bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sunflower management and life insurance: modeling the CEO’s utility function
Authors: Lin Jyh-Horng , Huang Fu-Wei , Chen Shi 
Published: June 2019

Purpose
The purpose of this paper is to develop a theoretical framework to answer the following question: What are the consequences of sunflower behavior as well as spread behavior for how asset-liability management is administrated in a life insurance company?

Design/methodology/approach
This paper takes into account the following: the chief executive officer (CEO) of a life insurance company confirms the board of directors’ belief – the preference of the like of higher return relative to the dislike of higher risk; the authors call such behavior sunflower management; the life insurance policyholder is entitled to a guaranteed interest rate and a participation percentage of the company’s investment surplus; and the authors examine the optimal insurer interest margin, i.e., the spread between the loan rate and the guaranteed rate.

Findings
Sunflower management translates into lower utility for the CEO and makes the CEO more prudent to risk-taking at an increased insurer interest margin for the provision of life insurance contracts. The effect of the guaranteed rate on the margin is ambiguous and depends on the level of guarantee itself. An increase in the participation level decreases the CEO’s loan risk-taking at an increased margin. It is shown that a trend toward higher return like of the board’s belief produces a corresponding trend toward the CEO’s decreasing risk-taking when the return like is revealed strongly. The results indicate that sunflower management as such is an important determinant in ensuring a safe insurance system.

Originality/value
This is the first paper to construct a contingent claim model to evaluate the expected value of the CEO’s utility function defined in terms of the equity returns and the equity risks of a life insurance company. The model explicitly considers CEO sunflower behavior, CEO spread behavior and the limited liability of shareholders.
Corporate social responsibility, customer loyalty and brand positioning
Authors: Akbari Morteza , Mehrali Maryam , SeyyedAmiri Nader , Rezaei Niloofar , Pourjam Afsaneh 
Published: June 2019

PurposeIn the current era, businesses and customers are becoming increasingly concerned with social and environmental issues, and unlike the past, the main focus is not merely on economic growth. As new customers are getting more informed and responsible toward their surroundings, it is necessary for enterprises to act responsibly to attract responsible customers. Therefore, this paper aims to investigate the impact of corporate social responsibility (CSR) on brand positioning and customer loyalty in travel agencies in Tehran, Iran.Design/methodology/approachThrough quota sampling, 86 agencies are selected and a number of 200 customers of those travel agencies are surveyed by means of purposive sampling.FindingsThe result reveals that CSR has a significant effect on loyalty of customers and brand positioning. In addition, the results indicate that all hypotheses have significant effects except for the C-C identification on customer loyalty.Practical implicationsTourism managers should bear in mind that performing CSR activities is not merely a cost burden but a viable strategy for creating competitive advantage. They should adapt their CSR activities to the industry environment.Originality/valueThe study provides important evidence about CSR and their role in brand positioning and customer loyalty in tourism industry. In addition, the study contributes to the literature by developing the link between CSR and brand positioning.
Assessing cognitive communication skills in dementia: a scoping review
Authors: Dooley Suzanna , Walshe Margaret 
Published: June 2019

AbstractBackgroundCognitive communication difficulties are a characteristic feature of dementia. These deficits have negative effects on all aspects of daily life. Yet, there are few options for standardized assessment of cognitive communication skills in people with dementia.AimsTo review published cognitive–communication assessments to determine what psychometrically sound assessments exist that are applicable to all people with dementia.Methods & ProceduresA scoping review of the literature was conducted using an established scoping review model. Cognitive–communication assessments validated in English with people with dementia were sought. A comprehensive search of eight relevant electronic databases was undertaken. Two reviewers independently analysed and assessed the psychometric quality of instruments that met inclusion criteria.Outcomes & ResultsFour cognitive–communication assessments were included in the review. Although psychometrically sound, none was suitable for administration at all stages of dementia. Only one was validated for different dementia types. None included subtests for evaluation of conversation ability, and none involved the evaluation of communication partners’ communication.Conclusions & ImplicationsThere are limited options for standardized communication assessment for individuals with dementia and their communication partners. Directions for the development of new measures are provided to facilitate research and improve clinical practice.
Whole‐genome sequencing reveals Listeria monocytogenes diversity and allows identification of long‐term persistent strains in Brazil
Authors: Camargo Anderson C. , Moura Alexandra , Avillan Johannetsy , Herman Nicole , McFarland Adelle P. , Sreevatsan Srinand , Call Douglas R. , Woodward Joshua J. , Lecuit Marc , Nero Luís A. 
Published: June 2019

