Leverage Resources Research Articles

The impact of a personal cancer diagnosis on adolescent and young adult cancer survivors' social connectedness: A qualitative analysis.

Adolescent/young adult cancer survivors (AYACS) are diagnosed with cancer between 15 and 39 years of age. Improving AYACS' survivorship quality is crucial-including improving social connectedness, a construct describing the quality, structure and function of social relationships. With better understanding of AYACS' social connectedness, network-based interventions can be developed to foster social health. This study explored how a personal cancer diagnosis impacts AYACS' social connectedness among 35 AYACS 15-25 years old. Three themes emerged through thematic analysis: (1) AYACS experience substantial heterogeneity related to social support needs; (2) AYACS leverage multiple relationships and resources when seeking support after a personal cancer diagnosis; (3) AYACS' individual experiences were unique in that some noted positive changes, whereas others noted negative changes in relationships within social networks, specifically with peers. These findings create a foundation to develop social programming, foster peer relationships, and incorporate social science methods to aid intervention development to strengthen AYACS' social connectedness.

Establishing a Successful Research Infrastructure for Orthopaedic Surgery Residents.

Research among orthopaedic surgery residents provides numerous benefits, which include but are not limited to development of critical thinking skills, greater understanding of study design and statistical analysis, strengthened fellowship applications, networking, and the ability to practice evidence based medicine. Research has been increasingly emphasized among orthopaedic surgery residency directors, and residency programs have uniformly implemented protected research time into their formal clinical training. Despite this, there are few resources describing the ability to conduct research effectively during residency. The purpose of this review is to provide an outline for implementing a successful, productive, high-output, resident-centric, research infrastructure leveraging resources available at clinical orthopaedic surgery residencies.

Perceiving and accessing resources in uncertain environments: insights from waste collection ventures in Burkina Faso

PurposeThis article explores how waste collection venture founders in an uncertain sub-Saharan African environment perceive and access resources. More particularly, it investigates why, even in a similar context, different types of resource-mobilizing practices can be observed among venture founders and how these different practices can be related to founders’ diverging perceptions of resource accessibility.Design/methodology/approachThe study compares seven waste collection ventures in Ouagadougou, Burkina Faso, a particularly uncertain market with shifting public regulation. The comparative case study analysis relies on interviews with venture founders, staff members and sector experts, as well as observations and archival data.FindingsThe findings suggest that the diverse approaches to resource accessibility can be associated with different ways in which venture founders perceive three key dimensions: environmental uncertainty (which is not necessarily seen as negative), the venture’s mission (for-profit or not-for-profit) and the founders’ self-perceptions. Three “perception-practice” patterns are identified, which illuminate different avenues for waste collection venture founders to access resources and position themselves in between local traditions and international influences.Research limitations/implicationsThe findings contribute to refining the understanding of the links between entrepreneurial perceptions and resource access in uncertain environments, and further illuminate the diversity and complexity of entrepreneurial approaches in sub-Saharan Africa.Practical implicationsThe findings of this paper may help waste management entrepreneurs better leverage resources and deal with uncertainty. Moreover, the paper includes recommendations to public authorities in charge of waste policy at the local, national and international levels, urging them to take the diversity of entrepreneurial approaches into consideration and formulate tailored policies to support waste entrepreneurs in accessing the resources they need.Social implicationsInforming the diversity of waste management practices and their effectiveness directly contributes to supporting small venture development and dealing with pollution, thereby addressing, respectively, sustainable development goals 8 (“Economic development and growth”) and 15 (“Life on land”).Originality/valueAs entrepreneurship in sub-Saharan Africa remains relatively underexplored in comparison with Western contexts, in particular from the perspective of entrepreneurial perceptions, the originality of this article is to connect resource access practices with the different perceptions unfolding in a similar context, thereby shedding light on how such diversity informs the understanding of entrepreneurial practices in uncertain contexts.

