bluuebunny/crossref_metadata_2025 huggingface dataset:
There is more than what meets the eye: university preparation for the socio-economic impact requirement in research assessment exercise 2020 in Hong Kong
Authors: Li Danling
Published: December 2021

Purpose

This paper aims to examine how Hong Kong universities have responded to a newly included assessment element of socio-economic impact in a government-implemented research evaluation system – Research Assessment Exercise (RAE) 2020 – within the context of tightening audits and forceful knowledge economy objectives.

Design/methodology/approach

This paper reports an institutional case study of the institutional-level response to the RAE 2020 impact requirement at a top-ranked comprehensive university in Hong Kong. A qualitative inquiry approach was adopted. The data sources mainly include university documents related to the RAE 2020 socio-economic impact policy, interview data with nine RAE-eligible academics at the case university, documents on the RAE exercises issued by the University Grants Committee (UGC) and field notes taken during the RAE information sessions.

Findings

The institutionalisation process of the RAE socio-economic impact agenda could be considered as establishing an indicator-oriented reward and recognition regime for knowledge transfer and knowledge exchange (KT/KE). Overall, two major institutional strategies were identified in operating the RAE 2020 impact agenda at the case university: (1) launching various policy initiatives: driven by the RAE-defined socio-economic impact; (2) incorporating socio-economic impact into faculty evaluation: premised upon the 16 KT performance indicators laid down by the UGC.

Originality/value

This article adds to the theoretical debate on the local reproduction of the global in studies of neoliberalism in higher education by describing a Hong Kong case study, supported by empirical data, of an actual university's responses to the newly included impact requirement in RAE 2020. More specifically, this study reveals that (1) the policy for socio-economic impact might be designed in a neutral or even benevolent manner, but has taken on a neoliberal and managerial dimension in its actual implementation; and (2) the neoliberal discourse underpinning the university's operation can be accounted for and explicated by the local factors embedded in the specific academic environment.
A profile of nontraditional agricultural real estate lender activity in the secondary market
Authors: Lyons Greg A. , Takach Jackson
Published: December 2021

Purpose

This paper uses novel data from a secondary market to assess how loans from nontraditional agricultural real estate lenders (NARELs) differ from traditional sources. Over $2 billion in loans from these entities were purchased by the secondary market between 2011 and 2020, but a lack of data has prevented a robust understanding of how these institutions operate.

Design/methodology/approach

The authors review loans from nontraditional lenders through their lifecycle in the secondary market from application to purchase and performance.

Findings

This paper finds no observable differences between nontraditional and traditional volumes with regards to borrower credit characteristics, loan approval rates, interest margins and loan performance. It finds significant differences between loan volumes and variable rate product use.

Originality/value

This is the first paper to use internal lender data to review nontraditional agricultural real estate loans and is the first analysis of nontraditional agricultural volumes in the secondary market.
Gender differences in fresh vegetable intake from 1979 to 2017 in Finland
Authors: Kähäri Antti
Published: December 2021

Purpose

Previous research has shown that in contemporary societies, women have a healthier dietary intake than men. However, no research has examined how this gender gap develops over the long term. The present study examined how gender differences in fresh vegetable intake frequency have evolved from 1979 to 2017 in Finland and whether differences are affected by age or educational level.

Design/methodology/approach

The data were derived from annually repeated, nationally representative “Health Behaviour and Health among the Finnish Adult Population” and “Regional Health and Well-being (RHW)” surveys on the health habits of the Finnish population. The dataset is a time series of repeated cross-sectional surveys. In total, the data sample comprised 161,996 Finns aged 20–64 years. Descriptive methods and logistic regression were used for the analysis.

Findings

During 1979–2017, the prevalence of daily vegetable intake increased from 12 to 35% among men and from 18 to 56% among women. Thus, the magnitude of the gap between genders doubled across the study period. The increased vegetable intake was partly explained by the changing education and age structures of society. Potential explanations and avenues for future research are also discussed. Policy implications depend on whether the findings are interpreted as a case of health differences or health inequality.

Originality/value

This study used a long time series to analyse how gender differences in vegetable intake have evolved in a Nordic welfare state context. It showed that the gap in fresh vegetable intake between men and women has widened.
Identifying and weighting of dimensions and indicators of individual job performance using fuzzy Delphi and fuzzy analytic hierarchy process techniques
Authors: Abbasi Milad , Monazzam Mohammad Reza , Arabalibeik Hossein , Shamsipour Mansour
Published: December 2021

Purpose

The purpose of the study was to identify and weight the dimensions and indicators of individual job performance (IJP).

Design/methodology/approach

To identify dimensions and their measuring indicators, a literature review was conducted in PubMed, Embase™, ProQest, Scopus®, Web of Science™ and Google Scholar. Based on the results of the literature review and consensus among the research team, dimensions and measuring indicators were identified and an IJP framework was constructed. For weighting dimensions and indicators, fuzzy analytical hierarchy process (FAHP) and fuzzy Delphi technique (FDT) were conducted, respectively.