SummaryAdvances in whole‐genome sequencing (WGS) technologies have documented genetic diversity and epidemiology of the major foodborne pathogen Listeria monocytogenes (Lm) in Europe and North America, but data concerning South America are scarce. Here, we examined the population structure and genetic diversity of this major foodborne pathogen collected in Brazil. Based on core genome multilocus sequence typing (cgMLST), isolates from lineages I (n = 22; 63%) and II (n = 13; 37%) were distributed into 10 different sublineages (SLs) and represented 31 new cgMLST types (CTs). The most prevalent SLs were SL9 (n = 9; 26%), SL3 (n = 6; 17%) and SL2 and SL218 (n = 5; 14%). Isolates belonging to CTs L2‐SL9‐ST9‐CT4420 and L1‐SL315‐ST520‐CT4429 were collected 3 and 9 years apart, respectively, revealing long‐term persistence of Lm in Brazil. Genetic elements associated with stress survival were present in 60% of isolates (57% SSI‐1 and 3% SSI‐2). Pathogenic islands were present in 100% (LIPI‐1), 43% (LIPI‐3) and 6% (LIPI‐4) of the isolates. Mutations leading to premature stop codons were detected in the prfA and inlA virulence genes. This study is an important contribution to understanding the genomic diversity and epidemiology of Lm in South America. In addition, the results highlight the importance of using WGS to reveal Lm long‐term persistence.
Comparative analyses of microbial community diversities of Tibetan kefir grains from three geographic regions
Authors: Liu Wenwen , Zhang Meimei , Xie Jie , Wang Hongwei , Zhao Xin , Chen Bingcan , Suo Huayi 
Published: June 2019

Tibetan kefir grains are the traditional starter for fermented milk products in Tibet, China. To gain a deeper understanding of their bacterial and fungal community diversities, we compared kefir grains from three different regions, Nyingchi, Lhasa and Yangbajing, using high‐throughput sequencing. The results of sequence analysis grouped the reads into four bacterial and four fungal phyla, comprising 34 bacterial and 139 fungal genera, and 44 bacterial and 195 fungal species. Firmicutes and Proteobacteria were two dominant bacterial phyla, and Lactobacillus and Acetobacter were the dominant bacterial genera. Basidiomycota and Ascomycota were the dominant fungal phyla. There was significant difference in the Basidiomycota and Ascomycota among three regions (P < 0.05). A significant difference in genera was observed in the percentage of Saccharomyces, Trichosporon, Aspergillus and Candida between the samples from Nyingchi, Lhasa and Yangbajing (P < 0.05). Based on principal component analysis (PCA), the Tibetan kefir grain samples from Nyingchi could be distinctly differentiated from the other two regions in term of fungal community, but no obvious difference existed in the bacterial population of samples from the three regions.
Proteolysis of reconstituted goat whey fermented by Streptococcus thermophilus in co‐culture with commercial probiotic Lactobacillus strains
Authors: Santos Widson Michael , de Caldas Nobre Michelangela Suelleny , Cavalcanti Mônica Tejo , dos Santos Karina Maria Olbrich , Salles Hévila Oliveira , Alonso Buriti Flávia Carolina 
Published: June 2019