Canadian Organization on Health Effects from Radiation Exposure (COHERE) strengthening co-operation within the Canadian Government on radiation research

The Canadian Organization on Health Effects from Radiation Exposure (COHERE) is a collaborative initiative between two federal organisations, Health Canada (HC) and the Canadian Nuclear Safety Commission (CNSC). COHERE will work to advance knowledge on biological mechanisms and human health risks from exposures to ionising radiation relevant to environmental and occupational settings. The objectives of the initiative include: better aligning Health Canada's and the CNSC's radiation science research priorities to focus and leverage resources; maintaining and enhancing expertise in radiobiology and epidemiology within the Government of Canada; providing an informed and consistent federal message to the public and stakeholders on matters involving low dose and low dose-rate ionising radiation; and strengthening Canada's contribution towards international efforts on the assessment of ionising radiation doses and health effects. These objectives support the application of international recommendations, Canadian regulations, and national guidance. COHERE's vision is to contribute knowledge to reduce scientific uncertainties from low dose and dose-rate exposures. It will advance our understanding by bridging the knowledge gap between human health outcomes, and linkages to molecular- and cellular-level responses to radiation. Research priorities focus on identifying sensitive, early, and key molecular events of relevance to risk assessment. The initiative will address questions of relevance to better apprise Canadians, including radiation workers, members of the public and indigenous peoples, on health risks from low dose and low dose-rate radiation exposure and inform radiation protection frameworks at a national and international level. Furthermore, it will support global efforts to conduct collaborative undertakings and better coordinate research. The strategic research agenda (SRA) developed by COHERE specifically considers the areas of research identified by many international radiation agencies to support the current and evolving system of radiological protection. The evolution of COHERE, its SRA and its activities since inception are discussed.

Community Co-creation through knowledge (Co)Production: The engagement of universities in promoting rural revitalization in China

The global discourse on the role of universities in rural revitalization has gained significant attention. The proposition is to leverage university expertise and resources to support rural development, including knowledge (co)production, community co-creation, and volunteerism – a practice that essentially bridges local actors and their knowledge with external actors and their knowledge. As advocated by UN Habitat III, the collaboration between universities and rural communities is an initiative exemplified by China's “Jointly Create a Beautiful Environment and a Happy Life” to enhance the built environment. This study aims to comprehensively investigate the implementation and outcomes of the “Rural Four Small Gardens” projects, which serve as a vital community development initiative within the Hongtang Village in Fengqing County, Yunnan Province, China. The research discusses those processes, observing opportunities for knowledge (co)production across diverse stakeholders in line with neo-endogenous rural development thinking. By exploring the co-creation approach employed in these projects, we seek to unravel how academia and local communities collaborate to address multifaceted challenges in rural areas. We argue that: 1) The engagement of rural communities through collaborative planning workshops serves as the fundamental cornerstone for university paired-up assistance; 2) the co-creation model for improving rural settlement necessitates the collective efforts of multiple stakeholders; 3) university faculty and students play pivotal roles during the process of service learning, practice research, and knowledge (co)production with villagers; and 4) Knowledge (co)production entails a dynamic process of co-construction, co-governance, and resource sharing, exemplified by co-creation initiatives of home development, farmyard enhancement, and infrastructure projects. The research offers insights for global universities seeking to engage in similar paired-up assistance initiatives, underscores the significance of co-creation in rural development, and enlightens planning education in practice and service.

Women and Entrepreneurship in Nepal

The concept of entrepreneurship of women in Nepal is becoming more popular as a means of socio-economic development. The lack of job opportunities and low business density often make entrepreneurship a possible option for those living in such locations, especially for women. A total of 16 women entrepreneurs were interviewed for this research project. All interviews for this study were conducted in English. All women participants were between the ages of 20 and 68. Thematic analysis was used to code the data. Research concerning women in Nepal and the ways they engage with entrepreneurship was undertaken in order to explore strategies used successfully by the women to identify ways of pursuing entrepreneurship in Nepal. Women entrepreneurs often boost local economies, create new jobs, use land in an environmentally friendly way, leverage local talent, products and resources, and improve the social sustainability of their communities. Women also launch innovative and sustainable projects that benefit people and revitalise local populations; while creating bonds and attracting new participants. Policy makers will find this research an important step forward, as it serves as a reference point for socio-economic reform. This study provides a valuable perspective on women’s entrepreneurship in Nepal.

A Comparative Analysis of the Regulatory Framework and Collaborative Environment for Pediatric Medical Device Development in Japan and the United States: Identifying Challenges, Support Mechanisms, and Emerging Opportunities.

