bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding and overcoming negative impacts of tourism in city destinations: conceptual model and strategic framework
Authors: Postma Albert , Schmuecker Dirk 
Published: November 2017

Purpose
The purpose of this paper is to clarify the mechanisms of conflict between residents and tourists and to propose a conceptual model to assess the impact of such conflicts on city tourism and to suggest a framework to develop strategies to deal with such conflicts and mitigate negative impacts.

Design/methodology/approach
Based on desk research a conceptual model was developed which describes the drivers of conflicts between residents and visitors. Building blocks of the model are visitors and their attributes, residents and their attributes, conflict mechanisms and critical encounters between residents and visitors, and indicators of the quality and quantity of tourist facilities. Subsequently the model was used to analyse the situation in Hamburg. For this analysis concentration values were calculated based on supply data of hotels and AirBnB, app-data, and expert consultations.

Findings
The study shows that in Hamburg there are two key mechanisms that stimulate conflicts: (1) the number of tourists in relation to the number of residents and its distribution in time and space; (2) the behaviour of visitors measured in the norms that they pose onto themselves and others (indecent behaviour of tourists).

Research limitations/implications
The model that was developed is a conceptual model, not a model with which hypotheses can be tested statistically. Refinement of the model needs further study.

Practical implications
Based on the outcomes of the study concrete strategies were proposed with which Hamburg could manage and control the balance of tourism.

Originality/value
City tourism has been growing in the last decades, in some cases dramatically. As a consequence, conflicts between tourists, tourism suppliers and inhabitants can occur. The rise of the so-called sharing economy has recently added an additional facet to the discussion. The ability to assess and deal with such conflicts is of importance for the way city tourism can develop in the future. This study is an attempt to contribute to the understanding of the mechanism behind and the nature of those conflicts, and the way they can be managed and controlled. Besides it illustrates how data generated by social media (apps) can be used for such purposes.
Researcher reflexivity: what it is and what it can be
Authors: Letiche Hugo 
Published: November 2017

Purpose
Second-order cybernetics is explored here as a learning intervention strategy. Researcher reflexivity, both the student’s and the professor’s, that is asserted is crucial to achieving a liberatory learning experience. But as Lacan has revealed, the “symbolic” (written, represented and studied) has a complex relationship to the “real”, which needs the “imaginary” to be active and creative. The aim of this paper is to investigate the complexity of these relationships and their import for reflexive learning, as it is grounded in second-order cybernetics.

Design/methodology/approach
This is a conceptual paper, comparing second-order cybernetics to current insights into researcher reflexivity, especially as grounded in Lacan and as it has been translated into an intervention strategy by Zizek and applied by the author. Supervision of MBA theses is examined as an exemplar.

Findings
A theory of researcher reflexivity is outlined with practical potential, which was demonstrated at the ASC 2016 conference.

Research limitations/implications
Exemplary learning is demonstrated and guidelines of practical significance are indicated, but these are not here further empirically researched.

Practical implications
The complexity of the “imaginary–symbolic–real” model and its value for reflexive learning is investigated. The application value of the model to learning and second-order cybernetics is developed.

Social/implications
A reflexive intervention is demonstrated in how one sees student/professor supervision and interaction.

Originality/value
Building on Glanville, it is shown that multiple reflexivities are needed to be put into play for second-order cybernetics to productively inform university practice. A difference of differences is needed to complexify feedback processes for cybernetic interventions to (best) succeed. The import of current theoretical debates from Lacan and Zizek to cybernetics is indicated.
Developing accreditation for community based surgery: the Irish experience
Authors: Ní Riain Ailís , Collins Claire , O’Sullivan Tony 
Published: November 2017

Purpose
Carrying out minor surgery procedures in the primary care setting is popular with patients, cost effective and delivers at least as good outcomes as those performed in the hospital setting. This paper aims to describe the central role of clinical leadership in developing an accreditation system for general practitioners (GPs) undertaking community-based surgery in the Irish national setting where no mandatory accreditation process currently exists.

Design/methodology/approach
In all, 24 GPs were recruited to the GP network. Ten pilot standards were developed addressing GPs’ experience and training, clinical activity and practice supporting infrastructure and tested, using information and document review, prospective collection of clinical data and a practice inspection visit. Two additional components were incorporated into the project (patient satisfaction survey and self-audit). A multi-modal evaluation was undertaken. A majority of GPs was included at all stages of the project, in line with the principles of action learning. The steering group had a majority of GPs with relevant expertise and representation of all other actors in the minor surgery arena. The GP research network contributed to each stage of the project. The project lead was a GP with minor surgery experience. Quantitative data collected were analysed using Predictive Analytic SoftWare. Krueger’s framework analysis approach was used to analyse the qualitative data.

