bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Hospital Staffing Models and Failure to Rescue
Authors: Ward Sarah T. , Dimick Justin B. , Zhang Wenying , Campbell Darrell A. , Ghaferi Amir A. 
Published: March 2018

Objective:
To identify hospital staffing models associated with failure to rescue (FTR) rates at low- and high-performing hospitals.

Background:
FTR is an important quality measure in surgical safety and is a metric that hospitals are seeking to improve. Specific unit-level determinants of FTR, however, remain unknown.

Methods:
Retrospective, observational study using data from the Michigan Quality Surgical Collaborative, which is a prospectively collected and clinically audited database in the state of Michigan. We identified 44,567 patients undergoing major general or vascular surgery from 2008 to 2012. Our main outcome measures were mortality, complications, and FTR rates.

Results:
Hospital rates of FTR across low, middle, and high tertiles were 8.9%, 16.5%, and 19.9%, respectively (P < 0.001). Low FTR hospitals tended to have a closed intensive care unit staffing model (56% vs 20%, P < 0.001) and a higher proportion of board-certified intensivists (88% vs 60%, P < 0.001) when compared to high FTR hospitals. There was also significantly more staffing of low FTR hospitals by hospitalists (85% vs 20%, P < 0.001) and residents (62% vs 40%, P < 0.01). Low FTR hospitals were noted to have more overnight coverage (75% vs 45%, P < 0.001) as well as a dedicated rapid response team (90% vs 60%, P < 0.001).

Conclusions:
Low FTR hospitals had significantly more staffing resources than high FTR hospitals. Although hiring additional staff may be beneficial, there remain significant financial limitations for many hospitals to implement robust staffing models. Thus, our ongoing work seeks to improve rescue and implement effective staffing strategies within these constraints.
CoboChild: a blended mobile game-based learning service for children in museum contexts
Authors: Hsu Tien-Yu , Liang HsinYi , Chiou Chuang-Kai , Tseng Judy C.R. 
Published: March 2018

Purpose
The purpose of this paper is to develop a blended mobile game-based learning service called CoboChild Mobile Exploration Service (hereinafter CoboChild) to support children’s learning in an environment blending virtual game worlds and a museum’s physical space. The contextual model of learning (CML) was applied to consider the related influential factors affecting museum learning and to promote children’s continuous learning and revisit motivations.

Design/methodology/approach
CoboChild provides a thematic game-based learning environment to facilitate children’s interactions with exhibits and other visitors. A practical system has been implemented in the National Museum of Natural Science (NMNS), Taiwan. A questionnaire was used to examine whether CoboChild can effectively fulfill the CML and to evaluate the impacts on museum learning.

Findings
CoboChild effectively fulfilled the CML to facilitate children’s interactive experiences and re-visit motivations in the blended mobile game-based learning environment. Most children described the system as providing fruitful playfulness while improving their interpretations of exhibitions and learning experiences.

Practical implications
CoboChild considers the related contextual influences on the effective support of children’s learning in a museum, and builds a child-centered museum learning environment with highly integrated blended learning resources for children. CoboChild has been successfully operating in the NMNS since 2011.

Originality/value
This study developed a blended mobile game-based learning service to effectively support children’s learning in museum contexts. The related issues are shown to improve the design of blended museum learning services. This innovative approach can be applied to the design of other child-centered services for engaging children’s interactive experiences in museums.
Cleaning up the paper trail – our clinical notes in open view
Authors: Lambe Gerard , Linnane Niall , Callanan Ian , Butler Marcus W. 
Published: March 2018

Purpose
Ireland’s physicians have a legal and an ethical duty to protect confidential patient information. Most healthcare records in Ireland remain paper based, so the purpose of this paper is to: assess the protection afforded to paper records; log highest risk records; note the variations that occurred during the working week; and observe the varying protection that occurred when staff, students and public members were present.

Design/methodology/approach
A customised audit tool was created using Sphinx software. Data were collected for three months. All wards included in the study were visited once during four discrete time periods across the working week. The medical records trolley’s location was noted and total unattended medical records, total unattended nursing records, total unattended patient lists and when nursing personnel, medical students, public and a ward secretary were visibly present were recorded.

Findings
During 84 occasions when the authors visited wards, unattended medical records were identified on 33 per cent of occasions, 49 per cent were found during weekend visiting hours and just 4 per cent were found during morning rounds. The unattended medical records belonged to patients admitted to a medical specialty in 73 per cent of cases and a surgical specialty in 27 per cent. Medical records were found unattended in the nurses’ station with much greater frequency when the ward secretary was off duty. Unattended nursing records were identified on 67 per cent of occasions the authors visited the ward and were most commonly found unattended in groups of six or more.

