Plain English Summary Research Articles

Exploration-exploitation and acquisition likelihood in new ventures

The market for acquisitions has been a blind spot in exploration-exploitation research in the new venture context. The introduction of the acquisition exit outcome as a performance dimension for new ventures, especially among high-tech ventures, shifts the traditional temporal logic of exploration-exploitation theory by introducing previously unacknowledged short-term benefits of exploration. We bring the acquisition outcome into the picture and investigate the relationship between the exploration-exploitation continuum and profitability, survival, and acquisition likelihood simultaneously. Using the Kauffman Firm Survey data, we provide evidence for a link between exploration and the likelihood of acquisition (defined as the business being sold to or merged with another business), although industry technology level poses a boundary condition such that the association is not observed in low- and medium-technology firms. An inverse U-shaped relationship that is monotone negative for most of the data range was found between exploration and the profitability of low- and medium-tech firms, and a negatively linear relationship was found for exploration and the profitability of high-tech firms. Our findings lend some support to the viability of “born to flip” strategies involving comparatively higher exploration levels in high-tech start-ups and sacrifice of short-term profitability. Plain English Summary Built-to-flip strategy really does work, but only for some startups. There has been a debate on whether start-ups should be managed specifically with the aim of short-term exit through M&As (built to flip) or if they should always focus on long-term viability (built to last). We tap into the Kauffman Firm Survey data to provide evidence-based insights on this issue. Our results support the viability of “built-to-flip” strategies among some new firms at least when it comes to the balance of exploration and exploitation, measured as relative allocation of employees to R&D vs. sales. High-tech ventures that exited through M&A had higher exploration levels compared to all other sub-groups including high-tech ventures that closed or did not exit, and all low- and medium-tech ventures. Among high-tech ventures, increased exploration does—to a point—lead to a higher likelihood of acquisition, but it comes at the price of reduced profitability. After this peak point, further increase in exploration reduces both acquisition likelihood and profitability.

The California Tax on Extreme Wealth (ACA 8 & AB 310): Revenue, Economic, and Constitutional Analysis

This white paper report provides Revenue, Economic, and Constitutional Analysis of the proposed California Tax on Extreme Wealth (ACA 8 & AB 310) and also a Plain-English Summary Outline of its major provisions.

Of free markets and a secular mind: the value of economic decentralization and individual secular values in entrepreneurship

Building upon Hayek’s seminal work regarding the benefits of market decentralization, in this study, we examine the complementary role of an individual’s secular values in further explaining the association between decentralization of economic affairs, entrepreneurial activity, and self-employment. We argue that studies on Hayek’s notion of decentralization may be incomplete in their conceptualization without a transition to individual morality based on more secular values. We consider decentralization of economic affairs and secular values to explain why entrepreneurial activity differs across countries. In study 1, we find that the decentralization of economic affairs increases the odds of being an entrepreneur in a startup, but does not influence the likelihood of owning/managing a business or perceptions related to the opportunity to start a business. In study 2, we find evidence of mixed support for decentralization and self-employment; however, with meaningful effect sizes but with marginal significance, we find that an individual’s secular values complement the association between decentralization of economic affairs and self-employment. The findings are robust to alternate specifications. By demonstrating the role of secular values in strengthening decentralization, we lay the foundation for melding economic perspectives with the freedom from religious ethos as an important consideration for entrepreneurial activity. However, the mixed effects of decentralization on different modes of entrepreneurship also call into question the value of decentralization in modern economies. Plain English Summary Higher levels of individual secular values, even by a small amount, enhance the benefits that economic decentralization can have on entrepreneurial activity. In this paper, we use a two-study approach to examine how individual secular values might influence the effects of economic decentralization on entrepreneurial activity. In study 1, we find that the decentralization of economic affairs increases the odds of being an entrepreneur in a startup, but does not influence the likelihood of owning/managing a business or individual perceptions related to existing opportunities to start a business. In study 2, we find evidence of mixed support for the effects of economic decentralization on self-employment. However, we find some evidence suggesting that an individual’s secular values complement the association between decentralization of economic affairs and self-employment. Thus, the principal implication of this study is that policymakers should take into consideration the overall secular values present in society when making decisions regarding economic decentralization, particularly with regard to understanding the potential effects that decentralization could have on entrepreneurial activity.

