Critical Lessons Research Articles

Assessing the Enactus Global Sustainability Initiative’s Alignment with United Nations Sustainable Development Goals: Lessons for Higher Education Institutions

Various institutions across the world encourage young people to get involved in community development initiatives and set up small businesses that contribute to the sustainability of society. There is a growing body of literature suggesting that Enactus International is a key stakeholder in this endeavor, as university students’ transformational innovations are developed and exported through Enactus-established collaborations. However, further investigation is required to identify how this phenomenon works. Previous studies have not explored Enactus student teams’ sustainability practices in relation to global goals, and most were limited to the context of a particular institution. As a result, this article examines the relationship between the Enactus sustainability initiative and the United Nations Sustainable Development Goals, thus identifying critical lessons for South African higher education institutions as well as HEIs in other nations facing comparable circumstances. A focused review methodology is used in this analysis to assess the Enactus global sustainability initiative’s alignment with the SDGs, which involves a comprehensive search of the Web of Science and Scopus databases to identify relevant articles. As the year 2030 approaches, the authors warn that university stakeholders’ resistance to change and knowledge gaps about sustainability practices, as well as other limiting factors identified in this study, may impede the attainment of Sustainable Development Goals in the country. This study intends to encourage higher education institutions as change agents, stimulating them to take the lead in overcoming obstacles to the attainment of the SDGs by 2030. The study illuminates cogent approaches necessary for HEIs to create a more sustainable world. It specifically highlights the multidisciplinary perspective and collaborative opportunities offered by SDG-driven organizations.

Critical Lessons in Tailoring Interventions: Listening to WISEWOMAN Participants.

To explore perspectives of participants in the WISEWOMAN program in Pennsylvania (PA-WISE) on challenges and facilitators of reducing cardiovascular disease risk as low-income and un-/under-insured middle-aged women. Researchers conducted this 2year qualitative data collection as one component of a broader, 5year PA-WISE process and outcome evaluation. Women from across Pennsylvania, primarily from rural communities. Interviewees were low-income, un-/under-insured women aged 40-64years who had recently participated in PA-WISE-facilitated health coaching and lifestyle programs (HC/LSPs). Researchers conducted individual telephone interviews with 38 women from four discrete samples of PA-WISE participants at 4time points. Three researchers used grounded theory, and an iterative process of line-by-line coding, data display, and reanalysis to identify emerging themes, sub-themes, and their relationships. Participants shared the important benefits of specific PA-WISE program traits. However, participants described significant financial constraints, difficult schedules, caregiving responsibilities, and insufficient social support as persistent challenges in their lives, making lifestyle changes in general, and program participation specifically, difficult. The challenges that low-income and un-/under-insured women identified amplify the importance of having interventions that offer flexibility, options, and tailoring of supports and resources. The timeless challenges articulated by participants in this study completed just before the COVID-19 pandemic, remain relevant to be addressed through the pandemic and beyond.

Languaging and language awareness in the global age 2020–2023: digital engagement and practice in language teaching and learning in (post-)pandemic times

This paper discusses key themes of the 15th biennial conference of the Association for Language Awareness (2020), with a focus on increasing digital engagement in language education. The COVID-19 pandemic occasioned an abrupt transition to emergency remote language teaching and learning (ERLTL) worldwide. The ALA 2020 conference was also affected by this transition; originally planned as a located conference in Geelong, Australia, it was eventually held online, a first in ALA’s conference history. The current paper engages with contemporary debates of language teaching and learning in two ways. Firstly, it traces recent discussions by presenting key findings from five papers given at the conference, and secondly, via a scoping review of literature focusing on critical lessons from the pandemic regarding language teaching and learning. The review captures recent research from the Australasian region. Key debates identified in the literature include the needs of teachers and learners during the transition to online learning, and how student engagement was affected. The literatures highlight that both educators and students have been developing new practices in teaching and learning resulting from the shift to online and blended modes, which may continue to shape language education and new pedagogies in the future.