Practical implications
This study is a timely reminder that confidential patient information is at risk from inappropriate disclosure in the hospital. There are few context-specific standards for data protection to guide healthcare professionals, particularly paper records. Nursing records are left unattended with twice the frequency of medical records and are found unattended in greater numbers than medical records. Protection is strongest when ward secretaries are on duty. Over-reliance on vigilant ward secretaries could represent a threat to confidential patient information.

Originality/value
While other studies identified data protection as an issue, this study assesses how data security varies inside and outside conventional working hours. It provides a rationale and an impetus for specific changes across the whole working week. By identifying the on-duty ward secretary’s favourable effect on medical record security, it highlights the need for alternative arrangements when the ward secretary is off duty. Data were collected prospectively in real time, giving a more accurate healthcare record security snapshot in each data collection point.
Barriers to empathy-based care: oncology nurses’ perceptions
Authors: Taleghani Fariba , Ashouri Elaheh , Memarzadeh Mehrdad , Saburi Mortaza 
Published: March 2018

Purpose
The purpose of this paper is to explore oncology nurses’ barriers to empathy-based care perceptions.

Design/methodology/approach
The authors used a descriptive qualitative method. In total, 18 oncology nurses were selected via purposive sampling. Data were collected through in-depth interviews and qualitative content analysis using an inductive approach.

Findings
Three main categories emerged from the data analysis: barriers related to nursing including: lacking compassion; disinterest in oncology nursing and self-criticism; psychological distress; barriers related to healthcare: job strain; task-centeredness; no formal training; poor manager support; nurse-patient gender imbalance; and barriers related to cancer care including: difficulty maintaining empathy with cancer patients; and inappropriate cancer patient

Practical implications
Oncology nurses provided insights into barriers to empathy-based care and the challenges they encountered while caring for cancer patients. Understanding these barriers is the first step to overcoming obstacles and creating an open and caring environment to provide an empathic care culture.

Originality/value
Given that oncology nurses experience several emotions, positive coping strategies for these distresses should be adopted. Healthcare systems should change cancer-caring culture from task-centered to patient-centered care. Compassion and empathy should become patient care values.
Brexit associated sharp depreciation and implications for UK’s inflation and balance of payments
Authors: Nasir Muhammad Ali , Simpson Justine 
Published: March 2018

Purpose
The purpose of this paper is to analyse the implications of exchange rate depreciation for inflation targeting and trade balance of UK in the context of the Brexit epoch.

Design/methodology/approach
The study employed a time-varying structural vector auto-regression (TVSVAR) model framework in which the sources of time variation were both the coefficients and variance-covariance matrix of the innovations on the data from January 1989 to September 2016.

Findings
The findings suggest that the depreciation of the Stirling has significant effects on inflation and trade balance in UK in context of Brexit epoch. It also showed that such a depreciation can be helpful in the improvement of external balance as well as steering the inflation to its statutory target. Despite, the inflation targeting, there is strong evidence of a pass-through.

Research limitations/implications
Research has profound implications in terms of the sharp depreciation of GBP associated with the Brexit outcome. The study is very topical and could be very interesting to the readership of JES as well as wider audience. The study has limitations in a context that the significance of the results and association of the under analysis entities is contingent on the future trade relationships and Channel between UK and EU. Therefore, although there is a lot of uncertainty about the future of Britain trade relationships, this study provides guidance on the importance of exchange rate channel if the similar trade arrangements prevails in the post-Brexit era.

Practical implications
The research has profound practical implications, using a TVSVAR model in which the relationship among the entities varies over time; it has shown the importance of exchange rate in terms of external balance and inflation targeting. Hence, it has appeal for the practitioners as well as academics.

Social implications
The research has great social implications. The Brexit is the biggest political and economic event of this era for UK and EU. There are big questions about the relationship between UK and EU in the post-Brexit epoch as well as questions about the future of the European integration. In this context, this study has shown that how the exchange rate could play an important role for the UK economy when its contemporary trade channels prevail. Concomitantly, it has social implications particularly for the European society.