There are specific obstacles to designing medical devices for children, such as commercial distortions and regulatory hurdles. This study compares the regulatory frameworks and collaborative ecosystems of the United States (US) and Japan, enabling the development of pediatric medical devices. The study illustrates the differences as well as parallels between the two countries by outlining their primary obstacles, channels of assistance, and prospects. The regulatory regimes of the US and Japan pose substantial challenges due to their intricate approval procedures and the dearth of pediatric-specific guidelines. However, while Japan's ecosystem is more dispersed, the US offers more well-established support mechanisms, such as funding initiatives and research alliances. Despite these difficulties, there are still prospects for innovative thinking and collaborative work. The article demonstrates successful partnerships between business, academia, and government in both countries, which have helped propel the advancement of pediatric devices. For stakeholders endeavoring to maneuver through thecomplex terrain of pediatric medical device development, this study offers valuable insights. With a comprehensive understanding of the regulatory and collaborative frameworks in Japan and the US, developers can more effectively leverage resources, overcome obstacles, and bring vital technology to market. The study's findings have implications for researchers, industry leaders, and policy regulators, providing recommendations for strategies aimed at stimulating innovation and enhancing children's healthcare outcomes internationally.

Bridging Real-World Data Gaps: Connecting Dots Across 10 Asian Countries.

The economic trend and the health care landscape are rapidly evolving across Asia. Effective real-world data (RWD) for regulatory and clinical decision-making is a crucial milestone associated with this evolution. This necessitates a critical evaluation of RWD generation within distinct nations for the use of various RWD warehouses in the generation of real-world evidence (RWE). In this article, we outline the RWD generation trends for 2 contrasting nation archetypes: "Solo Scholars"-nations with relatively self-sufficient RWD research systems-and "Global Collaborators"-countries largely reliant on international infrastructures for RWD generation. The key trends and patterns in RWD generation, country-specific insights into the predominant databases used in each country to produce RWE, and insights into the broader landscape of RWD database use across these countries are discussed. Conclusively, the data point out the heterogeneous nature of RWD generation practices across 10 different Asian nations and advocate for strategic enhancements in data harmonization. The evidence highlights the imperative for improved database integration and the establishment of standardized protocols and infrastructure for leveraging electronic medical records (EMR) in streamlining RWD acquisition. The clinical data analysis and reporting system of Hong Kong is an excellent example of a successful EMR system that showcases the capacity of integrated robust EMR platforms to consolidate and produce diverse RWE. This, in turn, can potentially reduce the necessity for reliance on numerous condition-specific local and global registries or limited and largely unavailable medical insurance or claims databases in most Asian nations. Linking health technology assessment processes with open data initiatives such as the Observational Medical Outcomes Partnership Common Data Model and the Observational Health Data Sciences and Informatics could enable the leveraging of global data resources to inform local decision-making. Advancing such initiatives is crucial for reinforcing health care frameworks in resource-limited settings and advancing toward cohesive, evidence-driven health care policy and improved patient outcomes in the region.

Corporate Social Responsibility and Social Needs in Health Care Sectors-A Critical Analysis of Social Innovation in the Health Sector in Taiwan.

Social innovation is often used as a mechanism to jump-start public-private partnerships to leverage resources to achieve social impact; the analysis of sustainability and the impact of corporate social responsibility (CSR) cannot be emphasized enough. Due to advances in the information and communication technology industry in Taiwan, this paper aims to explore whether these advancements drive CSR as a form of social innovation to meet health needs in Taiwan. This paper uses a case study to look at CSR programs in the health sector in Taiwan. Corporations with diverse missions and different CSR approaches that are available on the internet are selected. The analysis of the case study takes a qualitative, exploratory approach to shed light on current initiatives. The majority of CSR programs in Taiwan are private sector activities that emerged during the COVID-19 pandemic; current CSR activities in Taiwan are driven by awards, public relations, and external interests. Corporations in Taiwan have the potential to address the health care gaps of urban-rural health utilization among Taiwanese indigenous communities. It is recommended for corporations to (1) develop partnerships with public health experts or to (2) employ CSR personnel with health care backgrounds who can navigate the intersection between health, business, and policies to develop CSR strategies. Further evaluation of the projects mentioned in this paper to assess the direct and indirect impact on health outcomes could provide a more comprehensive understanding of the field of CSR in the health sector in Taiwan.

