TIAS School for Business and Society

BACKGROUND: Fresh red cells may improve outcomes in critically ill patients by enhancing oxygen delivery while minimizing the risks of toxic effects from cellular changes and the accumulation of bioactive materials in blood components during prolonged storage. METHODS: In this multicenter, randomized, blinded trial, we assigned critically ill adults to receive either red cells that had been stored for less than 8 days or standard-issue red cells (the oldest compatible units available in the blood bank). The primary outcome measure was 90-day mortality. RESULTS: Between March 2009 and May 2014, at 64 centers in Canada and Europe, 1211 patients were assigned to receive fresh red cells (fresh-blood group) and 1219 patients were assigned to receive standard-issue red cells (standard-blood group). Red cells were stored a mean (±SD) of 6.1±4.9 days in the fresh-blood group as compared with 22.0±8.4 days in the standard-blood group (P<0.001). At 90 days, 448 patients (37.0%) in the fresh-blood group and 430 patients (35.3%) in the standard-blood group had died (absolute risk difference, 1.7 percentage points; 95% confidence interval [CI], -2.1 to 5.5). In the survival analysis, the hazard ratio for death in the fresh-blood group, as compared with the standard-blood group, was 1.1 (95% CI, 0.9 to 1.2; P=0.38). There were no significant between-group differences in any of the secondary outcomes (major illnesses; duration of respiratory, hemodynamic, or renal support; length of stay in the hospital; and transfusion reactions) or in the subgroup analyses. CONCLUSIONS: Transfusion of fresh red cells, as compared with standard-issue red cells, did not decrease the 90-day mortality among critically ill adults. (Funded by the Canadian Institutes of Health Research and others; Current Controlled Trials number, ISRCTN44878718.).

Environmental, social and governance ("ESG") scores have been widely touted as indicators of share price resilience during the COVID-19 crisis. Contrary to this conventional wisdom, we present robust evidence that once industry affiliation, market-based measures of risk and accounting-based measures of performance, financial position and intangibles investments have been controlled for, ESG offers no such positive explanatory power for returns during the COVID crisis. Specifically, ESG is insignificant in fully specified returns regressions for each of the Q1 2020 COVID market crisis period and for the full COVID year of 2020. By contrast, a measure of the firm's stock of investments in internally generated intangible assets is an economically and statistically significant positive determinant of returns during each of the Q1 market implosion and full 2020 COVID year periods. Our results are robust to alternative measures of returns, as well as for using Refinitiv, Refinitiv II and MSCI data to capture ESG performance. We conclude that ESG did not immunize stocks during the COVID-19 crisis, but those investments in intangible assets did.

This article offers insights into the complexity of assessing the performance of public networks. We have identified three so‐called exogenous factors: form of the network, type of inception—whether the network was initially formed as voluntary or mandated—and developmental stage of the network. We argue that where a network stands on each of these factors will determine the appropriateness of specific criteria for assessing the performance of the network.

This article explores and extends the concept of hybridity to understand current changes in public services organizations, notably as seen from an organizational studies perspective. The notion of hybridity has become more important, given that the public sector increasingly blurs with other sectors and more social actors. Previous reliance on the use of ideal‐types in characterizing public services reforms has masked expanding heterogeneity. We here move beyond the (i) conventional focus on structural hybridity to consider (ii) institutional dynamics, (iii) social interactions, and (iv) new identities and roles in public services. Based on these four dimensions of hybridity, we review alternative theoretical frameworks. We suggest that bringing together work from the neighbouring disciplines of public administration and organization studies may improve our understanding of public services hybridity and outline a future research agenda.

