scholarly journals Rapid Conversion from Clinic to Telehealth Behavioral Services During the COVID-19 Pandemic

2020 ◽  
Author(s):  
Jennifer Crockett ◽  
Jessica Becraft ◽  
Sharon Phillips ◽  
Marguerite Wakeman ◽  
Michael Cataldo
Keyword(s):  
Applied Behavior Analysis ◽  
Daily Basis ◽  
Direct Impact ◽  
Rapid Adaptation ◽  
Rapid Changes ◽  
Clinical Program ◽  
Impact On Survival ◽  
Behavioral Services ◽  
Staff Behavior ◽  
The Impact

Survival often depends on behavior that can adapt to rapid changes in contingencies, which should be particularly well suited to a contingency sensitive and data-based discipline such as applied behavior analysis (ABA). The speed and scale with which contingencies shifted in early March due to the effects of COVID-19 represents a textbook case for rapid adaptation with direct impact on survival of many types of enterprises. We describe here the impact, changes and outcomes achieved by a large, multi-faceted ABA clinical program having: (a) ongoing data that forecasted and tracked changes; (b) staff well practiced with data-based shifts in operations (behavior); and (c) up-to-date information (data) on policy and regulations. The results showed rapid shifts in client and staff behavior on a daily basis, shifts in services from in-person to telehealth, and increases in volumes, revenue and margins. We detail regulations and provide actionable steps clinical organizations can take pertinent to this shift now and in the future. The COVID-19 challenges underscore the importance of maintaining robust coordination and communication across our field in order to address crises that affect our field.

scholarly journals The Impact of Top Management’s Support on the Collaboration of Green Supply Chain Participants and Environmental Performance

2020 ◽  
Vol 12 (21) ◽  
pp. 9090
Author(s):  
Jungeun Lee ◽  
Hye-Young Joo
Keyword(s):  
Supply Chain ◽  
Empirical Analysis ◽  
Environmental Performance ◽  
Green Supply Chain ◽  
Top Management ◽  
Direct Impact ◽  
Theoretical Mechanism ◽  
The Impact ◽  
The Empirical Analysis

The purpose of this study is to determine whether the support of top management significantly improves the level of environmental collaboration with participating companies upstream and downstream of the green supply chain and the impact on environmental performance. The results of the empirical analysis of 301 companies that are establishing a green supply chain are as follows. First, top management’s support positively affects the level of collaboration with suppliers and customers in the green supply chain. Secondly, support from top management has a direct impact on the company’s environmental performance. Thirdly, the environmental collaboration of participating companies partially plays a mediation role between the support of top management and the environmental performance. This study has significance in that it analyzes the theoretical mechanism of top management’s support for environmental collaboration with participating companies, leading to environmental performance, and draws implications.

scholarly journals The Impact of Mergers and Acquisitions and Sustainability on Company Performance in the Pharmaceutical Sector

2021 ◽  
Vol 13 (12) ◽  
pp. 6525
Author(s):  
Diana Marieta Mihaiu ◽  
Radu-Alexandru Șerban ◽  
Alin Opreana ◽  
Mihai Țichindelean ◽  
Vasile Brătian ◽  
...  
Keyword(s):  
Stock Market ◽  
Mergers And Acquisitions ◽  
Performance Improvement ◽  
Score Function ◽  
Pharmaceutical Companies ◽  
Company Performance ◽  
Direct Impact ◽  
Pharmaceutical Sector ◽  
Financial Measures ◽  
The Impact

The primary goal of this study was to determine the impact of mergers and acquisitions (M&A) and the environmental, social, and governance (ESG) sustainability scores of companies. In this regard, efforts to measure and analyze the evolution of a company’s performance, taking into account financial and non-financial measures using a score function, are adapted to the pharmaceutical sector. The sample consisted of 100 leading pharmaceutical companies, ranked by stock market capitalization, who registered 30% (n = 492) of the total M&A transactions over the study period (2010–2020). There was a direct and positive link between the M&A process and the evolution of company performance. The ESG score, as an indicator for measuring sustainability, has a positive and direct impact on company performance, indicating that a high ESG score determines an increase in company performance. A similar impact is identified for companies involved in M&A processes, meaning that companies in the pharmaceutical sector tend to register a performance improvement.

scholarly journals Indirect cholinergic activation slows down pancreatic cancer growth and tumor-associated inflammation

2020 ◽  
Vol 39 (1) ◽  
Author(s):  
Paulo L. Pfitzinger ◽  
Laura Fangmann ◽  
Kun Wang ◽  
Elke Demir ◽  
Engin Gürlevik ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Mouse Model ◽  
Tumor Stage ◽  
Ache Inhibitors ◽  
Impact On Survival ◽  
The Impact ◽  
Ache Expression ◽  
Cholinergic Activation