Originality/value
The research is an original piece of work. It has contributed to the debate on the exchange rate deprecation, external balance and inflation targeting in context of the Brexit associated sharp depreciation of Stirling. It has used a framework, i.e. TVSVAR, which also have unique features in terms of testing the associations among under analysis entities against time.
Shared experiences and awareness from learning in a student multicultural environment
Authors: Sanchez Bengoa Dolores , Ganassali Stephane , Kaufmann Hans Ruediger , Rajala Arto , Trevisan Italo , Berkel Johan van , Zulauf Katrin , Wagner Ralf 
Published: March 2018

PurposeThis paper aims to analyze the skills and attitudes development of multicultural teams. In todays’ environment, business interconnectivity and multicultural societies are becoming the normal way of living. Although students are increasingly facing multicultural learning environments, their awareness and willingness or harmonious and productive learning in these environments need to be prepared for in a systematic manner. Therefore, it is necessary that the students are conscious of their commonalities and differences with other students to gain cultural competence. Students’ progress in developing their cultural intelligence is determined by co-operative social skills and the amount of interactions in a multicultural environment.Design/methodology/approachThe research was conducted using a quantitative methodology. The questionnaire development roots in a students’ self-assessment scheme proposed by Armstrong (Wharton School, University of Pennsylvania) covering the progress made during the participation in an intercultural project.FindingsThe research findings relate to attitudes toward developing and sharing knowledge, stress, learning and task orientation, intercultural communication and cultural awareness skills related to the impacts of culture on the different ways of learning when working in multicultural teams. The study confirmed that knowledge gains and competence progress are higher in international teams compared to national teams.Research limitations/implicationsTo provide for better differentiation as to the student profile, e.g., nationality, cultural categories, a larger sample size is suggested.Practical implicationsThe study might be seen as a road map for universities and international companies alike for imparting cognitive, affective and behavioral competencies.Originality/valueThis study complements previous studies investigating the phenomenon of stress with multi-cultural complexity in more long-term durations. It implies stress factors to appear also in short-term multi-cultural exposures.
Strategic internationalization through curriculum innovations and stakeholder engagement
Authors: Guillotin Bertrand 
Published: March 2018

Purpose
Anti-globalization and protectionism movements have transformed strategic internationalization, international business (IB) student engagement and enrollment growth into very complex endeavors. Whereas the literature is rather scarce on solutions, this paper aims to offer some best practices at a highly ranked IB program that can be very useful to business school leaders.

Design/methodology/approach
Descriptive case study of the Fox IB program (Temple University, USA) is based on an inductive approach and the Quality Function Deployment framework to design and internationalize the curriculum.

Findings
Listening to the voice of the customers through student and employer testimonials, the author found the elements that make an IB program and curriculum successful. Even senior students who are “between opportunities” feel that the new IB curriculum have prepared them well for their career.

Research limitations/implications
While the case study methodology is well-suited to understand strategies and processes, this research has natural limitations in terms of generalizability.

Practical implications
Academic Directors and business school leaders can use these best practices to innovate, engage their stakeholders and grow enrollments. By increasing job placement opportunities and enrollments, they create a virtuous cycle of success and can obtain additional resources for their program.

Social implications
The value of management education to society is almost incalculable. IB is an integrative management discipline that is instrumental to the success of the global economy and society.

Originality/value
The best practices of the highly ranked Fox IB program and the 21 student and employer testimonials in this case study have never been shared before.
Factors affecting the voluntary use of internal audit: evidence from the UK
Authors: Ismael Hazem Ramadan , Roberts Clare 
Published: March 2018

PurposeThis study aims to identify the factors that lead non-financial companies listed in the UK to use an internal audit function (IAF) as a monitoring mechanism. Although the use of an IAF in the UK is voluntary, no prior research has examined the drivers for using one.Design/methodology/approachFinancial and non-financial data were collected from the annual reports of 332 UK non-financial companies listed on the London Stock Exchange (LSE) Main Market. Univariate tests and multivariate logistic regression tests were used to test the research hypotheses. A theoretical framework based on both agency theory and transaction cost economics (TCE) theory was used to explain the economic factors affecting the use of an IAF.FindingsThe study provides evidence that firm size, level of internal risks, agency problem between owners and managers and existence of an effective audit committee are associated with the existence of an IAF. Thus, the need to have strong internal control and risk management systems and to reduce both internal and external agency costs drives companies to have an IAF. These results suggest the importance of IAF as an internal corporate governance tool and the effectiveness of UK governance regulations in monitoring the effectiveness of internal control systems.Practical implicationsGiven the importance of the IAF’s corporate governance role, the study provides some policy implications. Regulators should pay more attention to the issue of maintaining an IAF, especially by large companies, the relationship between the IAF and other governance parties, especially the audit committee, and the disclosure of more relevant information about the IAF’s characteristics and practices.Originality/valueThis is the first study to examine the factors affecting the existence of the IAF within the UK’s distinctive regulatory approach of “comply or disclose reasons”. Furthermore, it provides a theoretical framework that explains how both the agency theory and TCE theory can interpret the adoption of internal audit.
Exploitative technological diversification, environmental contexts, and firm performance
Authors: Pan Xin , Chen Xuanjin , Ning Lutao 
Published: March 2018