Importance: Results of studies on use of prophylactic haloperidol in critically ill adults are inconclusive, especially in patients at high risk of delirium. Objective: To determine whether prophylactic use of haloperidol improves survival among critically ill adults at high risk of delirium, which was defined as an anticipated intensive care unit (ICU) stay of at least 2 days. Design, Setting, and Participants: Randomized, double-blind, placebo-controlled investigator-driven study involving 1789 critically ill adults treated at 21 ICUs, at which nonpharmacological interventions for delirium prevention are routinely used in the Netherlands. Patients without delirium whose expected ICU stay was at least a day were included. Recruitment was from July 2013 to December 2016 and follow-up was conducted at 90 days with the final follow-up on March 1, 2017. Interventions: Patients received prophylactic treatment 3 times daily intravenously either 1 mg (n = 350) or 2 mg (n = 732) of haloperidol or placebo (n = 707), consisting of 0.9% sodium chloride. Main Outcome and Measures: The primary outcome was the number of days that patients survived in 28 days. There were 15 secondary outcomes, including delirium incidence, 28-day delirium-free and coma-free days, duration of mechanical ventilation, and ICU and hospital length of stay. Results: All 1789 randomized patients (mean, age 66.6 years [SD, 12.6]; 1099 men [61.4%]) completed the study. The 1-mg haloperidol group was prematurely stopped because of futility. There was no difference in the median days patients survived in 28 days, 28 days in the 2-mg haloperidol group vs 28 days in the placebo group, for a difference of 0 days (95% CI, 0-0; P = .93) and a hazard ratio of 1.003 (95% CI, 0.78-1.30, P=.82). All of the 15 secondary outcomes were not statistically different. These included delirium incidence (mean difference, 1.5%, 95% CI, -3.6% to 6.7%), delirium-free and coma-free days (mean difference, 0 days, 95% CI, 0-0 days), and duration of mechanical ventilation, ICU, and hospital length of stay (mean difference, 0 days, 95% CI, 0-0 days for all 3 measures). The number of reported adverse effects did not differ between groups (2 [0.3%] for the 2-mg haloperidol group vs 1 [0.1%] for the placebo group). Conclusions and Relevance: Among critically ill adults at high risk of delirium, the use of prophylactic haloperidol compared with placebo did not improve survival at 28 days. These findings do not support the use of prophylactic haloperidol for reducing mortality in critically ill adults. Trial Registration: clinicaltrials.gov Identifier: NCT01785290.

In light of recent technological innovations and discourses around data and algorithmic analytics, scholars of many stripes are attempting to develop critical agendas and responses to these developments (boyd and Crawford 2012). In this mutual interview, three scholars discuss the stakes, ideas, responsibilities, and possibilities of critical data studies. The resulting dialog seeks to explore what kinds of critical approaches to these topics, in theory and practice, could open and make available such approaches to a broader audience.

This paper explores the scope for research on language and super-diversity.12 Following a protracted process of paradigm shift, sociolinguistics and linguistic anthropology are well placed to engage with the contemporary social changes associated with super-diversity. After a brief introductory discussion of what super-diversity entails, the paper outlines key theoretical and methodological developments in language study: named languages have now been denaturalised, the linguistic is treated as just one semiotic among many, inequality and innovation are positioned together in a dynamic of pervasive normativity, and the contexts in which people orient their interactions reach far beyond the communicative event itself. From here, this paper moves to a research agenda on super-diversity and language that is strongly embedded in ethnography. The combination of linguistics and ethnography produces an exceptionally powerful and differentiated view of both activity and ideology. After a characterisation of what linguistic ethnography offers social science in general, this paper sketches some priorities for research on language and communication in particular, emphasising the need for cumulative comparison, both as an objective in theory and description and as a resource for practical intervention.

This study aims to develop an integrative framework for green new product development (NPD) based on the existing literature and to empirically study the applicability of that integrative framework. This study answers three calls: for research that is rooted in a traditional NPD perspective, for research that integrates marketing aspects in a model of green NPD, and for research that acknowledges variations in greenness. The results from eight case studies in two industries (i.e., the chemical and food industries) substantiate the integrative framework and suggest that it provides a good basis for understanding green NPD. The study demonstrates that green NPD is not fundamentally different from traditional NPD but does contain features and underlying mechanisms that reflect the increased complexity of green NPD. The framework incorporates the targeting and positioning of green product innovations, thus establishing itself as a holistic framework. Most importantly, the study shows how greenness plays a pivotal role in tying the various elements of the framework together. The realized greenness of a new product is a central concept that helps managers understand complex relationships among industry type, green targeting, and green positioning.

BACKGROUND: The aim of this study was to describe barriers and facilitators for shared decision making (SDM) as experienced by older patients with multiple chronic conditions (MCCs), informal caregivers and health professionals. METHODS: A structured literature search was conducted with 5 databases. Two reviewers independently assessed studies for eligibility and performed a quality assessment. The results from the included studies were summarized using a predefined taxonomy. RESULTS: Our search yielded 3838 articles. Twenty-eight studies, listing 149 perceived barriers and 67 perceived facilitators for SDM, were included. Due to poor health and cognitive and/or physical impairments, older patients with MCCs participate less in SDM. Poor interpersonal skills of health professionals are perceived as hampering SDM, as do organizational barriers, such as pressure for time and high turnover of patients. However, among older patients with MCCs, SDM could be facilitated when patients share information about personal values, priorities and preferences, as well as information about quality of life and functional status. Informal caregivers may facilitate SDM by assisting patients with decision support, although informal caregivers can also complicate the SDM process, for example, when they have different views on treatment or the patient's capability to be involved. Coordination of care when multiple health professionals are involved is perceived as important. CONCLUSIONS: Although poor health is perceived as a barrier to participate in SDM, the personal experience of living with MCCs is considered valuable input in SDM. An explicit invitation to participate in SDM is important to older adults. Health professionals need a supporting organizational context and good communication skills to devise an individualized approach for patient care.

