (HBV) DNA, HBV RNA and hepatitis B surface antigen (HBsAg) and to evaluate their predictive value for mother‐to‐child transmission of HBV.

Design

An observational cohort study.

Setting

First Hospital of Jilin University.

Population

HBsAg‐positive and hepatitis B e antigen (HBeAg) ‐positive pregnant women were recruited.

Methods

Blood samples were collected from mothers before delivery, and HBV infection of infants was evaluated at 7 months of age.

Results

Overall, 268 mothers and 271 infants were enrolled. HBV DNA and HBsAg levels were correlated (rs = 0.699; P < 0.001), and HBV DNA (rs = 0.500; P < 0.001) and HBsAg (rs = 0.372; P < 0.001) were both correlated with HBV RNA. The areas under the curve for HBV DNA, HBsAg and HBV RNA for prediction of infection were 0.69 (95% CI 0.57–0.82), 0.63 (95% CI 0.51–0.76) and 0.65 (95% CI 0.52–0.78), respectively. Higher HBV DNA (odds ratio [OR] 4.77, 95% CI 1.44–15.86), higher HBsAg (OR 4.13, 95% CI 1.12–15.25) and higher HBV RNA (OR 3.19, 95% CI 1.09–9.32) were risk factors for HBV infection. Analysis of the HBV DNA‐RNA‐HBsAg Score revealed that it was an independent predictive factor for mother‐to‐child transmission (the OR of Score 3 was 8.81, 95% CI 2.79–27.82).

Conclusion

HBV DNA, HBV RNA and HBsAg were correlated in HBeAg‐positive pregnant women. HBsAg could be considered as a substitute marker of HBV DNA for HBeAg‐positive pregnant women in low‐income regions. We should pay special attention to pregnant women with high levels of all three markers.

Tweetable abstract

HBsAg could be considered as a substitute marker of HBV DNA for HBeAg‐positive pregnant women in low‐income regions. Special attention should be given to pregnant women with high levels of all three markers (HBV DNA, HBV RNA and HBsAg).
Association of maternal gestational weight gain with intellectual developmental disorder in the offspring: a nationwide follow‐up study in Sweden
Authors: Lee PMY , Tse LA , László KD , Wei D , Yu Y , Li J
Published: August 2021

Objectives

To investigate the association between maternal gestational weight gain (GWG) and offspring's intellectual developmental disorders (IDD); how this association is modified by maternal early‐pregnancy BMI.

Design

Population‐based cohort study.

Setting and population

All liveborn singletons with information on maternal GWG in the Swedish Medical Register during 1992–2006 (n = 467 485).

Methods

We used three GWG classifications, (1) Institute of Medicine (IOM) guidelines (‘ideal’ GWG: maternal underweight = 12.7–18.1 kg; normal = 11.3–15.9 kg; overweight = 6.8–11.3 kg; obesity = 5.0–9.1 kg), (2) LifeCycle project recommendation (‘ideal’ GWG: maternal underweight = 14.0–16.0 kg; normal = 10.0–18.0 kg; overweight = 2.0–16.0 kg; obesity class I = 2.0–6.0 kg; obesity class II ≤0.0–4.0 kg; obesity class III ≤0.0–6.0 kg) and (3) GWG centiles. Hazard ratio (HR) and 95% CI for offspring's IDD risk using Cox regression.

Main outcome measures

IDD was extracted from Swedish National Patient Register (code ICD‐9:317–319/ICD‐10:F70–F79).

Results

Forty‐one per cent of children were born to mothers with excessive GWG, 32.8% with ideal GWG and 26.2% with inadequate GWG according to IOM guidelines. Inadequate GWG was associated with 21% higher risk of offspring's IDD (95% CI 1.11–1.31) relative to ideal GWG. In contrast, when using the LifeCycle classification, children of mothers with inadequate GWG (HR 1.14, 95% CI 1.05–1.24) or excessive GWG (HR 1.09, 95% CI 1.01–1.17) had higher risks of IDD than those of mothers with ideal GWG. When using GWG centiles, extremely low GWG (<20th centile) and low GWG (20th–40th centile) were associated with elevated offspring's IDD risk. Further stratified analysis by maternal early‐pregnancy body mass index (BMI) showed that overweight/obese mothers (BMI ≥25 kg/m2) with extremely excessive GWG (>25 kg) was associated with an increased offspring's IDD.