Findings
A total of 9 GPs achieved all standards at initial review, 14 successfully completed corrective actions and 1 GP did not achieve the required standard. Standards were then amended to reflect findings and a supporting framework was developed.

Originality/value
The flexibility of the action-learning approach and the clinical leadership design allowed for the development of robust quality standards in a short timeframe.
Authentic leadership in healthcare: a scoping review
Authors: Malila Niina , Lunkka Nina , Suhonen Marjo 
Published: November 2017

Purpose
The purpose of this paper is to review peer-reviewed original research articles on authentic leadership (AL) in health care to identify potential research gaps and present recommendations for future research. The objectives are to examine and map evidence of the main characteristics, research themes and methodologies in the studies. AL is a leader’s non-authoritarian, ethical and transparent behaviour pattern.

Design/methodology/approach
A scoping review with thematic analysis was conducted. A three-step search strategy was used with database and manual searches. The included studies were composed of English language peer-reviewed original research articles referring to both AL and health care.

Findings
In total, 29 studies were included. The studies favoured Canadian nurses in acute care hospitals. AL was understood as its original definition. The review identified four research themes: well-being at work, patient care quality, work environment and AL promotion. Quantitative research methodology with the authentic leadership questionnaire and cross-sectional design were prevalent.

Research limitations/implications
Future research needs more variation in research themes, study populations, settings, organisations, work sectors, geographical origins and theory perspectives. Different research methodologies, such as qualitative and mixed methods research and longitudinal designs, should be used more.

Originality/value
This is presumably the first literature review to map the research on AL in health care.
Education and employment outcomes of young adults with a history of developmental language disorder
Authors: Conti‐Ramsden Gina , Durkin Kevin , Toseeb Umar , Botting Nicola , Pickles Andrew 
Published: November 2017

AbstractBackgroundDevelopmental language disorder (DLD) presents a considerable barrier for young adults to engage in further education and training. Early studies with young adults with DLD revealed poor educational achievement and lack of opportunities to progress in education. More recent studies have provided more positive findings. Relatively sparse data exist, however, on current cohorts and the factors that predict outcomes.AimsTo examine educational and employment outcomes in young adulthood in a sample of people with histories of DLD compared with an age‐matched peer group without DLD. We ask: How do educational pathways and early jobs compare between those with and without DLD? Are young adults with DLD receiving similar levels of income as their peers? To what extent are language and literacy abilities associated with outcomes?Methods & ProceduresParticipants included 84 individuals with DLD (67% males) and 88 age‐matched peers without DLD (56% males). Participants were on average 24 years of age. They completed a battery of psycholinguistic, literacy and nonverbal skills assessments. Data were also collected on educational qualifications, current educational status, extent of educational support received, employment status, history and support, as well as current income.Outcomes & ResultsThose with DLD obtained lower academic and vocational qualifications. Higher educational/vocational qualifications were associated with better language, better reading and higher performance IQ (PIQ). There were few differences between the two groups in terms of engagement with education, but the mean age at leaving education was significantly earlier in the participants with DLD. Substantially more participants with DLD reported receiving support or dispensation from their educational institution. There was no significant difference between groups in the proportion of young people currently employed, though a higher proportion of the age‐matched peers was in work full time. Participants with DLD were much more likely to be in non‐professional occupations. However, when examining pay in relation to types of occupation, the groups’ incomes were broadly comparable.Conclusions & ImplicationsAt the group level, young people with a history of DLD more commonly have less skilled employment and more rarely achieve professional roles. At the individual level there is considerable variation with smaller but not trivial proportions of young adults with a history of DLD showing good educational and employment outcomes. There are positive aspects to early adult outcomes for some young people with a history of DLD.
Risk profiles of personality traits for suicidality among mood disorder patients and community controls
Authors: Su M.‐H. , Chen H.‐C. , Lu M.‐L. , Feng J. , Chen I.‐M. , Wu C.‐S. , Chang S.‐W. , Kuo P.‐H. 
Published: November 2017