Use of compression therapy to treat lower limb wounds across Europe: a scoping review protocol.

IntroductionPoor lower wound care is an avoidable patient harm. Compression therapy is an effective way of treating non-ischaemic lower limbs wounds, but it is not always used appropriately. There are many guidelines which set out how compression therapy should be used, but there is dearth of evidence about how it is actually used at a population level across Europe.AimThe aim of this scoping review is to map the evidence published in English relating to the use of compression therapy to treat lower limb wounds across Europe.MethodsThis scoping review will be conducted in line with the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols and Scoping Reviews guidance. A search for relevant publications will be conducted on variety of databases and key websites in order to identify a comprehensive range of relevant literature. Peer reviewed empirical papers, theoretical papers and other publications in English relating to the use of compression therapy across Europe will be considered for inclusion.Ethics and disseminationEthical and research governance for this scoping review is not required because we will only gather secondary data. Our results will be disseminated to the widest possible audience through an open access paper in a peer reviewed international journal, conference presentations and a plain English summary. The results of this scoping review will be used by a panel of Key Opinion Leaders from across Europe to develop a driver diagram to underpin subsequent lower limb wound care improvement efforts.

Open Access+ Service: reframing library support to take research outputs to non-academic audiences

The University of Manchester Library has established a key role in facilitating scholarly discourse through its mediated open access (OA) services, but has little track record in intentionally taking OA research outputs to non-academic audiences. This article outlines recent exploratory steps the Library has taken to convince researchers to fully exploit this part of the scholarly communication chain. Driving developments within this service category is a belief that despite the recent rise in OA, the full public benefit of research outputs is often not being realized as many papers are written in inaccessibly technical language. Recognizing our unique position to help authors reach broader audiences with simpler expressions of their work, we have evolved our existing managed OA services to systematically share plain-English summaries of OA papers via Twitter. In parallel, we have taken steps to ensure that our commercial analytics tools work harder to identify and reach the networked communities that form around academic disciplines in the hope that these simpler expressions of research will be more likely to diffuse beyond these networks.

PARENTS 2 study: consensus report for parental engagement in the perinatal mortality review process.

ABSTRACTObjectiveThe PARENTS 1 study (Parents' Active Role and ENgagement in The review of their Stillbirth/perinatal death) found that parents would endorse the opportunity to give feedback into the perinatal mortality review (PNMR) process. In subsequent focus groups, healthcare professionals were positive about parental engagement, although they considered that there may be significant challenges. The objective of this study was to develop core principles and recommendations for parental engagement in PNMR in the UK.MethodsA two‐round Delphi technique was followed to reach consensus on core principles for parental engagement in the PNMR process; Round 1 included a national consensus workshop and Round 2 an online questionnaire. The consensus meeting was attended by a national panel of stakeholders (clinical and academic experts, parent advocates, managers and commissioners) in stillbirth and neonatal and bereavement care. To develop recommendations for parental engagement, participants discussed four key areas comprising: communication with parents, including receiving feedback; the format of the PNMR meeting; the parental engagement pathway; and challenging aspects of engaging with parents in reviews. Content analysis was conducted to generate recommendations from the meeting for a subsequent anonymous web‐based survey. Attendees of the consensus workshop and members of the PARENTS 2 Project Advisory Board were asked to rank recommendations using a 9‐point Likert scale from 1 (not important) to 9 (critically important). It had been agreed a priori, in compliance with established Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria, that ‘consensus’ would be achieved if over 70% of participants scored the principle as ‘critical’ (score of 7–9) and fewer than 15% scored the principle as ‘not important’ (score of 1–3). Principles for which consensus was achieved were included in the core recommendations.ResultsOf the 29 invited stakeholders, 22 participated in the consensus meeting and 25 (86% response rate) in the subsequent online questionnaire in June 2017. Consensus was agreed on 12 core principles. Of the 25 participants, 96% agreed that a face‐to‐face explanation of the PNMR process was of critical importance, 72% considered that parents should be offered the opportunity to nominate a suitable advocate, 92% believed that responses to parents' comments should be formally documented, 96% indicated that it was vital for action plans to be translated into lessons learnt and that this process should be monitored, and 100% of stakeholders voted that a plain‐English summary should be produced for the parents following the meeting. There was good agreement on a further seven principles.ConclusionsKey national stakeholders were unanimously supportive of parental engagement in the PNMR process and agreed on core principles to make this process feasible, meaningful and robust. A 6‐month pilot of parental engagement in the PNMR process (PARENTS 2 study) in two UK units took place after the consensus on core principles. In collaboration with the National Perinatal Epidemiology Unit, the findings will inform the national standardized PNMR tool. © 2018 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.