Conclusion

Our findings suggest that inadequate maternal GWG may increase offspring's IDD risk, irrespective of maternal early‐pregnancy BMI. Extremely excessive GWG (>25 kg) may increase offspring's IDD risk, but only among mothers with an early‐pregnancy BMI ≥25 kg/m2.

Tweetable abstract

Inadequate maternal weight gain during pregnancy may increase the risk of offspring's intellectual disability, regardless of maternal BMI.
Trends in maternal mortality in India over two decades in nationally representative surveys
Authors: Meh C , Sharma A , Ram U , Fadel S , Correa N , Snelgrove JW , Shah P , Begum R , Shah M , Hana T , Fu SH , Raveendran L , Mishra B , Jha P
Published: August 2021

Objective

To assess national and regional trends and causes‐specific distribution of maternal mortality in India.

Design

Nationally representative cross‐sectional surveys.

Setting

All of India from 1997 to 2020.

Sample

About 10 000 maternal deaths among 4.3 million live births over two decades.

Methods

We analysed trends in the maternal mortality ratio (MMR) from 1997 through 2020, estimated absolute maternal deaths and examined the causes of maternal death using nationally representative data sources. We partitioned female deaths (aged 15–49 years) and live birth totals, based on the 2001–2014 Million Death Study to United Nations (UN) demographic totals for the country.

Main outcome measures

Maternal mortality burden and distribution of causes.

Results

The MMR declined in India by about 70% from 398/100 000 live births (95% CI 378–417) in 1997–98 to 99/100 000 (90–108) in 2020. About 1.30 million (95% CI 1.26–1.35 million) maternal deaths occurred between 1997 and 2020, with about 23 800 (95% CI 21 700–26 000) in 2020, with most occurring in poorer states (63%) and among women aged 20–29 years (58%). The MMRs for Assam (215), Uttar Pradesh/Uttarakhand (192) and Madhya Pradesh/Chhattisgarh (170) were highest, surpassing India’s 2016–2018 estimate of 113 (95% CI 103–123). After adjustment for education and other variables, the risks of maternal death were highest in rural and tribal areas of north‐eastern and northern states. The leading causes of maternal death were obstetric haemorrhage (47%; higher in poorer states), pregnancy‐related infection (12%) and hypertensive disorders of pregnancy (7%).

Conclusions

India could achieve the UN 2030 MMR goals if the average rate of reduction is maintained. However, without further intervention, the poorer states will not.

Tweetable abstract

We estimated that 1.3 million Indian women died from maternal causes over the last two decades. Although maternal mortality rates have fallen by 70% overall, the poorer states lag behind.
Polycystic ovary syndrome and risk of stillbirth: a nationwide register‐based study
Authors: Valgeirsdottir H , Kunovac Kallak T , Sundström Poromaa I , Jonsson M , Roos N , Lindström L , Wikström A‐K
Published: August 2021

Objective

To investigate whether polycystic ovary syndrome (PCOS) is associated with increased risk of stillbirth and whether any such association is linked to PCOS with a severe hyperandrogenic profile.

Design

Nationwide register‐based cohort study.

Setting

Sweden.

Population

The cohort consisted of women giving birth to singleton infants in 1997–2015. All women with a diagnosis of PCOS in the period 1997–2017 and a randomly selected reference group of women without PCOS diagnosis were included. PCOS with a severe hyperandrogenic profile was defined as a PCOS diagnosis with at least two dispensations of prescribed anti‐androgens during 2005–2017.

Methods

The risk of stillbirth in women with PCOS was estimated through multiple logistic regression, using women without PCOS as a reference. Risks were expressed as adjusted odds ratios (aORs) with 95% confidence intervals (95% CIs), adjusted for maternal age, parity, body mass index, type‐1 diabetes, educational level and country of birth.

Main outcome measures

Stillbirth, at ≥22 weeks of gestation in 2008–2015 and at ≥28 weeks of gestation in 1997–2007.

Results

Compared with women without PCOS (n = 241 750), women with PCOS (n = 41 851) had a 50% increased risk of stillbirth (aOR 1.50, 95% CI 1.28–1.77). The incidence of stillbirth in women with PCOS was particularly increased at term. Women with PCOS and a severe hyperandrogenic profile (n = 13 713) did not have a stronger association with stillbirth than women with PCOS who did not have such a profile.

Conclusions

PCOS is associated with stillbirth and should be considered as a possible risk factor in antenatal care. Further research is warranted to investigate possible causal mechanisms.