ObjectiveTo examine the associations between personality traits and suicidal ideation (SI) and attempt (SA) in mood disorder patients and community controls.MethodWe recruited 365 bipolar, 296 major depressive disorder patients, and 315 community controls to assess their lifetime suicidality. Participants filled out self‐reported personality questionnaires to collect data of personality traits, including novelty seeking (NS), harm avoidance (HA), extraversion (E), and neuroticism (N). We used logistic regression models adjusted for diagnoses to analyze combinational effects of personality traits on the risk of suicide. Additionally, radar charts display personality profiles for suicidal behaviours by groups.ResultsAll personality traits were associated with the risk of suicidality with various effect size, except for E that showed protective effect. High N or HA had prominent and independent risk effects on SI and SA. Combinations of high N and low E, or high HA and NS were the risk personality profiles for suicidality. Higher N scores further distinguished SA from SI in mood disorder patients.ConclusionIntrovert personality traits showed independent risk effects on suicidality regardless of diagnosis status. Among high‐risk individuals with suicidal thoughts, higher neuroticism tendency is further associated with increased risk of suicide attempt.
Religiosity and psychological resilience in patients with schizophrenia and bipolar disorder: an international cross‐sectional study
Authors: Mizuno Y. , Hofer A. , Frajo‐Apor B. , Wartelsteiner F. , Kemmler G. , Pardeller S. , Suzuki T. , Mimura M. , Fleischhacker W. W. , Uchida H. 
Published: November 2017

ObjectiveThe impact of religious/spiritual activities on clinical outcomes in patients with serious mental illnesses remains controversial, which was addressed in this international cross‐sectional study.MethodThree‐hundred sixty‐nine subjects were recruited from Austria (n = 189) and Japan (n = 180), consisting of 112 outpatients with paranoid schizophrenia, 120 with bipolar I disorder (DSM‐IV), and 137 healthy controls. Religiosity was assessed in terms of attendance and importance of religious/spiritual activities, while resilience was assessed using the 25‐item Resilience Scale. General linear models were used to test whether higher religiosity will be associated with higher resilience, higher social functioning, and lower psychopathology. The association between levels of spiritual well‐being and resilience was also examined.ResultsAttendance of religious services (F[4,365] = 0.827, P = 0.509) and importance of religion/spirituality (F[3,365] = 1.513, P = 0.211) did not show significant associations with resilience. Regarding clinical measures, a modest association between higher importance of religion/spirituality and residual manic symptoms was observed in bipolar patients (F[3,118] = 3.120, P = 0.029). In contrast to the findings regarding religiosity, spiritual well‐being showed a strong positive correlation with resilience (r = 0.584, P < 0.001).ConclusionThe protective effect of religiosity in terms of resilience, social functioning, and psychopathology was not evident in our sample. Spiritual well‐being appears more relevant to resilience than religiosity.
A man before his time: Russell's insights into nicotine, smoking, treatment and curbing the smoking problem
Authors: McNeill Ann , Robson Debbie 
Published: November 2017

AbstractBackground and aimsThis narrative review aimed to provide a brief overview of five key research ‘classics’ produced by the innovative and radical thought leader, Professor Michael Anthony Hamilton Russell (1932–2009), drawing upon his other work wherever feasible.MethodsNarrative review. From more than 250 publications, we selected papers we considered seminal texts, published in 1971, 1976, 1978, 1979 and 1991.ResultsRussell was among the first researchers to explain that smoking was a dependence disorder caused by the drug nicotine decades before this was recognized formally. He therefore saw quickly the importance of delivering nicotine in a less harmful format as a way of controlling nicotine withdrawal when stopping smoking, first studying nicotine gum. In addition to pharmacotherapies, Russell's research also explored the role of behavioural support, particularly the role of general practitioners (GPs), alone as well as supported by specialist clinics; this research underpinned initiatives in England to reimburse doctors for giving advice to smokers, and to provide a national network of smoking cessation services. Research on nicotine uptake from other delivery systems and routes led Russell to theorize that the speed and dose of delivery impacted upon the effectiveness of a product to act as a substitute for smoking. He commented on the addictiveness of the high nicotine boli delivered in quick succession when smoking cigarettes and argued that alternative recreational nicotine delivery systems would need to be promoted actively to smokers in order for them to compete with cigarettes, a forerunner for contemporary debates on electronic cigarettes.ConclusionsThe legacy of Russell's landmark research is seen in present‐day nicotine science, policy and discourse.
Quantifying Publication Bias in Meta-Analysis
Authors: Lin Lifeng , Chu Haitao 
Published: November 2017

Summary
Publication bias is a serious problem in systematic reviews and meta-analyses, which can affect the validity and generalization of conclusions. Currently, approaches to dealing with publication bias can be distinguished into two classes: selection models and funnel-plot-based methods. Selection models use weight functions to adjust the overall effect size estimate and are usually employed as sensitivity analyses to assess the potential impact of publication bias. Funnel-plot-based methods include visual examination of a funnel plot, regression and rank tests, and the nonparametric trim and fill method. Although these approaches have been widely used in applications, measures for quantifying publication bias are seldom studied in the literature. Such measures can be used as a characteristic of a meta-analysis; also, they permit comparisons of publication biases between different meta-analyses. Egger's regression intercept may be considered as a candidate measure, but it lacks an intuitive interpretation. This article introduces a new measure, the skewness of the standardized deviates, to quantify publication bias. This measure describes the asymmetry of the collected studies’ distribution. In addition, a new test for publication bias is derived based on the skewness. Large sample properties of the new measure are studied, and its performance is illustrated using simulations and three case studies.
Benefit finding trajectories in cancer patients receiving psychological care: Predictors and relations to depressive and anxiety symptoms
Authors: Zhu Lei , Ranchor Adelita V. , Helgeson Vicki S. , van der Lee Marije , Garssen Bert , Stewart Roy E. , Sanderman Robbert , Schroevers Maya J. 
Published: November 2017