OP79 Improving Public Understanding Of Scottish Medicines Consortium Advice

IntroductionTransparency of processes and decision making is important to the Scottish Medicines Consortium (SMC). An independent review of access to new medicines in Scotland in 2016 recommended that SMC should review its communication of decisions with a view to achieving greater transparency. SMC therefore began to develop plain English summaries of advice on each new medicine.MethodsA multi-stakeholder approach was adopted to develop the summary documents, with patient groups involved. Firstly, a review of communications for the public from other HTA organizations was conducted. The public involvement team then held a workshop to find out what patient groups felt would be important to include when explaining SMC decisions to patients and the public. The process was also informed by reviewing examples of good practice from other parts of NHSScotland, including patient versions of Scottish Intercollegiate Guidelines Network (SIGN) clinical guidelines. Exemplar documents were then developed and feedback sought from the Public Involvement Network Advisory Group.ResultsA format was developed for the SMC ‘Decision Explained’ summaries consisting of a question and answer format for each medicine decision in a two page document. The summaries were piloted internally over a six month period, during which the development process and layout were finalized. Since September 2018 these summaries have been published on the website alongside the technical advice.ConclusionsPartnership working between SMC and patient groups has helped to develop a new way of communicating SMC's decisions to patients and the public in a clear way, helping to improve transparency and understanding. Evaluation of the summaries will be undertaken from six months of publication.

Better Outcomes for Older people with Spinal Trouble (BOOST) Trial: a randomised controlled trial of a combined physical and psychological intervention for older adults with neurogenic claudication, a protocol

IntroductionNeurogenic claudication due to spinal stenosis is common in older adults. The effectiveness of conservative interventions is not known. The aim of the study is to estimate the clinical and...

Randomised controlled trial using a theory-based m-health intervention to improve physical activity and sleep health in adults: the Synergy Study protocol

IntroductionThere is a need to reduce physical inactivity and poor sleep health in the adult population to decrease chronic disease rates and the associated burden. Given the high prevalence of...

Understanding Plain English summaries. A comparison of two approaches to improve the quality of Plain English summaries in research reports

Plain English summaryThere is a need for the authors of research reports to be able to communicate their work clearly and effectively to readers who are not familiar with the research area. The National Institute for Health Research (NIHR), along with a number of other funding bodies and journals, require researchers to write short lay summaries, often termed plain English summaries (PESs), to make research accessible to the general public. Because many researchers write using technical, specialised language, particularly in scientific reports, writing PESs can be challenging. In this study we looked at how to improve the quality of PESs. We took PESs which had been submitted to the NIHR Journals Library and asked authors to rewrite them using new guidance. We also asked an independent medical writer to edit the summaries. We measured the quality of these three versions (original summary, rewritten summary and edited summary) in two ways. First, we asked a group of people who were not specialists in the subject area to read and rate how easy the summaries were to understand. Secondly, we used a well-known measure called the Flesch reading ease score to assess how easy the PESs were to read. We found that there was no difference in how easy people found the summaries to understand across the three versions. However, the PESs that were rewritten by the authors and that were edited by the independent medical writer were both easier to read than the originals. This shows that PESs can be improved and for organisations who feel that employing an independent writer to edit summaries, providing clear, practical guidance to authors may be a cost-effective alternative.BackgroundPlain English summaries (PES) or lay summaries are often included as part of research reports and journal articles. These summaries are vital to ensure that research findings are accessible and available to non-specialist audiences, for example patients and members of the public.Writing a PES requires the adoption of a different style than is generally used in a traditional scientific report, and researchers can find this challenging. This study explored two possible ways to improve the quality of PESs in the NIHR Journals Library: 1) Providing enhanced guidance to authors and asking them to rewrite the PES and 2) Employing an independent medical writer to edit the PES.MethodsWe compared the three versions of the PES (original, author rewritten and independent writer edited) to assess 1) how easy they were to understand and 2) how easy they were to read. In order to establish how easy PESs were to understand, a group of 60 public reviewers read a set of summaries and rated them on a four point scale from “Did not understand” to “Understood all”. The Flesch reading ease score was used to measure how easy the summaries were to read.ResultsResults indicated no significant difference across the three versions of the PES in terms of ease of understanding. However, both the author rewritten and independent writer edited versions were significantly easier to read than the original. There was no significant difference in ease of reading between these two versions.ConclusionThese findings suggest that employing independent medical writers to edit PESs and providing clear, practical guidance to authors are two ways in which the readability of PESs could be improved. Results have implications for journal editors and publishers seeking to enhance accessibility and availability of research findings.