Findings

Based on the results, the conceptual framework showed that IJP consisted of four dimensions as follows: task performance (TP), contextual performance (CP), counterproductive work behaviors (CWBs) and adaptive performance (AP). The results of FAHP showed that TP (0.358) had the highest weighting in measuring IJP. The weight of CWBs, CP and AP was 0.302, 0.244 and 0.096, respectively. The results showed that 102 indicators were identified to measure the dimensions. Using the FDT, 45 indicators were accepted and 57 were rejected. Of the accepted indicators, 12 indicators belonged to TP. In addition, 11, 12 and 10 belonged to CP, CWBs and AP, respectively.

Research limitations/implications

The results of the article can be useful in research and practice and bridge the gap between theory and practice. In the research area, the researchers can use this model to develop questionnaires for evaluating IJP in all occupations. The researchers can choose the most effective dimensions or indicators in accordance with the corresponding occupation. Moreover, the results can be used in practice (economic and commercial impact), teaching, influencing public policy and helping to establish a more complete knowledge system.

Originality/value

In order to select dimensions and their measuring indicators, the work in the study took the unique approach to employ powerful decision-making methods combined with fuzzy methods to remove any ambiguity in opinions.
Designing servicescapes for transformative service conversations: lessons from mental health services
Authors: Gopaldas Ahir , Siebert Anton , Ertimur Burçak
Published: December 2021

Purpose

Dyadic services research has increasingly focused on helping providers facilitate transformative service conversations with consumers. Extant research has thoroughly documented the conversational skills that providers can use to facilitate consumer microtransformations (i.e. small changes in consumers’ thoughts, feelings and action plans toward their well-being goals). At the same time, extant research has largely neglected the role of servicescape design in transformative service conversations despite some evidence of its potential significance. To redress this oversight, this article aims to examine how servicescape design can be used to better facilitate consumer microtransformations in dyadic service conversations.

Design/methodology/approach

This article is based on an interpretive study of mental health services (i.e. counseling, psychotherapy and coaching). Both providers and consumers were interviewed about their lived experiences of service encounters. Informants frequently described the spatial and temporal dimensions of their service encounters as crucial to their experiences of service encounters. These data are interpreted through the lens of servicescape design theory, which disentangles servicescape design effects into dimensions, strategies, tactics, experiences and outcomes.

Findings

The data reveal two servicescape design strategies that help facilitate consumer microtransformations. “Service sequestration” is a suite of spatial design tactics (e.g., private offices) that creates strong consumer protections for emotional risk-taking. “Service serialization” is a suite of temporal design tactics (e.g., recurring appointments) that creates predictable rhythms for emotional risk-taking. The effects of service sequestration and service serialization on consumer microtransformations are mediated by psychological safety and psychological readiness, respectively.

Practical implications

The article details concrete servicescape design tactics that providers can use to improve consumer experiences and outcomes in dyadic service contexts. These tactics can help promote consumer microtransformations in the short run and consumer well-being in the long run.

Originality/value

This article develops a conceptual model of servicescape design strategies for transformative service conversations. This model explains how and why servicescape design can influence consumer microtransformations. The article also begins to transfer servicescape design tactics from mental health services to other dyadic services that seek to facilitate consumer microtransformations. Examples of such services include career counseling, divorce law, financial advising, geriatric social work, nutrition counseling, personal styling and professional organizing.
Criminological measures to counteract corruption offences in the field of illegal gambling
Authors: Berdaliyeva Anara S. , Kim Alexandr I. , Seraliyeva Aliya M. , Gassanov Aivazkhan A. , Dunentayev Makhambet V.
Published: December 2021

Purpose

Despite all the anti-corruption measures and anti-corruption initiatives, people offer or accept bribes without any hesitation. As anywhere in the world, the negative consequences of corruption lead to a reduction in direct investment, increase inequality and poverty, distort and use public investment and reduce public revenues. The purpose of this article is to study the criminological measures to counteract corruption offences in the field of illegal gambling.

Design/methodology/approach

The methodological basis of the study is the provisions of the theory of knowledge: the laws of dialectical materialism, philosophical categories and scientific principles of cognition of social and legal reality.

Findings

Although many components of foreign state anti-corruption programmes are quite problematic to apply in modern realities in the Republic of Kazakhstan, according to legal scholars, through gradual implementation into the legislation of the Republic of Kazakhstan because of the systematic improvement by the state of the content of regulations and responsible implementation of anti-corruption strategies. In this regard, one of the conditions in the fight against corruption is actions aimed at using the best practices of countries that are similar to each other in terms of religion, habits, traditions, ethics and morality.