ObjectivesThis study aimed to (1) identify benefit finding trajectories in cancer patients receiving psychological care; (2) examine associations of benefit finding trajectories with levels of and changes in psychological symptoms; and (3) examine whether socio‐demographic and medical characteristics distinguished trajectories.DesignNaturalistic longitudinal study design.MethodsParticipants were 241 cancer patients receiving psychological care at specialized psycho‐oncological institutions in the Netherlands. Data were collected before starting psychological care, and three and 9 months thereafter. Latent class growth analysis was performed to identify benefit finding trajectories.ResultsFive benefit finding trajectories were identified: ‘high level‐stable’ (8%), ‘very low level‐small increase’ (16%), ‘low level‐small increase’ (39%), ‘low level‐large increase’ (9%), and ‘moderate level‐stable’ (28%). People in distinct benefit finding trajectories reported significant differential courses of depression but not of anxiety symptoms. Compared with the other four trajectories, people in the ‘low level‐large increase’ trajectory reported the largest decreases in depression over time. Perceptions of cancer prognosis distinguished these trajectories, such that people with a favourable prognosis were more likely to belong to the ‘high level‐stable’ trajectory, while people perceiving an uncertain prognosis were more likely to belong to the ‘low level‐large increase’ trajectory of benefit finding.ConclusionsCancer patients showed distinct benefit finding trajectories during psychological care. A small proportion reporting a large increase in benefit finding were also most likely to show decreases in depressive symptoms over time. These findings suggest a relation between perceiving benefits from cancer experience and improved psychological functioning in cancer patients receiving psychological care.
Statement of contribution

What is already known on this subject?

People vary in course of benefit finding (BF) after trauma, with some experiencing enhanced BF and others decreased BF.

Empirical studies have identified subgroups of cancer patients with distinct BF trajectories.

What does this study add?

This is the first study showing that cancer patients followed different BF trajectories during psychological care.

Only a small proportion experienced clinically meaningful increases in BF over time.

More attention is needed for cancer patients with decreased BF, as they are at a higher risk of remaining depressed.
How Will Higher Minimum Wages Affect Family Life and Children's Well‐Being?
Authors: Hill Heather D. , Romich Jennifer 
Published: November 2017

AbstractIn recent years, new national and regional minimum wage laws have been passed in the United States and other countries. The laws assume that benefits flow not only to workers but also to their children. Adolescent workers will most likely be affected directly given their concentration in low‐paying jobs, but younger children may be affected indirectly by changes in parents’ work conditions, family income, and the quality of nonparental child care. Research on minimum wages suggests modest and mixed economic effects: Decreases in employment can offset, partly or fully, wage increases, and modest reductions in poverty rates may fade over time. Few studies have examined the effects of minimum wage increases on the well‐being of families, adults, and children. In this article, we use theoretical frameworks and empirical evidence concerning the effects on children of parental work and family income to suggest hypotheses about the effects of minimum wage increases on family life and children's well‐being.
Immune checkpoint inhibitors: new strategies to checkmate cancer
Authors: Wilson R A M , Evans T R J , Fraser A R , Nibbs R J B 
Published: November 2017

SummaryImmune checkpoint inhibitors (ICIs) targeting cytotoxic T lymphocyte-associated protein-4 (CTLA-4) or programmed cell death protein 1 (PD-1) receptors have demonstrated remarkable efficacy in subsets of patients with malignant disease. This emerging treatment modality holds great promise for future cancer treatment and has engaged pharmaceutical research interests in tumour immunology. While ICIs can induce rapid and durable responses in some patients, identifying predictive factors for effective clinical responses has proved challenging. This review summarizes the mechanisms of action of ICIs and outlines important preclinical work that contributed to their development. We explore clinical data that has led to disease-specific drug licensing, and highlight key clinical trials that have revealed ICI efficacy across a range of malignancies. We describe how ICIs have been used as part of combination therapies, and explore their future prospects in this area. We conclude by discussing the incorporation of these new immunotherapeutics into precision approaches to cancer therapy.