Oxygen administration is uniformly used in emergency and intensive care medicine and has life-saving potential in critical conditions. However, excessive oxygenation also has deleterious properties in various pathophysiological processes and consequently both clinical and translational studies investigating hyperoxia during critical illness have gained increasing interest. Reactive oxygen species are notorious by-products of hyperoxia and play a pivotal role in cell signaling pathways. The effects are diverse, but when the homeostatic balance is disturbed, reactive oxygen species typically conserve a vicious cycle of tissue injury, characterized by cell damage, cell death, and inflammation. The most prominent symptoms in the abundantly exposed lungs include tracheobronchitis, pulmonary edema, and respiratory failure. In addition, absorptive atelectasis results as a physiological phenomenon with increasing levels of inspiratory oxygen. Hyperoxia-induced vasoconstriction can be beneficial during vasodilatory shock, but hemodynamic changes may also impose risk when organ perfusion is impaired. In this context, oxygen may be recognized as a multifaceted agent, a modifiable risk factor, and a feasible target for intervention. Although most clinical outcomes are still under extensive investigation, careful titration of oxygen supply is warranted in order to secure adequate tissue oxygenation while preventing hyperoxic harm.

INTRODUCTION: Although substantial generic knowledge about integrated care has been developed, better understanding of the factors that drive behaviour, decision-making, collaboration and governance processes in integrated care networks is needed to take integrated care forward. To gain more insight into these topics and to understand integrated care in more depth, a set of underlying values of integrated care has been developed and defined in this study. THEORY AND METHODS: A systematic literature review was conducted to identify the underlying values of integrated care. Values theory was used as a theoretical framework for the analysis. RESULTS: This study identified 23 values in the current body of knowledge. The most frequently identified values are 'collaborative', 'co-ordinated', 'transparent', 'empowering', 'comprehensive', 'co-produced' and 'shared responsibility and accountability'. DISCUSSION AND CONCLUSION: The set of values is presented as a potential basis for a values-driven approach to integrated care. This approach enables better understanding of the behaviours and collaboration in integrated care and may also be used to develop guidance or governance in this area. The practical application of the values and their use at multiple levels is discussed. The consequences of different stakeholder perceptions on the values is explored and an agenda for future research is proposed.

Much is known about the importance of dynamic capabilities. Yet, surprisingly little is known about how multiple dynamic capabilities might be developed in parallel, since most existing work explores a particular dynamic capability in isolation. Using rich quantitative and qualitative data on D ow C hemical's acquisitions, joint ventures, and divestitures over the past 20 years, we seek to address this gap. Besides contributing by adding fresh insights about managing growth and the utility of distributed practice, and by shedding light on positive and negative experience transfer, our core contribution is an emergent theoretical framework that develops the concept of “concurrent learning. ” Copyright © 2014 John Wiley &amp; Sons, Ltd.

In this paper we give models and algorithms to describe and analyze the collaboration among authors of Wikipedia from a network analytical perspective.The edit network encodes who interacts how with whom when editing an article; it significantly extends previous network models that code author communities in Wikipedia.Several characteristics summarizing some aspects of the organization process and allowing the analyst to identify certain types of authors can be obtained from the edit network.Moreover, we propose several indicators characterizing the global network structure and methods to visualize edit networks.It is shown that the structural network indicators are correlated with quality labels of the associated Wikipedia articles.