Originality/value

Anti-corruption initiatives using information and communication technologies, such as digital public services and e-government, crowdsourcing platforms, tools for exposing, transparency portals, blockchain and artificial intelligence technologies can provide significant assistance in combating manifestations of corruption in the field of illegal gambling on the internet in the Republic of Kazakhstan.
Challenges and chances for local health and social care integration – Lessons from Greater Manchester, England
Authors: Chang Ming-Fang
Published: December 2021

Purpose

Sustainability and transformation partnerships (STPs) were introduced to England, asking 44 local areas to submit their health and social care plans for the period from October 2016 to March 2021. This study aims to offer a deeper understanding of the complex structure in the local practice, and to discuss the associated challenges and chances.

Design/methodology/approach

Documentary analysis, qualitative interviews and questionnaire survey are used for this study. Findings have been compared and analysed thematically.

Findings

The study participants reported that apart from pooled budgets, past collaborative experience and local leadership are crucial elements for transforming health and social care integration in Greater Manchester (GM). Also, this study provides policy recommendations to promote effective collaborative partnerships in local practices and mitigate local inequity of funding progress.

Research limitations/implications

The findings of this paper cannot be extrapolated to all stakeholders due to the limited samples. Meanwhile, some of the discussions about the case of GM may not be transferrable to other STPs.

Originality/value

This study argues that the success of pooled budgets is the result, rather than the cause, of effective negotiations between various stakeholders; and therefore, there is no evidence suggesting that pooled budgets can resolve the discoordination of health and social care. Moreover, due to the bottom-up approach adopted by STPs, more effective boroughs tend to receive additional funding, resulting in an increasing gap of development between effective and ineffective boroughs.
Library staff support with Fourth Industrial Revolution's application to provide information resources to remote clients during the COVID-19 library services
Authors: Dube Tinyiko Vivian
Published: December 2021

Purpose

The Fourth Industrial Revolution (4IR) and the Coronavirus Disease 2019 (COVID-19) have challenged the academic libraries system with a paradigm shift that has never been experienced before. This article highlights how the library staff offered support with the 4IR to the remote during the COVID-19 era; to ensure that the provision of information resources does not halt because of the imposed lockdown COVID-19 regulations. The purpose of this study was to examine the library staff support with 4IR's application to provide information resources to remote clients during the COVID-19 library services.

Design/methodology/approach

The study was anchored by the positivism research paradigm and used a quantitative research approach. Microsoft Form was used to design an online questionnaire to collect data from the library staff working in a distance education environment in Gauteng Province of South Africa. The collected data were analyzed using the Statistical Package for the Social Sciences (SPSS).

Findings

The findings discovered that the library staff was keen on job innovation; however, the COVID-19 restrictions were a major cause for the library staff not to provide information resources to remote clients effectively.

Research limitations/implications

The 4IR has both positive and negative effects on the library staff and the remote clients. To ensure that academic libraries fully embrace the 4IR; it is imperative to examine how the remote clients affected by digital divide can benefit from this revolution since they do not have access to adequate gadgets such as laptops/personal computers/tablets/smartphone/iPods and data for Internet connection.

Practical implications

This study contributed to the Library and Information Science's (LIS) field by adding value to the knowledge base concerning how the library staff working in academic libraries operating in a distance education environment in Gauteng Province of South Africa offered support to the remote clients during the COVID-19 pandemic that impacted the drastic adoption of the 4IR.

Social implications

Stakeholders, library management and policymakers gained insight to revisit the existing library staff support regarding mentoring, coaching training remote clients on how to access and download online information resources. This is inspired by the fact that COVID-19 significantly influenced library services' value for knowledge by facilitating policy changes and aligning with 4IR.

Originality/value

The study greatly influences policymakers and information practitioners to mobilize new methods of library staff support.
Political connections, political uncertainty and audit fees: evidence from Pakistan
Authors: Ahmad Fawad , Bradbury Michael , Habib Ahsan
Published: December 2021

Purpose

This paper aims to examine the association between political connections, political uncertainty and audit fees. The authors use various measures of political connections and uncertainty: political connections (civil and military), political events (elections) and a general measure of political stability (i.e. a world bank index).

Design/methodology/approach

The authors measure the association between political connections, political uncertainty and audit fees. Audit fees reflect auditors’ perceptions of risk. The authors examine auditors’ business risk, clients’ audit and business risk after controlling for the variables used in prior audit fee research.

Findings

Results indicate that civil-connected firms pay significantly higher audit fees than non-connected firms owing to the instability of civil-political connections. Military-connected firms pay significantly lower audit fees than non-connected firms owing to the stable form of government. Furthermore, considering high leverage as a measure of clients’ high audit risk and high return-on-assets (ROA) as a measure of clients’ lower business risk, the authors interact leverage and ROA with civil and military connections. The results reveal that these risks moderate the relationship between political connection and audit fees. Election risk is independent of risk associated with political connections. General political stability reinforces the theme that a stable government results in lower risks.