Integrated Long-Term Care 'Neighbourhoods' to Support Older Populations: Evolving Strategies in Japan and England.

Western countries are currently facing the public health challenge of a rapidly aging population and the associated challenge of providing long-term care services to meet its needs with a reduced working age population. As people age, they will increasingly require both health and social care services to maintain their quality of life and these will need to be integrated to provide cost-effective long-term care. The World Health Organization recommended in 2020 that all countries should have integrated long-term care strategies to better support their older populations. Japan, with the most rapidly ageing society in the world, started to address this challenge in the 1990s. In 2017, it introduced a national policy for integrated long-term health and social care services at a local geographical level for older people. England has recently embarked on its first plan aiming for the integration of services for older people. In this article, we compare these approaches to the integration of long-term care systems, including the strengths of each. The paper also considers the effects of historical, cultural and organizational factors and the emerging role of technology. Finally, we identify critical lessons that can inform strategy development in other countries, and highlight the need to provide more international comparisons.

Critical Lessons About Leadership from Dr. Martin Luther King, Jr.

Critical Lessons About Leadership from Dr. Martin Luther King, Jr.

Adaptive Subgradient Methods for Leadership And Development

Leading businesses now include environmental sustainability into their organisational strategy. A proactive, advantage-driven strategy like this necessitates change at all levels. This article outlines the best practises used by businesses that have successfully included environmental considerations into their strategicdaily operations and planning. The critical and obvious lessons that these companies must now apply are: Businesses that continue to use band-aids and short-term solutions to address environmental challenges will eventually be at a competitive disadvantage.. The idea for the teacher leaders was inspired by their involvement in SCI-LINK, a programme that started as a way to connect science teachers and environmental scientists but over the course of six years expanded to include a variety of activities and a learning community for teachers, scientists, and science educators. Four components of SCI-LINK fostered and supported the development of leaders. The implications for the growth of leadership in scientific education and other fields are examined. improving leadership. It is both dependent on other people's leadership and self-sustaining.. No one person, group, or nation can exercise ultimate domination on its own in today's complex globe. A accurate representation of how much leadership is now used is distributed leadership

Evaluating the History-Taking Process of Sexual Reproductive Health Problems in Tanzania: Lessons from a Study of Health Students and Practitioners.

Building trust and therapeutic relationships between healthcare providers and patients are crucial for delivering high-quality, comprehensive sexual and reproductive health (SRH) services. Yet, while patients face substantial SRH disparities in Tanzania, little is known about health care professionals' [HCPs] SRH history-taking practices and experiences. This paper describes HCPs' interdisciplinary practices, experience in conducting SRH taking, and the critical lessons learned to optimize quality SRH care. We conducted 18 focus group discussions in June 2019 in Dar es Salaam, Tanzania, with 60 healthcare practitioners and 61 students in midwifery, nursing, and medicine. We implemented a purposive, stratified sampling design to explore the experiences and perspectives of HCPs regarding providing sexual health services. We employed a grounded theory approach to perform the analysis. We provided seven scenarios to participants to discuss how they would manage SRH health problems. The scenarios helped us evaluate the practice and experience of SRH in Tanzania. Four broad themes and sub-themes emerged during the discussion; 1) SRH history-taking practices and experiences in the health care facilities; 2) the perceived benefit of effective SRH history-taking; 3) Factors hindering the SRH history-taking process; 4) The power of confidence. These findings have implications for strengthening a sexual health curriculum for medical students and continuing education programs for practicing health professionals designed to address the observed health disparities in Tanzania. These findings affirm that proper SRH history-taking requires a conducive environment, knowledge of relevant SRH-related laws and regulations; application of evidence-based techniques; and giving patients autonomy to make decisions for their health while making recommendations regarding standard care. Comprehensive SRH history-taking identifies critical data for illness diagnosis, provides foundational information for risk-reduction behavioural change counselling, and reduces medical costs. Therefore, the primary goal is to optimize health professional training on SRH issues and history-taking skills within the medical interview.