Abstract Background Nerve-cancer interactions are increasingly recognized to be of paramount importance for the emergence and progression of pancreatic cancer (PCa). Here, we investigated the role of indirect cholinergic activation on PCa progression through inhibition of acetylcholinesterase (AChE) via clinically available AChE-inhibitors, i.e. physostigmine and pyridostigmine. Methods We applied immunohistochemistry, immunoblotting, MTT-viability, invasion, flow-cytometric-cell-cycle-assays, phospho-kinase arrays, multiplex ELISA and xenografted mice to assess the impact of AChE inhibition on PCa cell growth and invasiveness, and tumor-associated inflammation. Survival analyses were performed in a novel genetically-induced, surgically-resectable mouse model of PCa under adjuvant treatment with gemcitabine+/−physostigmine/pyridostigmine (n = 30 mice). Human PCa specimens (n = 39) were analyzed for the impact of cancer AChE expression on tumor stage and survival. Results We discovered a strong expression of AChE in cancer cells of human PCa specimens. Inhibition of this cancer-cell-intrinsic AChE via pyridostigmine and physostigmine, or administration of acetylcholine (ACh), diminished PCa cell viability and invasion in vitro and in vivo via suppression of pERK signaling, and reduced tumor-associated macrophage (TAM) infiltration and serum pro-inflammatory cytokine levels. In the novel genetically-induced, surgically-resectable PCa mouse model, adjuvant co-therapy with AChE blockers had no impact on survival. Accordingly, survival of resected PCa patients did not differ based on tumor AChE expression levels. Patients with higher-stage PCa also exhibited loss of the ACh-synthesizing enzyme, choline-acetyltransferase (ChAT), in their nerves. Conclusion For future clinical trials of PCa, direct cholinergic stimulation of the muscarinic signaling, rather than indirect activation via AChE blockade, may be a more effective strategy.

Patients With Invasive Breast Cancer Who Refuse Treatment: An Analysis of Associated Factors and Impact on Survival

2021 ◽  
pp. 000313482110241
Author(s):  
Jackelyn J. Moya ◽  
Ashkan Moazzez ◽  
Junko J. Ozao-Choy ◽  
Christine Dauphine
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Invasive Breast Cancer ◽  
Risk Groups ◽  
Breast Cancer Treatment ◽  
Study Cohort ◽  
National Cancer Database ◽  
Optimal Outcomes ◽  
Impact On Survival ◽  
The Impact

Background Completion of surgical resection and adjuvant/neoadjuvant treatments (chemotherapy, radiation, and endocrine therapy) is necessary to achieve optimal outcomes in invasive breast cancer. The objective of this study was to determine the characteristics of patients refusing treatment and to analyze the impact of refusal on survival. Study Design A retrospective cohort study of invasive breast cancer cases diagnosed 2004-2016 was performed utilizing the National Cancer Database. Results Of 2 058 568 cases comprising the study cohort, .6% refused recommended surgery, 14.1% refused chemotherapy, 5.5% refused radiation, and 6.3% refused endocrine therapy. Patients refusing therapy were older and more likely uninsured; they did not live farther from the treating hospital. Racial disparities were also associated with refusal. Surgery refusal had the highest hazard ratio for mortality (2.7; 95% CI: 2.5-3.0, P < .001) compared to chemotherapy (1.3; 95% CI: 1.3-1.4, P < .001), radiation (1.8; 95% CI: 1.7-1.9, P < .001), and endocrine therapy (1.5; 95% CI: 1.4-1.6, P < .001) independent of race, insurance, receptor status, and stage. Conclusion This study demonstrates significant associations with refusal of breast cancer treatment and quantifies the impact on mortality, which may help to identify at-risk groups for whom interventions could prevent increases in mortality associated with declining treatment.

Research on the Impact Pressure of the Hydraulic Rolling-Cut Shear

2010 ◽  
Vol 145 ◽  
pp. 410-413 ◽  
Author(s):  
Jing Wang ◽  
He Yong Han ◽  
Qing Xue Huang ◽  
Jun Wang
Keyword(s):  
Hydraulic System ◽  
Impact Pressure ◽  
Direct Impact ◽  
Actual Situation ◽  
Work Situation ◽  
Servo Valve ◽  
Indirect Impact ◽  
Hydraulic Servo ◽  
Hydraulic Servo System ◽  
The Impact

The reasons for impact pressure are obtained by the research the hydraulic system of Hydraulic Rolling-Cut Shear. The impact pressure of hydraulic system is divided into direct impact and indirect impact. Based on analyzing the actual situation the measures should be taken to reduce the impact pressure when design hydraulic system. The suitable length of pipeline can improve the performance of the hydraulic system because the length is important for the impact pressure. The accumulator can absorb impact pressure and improve the work situation of servo valve. Therefore, the suitable accumulators should be set in the hydraulic system. The study provides theory basis for the pipe design of large hydraulic servo system.