Originality/value

The authors combine cross-sectional measures of political uncertainty (civil or military connections) with time-dependent measures (general measures of political instability and elections).
Feel like quitting the job? A causal attribution approach to social and work overload consequences
Authors: Ali Syed Ahmad , Mujahid Khadija , Umar Muhammad
Published: December 2021

Purpose

In an effort to study the effects of stress factors i.e. work overload and social overload, the authors integrate causal attribution research to develop a stress outcome model. Drawing on Affective Events theory, this study aims to investigate how work and social overload lead to turnover intentions with the mediating role of emotional exhaustion.

Design/methodology/approach

A quantitative approach to examine the direct linkage of stress factors to turnover intention was tested for 409 respondents working at middle and senior manager level posts in the banking sector of Lahore, Pakistan. Partial least square structure equation modeling technique was applied through Smart_PLS3.0 for hypothesis testing.

Findings

Results revealed a strong relationship between stress factors (i.e. social overload and work overload) and turnover intentions in the presence of emotional exhaustion as a significant mediator.

Originality/value

The study adds value to the theory and practice by examining the understudied stress factors (social overload) along with work overload and their consequences on the employees.
Locked-out: generational inequalities of housing tenure and housing type
Authors: Lowies Braam , Squires Graham , Rossini Peter , McGreal Stanley
Published: December 2021

Purpose

The purpose of this paper is to first explore whether Australia and the main metropolitan areas demonstrate significant differences in tenure and property type between generational groups. Second, whether the millennial generation is more likely to rent rather than own. Third, if such variation in tenure and property type by millennials is one of individual choice and lifestyle or the impact of housing market inefficiencies.

Design/methodology/approach

This paper employs a comparative research approach using secondary data from the Australian Bureau of Statistics (ABS) to consider housing tenure and type distributions across generations as well as through cross-city analysis.

Findings

The results show that home ownership is still the dominant tenure in Australia, but private rental is of increasing significance, becoming the tenure of choice for Millennials. Owner occupation is shown to remain and high and stable levels for older generations and while lower in percentage terms for Generation X; this generation exhibits the highest growth rate for ownership. Significant differences are shown in tenure patterns across Australia.

Originality/value

The significance of this paper is the focus on the analysis of generational differences in housing tenure and type, initially for Australia and subsequently by major metropolitan areas over three inter-census periods (2006, 2011 and 2016). It enhances the understanding of how policies favouring ageing in place can contradict other policies on housing affordability with specific impact on Millennials as different generations are respectively unequally locked-out and locked-in to housing wealth.
Two improved scanning path planning algorithms and a 3D printing control system with circular motion controller
Authors: Wang Dier , Zhang Jun
Published: December 2021

Purpose

This paper aims to improve the infilling efficiency and the quality of parts forming. It proposes two improved scanning path planning algorithm based on velocity orthogonal decomposition.

Design/methodology/approach

The algorithms this paper proposes replace empty paths and corners with circular segments, driving each axis synchronously according to the SIN or COS velocity curve to make the extruder always moves at a constant speed at maximum during the infilling process. Also, to support the improved algorithms, a three-dimensional (3D) printing control system based on circular motion controller is also designed.

Findings

The simulation and experiment results show that the improved algorithms are effective, and the printing time is shortened more significantly, especially in the case of small or complex models. What’s more, the optimized algorithm is not only compact in shape but also not obvious in edge warping.

Research limitations/implications

The algorithms in this paper are not applicable to traditional motion controllers.

Practical implications

The algorithms in this paper improve the infilling efficiency and the quality of parts forming.

Social implications

There are no social implications in this paper.

Originality/value

The specific optimization method of parallel-line scanning algorithm based on velocity orthogonal decomposition is replacing the empty paths with arc corners. And the specific optimization method of contour offsetting algorithm based on velocity orthogonal decomposition is to add connection paths between adjacent contours and turn all straight corners into arcs. What’s more, the 3D printing control system based on the circular motion controller can achieve multi-axis parallel motion to support these two improved path scanning algorithms.
Safety of conventional immunosuppressive therapies for patients with dermatological conditions and coronavirus disease 2019: A review of current evidence
Authors: Arora Harleen , Boothby‐Shoemaker Wyatt , Braunberger Taylor , Lim Henry W. , Veenstra Jesse
Published: December 2021