Reconstituted goat whey was fermented with the starter Streptococcus thermophilus TA‐40 in co‐culture with four probiotic adjuncts (independent treatments): Lactobacillus casei BGP93 (T1), Lactobacillus paracasei BGP1 (T2), Lb. paracasei LPC37 (T3) and Lactobacillus rhamnosus LR32 (T4). Lactobacillus populations were higher than 7 log cfu/mL after fermentation and storage. Proteolysis increased significantly (P < 0.05) during fermentation in all trials. Relative amount of low‐molecular‐weight protein fractions (<6.5 kDa) increased in goat whey trials with T1, T3 and T4 during fermentation and storage. The goat whey powder was considered a potential substrate for starter and probiotic cultures, which raised the opportunities to upgrade this by‐product into a functional food.
Poor sleep quality predicts psychotic‐like symptoms: an experience sampling study in young adults with schizotypal traits
Authors: Simor P. , Báthori N. , Nagy T. , Polner B. 
Published: June 2019

ObjectivePsychotic‐like experiences (PLEs) are unusual experiences such as perceptual abnormalities and delusional‐like thoughts that resemble the symptoms of psychosis at the sub‐clinical level. PLEs are associated with sleep complaints in healthy and clinical samples; however, evidence for day‐to‐day associations between poor sleep and subsequent PLEs under naturalistic conditions is scarce. We hypothesized that poor sleep quality would predict next days’ PLEs, and vice versa, daytime PLEs would be associated with worse subsequent sleep quality.MethodSeventy‐three university students with moderate to high levels of positive schizotypy participated in an experience sampling study. Participants rated their sleep each morning, as well as PLEs and affective states during the day over 3 weeks.ResultsMultilevel regression models indicated that poor sleep quality predicted increased PLEs the following day. Poor sleep was linked to negative daytime mood that partially mediated the associations between sleep quality and next days’ PLEs. Furthermore, PLEs were enhanced in the evening as compared to daytime reports. The prediction of poor sleep quality by previous days’ PLEs was negligible.ConclusionsThe results are consistent with the position that sleep‐related interventions might reduce the risk of psychosis, especially in individuals that tend to experience psychotic‐like phenomena and negative affect.
Cortical thickening in remitters compared to non‐remitters with major depressive disorder following 8‐week antidepressant treatment
Authors: Saricicek Aydogan A. , Oztekin E. , Esen M. E. , Dusmez S. , Gelal F. , Besiroğlu L. , Zorlu N. 
Published: June 2019

ObjectiveLittle is known about the relationship between antidepressant treatment outcomes and underlying neurobiological mechanisms in patients with major depressive disorder (MDD). In this prospective study, we aimed to investigate how cortical thickness and subcortical volumes differed between remitter and non‐remitter patients with MDD.MethodsFifty‐eight patients with MDD with a score of at least 17 on the 17‐item Hamilton Depression Rating Scale and free of medication for at least 2 months and 41 healthy controls underwent structural magnetic resonance imaging. At the baseline, patients with MDD started on either selective serotonin reuptake inhibitors, serotonin‐norepinephrine reuptake inhibitors, or vortioxetine. After 8‐week antidepressant treatment, patients with MDD were scanned using the same MRI protocol. Structural images were analyzed using the FreeSurfer software package (version 6.0).ResultsLongitudinal analyses showed remitter patients with MDD had significantly greater right cerebral cortex thickening in six significant clusters, including superior temporal cortex, precuneus, rostral middle frontal cortex, pars opercularis (although the cluster extends into the insula), inferior parietal cortex, and supramarginal cortex than in non‐remitter patients with MDD.ConclusionOur results suggest that distinct antidepressant treatment‐related structural alterations in brain regions implicated in cognition, emotion regulation, and rumination might be associated with treatment outcome.
Brief Report: Low‐Barrier Buprenorphine Initiation Predicts Treatment Retention Among Latinx and Non‐Latinx Primary Care Patients
Authors: Lee Christina S. , Rosales Robert , Stein Michael D. , Nicholls Mariana , O’Connor Bridget M. , Loukas Ryan Vanessa , Davis Elizabeth A. 
Published: June 2019