Tweetable abstract

Women with PCOS have increased risk of stillbirth, and the incidence is particularly increased at term.
Do indicators influence treaty ratification? The relationship between mid‐range performance and policy change
Authors: WESTERN SHAINA D.
Published: September 2021

Treaties are a valuable tool for policymakers because they are both legally binding on, and symbolically powerful signals of, commitments of states that ratify. Why states choose to ratify treaties is unclear, although social pressures appear to play some role. This article argues that global performance indicators can influence the ratification process, but that the effect varies depending on where states fall on these measures. In the mid‐range of a scale, fast ratification has significant benefits and relatively few costs. However, indicators have less of a catalysing effect at the extreme ends of the scale, where the costs are higher and the benefits are lower. This article uses policy performance indicators as independent variables in duration analyses of the ratification of the United Nations Convention against Corruption (2003) and the Protocol to Prevent, Suppress and Punish Trafficking in Persons Especially Women and Children (2000). It finds states in the mid‐range of the indicator are faster to ratify than states that are not ranked, whereas the other categories are statistically insignificant. These findings imply that indicators matter for those in the middle, but not as much for those at the extremes. This finding enriches our understanding of treaty ratification and has potential implications for performance metrics as a tool to promote policy change for those states in the middle, highlighting the strengths and limitations of indicators as a force for change.
Cultural intelligence and establishment of organisational diversity management practices: An upper echelons perspective
Authors: Turner Lauren A. , Merriman Kimberly K.
Published: August 2021

Drawing from upper echelons theory, this study examines Chief Human Resource Officers (CHROs) level of cultural intelligence as a predictor of diversity management practices established during their tenure. We model cultural intelligence (CQ) as an individual difference that combines with functional expertise to bolster attention to diversity management. CHRO cultural intelligence is further posited to have an indirect effect on the establishment of diversity management practices through CHRO propensity for transformational leadership behaviours, in this case directed towards other TMT members to garner support for diversity management practices. We test arguments with primary and secondary data from a sample of 193 CHROs and their institutions. Findings address the call to analyse functional TMT roles and factors that impact their effectiveness, and speak to the continued evolution of CQ as a research construct. We conclude with research and practical implications at a time of heightened attention to diversity.
Crafting Compliance Regime under COVID‐19: Using Taiwan's Quarantine Policy as a Case Study
Authors: Yen Wei‐Ting , Liu Li‐Yin
Published: August 2021

One year after the World Health Organization declared COVID‐19 a global pandemic, governments around the world adopt similar practices in containing the COVID‐19 spread. Nevertheless, variation exists in the level of policy compliance, which directly contribute to policy success/failure across countries. As the pandemic continues, pandemic fatigue also decreases the public’s willingness to comply. Increasing policy compliance during the remainder of pandemic has become a transnational concern. Using Taiwan’s quarantine policy as an example, this article illustrates three aspects to craft an effective compliance regime to fight public health crises like COVID‐19: (1) a comprehensive policy mix to reduce heterogeneous compliance barriers that impact different social groups; (2) constant and various policy communication with heterogeneous target audiences; and (3) leveraging and integrating street‐level bureaucrats in the policy implementation stages. Taiwan’s case provides several policy lessons for other countries: compliance regime is not driven by top‐down enforcement but through the integration of policy design and implementation that remove all barriers for compliance. Taiwan’s street level bureaucrats are the glue of the compliance regime. This article bears policy implications for policy makers around the world when aiming for increasing policy compliance.
Long‐term financing effects of Chinese non‐SOEs Belt and Road OFDI
Authors: Huang Ling , Liu Haiyue , Hou Jack , Xiao Fulong
Published: August 2021

Taking a political legitimacy perspective, this paper examines how the outward foreign direct investment (OFDI) of Chinese non‐state‐owned enterprises (non‐SOEs) in countries along the Belt and Road (B&R) affected their financing capabilities. It was found that the OFDI in B&R countries significantly increased the access of non‐SOE to long‐term and policy‐based loans, with this effect being more pronounced in firms that had stronger political connections and in areas that had greater political pressure, no prefecture‐level terminations of officials, and a lower marketisation degree. It was further found that the non‐SOE OFDI along the B&R improved the political performance of local officials and was an effective mechanism for enhancing financing capabilities.
Informed consent and birth preparedness/complication readiness: A qualitative study at two tertiary maternity units
Authors: Ely Sally , Langer Susanne , Dietz Hans Peter
Published: August 2021

Background

Informed consent in obstetrics should involve full disclosure of risks, benefits and alternative interventions. However, we have found no evidence of a formal informed consent process before an attempt at vaginal delivery in published policy or practice. The idea of informed consent in vaginal birth has attracted controversy and has been the subject of some debate.