The effect of coronavirus disease 2019 (COVID‐19) on patients receiving conventional immunosuppressive (IS) therapy has yet to be fully determined; however, research on using IS therapy for treating COVID‐19 in acutely ill patients is increasing. While some believe that IS therapy may be protective, others argue that these agents may make patients more susceptible to COVID‐19 infection and morbidity and advocate for a more cautious, individualized approach to determining continuation, reduction, or discontinuation of therapy. In this review, we aim to provide an overview of COVID‐19 risk in dermatological patients who are receiving conventional IS therapies, including mycophenolate mofetil, methotrexate, cyclosporine, azathioprine, apremilast, JAK inhibitors, and systemic steroids. Additionally, we provide recommendations for management of these medications for dermatological patients during the COVID‐19 pandemic. Treatment of dermatological disease during the COVID‐19 pandemic should involve shared decision‐making between the patient and provider, with consideration of each patient’s comorbidities and the severity of the patient’s dermatological disease.
Variation in biotic interactions mediates the effects of masting and rainfall fluctuations on seedling demography in a subtropical rainforest
Authors: Martini Francesco , Chang‐Yang Chia‐Hao , Sun I‐Fang
Published: December 2021

Seedling dynamics are critical for determining community composition and future forest structure. Two mechanisms are crucial drivers of seedling vital rates: biotic interactions and environmental filtering. Biotic interactions at the neighbourhood scale, such as the Janzen–Connell effect, are considered among the main mechanisms maintaining species coexistence. These effects can show considerable temporal variation because of changes in neighbourhood density (i.e. seedling recruitment following masting years) and weather conditions. However, there is limited evidence of whether interannual variation in these conditions modulates biotic interactions and its potential cascading effects on seedling vital rates.

We used seedling data collected over 17 years in a subtropical rainforest in northern Taiwan. We modelled interannual variation in first‐year survival and growth of 12,830 seedlings of 36 species and 47 cohorts using (generalized) linear mixed‐effects models with several crowding indices and abiotic conditions (edaphic and topographic factors) as predictors.

The first‐year seedling survival and growth depended on both weather conditions and neighbourhood density. Seedling survival was greater when recruitment was more abundant and in years with greater rainfall, and this was mostly mediated by the interaction with conspecific and heterospecific seedlings. Seedling growth decreased with the increasing abundance of new recruits and increased with annual rainfall. Growth was negatively affected by the basal area of conspecific and heterospecific trees and by the density of conspecific seedlings when the number of new recruits was greater. The abiotic factors had a limited effect on seedling survival and growth compared to biotic factors.

Synthesis. Our results show that variation in recruitment abundance due to masting and annual rainfall significantly affects seedling vital rates by changing biotic interactions. These findings are in accordance with the economy of scale hypothesis, which predicts higher per‐capita reproductive success in years of higher seed production. Furthermore, the results support the hypothesis that fluctuations in rainfall can alter biotic interactions in forests. Efforts to predict forest community responses to climate changes should consider the temporal variations in biotic interactions.
Occupational therapy in oncology palliative care for adolescents and young adults: Perspectives of Australian occupational therapists
Authors: Wallis Amy , Meredith Pamela , Stanley Mandy
Published: December 2021

Introduction

Palliative Care Australia suggests current needs (emotional wellbeing, understanding of cancers impact on relationships, everyday activities, and life milestones) for adolescent and young adults in palliative care are unmet due to a lack of age‐specific palliative care facilities in Australia. This includes the provision of occupational therapy that can impact these unmet needs. Although the occupational therapy role in palliative care has been documented, little is known about existing occupational therapy services or occupational needs for young people with palliative care needs. The aims of this study were to obtain occupational therapists insights of working with this population in Australia regarding (1) gaps in palliative care services for this population; (2) facilitators and challenges to providing occupational therapy for this group; and (3) perceived occupational needs of young people living with a life‐limiting cancer diagnosis.

Methods

Using snowball sampling, an online survey was distributed to occupational therapists with experience working in palliative cancer care with adolescents and young adults. Available for 6 weeks, the survey included demographic, work history, and service delivery questions. Forced‐choice questions were summarised descriptively, and content analysis was used to analyse free‐text data.

Results

Eleven completed surveys were returned. Overall, therapists perceived current palliative care services for this population within Australia to be lacking. Two gaps emerged: age‐appropriate facilities and gaps in provision of psycho‐social and occupational therapy services. Funding, lack of knowledge of the occupational therapy role, and professional confidence were highlighted as challenges to practice. Main occupational needs related to maintenance of as “normal” a life as possible: maintaining occupational role engagement, continuing connection with others, and being heard regarding their occupational needs.