The consultation of rugby players in co-developing a player health study: feasibility and consequences of sports participants as research partners

Plain English summary Many funding bodies within the United Kingdom and globally have encouraged public involvement in research. The Department of Health has also called public involvement a sign of good research. Despite the wide acceptance of public involvement improving many aspects of research, from its design to its communication, involvement has varied levels of implementation across different fields of research. Sports people have rarely been involved in research, partly as this research tends not to be funded by mainstream funding bodies. This may lead to a lower research quality, not founded in player (‘service user’) experiences.When creating a study of former rugby player health, we were very keen to involve rugby players, understand their thoughts on player health, and their playing experiences. This article explains how rugby players were involved in several ways, but mainly in group discussions during the design stage. These groups helped to inform our study’s aims and questionnaire, ensure the questionnaire would capture player experiences and answer questions relevant to players, that they would like to understand after their participation in rugby.We found that these groups were easy to arrange, and that in only one session with each group, we were given many ideas of how to improve the questionnaire and study. We believe that other studies in sports should involve sports people, and that this is a useful activity that will change data collection forms and processes, improving the research, helping researchers, and making studies more suitable for players who take part in them.Background Patient and public involvement (‘involvement’) in the UK has increased in accordance with funding requirements, patient-centered health policy initiatives and reporting of the positive impact of involvement for those involved, research and researchers. However, involvement has not been implemented equally across all disease areas and populations. The aim of this process was to involve rugby players across the research cycle of a player health study, ensure the study is player-centred, and that players had approved and informed the design of the study and its questionnaire from their playing experiences.Methods Two group discussions were undertaken with current students who were playing rugby at a Collegiate University. All male and female University rugby players and two College rugby teams were approached to become involved. Sessions were chaired by a player-lead using a topic guide and were audio-recorded and transcribed. Player suggestions were extracted by the player-lead and discussed within the study team for inclusion in the player health study and its questionnaire.Results Players readily engaged with the sessions and made many contributions to the development of the study and the questionnaire. Players discussed whether certain topics were being collected satisfactorily, and whether the questionnaire would encompass their playing experiences or that of other players. Players suggested where answers might be less reliable, and ways in which this could be improved. Players recommended additions to the questionnaire, and questioned researchers on the choice of language, motivation for question inclusion and if measures were standardised or novel. Alterations were made to the questionnaire based on suggestions, where these were agreed by the study team.Conclusions Involving a group of players in the design of a player health study and questionnaire was not an arduous process and was rewarding for researchers. The process resulted in numerous alterations to the questionnaire and its functionality, which may improve response rate, the experience of players participating in the player health study, and their ability to report relevant information aligned with their previous experience. Player involvement in research was feasible to implement and improved not only the questionnaire, but also researcher confidence in the project and player experiences being accurately captured and leading a reliable data collection processes in a population with the potential for cultural bias to affect the ascertainment of health, pain and injury.

Developing resources to facilitate culturally-sensitive service planning and delivery - doing research inclusively with people with learning disabilities.