BACKGROUND: During resuscitation in severe sepsis and septic shock, several goals are set. However, usually not all goals are equally met. The aim of this study is to determine the relative importance of the different goals, such as mean arterial pressure (MAP), lactate, central venous oxygen saturation (ScvO2) and central to forefoot temperature (delta-T), and how they relate to intensive care unit (ICU) and hospital mortality. METHODS: In a retrospective cohort study in a 20-bed mixed medical and surgical ICU of a teaching hospital we studied consecutive critically ill patients who were admitted for confirmed infection and severe sepsis or septic shock between 2008 and 2014. All validated MAP, lactate levels, ScvO2 and delta-T for the first 24 hours of ICU treatment were extracted from a clinical database. Logistic regression analyses were performed on validated measurements in the first hour after admission and on mean values over 24 hours. Patients were categorized by MAP (24-hour mean below or above 65 mmHg) and lactate (24-hour mean below or above 2 mmol/l) for Cox regression analysis. RESULTS: From 837 patients, 821 were eligible for analysis. All had MAP and lactate measurements. The delta-T was available in 812 (99%) and ScvO2 was available for 193 out of these patients (23.5%). Admission lactate (p < 0.001) and admission MAP (p < 0.001) were independent predictors of ICU and hospital mortality. The 24-hour mean values for lactate, MAP and delta-T were all independent predictors of ICU mortality. Hospital mortality was independently predicted by the 24-hour mean lactate (odds ratio (OR) 1.34, 95% confidence interval (CI) 1.30-1.40, p = 0.001) mean MAP (OR 0.96, 95% CI 0.95-0.97, p = 0.001) and mean delta-T (OR 1.09, 95% CI 1.06-1.12, p = 0.001). Patients with a 24-hour mean lactate below 2 mmol/l and a 24-hour mean MAP above 65 mmHg had the best survival, followed by patients with a low lactate and a low MAP. CONCLUSIONS: Admission MAP and lactate independently predicted ICU and hospital mortality. The 24-hour mean lactate, mean MAP and mean delta-T independently predicted hospital mortality. A Cox regression analysis showed that 24-hour mean lactate above 2 mmol/l is the strongest predictor for ICU mortality.

The past two decades witnessed the raise of closed-loop supply chain due to huge attention to the environment and business social responsibility. Both academia and industry have examined recycling and remanufacturing of the used products, due to these concerns complicated by resource scarcity, and government regulations. In this paper, a three-level closed-loop supply chain consisting of a manufacturer, retailer, and third-party collector are considered. The manufacturer builds simultaneously new products from raw materials and remanufactures the returning products. The main idea of the study is to evaluate optimal pricing and collection decisions under channel leadership with two competitive recycling channels including retailer collecting and third-party collector collecting. Based on game theory, four different scenarios are developed - a centralized model and three decentralized models based on the Stackelberg game including Manufacturer Stackelberg, Retailer Stackelberg, and third-party collector Stackelberg. To verify the model, the real case of a TV set producer is studied and then the optimal decisions compared and analyzed in different scenarios. The effect of competition between the retailer and the third-party collector recycling channel has been examined on decision variables, member profits and total profit. A comprehensive sensitivity analysis has been carried out considering the base market size parameter and the sensitivity of demand to retail prices. The examination of the results from the environmental and consumer welfare aspects shows that the retailer leadership decentralized model is often the most effective scenario in closed-loop supply chain, and considering the overall benefit of the supply chain between decentralized models, the retailer leadership model is the best and closest model to the centralized model.

Although marketing scholars often seek to contribute new knowledge that is applicable across industries, some industries have unique characteristics that require industry-specific knowledge development. The authors argue that this requirement applies to the life sciences industry, defined as companies in pharmaceuticals, biotechnology, and therapeutic medical devices. Marketers in the life sciences industry face novel and unique challenges along eight decision areas in therapy creation, therapy launch, and therapy promotion. In therapy creation, they face therapy pipeline optimization, innovation alliance formation, and therapy positioning decisions. In therapy launch, they face global market entry timing and key opinion leader selection decisions. Therapy promotion mostly revolves around sales force management, communication management, and stimulating patient compliance. The authors qualify these decision areas according to their practical importance and academic potential. The article derives preliminary generalizations and propositions from prior research and practice and steers further research in specific directions. The authors believe that marketing of the life sciences offers a fertile area for further research because, among other things, its potential impact transcends any problems typically investigated by marketing scholars.

Although there are promising benefits of supportive technology in dementia care, use of these technologies is still limited. It is challenging for researchers and developers in this field to actively involve people with dementia in development. This review updates and builds on existing knowledge by including a contemporary and relevant perspective. This perspective was gained by including search words and search databases from the field of Human Computer Interaction (HCI) and Design, as these fields were expected to supply novel insights in the complex task of actively involving people with dementia in developing supportive technologies. A total of 49 out of 3456 studies were included which describe the development of a great variety of technologies. Often people with dementia were involved in the generative or evaluative phase of the development. Interviews and observations were most commonly used methods. In seven articles the people with dementia were co-designers. This literature review reflects that people with dementia can influence the development of technology in regards to content, design, and even the initial idea, although the impact on how they experience their own involvement remains largely unknown. There is a lack of specific knowledge on appropriate methods and materials for active involvement of people with dementia in supportive technology development, even when including articles from the field of HCI and Design. Future research is needed to further appreciate and improve the desired role of people with dementia in meaningful technology development.