Blue valorization of lignin-derived monomers via reprogramming marine bacterium Roseovarius nubinhibens.

Biological valorization of lignin, the second most abundant biopolymer on Earth, is an indispensable sector to build a circular economy and net-zero future. However, lignin is recalcitrant to bioupcycling, demanding innovative solutions. We report here the biological valorization of lignin-derived aromatic carbon to value-added chemicals without requesting extra organic carbon and freshwater via reprogramming the marine Roseobacter clade bacterium Roseovarius nubinhibens. We discovered the unusual advantages of this strain for the oxidation of lignin monomers and implemented a CRISPR interference (CRISPRi) system with the lacI-Ptrc inducible module, nuclease-deactivated Cas9, and programmable gRNAs. This is the first CRISPR-based regulatory system in R. nubinhibens, enabling precise and efficient repression of genes of interest. By deploying the customized CRISPRi, we reprogrammed the carbon flux from a lignin monomer, 4-hydroxybenzoate, to achieve the maximum production of protocatechuate, a pharmaceutical compound with antibacterial, antioxidant, and anticancer properties, with minimal carbon to maintain cell growth and drive biocatalysis. As a result, we achieved a 4.89-fold increase in protocatechuate yield with a dual-targeting CRISPRi system, and the system was demonstrated with real seawater. Our work underscores the power of CRISPRi in exploiting novel microbial chassis and will accelerate the development of marine synthetic biology. Meanwhile, the introduction of a new-to-the-field lineage of marine bacteria unveils the potential of blue biotechnology leveraging resources from the ocean.IMPORTANCEOne often overlooked sector in carbon-conservative biotechnology is the water resource that sustains these enabling technologies. Similar to the "food-versus-fuel" debate, the competition of freshwater between human demands and bioproduction is another controversial issue, especially under global water scarcity. Here, we bring a new-to-the-field lineage of marine bacteria with unusual advantages to the stage of engineering biology for simultaneous carbon and water conservation. We report the valorization of lignin monomers to pharmaceutical compounds without requesting extra organic substrate (e.g., glucose) or freshwater by reprogramming the marine bacterium Roseovarius nubinhibens with a multiplex CRISPR interference system. Beyond the blue lignin valorization, we present a proof-of-principle of leveraging marine bacteria and engineering biology for a sustainable future.

Patient, family, and community factors associated with medication adherence among people with hypertension or diabetes: A cross-sectional analysis

BackgroundWhile suboptimal medication adherence remains an obstacle to the management of hypertension and diabetes in China, few studies have investigated associated factors with medication adherence on different dimensions simultaneously. ObjectiveTo systematically examine associated patient, family, and community factors with suboptimal medication adherence among people with hypertension and/or type 2 diabetes in China. MethodsThe study stratified a random sample of 622 adults aged 45 years or older with hypertension and/or type 2 diabetes from three southeast cities in China in 2019. Trained interviewers used the Morisky Green Levine Medication Adherence Scale, Self-Efficacy to Manage Chronic Disease (SEMCD) Scale, and the Family Adaptability, Partnership, Growth, Affection, and Resolve (APGAR) Scale to assess medication adherence, self-efficacy, and family function, respectively. Participants also reported their perceived satisfaction with community health services (quantity, quality, affordability, and overall acceptance). The study used the multivariable logistic regression to assess the association of patient, family, and community factors with suboptimal medication adherence. ResultsAmong the participants, 42.9% reported suboptimal medication adherence. In the multivariable logistic regression model, male participants (odds ratio [OR] = 0.55, p = 0.001) had higher medication adherence compared to females. Having a self-efficacy score that was lower than or equal to the sample mean was significantly associated with lower adherence (OR = 1.44, p = 0.039). Participants unsatisfied with the affordability of community health services and medicine had lower adherence (OR = 2.18, p = 0.028) than those neutral or satisfied. There were no significant associations between family function and medication adherence. ConclusionsSex, self-efficacy, and perceived affordability of community health services were important factors associated with medication adherence. Healthcare professionals are recommended to consider multiple factors and leverage services and resources in community health centers when promoting medication adherence.