PurposeAlthough technological diversification is often understood as an explorative activity, the authors argue that it can also be explained as exploitation. The purpose of this paper is to examine how exploitative technological diversification (ETD) affects firm performance and what factors may moderate this relationship.Design/methodology/approachThe sample consists of 1,569 Chinese listed firms with 7,555 observations from 2003 to 2014. Patent data were collected from the State Intellectual Property Office, while financial information was collected from the China Stock Market and Accounting Research database. The system generalised method of moments model was used for testing the hypotheses.FindingsThe empirical findings indicate that the relationship between ETD and firm performance is inversely U-shaped. Moreover, this relationship is negatively moderated by environmental munificence, which refers to the availability of resources in the environment where the firm operates, and positively moderated by environmental dynamism, which refers to the extent of volatility and unpredictable change in firms’ external environments.Originality/valueOverlooking ETD limits applications of diversification logic and the precision of their predictions. This paper tries to fill this gap by empirically testing the relationship between ETD and financial performance.
Re-imagining marketing as societing
Authors: Kashif Muhammad , Fernando P.M.P. , Altaf Umair , Walsh John 
Published: March 2018

Purpose
Marketing theory and practice is under severe criticism – socialists and the practitioners criticize marketing in its current form which calls for active efforts by marketers to reposition the discipline – making it beneficial to the masses. The Western world is thoroughly investigated based on the opinions of public regarding marketing as a discipline. However, studies which present a non-Western consumer’s attitudes toward the role of marketing in a society are scant. This purpose of this study is to encapsulate Pakistani consumers’ understandings and attitudes toward marketing with an emphasis on their perceptions of the ethicality and transformative power of the discipline.

Design/methodology/approach
A purposive convenience sample of 40 professionals with diverse non-marketing backgrounds and of the widest possible demographic profile participated in in-depth, unstructured interviews. The content analysis and grounded theory method were used for the analysis.

Findings
Marketing is appreciated for creating product awareness and, occasionally, combating social problems, but this positive image is clouded by severely criticizing it for promoting materialism, being irritatingly pervasive and pushy, as well as for using unethical and unfair practices.

Practical implications
The study offers a valuable insight into the discipline’s performative and social legitimation in a fast-growing Asian economy. The authors recommend paths for a positive repositioning of the discipline that will improve its public image and enhance its potential for being recognized as a force for positive social change.

Originality/value
Further to enhancing our understanding of consumer attitudes toward marketing, this paper’s value lies in it being the first ever exploration of the developing country perspective. Most importantly, it contributes to a debate that could enlighten the much-needed repositioning of marketing as a discipline to make it useful for masses.
Paradigm for diagnosing mycobacterial disease: direct detection and differentiation ofMycobacterium tuberculosiscomplex and non-tuberculous mycobacteria in clinical specimens using multiplex real-time PCR
Authors: Kim Jeong-Uk , Ryu Dae-Shick , Cha Choong-Hwan , Park Seon-Hee 
Published: March 2018

AimsMycobacterium tuberculosisand non-tuberculous mycobacteria (NTM) are clinically different, and the rapid detection and differentiation ofM. tuberculosiscomplex (MTBC) and NTM is crucial for patient management and infection control. Given the slow growth of most pathogenic mycobacteria, nucleic acid amplification assays are excellent tools for direct identification of mycobacteria in clinical specimens. Recently, a multiplex real-time PCR assay was developed that can directly detect 20 mycobacterial species in clinical specimens. Here, we evaluated the diagnostic performance of the assay for diagnosing mycobacterial disease under routine laboratory conditions.MethodsA total of 3334 specimens collected from 1437 patients suspected of tuberculosis infection were subjected to acid-fast bacilli staining, conventional culture and the multiplex real-time PCR assay. To evaluate the sensitivity and specificity of the assay, the overall diagnosis of tuberculosis was defined by positive culture plus medical history, and the 2007 American Thoracic Society and Infectious Disease Society of America diagnostic criteria for NTM disease were applied.ResultsThe sensitivity, specificity, positive predictive value and negative predictive value were 87.5%, 99.6%, 96.1% and 98.5%, respectively, for the detection of MTBC isolates and 53.3%, 99.9%, 95.2%, and 98.9%, respectively, for detecting NTM isolates.ConclusionsThus, the assay can correctly differentiate between MTBC and NTM isolates in clinical specimens and would be a useful tool for the rapid differentiation of tuberculosis and NTM disease, despite its limited sensitivity for the diagnosis of NTM disease.