Conclusion

Findings suggest a need for service changes, including custom‐designed facilities, improved funding, training and mentoring, to support age‐appropriate and occupation‐focussed care for the young person in cancer‐specific palliative care.
Application of molecularly imprinted solid‐phase extraction coupled with liquid chromatography method for detection of penicillin G in pasteurised milk samples
Authors: Pourtaghi Abbas , Mohammadinejad Arash , Asgharian Rezaee Mitra , Saberi Mohammad Reza , Motamedshariaty Vahideh Sadat , Mohajeri Seyed Ahmad
Published: December 2021

In the present study, a polymeric powder, synthesised using methacrylic acid as the functional monomer and ethylene glycol dimethacrylate as the cross‐linker, was used as a highly selective sorbent in a molecularly imprinted solid‐phase extraction cartridge to extract penicillin G from milk samples. Detection was performed using high performance liquid chromatography. The proposed method was used to determine penicillin G in the milk matrix in the range of 3–1000 ng/mL (limit of detection 2 ng/mL) with relative recoveries of 81–90% (relative standard deviation 2.14–4.35%). Finally, the calibrated method was used to quantify penicillin G residue in commercial pasteurised milk samples.
Uptake and outcomes of sentinel lymph node mapping in women undergoing minimally invasive surgery for endometrial cancer
Authors: Dioun Shayan , Chen Ling , Melamed Alexander , Gockley Allison , St. Clair Caryn M. , Hou June Y. , Khoury‐Collado Fady , Hershman Dawn L. , Wright Jason D.
Published: December 2021

Objective

To examine the patterns and outcomes of sentinel lymph node (SLN) assessment in women with endometrial cancer.

Design

Retrospective cohort study.

Setting

United States inpatient and outpatient hospital services.

Population

Women with endometrial cancer who underwent a laparoscopic or robotic‐assisted hysterectomy.

Methods

The Perspective Database from 2012 to 2018 was used. Performance of lymph node dissection was classified as SLN mapping, lymph node dissection or no nodal evaluation. Adjusted regression models were developed to examine the association between SLN mapping and morbidity and cost.

Main Outcome Measures

Utilisation rates, morbidity and cost of both lymph node dissection and SLN mapping.

Results

Among 45 381 patients, SLN mapping was performed for 7768 patients (17.1%), lymph node dissection was performed for 23 214 patients (51.2%) and no lymphatic evaluation was performed for 14 399 patients (31.7%). SLN mapping increased from 1.8% in 2012 to 35.3% in 2018, whereas the rate of lymph node dissection decreased from 63.5% to 39.1% (p < 0.001). Among women who underwent nodal evaluation, residence in the west, White race and use of robotic‐assisted hysterectomy were associated with SLN mapping (p < 0.05 for all). The complication rate was 5.9% for SLN mapping, compared with 7.3% in those that underwent lymph node dissection (aRR 0.85, 95% CI 0.77–0.95). The median hospital costs for women who underwent SLN mapping ($10 479) and lymph node dissection ($10 747) were higher than for those who did not undergo nodal assessment ($9149) (p < 0.001).

Conclusions

The performance of SLN mapping is increasing for endometrial cancer. Compared with lymph node dissection, SLN mapping is associated with lower morbidity. SLN mapping significantly increases the costs compared with hysterectomy alone.

Tweetable Abstract

SLN mapping is increasing rapidly for endometrial cancer and is associated with decreased perioperative morbidity.
Provider perspectives on integrating family caregivers into patient care encounters
Authors: Griffin Joan M. , Riffin Catherine , Bangerter Lauren R. , Schaepe Karen , Havyer Rachel D.
Published: December 2021

Objective

To examine and compare health care provider perceptions for integrating family caregivers into patient encounters and other processes of care by medical specialty.

Data Sources/Setting

Data were from 19 interviews conducted in 2018, 10 with primary care or palliative care providers and nine with proceduralists or interventionists in practices located in Minnesota, Florida, and Arizona.

Study Design

This was a qualitative study using data collected from one‐on‐one, semi‐structured interviews with physicians.

Data Collection

By using purposeful “maximum variation” sampling to capture differences between primary and palliative care providers and proceduralists/interventionists, data were collected, reviewed, coded, and then analyzed using inductive content analysis with a constant comparison approach.

Primary Findings

Primary care providers described a lack of organizational and institutional resources to support caregivers. Accordingly, they were compelled to curb caregiver engagement in order to meet patients' clinical care needs within the time and workflow demands in encounters. Proceduralists and interventionists described the need to assess caregivers for suitability to provide care during intense periods of treatment. They reported having access to more formal organizational resources for supporting caregivers. Overall, providers described a paradox, where caregivers are seen as contributing value to patient encounters until they need training, education, or support to provide care, at which point they become burdensome and require more time and resources than are typically available.

Conclusions

Results highlight how organizational constraints inhibit caregiver engagement in patient encounters and influence provider attitudes about engaging caregivers and assessing their unmet needs. Findings also provide insights into challenges across practice types for implementing state and federal laws that promote caregiver engagement.
Effluent N‐terminal expressed in renal cell carcinoma/mesothelin predicts increased peritoneal permeability in patients undergoing peritoneal dialysis
Authors: Idei Mayumi , Abe Masaaki , Tanaka Mototsugu , Nakata Junichiro , Isshiki Miwa , Hino Okio , Miida Takashi
Published: December 2021

Introduction

We investigated whether N‐terminal and C‐terminal products of expressed in renal cell carcinoma/mesothelin (N‐ERC and C‐ERC) in peritoneal effluent can predict peritoneal permeability in patients undergoing peritoneal dialysis (PD).