A Study of Anticipatory Failure Determination (AFD) based on Scenario Analysis Methods

Theory of Inventive Problem Solving (TRIZ) is a methodological algorithm that helps solve complex problems by generating original ideas. The Anticipatory Failure Determination (AFD) method is one of the problem-solving methodologies within TRIZ. It is a creative way to solve problems when you cannot find the cause of a problem or observe the situation in which it occurs. This study aimed to investigate the effectiveness of the Anticipatory Failure Determination (AFD) method, which is one of the problem solving methodologies within the Theory of Inventive Problem Solving (TRIZ). TRIZ is a methodological algorithm designed to address complex problems by stimulating the generation of original ideas. It involves a shift in thinking: instead of looking for the cause of a problem (i.e., "why does it happen?"), it looks for ideas to solve the problem (i.e., "how can I make it happen?") by formulating a hypothesis and testing the hypothesis. In doing so, they explore and leverage resources that exist within or adjacent to the system to support the failure hypothesis. A resource is anything that is used to fulfill the ideal final result. In this study, scenario analysis, a methodology synonymous with foresight, is integrated into the AFD framework to enhance problem-solving capabilities. By incorporating scenario analysis, the formulation of failure hypotheses crucial to the AFD process is facilitated. Additionally, a case study demonstrating the application of AFD augmented by scenario analysis is presented, showcasing its efficacy in resolving complex problems. This integration aims to proactively mitigate future risks and prevent potential damages. Through this research, a comprehensive understanding of how scenario analysis enriches the AFD methodology is provided, empowering practitioners to pre-emptively address emerging challenges. Ultimately, the goal is to fortify problem-solving capacities and foster resilience in the face of evolving complexities.

Examining the creation of synergy in community coalitions for smoke-free environments in Armenia and Georgia.

Community coalitions depend on their members to synergistically pool diverse resources, including knowledge and expertise, community connections and varied perspectives, to identify and implement strategies and make progress toward community health improvement. Several coalition theories suggest synergy is the key mechanism driving coalition effectiveness. The Community Coalition Action Theory (CCAT) asserts that synergy depends on how well coalitions engage their members and leverage their resources, which is influenced by coalition processes, member participation and satisfaction and benefits outweighing costs. The current study used mixed methods, including coalition member surveys (n = 83) and semi-structured interviews with leaders and members (n = 42), to examine the process of creating collaborative synergy in 14 community coalitions for smoke-free environments in Armenia and Georgia. Members, typically seven per coalition representing education, public health, health care and municipal administration sectors, spent an average of 16hr/month on coalition-related work. Common benefits included making the community a better place to live and learning more about tobacco control. The greatest cost was attending meetings or events at inconvenient times. Members contributed various resources, including their connections and influence, skills and expertise and access to population groups and settings. Strong coalition processes, greater benefits and fewer costs of participation and satisfaction were correlated with leveraging of member resources, which in turn, was highly correlated with collaborative synergy. Consistent with CCAT, effective coalition processes created a positive climate where membership benefits outweighed costs, and members contributed their resources in a way that created collaborative synergy.

An efficient provably secure authentication and key agreement protocol for satellite communication networks

AbstractThe leverage of satellite resources to establish a communication network offers a wide range of benefits, including the capability to support news gathering, broadcasting, and aeronautical and maritime tracking. The unique aspects of the satellite‐linked terrestrial network provide high‐speed services, dependable and consistent network quality, and comprehensive geographic coverage of remote regions. Unfortunately, these structural features also render the network vulnerable to unauthorized intrusion, potentially leading to significant disruptions. Consequently, the implementation of authentication measures presents an appealing solution for enhancing the overall service quality of this network. Recently, Kumar et al. presented an authentication and key agreement scheme for satellite communications. Strikingly, their scheme proves inadequate in safeguarding against several malicious attacks and reveals certain design weaknesses. In this article, we present a reliable and secure authentication protocol that takes advantage of the complexities inherent in the elliptic curve discrete logarithm problem. We assess the protocol's effectiveness against various types of attacks using formal proof, Burrows–Abadi–Needham logic, informal descriptive proof analysis, and the verification tool SCYTHER. Furthermore, we compare the computational, communication, and storage overhead of our proposed protocol to an existing one, demonstrating its efficiency and superiority.