Background and ObjectivesPatients are at risk of dropout while waiting for buprenorphine treatment. Study goals are to compare 3‐month retention in two different methods to buprenorphine initiation among persons with opioid use disorder.MethodsWe compared 3‐month treatment retention rates of low‐barrier buprenorphine initiation (i.e., rapid induction) (n =58) or a traditional method of buprenorphine initiation (
n = 45) for persons with opioid use disorder seen at an urban community health center.ResultsLogistic regression revealed that low‐barrier initiation had 11.11 greater odds of retention compared with traditional methods (p <0.001). Latinx patients benefited more than non‐Latinx patients (OR = 14.79,
p =.039).Discussion and ConclusionsAll patients were more likely to be retained using low‐barrier initiation. A significantly larger effect on retention among Latinx patients was observed.Scientific SignificanceRapid buprenorphine initiation increases treatment retention which improves treatment outcomes for persons with opioid use disorder. Study findings support a less restrictive services model that is even more effective for Latinx patients. (Am J Addict 2019;28:409–412)
Family intervention improves outcomes for patients with delirium: Systematic review and meta‐analysis
Authors: McKenzie Jessica , Joy Anna 
Published: June 2019

AbstractObjectiveTo determine if family caregiver involvement in interventions with patients with delirium improves patient outcomes.MethodsA search of three databases (Medline‐Ovid, CINAHL and Embase) was conducted. Eligibility criteria included adult patients and involvement of family caregivers in any delirium intervention. Data were extracted from each study (determined by PEDro scale) using a customised form. A meta‐analysis was undertaken which compared the length of hospital stay and duration of delirium. PROSPERO registration number is CRD42017077650.ResultsFive studies involving 505 participants published over a 5‐year period were suitable for inclusion. Low‐level evidence demonstrated family caregiver involvement may reduce caregiver's anxiety and hospital staff viewed administration of education to family caregivers as efficient. Meta‐analysis suggested family interventions reduce length of hospital stay for patients with delirium. It remains unclear if it affects the duration of delirium.ConclusionFamily caregivers providing interventions to patients with delirium can improve patient outcomes.
Ibrutinib‐related atrial fibrillation: A single center Australian experience
Authors: Ezad Saad , Khan Arshad A. , Cheema Hooria , Ashraf Asma , Ngo Doan T. M. , Sverdlov Aaron L. , Collins Nicholas J. 
Published: June 2019

AbstractBackgroundIbrutinib increases the risk of atrial fibrillation (AF) and is associated with bleeding tendencies. Reported rates of arrhythmia are variable in different studies. The aim of the current analysis was to evaluate the incidence of AF in a single‐center cohort of patients.MethodsThis analysis was conducted at Hunter New England Local Health District, Australia between April 1, 2015 and June 30, 2017. We included all consecutive patients commenced on ibrutinib for hematological malignancies. Patients with a history of paroxysmal AF were excluded. The primary end point was incidence of AF. Time to diagnosis and management were secondary outcomes of interest.ResultsA total of 24 patients (age 73 ± 9 years, males n = 16 [67%]) were commenced on ibrutinib treatment during the study period with chronic lymphocytic leukemia (n = 21, 88%) as the main indication. During a median follow‐up of 12 months, four (17%) patients were diagnosed with AF with increasing age, duration of ibrutinib treatment as associations. The median time to AF diagnosis was 9 (interquartile range [IQR]: 7‐18) months. All patients were managed with a rate control strategy with beta blockers as the preferred agents. Three (75%) patients were commenced on anticoagulation for stroke prevention. During a follow‐up of 18 (IQR: 17‐23) months following AF onset, one patient required hospitalization for AF. There were no bleeding complications reported.ConclusionsIn conclusion, this series noted a higher incidence of AF than previously reported. Oncologists and cardiologists need to be aware of the increased risk of AF in patients receiving ibrutinib.
Advance care planning in rural New South Wales from the perspective of general practice registrars and recently fellowed general practitioners
Authors: Littlewood Jean , Hinchcliff Reece , Lo Winston , Rhee Joel 
Published: June 2019