Implementation of continuous-wave Doppler ultrasound to detect the high-risk foetus in the low-risk mother: lessons from South Africa

IntroductionDetecting the risk of stillbirth during pregnancy remains a challenge. Continuous-wave Doppler ultrasound (CWDU) can be used to screen for placental insufficiency, which is a major cause of stillbirths in low-risk pregnant women. This paper describes the adaptation and implementation of screening with CWDU and shares critical lessons for further rollout. Screening of 7088 low-risk pregnant women with Umbiflow™ (a CWDU device) was conducted in 19 antenatal care clinics at nine study sites in South Africa. Each site comprised a catchment area with a regional referral hospital and primary healthcare antenatal clinics. Women with suspected placental insufficiency as detected by CWDU were referred for follow-up at the hospital. A 35–43% reduction in stillbirths was recorded.MethodsThe authors followed an iterative reflection process using the field and meeting notes to arrive at an interpretation of the important lessons for future implementation of new devices in resource-constrained settings.ResultsKey features of the implementation of CWDU screening in pregnancy combined with high-risk follow-up are described according to a six-stage change framework: create awareness; commit to implement; prepare to implement; implement; integrate into routine practice; and sustain practice. Differences and similarities in implementation between the different study sites are explored. Important lessons include stakeholder involvement and communication and identifying what would be needed to integrate screening with CWDU into routine antenatal care. A flexible implementation model with four components is proposed for the further rollout of CWDU screening.ConclusionsThis study demonstrated that the integration of CWDU screening into routine antenatal care, combined with standard treatment protocols at a higher-level referral hospital, can be achieved with the necessary resources and available maternal and neonatal facilities. Lessons from this study could contribute to future scale-up efforts and help to inform decisions on improving antenatal care and pregnancy outcomes in low- and middle-income countries.

Maintaining Warp Speed: Policy Requirements for a Just-in-Time, Capability-Based, Scalable Medical Countermeasure Research and Development Enterprise.

Maintaining Warp Speed: Policy Requirements for a Just-in-Time, Capability-Based, Scalable Medical Countermeasure Research and Development Enterprise.

Digital ethnography: ethics through the case of QAnon.

Digital ethnography is a relatively new practice with unclear standards and guidelines. As a result, the ethics of the practice remain unclear. Scholarly debates have emerged surrounding the decision of many researchers and institutional review boards to treat social media data as public. Concerns have also been raised about how informed consent can be adapted to online fieldwork. How does a researcher make their presence known when they are not visible in the traditional sense? Which online interactions should be considered public, and which are private? How can we protect the anonymity of social media users? This article leverages original digital ethnographic research on QAnon social media spaces to suggest ethical guidelines for digital ethnographic practices. It begins with a description of the research, followed by discussions of the public-private binary, lurking, data reconstruction, and institutional review boards. This article advocates for rethinking the public-private binary as it applies to the digital world, ameliorating the "lurker" concern by making the presence of the researcher known in appropriate spaces, and maintaining the integrity of the data by avoiding reconstruction. Although many digital ethnographers have chosen to reconstruct or paraphrase online data to protect privacy, this practice comes with its own ethical dilemmas. The ethical dilemmas and guidance discussed in this article are critical lessons for digital and in-person ethnographers alike.