Sustainability Planning for a Community Network to Increase Participation in Evidence-Based Lifestyle Change Programs: A Mixed-Methods Approach.

Community-based chronic disease prevention programs can have long-term, broad public health benefits. Yet, only 40 to 60% of evidence-based health programs are sustained. Using established frameworks and evidence-based tools to characterize sustainability allows programs to develop structures and processes to leverage resources effectively to sustain effective program activities and systems. This study used a mixed-methods, partner-engaged approach to identify barriers and facilitators to sustaining a community network (the Alliance program) aimed to increase participation in evidence-based lifestyle change programs delivered in the community. Surveys and qualitative interviews were conducted with the Alliance partners based on the Program Sustainability Assessment Tool and Consolidated Framework for Implementation Research. Overall, partners felt Alliance had a high capacity for sustainability. Strategic planning, communication, and partnerships were areas partners prioritized to improve the potential for sustaining the program. Results informed the co-development of a sustainability action plan. This paper furthers our understanding of factors critical for the sustainability of community-based programs for chronic disease prevention and health equity and presents a process for developing action plans to build sustainability capacity.

Dynamic open innovation to determine technology-based interoperability requirement for electric motorcycle swappable battery

Electric motorcycle swappable batteries (EMSB) require interoperability standards so that swappable batteries (SB) can be exchanged and operated between brands to minimize investment costs. The stages in standards development have similar characteristics to the open innovation process, namely the involvement of external interested parties: manufacturers, regulators, customers, suppliers, experts, and researchers. For that, in the standards development process, all stakeholders must collaborate to leverage knowledge, expertise, resources, and innovative ideas. This article, therefore, aims to determine the essential parameters that need to be established in interoperability requirements and develop an economic model to estimate the financial impact. The model framework in this research integrated the Framework for Analysis, Comparison, and Testing of Standards (FACTS) and The International Organization for Standardization (ISO) Methodology using the dynamic open innovation approach. The sample was 20 respondents representing stakeholders. This research used a semi-open questionnaire developed from the E-Mobility Systems Architecture (EMSA) model on three-layer interoperability (components, communications, and information) and economics benefit standard methodology. This research recommends SB dimensions, SB voltage, connector types, safety, and component compatibility requirements (BMS, sensors, controllers) to be regulated at the component layer. Meanwhile, further consensus is still needed at the communication and information layer. The economic model developed has been successfully applied using hypothetical data.

“I’m Doing the Best that I Can”: Mothers Lived Experience with Food Insecurity, Coping Strategies, and Mental Health Implications

BackgroundFood insecurity can have lasting physical and mental health consequences. The experience of food insecurity within a household may disproportionately impact mothers because they tend to manage the household food environment. ObjectiveThis study sought to understand the stresses faced by United States mothers experiencing food insecurity, related coping mechanisms, and the impacts of these stressors on their mental health. MethodsSemistructured interviews were conducted in May and June 2022 with a purposive sample of Virginia mothers who reported experiences of food insecurity. Participants were recruited from a related survey and university and community LISTSERVs. Interviews were transcribed and analyzed by trained coders. A thematic analysis was conducted to describe themes that emerged from the data. Virtual interviews were 20–60 min in duration. Mothers with children living in their household, having experienced food insecurity, and living in Virginia were eligible. ResultsThe following 3 themes emerged from the interviews with the mothers (n = 15): 1) food insecurity added stress to mothers’ lives in multiple ways (e.g. worry about obtaining the “right” foods and internalized or experienced stigma), 2) mothers used positive and negative coping strategies to address the impacts of these stressors (e.g. use of community resources and reduced personal food intake), and 3) the stressors and coping strategies had varying impacts on mothers’ mental health (e.g. added to existing mental health challenges or reduced their mental capacity to make changes). ConclusionsStudy findings suggest that a multilevel and tailored approach to address diverse stressors is warranted. Future research should explore emotional coping strategies that comprehensively empower mothers to manage stressors, leverage resources, and reduce social stigma associated with food insecurity and accessing nutrition and mental health assistance. This may improve their household food security and mitigate the burden of stressors on their mental health because system-level solutions to food insecurity are pursued.