Aim

To explore the perspectives and experiences of informed consent and birth preparedness/complication readiness for birthing women in a high resource setting.

Materials and methods

Qualitative study using semi‐structured interviews to examine experiences and perspectives of women following birth.

Results

Forty telephone interviews were concluded. Eight statement categories were identified: (i) no issues of consent, (ii) absent/inadequate informed consent, (iii) adequate birth preparedness/complication readiness, (iv) inadequate birth preparedness/complication readiness, (v) desire to forfeit decision making to a trusted and accountable health professional, (vi) belief that informed consent is not realistic in birth under some circumstances, (vii) negative feelings related to birth and (viii) poor postnatal follow‐up.

Conclusions

When complications arose during birth, 20% of participants felt that informed consent was absent/inadequate, 25% of participants suggested policy change in favour of a formal informed consent process and 55% of participants suggested policy change in favour of increased birth preparedness/complication readiness. Our study suggests that informed consent for vaginal birth and formal birth preparedness/complication readiness should form part of routine antenatal care. Women’s preferences for decision‐making and informed consent should be established before birth.
Investigating the link between social cooperation sector and economic well‐being of Italian provinces through the lens of social capital
Authors: Terzo Giuseppe
Published: September 2021

This paper investigates, through the lens of social capital, the contribution of social cooperation to the economic well‐being of Italian provinces. The empirical investigation is in two phases. First, I carry out a cross‐sectional analysis on data from 2015 to 2019 to verify whether social‐cooperation diffusion, expressed by social‐cooperative‐employee density, is positively related to a composite index of social capital. This analysis confirms the hypothesis that the diffusion of social cooperation effectively approximates the territorial social‐capital endowment. Second, I structure a panel data analysis for the period 2012 to 2017 to investigate the link between social cooperation as a source of social capital and the economic well‐being of Italian provinces. The results of this analysis corroborate the hypothesis—consistent with copious literature showing the positive role of social capital in the economic development processes—that social cooperation positively affects material living conditions through the generation of social value.
A survey of producer practices and reproductive performance of containment and supplementary fed ewes
Authors: Robertson SM , Gunn A , Piltz J , Friend MA
Published: September 2021

Containment feeding, where ewes are fed complete rations, is used to maintain flock numbers in periods of inadequate pasture supply. Producer practices influence both the reproductive performance of ewes and the risk of health challenges. The aim of this study was to evaluate the reproductive, feeding and health management practices of producers using containment or supplementary feeding, and quantify any associations between practice and reproductive performance. An online survey of Australian producers was conducted in 2020. The number of responses (n = 43) allowed benchmarking but was insufficient to determine correlations between practice and performance. The reported pregnancy rate of adult Merino ewes was variable between respondents (78%–95%; n = 11), and lambs marked per ewe joined ranged from 60% to 110% (n = 9). In non‐Merino flocks, lambs marked ranged from 82% to 161% (n = 4). Most respondents (9/11) fed cereal grain with hay or straw, either daily or two or three times a week. However, some respondents fed grain only or roughage only, such that the percentage of roughage in diets ranged from 0% to 100%. Ewes were most frequently separated into age groups for feeding, and shy feeders were only removed by 25% of respondents. Although generally the reported reproductive rate was high, wide variation indicates potential for improvement. Best practice management for containment remains unclear and requires further research given the diverse practices used. Veterinary practitioners should be aware that some of the practices used may contribute to reduced productivity or health issues in ewes.
Stakeholder relations of sustainable banks: Community benefit above the common good
Authors: Naranova‐Nassauer Anastasia
Published: August 2021

This paper explores stakeholder relations of sustainable banks as organizations that simultaneously pursue the community development and market profitability goals. The study features the Global Alliance for Banking on Values (GABV), an international group of 62 financial institutions and 16 strategic partners, which collectively hold $200 billion USD of assets under management. Using the organizational identity orientation framework (Brickson, 2005, 2007), it reveals that, contrary to widely held assumptions that community‐focused organizations serve a broad common good purpose, sustainable banks take a relational stance based on effectively prioritizing community issues aligned with their missions and establishing strong partnerships with selected counterparts. Sustainable banks approach their stakeholder relations through the relational identity orientation expressed in the practices of inclusion of affected communities, full incorporation of local needs, philanthropic inclusiveness, transparency and power balance among stakeholders, governmental commitments, and relational hiring and socializing.