The meaningful participation of stakeholders in decision-making is now widely recognized as a crucial element of effective water resource management, particularly with regards to adapting to climate and environmental change. Social learning is increasingly being cited as an important component of engagement if meaningful participation is to be achieved. The exact definition of social learning is still a matter under debate, but is taken to be a process in which individuals experience a change in understanding that is brought about by social interaction. Social learning has been identified as particularly important in transboundary contexts, where it is necessary to reframe problems from a local to a basin-wide perspective. In this study, social learning is explored in the context of transboundary water resource management in the St. Lawrence River Basin. The overarching goal of this paper is to explore the potential role of serious games to improve social learning in the St. Lawrence River. To achieve this end, a two-pronged approach is followed: (1) Assessing whether social learning is currently occurring and identifying what the barriers to social learning are through interviews with the region’s water resource managers; (2) Undertaking a literature review to understand the mechanisms through which serious games enhance social learning to understand which barriers serious games can break down. Interview questions were designed to explore the relevance of social learning in the St. Lawrence River basin context, and to identify the practices currently employed that impact on social learning. While examples of social learning that is occurring have been identified, preliminary results suggest that these examples are exceptions rather than the rule, and that on the whole, social learning is not occurring to its full potential. The literature review of serious games offers an assessment of such collaborative mechanisms in terms of design principles, modes of play, and their potential impact on social learning for transboundary watershed management. Serious game simulations provide new opportunities for multidirectional collaborative processes by bringing diverse stakeholders to the table, providing more equal access to a virtual negotiation or learning space to develop and share knowledge, integrating different knowledge domains, and providing opportunities to test and analyze the outcomes of novel management solutions. This paper concludes with a discussion of how serious games can address specific barriers and weaknesses to social learning in the transboundary watershed context of the St. Lawrence River Basin.

The tenets of self-determination theory as applied to support were tested with structural equation modelling for 186 people with ID with a mild to borderline level of functioning. The results showed that (a) perceived autonomy support was positively associated with autonomous motivation and with satisfaction of need for autonomy, relatedness, and competence; (b) autonomous motivation and need satisfaction were associated with higher psychological well-being; (c) autonomous motivation and need satisfaction statistically mediated the association between autonomy support and well-being; and (d) satisfaction of need for autonomy and relatedness was negatively associated with controlled motivation, whereas satisfaction of need for relatedness was positively associated with autonomous motivation. The self-determination theory provides insights relevant for improving support for people with intellectual disability.

BACKGROUND: While healthcare systems vary in their structure and available resources, it is widely recognized that medical doctors play a key role in their adaptation and performance. In this article, we examine recent government and organizational policies in two different health systems that aim to develop clinical leadership among the medical profession. Clinical leadership refers to the engagement and guiding role of physicians in health system improvement. Three dimensions are defined to conduct our analysis of engaging medical doctors in healthcare leadership: the position and status of medical doctors within the system; the broader institutional context of governmental and organizational policies to engage medical doctors in clinical leadership roles; and the main factors that may facilitate or limit achievements. METHODS: Our aim in this study is exploratory. We selected two contrasting cases according to their level of institutional pluralism: one national health insurance system, Canada, and one etatist social insurance system, the Netherlands. We documented the institutional dynamics of medical doctors' engagement and leadership through secondary sources, such as government websites, key policy reports, and scholarly literature on health policies in both countries. RESULTS: Initiatives across Canadian provinces signal that the medical profession and governments search for alternatives to involve doctors in health system improvement beyond the limitations imposed by their fundamental social contract and formal labour relations. These initiatives suggest an emerging trend toward more joint collaboration between governments and medical associations. In the Dutch system, organizational and legal attempts for integration over the past decades do not yet fit well with the ideas and interests of medical doctors. The engagement of medical doctors requires additional initiatives that are closer to their professional values and interests and that depart from an overly focus on top down performance indicators and competition. CONCLUSIONS: Different institutional contexts have different policy experiences regarding the engagement and leadership of medical doctors but seem to face similar policy challenges. Achieving alignment between soft (trust, collaboration) and hard (financial incentives) levers may require facilitative conditions at the level of the health system, like clarity and stability of broad policy orientations and openness to local experimentation.