The impact of open innovation on the environmental sustainability practices and international sales intensity nexus: A multicountry study

Amid growing environmental concerns and increasing customer demand for environmental sustainability practices (ESP), international firms strive to develop ESP and leverage resources across their global networks as key players in global innovation systems. In this context, we investigate whether adopting an open innovation (OI) strategy is a viable solution to meet the demand for ESP and foster internationalization. Specifically, this study examines the potential moderating effect of OI on ESP because both entail the ability to coordinate, orchestrate, and synchronize networks to enhance international sales. Our study encompasses a multicountry sample of 514 internationally operating manufacturers. The findings reveal that simultaneous efforts to adopt OI with suppliers and ESP constrain the positive association between ESP and international sales intensity. We provide theoretical arguments to elucidate this counterintuitive finding, thereby revitalizing the discussion on the role of international firms’ adoption of ESP and sustainable innovation.

The Impact of Growth Mindset Interventions on Students’ Motivation, Resilience, and Academic Achievement

This study focuses on the impact of growth mindset interventions on students’ motivation, resilience and academic achievement. The specific objectives of the study entail: to assess the impacts of growth mindset interventions on student motivation, resilience, and academic performance in educational settings, to examine the practical strategies employed by educators to implement growth mindset interventions effectively and to identify potential challenges and limitations of growth mindset interventions in fostering a growth mindset culture in schools. The study employed qualitative research approach and used documentary review to collect data of the study. The findings of the study on the impact of growth mindset interventions on students’ motivation, resilience and academic achievement revealed that growth mindset interventions have demonstrated significant positive impacts on students' motivation in educational settings, evidence from various studies demonstrates that growth mindset interventions have a positive impact on students' resilience in educational settings and lastly various recent research studies conducted provide evidence of the positive impact of growth mindset interventions on students' academic achievement, motivation, engagement, resilience, and persistence. The findings of the study on the practical strategies employed by educators to implement growth mindset interventions effectively entail: provision of explicit instruction, fostering a supportive classroom culture, teaching effective learning strategies, provision of feedback that promotes growth mindset, encouragement of reflection and metacognition, modelling a growth mindset and leverage of technology and digital resources: The findings of the study on the potential challenges and limitations of growth mindset interventions in fostering a growth mindset culture in schools include: limited sustainability, individual differences, low teacher training, contextual factors and overgeneralization. The study recommends that Schools and educational institutions should actively incorporate growth mindset interventions into their curriculum and teaching strategies, encouraged to set realistic and achievable goals and regularly reflect on their progress, provide professional development opportunities and training programs for educators to enhance their understanding of growth mindset principles and strategies and should create an environment that promotes positivity, encouragement, and a sense of belonging.

Evaluating registry-based trial economics: Results from the STRESS clinical trial

BackgroundRegistry-based trials have the potential to reduce randomized clinical trial (RCT) costs. However, observed cost differences also may be achieved through pragmatic trial designs. A systematic comparison of trial costs across different designs has not been previously performed. MethodsWe conducted a study to compare the current Steroids to Reduce Systemic inflammation after infant heart surgery (STRESS) registry-based RCT vs. two established designs: pragmatic RCT and explanatory RCT. The primary outcome was total RCT design costs. Secondary outcomes included: RCT duration and personnel hours. Costs were estimated using the Duke Clinical Research Institute's pricing model. ResultsThe Registry-Based RCT estimated duration was 31.9 weeks greater than the other designs (259.5 vs. 227.6 weeks). This delay was caused by the Registry-Based design's periodic data harvesting that delayed site closing and statistical reporting. Total personnel hours were greatest for the Explanatory design followed by the Pragmatic design and the Registry-Based design (52,488 vs 29,763 vs. 24,480 h, respectively). Total costs were greatest for the Explanatory design followed by the Pragmatic design and the Registry-Based design ($10,140,263 vs. $4,164,863 vs. $3,268,504, respectively). Thus, Registry-Based total costs were 32 % of the Explanatory and 78 % of the Pragmatic design. ConclusionTotal costs for the STRESS RCT with a registry-based design were less than those for a pragmatic design and much less than an explanatory design. Cost savings reflect design elements and leveraging of registry resources to improve cost efficiency, but delays to trial completion should be considered.