The Integration of Point-of-Care Ultrasound into Practical Trauma Training in Ukraine: A Case Study Highlighting Feasibility, Satisfaction, and Pre- and Post-Training Comfort with the Technology

Introduction:As of October 2022, the civilian casualty count of the invasion of Ukraine is reported to be 16,295, with actual figures believed to be considerably higher. As explosive trauma continues to terrorize populations, frontline medical personnel are faced with escalating resource constraints including transport, imaging modalities, and electricity. Point of care ultrasound (POCUS) is considered the gold standard in acute trauma evaluation, but very few hospitals or pre-hospital medics have access to or training in POCUS.Method:In collaboration with the Ukrainian Ministry of Health, the World Health Organization, and the Global Health Program at Butterfly Network, Team Rubicon developed and conducted 64 practical trauma trainings and donated 50 Butterfly iQ+ portable ultrasound devices in Ukraine between August and October, 2022. Of these trainings, 19 specifically focused on the use of POCUS for trauma. Pre- and post-surveys were deployed to determine demographics, comfort level with POCUS for trauma care, and usefulness of the course.Results:In total, 149 individuals were trained in POCUS for trauma. Of these, 130 were physicians, 15 were paramedics, three were RNs, and one was a pharmacist. Only 14.8% of these clinicians self-reported any previous POCUS training. All participants reported an increase in comfort level, with an average pre- and post-course comfort scores of 1.9 and 3.3 (4=very comfortable), respectively. General satisfaction with the training was high (average score of 9.8/10). Qualitative feedback commended the quality and novelty of this training, requested further examples of pathology, and endorsed more POCUS trainings, generally. The most critical lesson learned was the need to re-orient training around the foundations of POCUS given low levels of experience and training.Conclusion:Access and training in POCUS for trauma is critical for resource-constrained medical personnel operating in conflict-affected communities. A one-day POCUS practicum-oriented course is feasible to support awareness and proficiency.

China’s war on poverty

Prior to China’s reform, the poverty count surpassed that of the whole African continent. However, within five years, the Chinese could reverse this narrative. Between 1980 and 2020, China lifted a staggering 800 million citizens out of poverty. By February 2021, the Chinese declared that the war on ‘absolute poverty’ had been won when measured using the standard equivalence of $2.30 a day per person. In consonance with the Chinese feat on poverty, the study examines the strategy adopted in defeating poverty and highlights fundamental lessons that rural developmental stakeholders in South Africa may embrace in achieving a similar feat. To achieve this aim, the study adopted a literature review alongside a desktop analysis in deducing critical lessons from the Chinese war on poverty that may apply to rural developmental stakeholders in South Africa. Hence, an extensive assemblage of earlier studies on Chinese poverty alleviation strategies was looked into systematically. The study highlights potential challenges the South African rural developmental stakeholders may face in an attempt to replicate the Chinese stratagem. The study thus concludes with practical steps rural developmental stakeholders in South Africa may adopt to create viable rural spaces devoid of egregious forms of poverty.

The need to nurture Aotearoa New Zealand's healthcare workforce.

This commentary examines the ethical significance of recently published research demonstrating the extent to which healthcare workers experienced stress and increased challenges in the workplace due to inadequate access to personal protective equipment (PPE) during the first COVID-19 surge in Aotearoa New Zealand. The inadequate state of New Zealand's PPE stockpile and distribution system at the beginning of the pandemic was a critical signal, a "canary in the coalmine", of broader challenges facing the New Zealand healthcare system, particularly for healthcare worker safety and wellbeing. As New Zealand reforms its health system with the aim of improving access to and equity of care, an opportunity exists to apply critical lessons learnt from the COVID-19 pandemic about the need to prioritise the wellbeing of the healthcare workers we are dependent upon to deliver that care. Failure to apply this new knowledge will see the system similarly unprepared for future public health emergencies, which are likely to be imminent, and potentially with healthcare workers less willing to accept the burdens placed on them. The Nurture Framework, which has emerged from the voices of healthcare workers within this research, should be adopted as part of health reforms and ongoing emergency preparedness planning. Trust, transparency, respect and safety, the four values of the Framework, are fundamental for all workers who contribute their skills, knowledge and time to our healthcare organisations.