Methods

Thirty‐seven peritoneal effluent samples were obtained from 26 PD patients. High transport status was determined by the peritoneal equilibration test as a dialysate/plasma ratio of creatinine (D/P Cr) ≥ 0.81. Effluent cancer antigen 125 (CA125) was used as a reference.

Results

Effluent N‐ERC concentration was better correlated with D/P Cr than effluent C‐ERC or CA125 concentration. In multivariate analyses, effluent N‐ERC and C‐ERC, but not CA125, were significant predictors of high transport status after adjusting for age, PD duration, and residual renal Kt/V. ROC analysis showed that effluent N‐ERC was the best predictor of high transport status among those three biomarkers.

Conclusion

Effluent N‐ERC predicts increased peritoneal permeability in patients undergoing PD.
The Limits to China's Peaceful Rise – Deep Integration and a New Cold War
Authors: Yue Jianyong
Published: December 2021

This article challenges the dominant view that China has risen, and that its economic ascent has created a restless empire poised to overturn the liberal international order. This author argues that China's deep integration into the global economy from the early 1990s onward, as necessitated by both Chinese domestic politics and America's grand strategy of drawing China out, has eventually set the country on a path of dependent development and has made China not a solid superpower candidate, but rather a fragile great power. It is ironic that it is the empire‐sized country's entrapment in semi‐peripheral development, rather than its economic‐technological ‘rise’, that has inevitably led to the return of great power rivalry and the coming of the new Cold War.
Senescence‐induced changes in CD4 T cell differentiation can be alleviated by treatment with senolytics
Authors: Lorenzo Erica C. , Torrance Blake L. , Keilich Spencer R. , Al‐Naggar Iman , Harrison Andrew , Xu Ming , Bartley Jenna M. , Haynes Laura
Published: December 2021

Aging and senescence impact CD4 T helper cell (Th) subset differentiation during influenza infection. In the lungs of infected aged mice, there were significantly greater percentages of Th cells expressing the transcription factor FoxP3, indicative of regulatory CD4 T cells (Treg), when compared to young. TGF‐beta levels, which drive FoxP3 expression, were also higher in the bronchoalveolar lavage of aged mice and blocking TGF‐beta reduced the percentage of FoxP3+ Th in aged lungs during influenza infection. Since TGF‐beta can be the product of senescent cells, these were targeted by treatment with senolytic drugs. Treatment of aged mice with senolytics prior to influenza infection restored the differentiation of Th cells in those aged mice to a more youthful phenotype with fewer Th cells expressing FoxP3. In addition, treatment with senolytic drugs induced differentiation of aged Th toward a healing Type 2 phenotype, which promotes a return to homeostasis. These results suggest that senescent cells, via production of cytokines such as TGF‐beta, have a significant impact on Th differentiation.
Positively Pregnant: Development and piloting of a mobile app for social and emotional well‐being in pregnancy
Authors: Barber Carol Cornsweet , Masters‐Awatere Bridgette
Published: December 2021

This paper describes development of a mobile e‐health application, Positively Pregnant, which provides tools to meet the psychological challenges of pregnancy and transition to parenthood. Positively Pregnant was developed with input from maternity carers and consumers, incorporating local cultures and contexts as well as international research on effective interventions for stress management and mental well‐being. The prototype app was piloted with 88 New Zealand women. Participants in the pilot used an average of 11.96 (SD = 7.44) components, and most were satisfied (45.1%) or neutral (40.3%) regarding the app. For 23 of the 26 interactive components, the majority of those who tried the component reported that they found it helpful. Participants reported a significant reduction in subjective stress (η2 = .088,p = .023). Feedback from pilot participants was incorporated in a version of the app that was publically launched as a free tool to support developing families. Mobile e‐health applications are a promising medium for providing preventative interventions and psychoeducation about the social and emotional challenges of pregnancy and early parenting; Positively Pregnant is an example of a tool, grounded in strength‐based, empirically supported strategies, to provide parents with support and information at this critical time.
Debt Begets Debt: The Sri Lankan Welfare State and Fiscal Sustainability
Authors: Abeysinghe Tilak
Published: December 2021