AbstractObjectiveThis study examined advance care planning as delivered by general practice registrars and recently fellowed GPs in New South Wales rural settings. The facilitators and barriers to advance care planning uptake in these areas were investigated, as well as the state of general practice training on advance care planning.DesignQualitative descriptive methodology, involving semi‐structured face‐to‐face and telephone interviews.SettingPrimary care.ParticipantsGeneral practice registrars and recently fellowedGPs in New South Wales rural settings. Definition of rural using the Australian Standard Geographical Classification ‐ Remoteness Area. Thirteen participants were included in the study.Main outcome measuresThematic analysis of interview transcripts elucidated key issues emerging from participants' accounts.ResultsKey barriers included doctor‐dependent uptake, demands on doctor's time and the limited relevant resources available. Facilitators recognised were patient control in end‐of‐life care and long‐standing relationships betweenGPs and their patients. Uptake among patients was low, and minimal training on advance care planning reported.ConclusionThe lack of training opportunities in advance care planning during vocational training, especially when combined with the essential role played by ruralGPs in initiating advance care planning and providing end‐of‐life care, appears to be a major problem that might contribute to poor uptake among patients in rural areas. This study demonstrated, however, the significant benefits that advance care planning could bring in patients living in rural communities if delivered effectively. Given that ruralGPs face a number of barriers to providing routine health care, these results highlight an important need to provideGPs and rural communities with support, education, incentive, better administrative tools, options and greater awareness of advance care planning.
Increasing the social participation of older rural residents: Opportunities offered by “OPTEACH”
Authors: Hughes Clarissa , Bernoth Maree , Winkler Denise 
Published: June 2019

AbstractProblemThe issues addressed in this article are two‐fold. Firstly, education about ageing is predominantly textbook‐based. Secondly, many rural older people face social isolation which impacts their health. In addressing the first issue, we discovered that our project, Older Persons Teaching and Empowering Aged Care Students (OPTEACH), has the potential to have a positive impact on the second issue.DesignWe run university education sessions involving older people. Since such sessions present unique challenges, we obtained a grant to develop resources to assist educators and support rural older people to become “OPTEACHers.”SettingOPTEACH was undertaken in several rural communities in New South Wales and included staff and residents at residential aged care facilities and community‐dwelling rural older people.Key measures for improvementOur previous work had highlighted a need for educator resources that would facilitate “ageing” being taught in a way that both involved and respected older people. Our ethos centres on the “co‐creation” of knowledge, and having older peoples' unique contributions recognised and celebrated.Strategies for changeResources to assist with planning and being involved in OPTEACH education sessions are available at www.opteach.com.au. They will support a growing community of “OPTEACHers,” with beneficial flow‐on effects for rural older people.Effects of changeWe seek to provide practical support to both educators and older people to provide “real life” education on the experience of ageing.Next stepsFurther evaluation is needed, yet we anticipate a positive impact on self‐esteem, community “connectedness” and quality of life for older rural “OPTEACHers” as the approach gains momentum.
From smartphone to bed‐side: exploring the use of social media to disseminate recommendations from the National Tracheostomy Safety Project to front‐line clinical staff
Authors: Ng F. K. , Wallace S. , Coe B. , Owen A. , Lynch J. , Bonvento B. , Firn M. , McGrath B. A. 
Published: June 2019

SummaryTraditional methods used to disseminate educational resources to front‐line healthcare staff have several limitations. Social media may increase the visibility of these resources among targeted groups and communities. Our project aimed to disseminate key clinical messages from the National Tracheostomy Safety Project to those caring for patients with tracheostomies or laryngectomies. We commissioned an external media company to design educational material and devise a marketing strategy. We developed videos to communicate recommendations from the safety project and used Facebook, Twitter, YouTube and LinkedIn to deliver these to our target users. We recorded 629,270 impressions over a paid 12‐week campaign. Our YouTube channel registered more than a five‐fold increase in views and watch time during the campaign as compared with the previous year. Around two‐thirds of views across all platforms were from peer‐to‐peer sharing. We spent £4140 on social media advertising, with each view and click costing £0.02 and £0.67, respectively. This intelligence‐led approach using social media is an effective and efficient method to disseminate knowledge on the principles of safe tracheostomy care to front‐line clinical staff. Similar strategies may be effective for other patient safety topics, especially when targeting groups that do not use medical journals or other traditional means of dissemination.