COVID-19 Research in Hospitality and Tourism: Critical Analysis, Reflection, and Lessons Learned

The COVID-19 pandemic has drastically affected everyday life and business. To describe the impacts, 566 COVID-19-related articles were published between January 2020 and March 2022 in 18 hospitality and tourism journals. This study identifies the research streams, using content and bibliometric analyses. Content analysis and co-citation analysis revealed six research streams and four research clusters, respectively. A critical analysis was conducted to reflect the theoretical and practical implications and provide suggestions for future research directions. The identified research weaknesses include concerns relating to generalizability, sampling and measurement-related issues, online survey methods, failure to identify different stakeholders’ views on the adoption of new technologies, lack of practical coping scheme studies, lack of effort to adopt multidisciplinary theories, and little exploration of customers’ reactions to virtual events. Results of this study can help facilitate and consolidate the knowledge on the impacts of the pandemic and proactively prepare for future disease crises.

Medical University of South Carolina case study: A structured approach to improving quality metrics for achieving maximum pay-for-performance incentive payments

To get healthcare costs under control and ‘bend the cost curve’, the Centers for Medicare & Medicaid Services is driving a shift from the fee-for-service (FFS) reimbursement model, which rewards quantity over quality, to value-based care payment models that encourage efficient delivery of high-quality, lower-cost care. Commercial payers are also shifting away from FFS and tying payment to quality metric scores and performance. The Medical University of South Carolina (MUSC) participates in one of the state’s largest pay-for-performance (P4P) initiatives. The payer uses a scorecard that assigns points, associated with incentive dollars, for meeting or exceeding benchmarks in publicly reported quality metrics. In late 2020, MUSC and ECG Management Consultants partnered to assess MUSC’s flagship hospital performance, analysing historical scorecard performance and improvement opportunities. MUSC’s biggest challenges included clinical practice variation, data accessibility and competing priorities, particularly during the COVID-19 pandemic. The hospital was leaving money on the table for process and outcomes measures for harm avoidance and patient safety, unplanned readmissions and appropriate use of emergency department and outpatient cardiac imaging. To overcome quality improvement (QI) barriers, multidisciplinary workgroups were established for each of the focus areas. Workgroup participants used MUSC’s IMPROVE methodology, incorporating Lean, Six Sigma and continuous process improvement best practices to effect change. From this foundational, structured QI approach — focused on a select group of metrics — MUSC is projected to earn US$11.6m in incentives between fiscal years 2023 and 2025, while improving clinical outcomes and patient safety. MUSC will apply the critical success factors and lessons learned to other QI opportunities across the entire MUSC Health system as the organisation strives to reduce process and outcome variability. Hospitals and health systems that engage in efforts similar to those undertaken in the ECGMUSC collaboration can build a foundation of strong QI capabilities and realise improved incentive payment dollars under P4P arrangements.

The Toxic Bully Boss: Echoes of American Slavocracy Tactics in Adverse Workplace Leadership Styles

The Toxic Bully Boss: Echoes of American Slavocracy Tactics in Adverse Workplace Leadership Styles

Measuring Innovation Effectively—Nine Critical Lessons

Overview: Few companies and organizations remain innovative for long periods of time, and despite high ambitions, many innovation initiatives fail to yield the desired results. Identifying how best to measure the effectiveness of innovation initiatives is key to ensuring that those efforts actually help an organization achieve its overall goals. This article offers organizations and their leaders practical advice for measuring innovation effectively. Specifically, it defines innovation measurement and its importance in precise terms and summarizes six years of our research on innovation measurement in multiple firms and industries. We articulate nine critical lessons for improving innovation measurement in real-world practice clustered into three overarching themes: Strategy, Organization, and Measurement Design. Each of the nine lessons elucidates a problem, identifies potential consequences, and proposes concrete solutions that organizations can implement as they strive to better measure and, ultimately, improve their innovation management initiatives.