Universal free education, healthcare and food subsidy and land (and housing) for the landless were the key features of the Sri Lankan welfare state. In the 1960s and 1970s, Sri Lanka was an outlier among developing countries in that it had high human development indicators for a low‐income country. Sri Lanka cannot make the same claims today. Many developing countries have surpassed Sri Lanka. Insufficient economic growth and perpetual budget deficits have resulted in an unsustainable build‐up of public debt. A segmented trend analysis of the debt‐to‐GDP ratio shows that social welfare programs are not the main drivers of unsustainable debt trends at present. It is debt servicing that perpetuates the debt burden. In fact, the fiscal constraints of the country have taken a heavy toll on the quality of the social programs. The debt burden resulting from an aging population, although largely offset at present by the declining proportion of young people in the population, is bound to increase further. Interestingly, apart from higher GDP growth, a quality‐adjusted road network seems to contribute to lowering the debt burden through indirect growth effects. By implication, essential infrastructure development increases the debt burden in the short run but reduces the debt burden in the long run when the growth effects start to kick in.
Impact of Financial Literacy on Retirement Financial Portfolio: Evidence from China*
Authors: Sun Ruiting , Zhang Huanhuan , Turvey Calum G. , Xiong Xueping
Published: December 2021

Financial literacy is an important factor that affects financial assets saved for retirement. Based on the China Household Finance Survey (2017) data and the two‐stage life cycle model, we study the impact of financial literacy on retirement financial portfolios. The findings are as follows: (i) financial literacy has a significant positive impact on the choice of wealth management products, risky financial assets and the total amount of retirement financial assets, but it has a negative impact on the choice of bank savings; (ii) financial literacy has a significant negative impact on the proportion of savings but has a significant positive impact on the proportion of wealth management products and risky financial assets; and (iii) using a different financial literacy index, considering selection bias and the influence of financial practitioners in the household, we prove the reliability of the above results. The paper highlights the importance of financial education and provides strong support for public (government) involvement to strengthen financial literacy education and improve the awareness of retirement financial planning to reduce the financial pressures faced by many of China's elderly citizenry.
Trajectories of adolescent stressful life events and young adults’ socioeconomic and relational outcomes: Weight and depressive symptoms as mediators
Authors: Wickrama K.A.S. , Klopack Eric T. , Sutton Tara E.
Published: December 2021

Little is known about how biological and psychological consequences of adolescent stressful life events (SLEs) are jointly associated with socioeconomic and relational outcomes in adulthood. To address this gap, the present study involved testing a model based on the life course perspective that posits adolescent SLE trajectories produce parallel trajectories of depressive symptoms and weight status, which are jointly associated with socioeconomic status and intimate relationship quality in adulthood. Prospective data over 13 years from a nationally representative sample of 11,677 US adolescents was utilized. The results demonstrated that trajectories of BMI and depressive symptoms, which showed contemporaneous and longitudinal comorbidities over the early life course, were influenced by adolescent SLEs. Both BMI and depressive symptoms trajectories are additively and jointly associated with socioeconomic status and intimate relationship quality in adulthood. Additionally, adolescent SLE trajectories are directly associated with these adult outcomes. These observed associations persisted even after controlling for early family socioeconomic adversity and race/ethnicity. The theoretical and practical implications of these findings are discussed.
Prognostic significance of serum immunoglobulin paraprotein in mucosa‐associated lymphoid tissue (MALT) lymphoma
Authors: Ren Yi‐Min , Shang Chun‐Yu , Liang Jin‐Hua , Yin Hua , Xia Yi , Wu Jia‐Zhu , Wang Li , Jian‐Yong Li , Li Yue , Xu Wei
Published: December 2021

To assess the prognostic significance of immunoglobulin (Ig) paraproteinaemia in mucosa‐associated lymphoid tissue (MALT) lymphoma, 218 patients diagnosed with MALT lymphoma were enrolled in this study. Serum Ig paraprotein was detected in 42 of 218 patients (19.3%), mostly IgM‐K (15, 35.7%), followed by IgM‐L and IgG‐L. Advanced age (p = 0.025), poor Eastern Cooperative Oncology Group performance status (p = 0.014), bone marrow involvement (p = 0.019), B symptoms (p = 0.039), advanced disease stage (III−IV) (p < 0.0001), elevated serum β2‐microglobulin level (p < 0.0001), multiple extranodal sites of involvement (p < 0.0001), nodal involvement (p < 0.0001), systemic therapy (p < 0.0001) and higher MALT‐lymphoma International Prognostic Index (MALT‐IPI) scores (p = 0.001) were significantly associated with the presence of serum Ig paraprotein. Multivariate Cox regression analysis showed that Ig paraproteinaemia was an independent prognostic predictor for inferior progression‐free survival (PFS) and overall survival. A new prognostic index based on MALT‐IPI and Ig paraproteinaemia, as assessed using receiver operating characteristic curves and the area under the curve statistics, showed better discriminative ability than MALT‐IPI in predicting PFS. In conclusion, Ig paraproteinaemia was a promising prognostic predictor for MALT lymphoma. Ig paraproteinaemia together with MALT‐IPI might contribute to optimising therapeutic management in clinical practice.