Toward a Smart Organization, Integrating KM Processes and Organizational Capabilities

2022 ◽  
Vol 14 (1) ◽  
pp. 0-0
Keyword(s):  
Structural Equation ◽  
Common Knowledge ◽  
Organizational Capabilities ◽  
Equation Modeling ◽  
Direct Impact ◽  
Suggested Model ◽  
Mediating Role ◽  
The Impact ◽  
Telecommunications Companies

It is common knowledge that organizations today face the challenges of growing competition. Therefore, organizations need to develop smarter to plan for several diverse and real-time challenges. The aim of this paper is to test the impact of knowledge management (KM) processes, organizational capabilities (OC), and mediating KM mechanisms and KM technologies toward a smart organization (SO). In this paper, structural equation modeling was applied by using Smart PLS 3.3.3 software to test hypotheses and the accuracy of the suggested model. The results showed a direct impact between all constructs and are a reflection of the SO of the employees (N=225) working in three Jordanian telecommunications companies. Additionally, the outcomes provision the partial mediating role of KM mechanisms and KM technology with OC in the SO. These outcomes can support leaders in generating a consciousness in addition to favorable OC, KM mechanisms, and KM technologies inside the organization, which enables the actual implementation of SO and uses the outcomes to plan their SO strategies.

Routine sanctions, humiliation and human struggle: qualitative biographies of young people’s experience of live marginality

2017 ◽  
Author(s):  
Linda Brooks
Keyword(s):  
Young Adults ◽  
Young People ◽  
Real Life ◽  
Social Disadvantage ◽  
Local Communities ◽  
Direct Impact ◽  
Social Suffering ◽  
The Impact

Linda Brooks examines the impact of the current government austerity measures experienced at a local charity based in the borough of Castle Point in Essex. Linda draws from first-hand experience of working with young adults to provide valuable insights into the direct impact of austerity measures as lived under social suffering. She employs ethnographic and biographical approaches to show real life examples of the impact of government austerity measures, which increase social disadvantage for young people within the local communities.

scholarly journals An Investigation of Soundscape Factors Influencing Perceptions of Square Dancing in Urban Streets: A Case Study in a County Level City in China

2019 ◽  
Vol 16 (5) ◽  
pp. 840 ◽  
Author(s):  
Jieling Xiao ◽  
Andrew Hilton
Keyword(s):  
Daily Basis ◽  
County Level ◽  
Urban Streets ◽  
Site Survey ◽  
Chi Squared ◽  
Related Group ◽  
Physical Features ◽  
The Impact ◽  
The City

Square dancing is a popular music-related group physical exercise for health benefits in China mainly participated by mid-aged women and elderly people. This paper investigates the soundscape and enjoyment of the square dancing in urban streets through a case study in Lichuan, a county level city in southwest China, in December 2017. It examines the impact of gender, age, participation and places on perceptions of square dancing soundscape. Two sites along two main urban streets in the city were selected to conduct onsite investigations where residents spontaneously perform square dancing on a daily basis. Ethnographical observations were conducted to identify the social-physical features and sounds of both sites during the dance and without dance. Sound pressure measurements (LAeq and LAmax) were also conducted under the two conditions. An off-site survey was distributed through the local social media groups to understand residents’ everyday experiences and perceptions of square dancing in the city; 106 responses were received for the off-site survey. T-tests and Chi-squared tests were used for statistical analysis of the survey data. The results show gender does appear to be a factor influencing the regularity of participation in square dancing, with a bias towards more female participants. Participation frequency of square dance has an impact on the enjoyment of square dancing. There is no correlation between the dislike of watching square dancing, or dislike of the music and a desire to restrict locations for square dancing.

scholarly journals Assessing the Impact of Deliberative Democratic Initiatives at the Local Level: A Framework for Analysis

2018 ◽  
Vol 51 (5) ◽  
pp. 749-769 ◽  
Author(s):  
Ank Michels ◽  
Harmen Binnema
Keyword(s):  
The Netherlands ◽  
Policy Making ◽  
Local Community ◽  
Local Politics ◽  
Public Policies ◽  
Local Level ◽  
Direct Impact ◽  
Indirect Impact ◽  
The Impact

Although deliberative reforms have been proposed to strengthen democracy, little is known about their impact on politics, public policies, and society. This article develops a framework to systematically assess this impact, differentiating between direct and indirect forms of impact. We apply this framework to two cases of deliberative citizens’ summits in the Netherlands. Our analysis reveals that these summits have a limited direct impact on local politics and policy making, but a relatively strong indirect impact on the local community. The article also discusses some conditions that mediate the impact of the forum.

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