Self-Centering Structures Against Earthquakes: A Critical Review

ABSTRACT With critical lessons drawn from past major earthquakes, the engineering community is appealing for a fundamental shift in the existing design philosophy for structures in seismic zones. One strategy is to endow structures with self-centering (SC) capability. While the concept of SC structures is not new, many novel technologies have been recently emerging that are more efficient, compact, and cost-effective; on the other hand, growing controversy and dispute have also been appearing with deepening investigations. This paper presents a critical review of the evolution of SC technologies and systems for both researchers and practitioners, with an emphasis on post-tension (PT), high-performance spring, and shape memory alloy (SMA) strategies. These SC technologies, together with various energy dissipation options, form the basis of a large part of the newly proposed SC philosophies. This review also includes typical SC structural members such as beam-to-column connections, braces, dampers, shear walls, bridge piers, and isolation bearings, followed by a discussion on the dynamic behavior from a system-level point of view. Available design approaches for SC structures are also touched upon, and practical applications that have emerged over the past decades in several countries including Canada, China, New Zealand, and the US are presented. This paper concludes with an executive summary that covers technological advances, knowledge gaps, and future research directions.

Christianity’s Earliest Encounter with the Ancient Techno-Scientific China: Critical Lessons from Jingjiao’s Approach

This article investigates the earliest Christian encounter with ancient China through the missionaries of the Church of the East in the seventh century. In his monumental Science and Civilisation in China, Joseph Needham argues that China was then a country with one of the world’s most advanced science and technology. It was also a time when Buddhism, Daoism, Confucianism, Manichaeism, and Zoroastrianism contributed to a pluralistic society. The paper attempts to answer questions such as: How did the Christian missionaries, as representatives of a minority religion, engage with techno-scientific China theologically? Were their efforts successful? What critical lessons can we learn from their successes and/or failures? By studying the earliest Christian texts in China, the proposal argues that, being equipped with advanced Greek-Byzantine scientific knowledge and skills in medicine, architecture, astronomy, and mechanics, the Church of the East missionaries boldly engaged with the ancient techno-scientific and pluralistic China through their qi-tological, or creative pneumatological approach, which is closely intertwined with the Chinese metaphysical concept of qi (or Chi, breath, air). The article proposes that such an approach serves as a crucial bridge toward a constructive Chinese theology of science for the pluralistic world of the third millennium.

Chapter 16 - Lessons from antiamyloid-β immunotherapies in Alzheimer's disease

The amyloid hypothesis, that established amyloid-β (Aβ) peptide as the primary cause of Alzheimer's disease (AD) and related dementia, has driven the development of treatments for neurodegeneration for 30 years. During the last decades, more than 200 clinical trials testing more than 30 anti-Aβ immunotherapies have been assessed as potential treatments for AD. A vaccine against Aβ was the first immunotherapy intended to avoid aggregation of Aβ into fibrils and senile plaques, but it dramatically failed. Several other vaccines have been proposed as potential AD treatments, targeting different domains or structural motifs of Aβ aggregates, but without clear clinical benefits or effectiveness. In contrast, anti-Aβ therapeutic antibodies have focused on recognizing and removing Aβ aggregates (oligomers, fibrils, or plaques) by eliciting immune clearance. In 2021, the first anti-Aβ antibody, aducanumab (branded as Aduhelm), received FDA approval under an accelerated approval process. The effectiveness and the overall processes regarding the approval of Aduhelm have been under major criticism and scrutiny, prompting a vote of no confidence by public and private health providers, limiting the coverage only to patients enrolled in clinical trials and not for the general elderly patients. Additionally, another three therapeutic anti-Aβ antibodies are following the same path for potential FDA approval. Here, we present the current status of anti-Aβ immunotherapies under evaluation in preclinical and clinical trials for the treatment of AD and related dementia, with a discussion of the main findings and critical lessons learned from the observations from Phase III, II, and I clinical trials of anti-Aβ vaccines and antibodies.