Plain English summary(Please see www.Toolsfortalking.co.uk for an easy read summary of the project.)The Tools for Talking are a set of resources that were developed through collaboration between Black, Asian and minority ethnic people with learning disabilities and researchers at the University of Birmingham. The resources were designed to be used by people with learning disabilities and service providers to facilitate culturally-sensitive communication and information sharing, service planning and delivery. They comprise illustrative videos and exploratory activities relating to five topics, namely, culture, activities, support from staff, important people, choices and independence. These topics emerged as important to people with learning disabilities during the ‘Access to Social Care-Learning Disabilities’ (ASC-LD) study which involved interviews with 32 adults with learning disabilities from Black, Asian and minority ethnic communities. The results of the ASC-LD study were used to develop a set of draft resources which were then co-developed through collaboration with people with learning disabilities and service providers. A ‘Partnership event’ was convened to involve stakeholders in the development of the resources. This paper describes the refinement of these materials by people with learning disabilities from Black, Asian and minority ethnic backgrounds in cooperation with a range of other stakeholders. Background Black, Asian and minority ethnic people with learning disabilities face inequities in health and social care provision. Lower levels of service uptake and satisfaction with services have been reported, however, this is largely based on the views of carers. The ‘Access to Social Care: Learning Disabilities (ASC-LD)’ study sought to explore the views and experiences of social support services among adults with learning disabilities from Black, Asian and minority ethnic communities. Interviews with 32 Black, Asian and minority ethnic adults with learning disabilities were conducted to explore participants’ cultural identities, their understanding and experience of ‘support’. The views and experiences expressed in the ASC-LD study were used in the ‘Tools for Talking project’ to develop a suite of resources designed to facilitate culturally-sensitive communication and information-sharing, service planning and delivery through improved mutual understanding between providers and users of services. This paper describes the Tools for Talking project which sought to co-develop the resources through a partnership event. Methods An inclusive approach was adopted to address issues that are important to people with learning disabilities, to represent their views and experiences, and to involve Black, Asian and minority ethnic people with learning disabilities in the research process. Partnerships were developed with provider organisations and service users who were invited to a ‘Partnership Event’. Collaborators at the partnership event were asked to comment on and evaluate draft resources which included a series of videos and activities to explore topics that emerged as important in the ASC-LD study. Their comments were collated and the tools developed as they suggested. Results Using the results from the ASC-LD study helped to ensure that the draft resources were relevant to service users, addressing topics that were important to them. The partnership event was an effective method to collaborate with a relatively large number of stakeholders. However, the event was resource intensive and required substantial planning to ensure active and meaningful participation. Considerations, such as inviting stakeholders, developing the programme and selecting a venue are discussed. Conclusions The partnership approach has led to the development of a set of five illustrative videos and accompanying activities that address issues that emerged from the collaborative process including: culture, activities, support from staff, important people, choices and independence. These resources are freely available at: www.Toolsfortalking.co.uk. They are designed to be used by users and providers of services, but may also be useful in other settings.

Improving communication of clinical trial results: plain English summaries in the NIHR journals library

Background Plain English summaries (PESs) are a valuable tool for making research findings available and accessible to patients and the public. They provide brief descriptions of research written in non-specialist language. The National Institute for Health Research Journals Library (NIHRJL) currently requires authors to provide a 250 word PES. This is published online as part of the final, open-access report. Practice varies among other funders and journals, some of whom employ independent external writers (IEWs) for this purpose.

One small step….

Plain English summaryThis editorial introduces the new, online, open-access journal Research Involvement and Engagement. The journal considers manuscripts on any aspect of the engagement or involvement of patients, carers or members of the public in design, delivery and dissemination of research in health or social care.We support the involvement of patients in the production of the journal, as co-authors, as reviewers and as consumers of the journal, through plain English summaries. We want patients and the wider public to become engaged with research and influence its future direction. Through the co-production of the Journal, we wish to encapsulate the vision of “nothing about me without me”.The journal of Research Involvement and Engagement provides a dedicated place for publication of research focused on public involvement and engagement, as well as a forum for discussion of methodological issues that will lead to increased scientific rigour in public involvement and to an enhanced evidence base to underpin best practice internationally.

PDBe: Protein Data Bank in Europe

The Protein Data Bank in Europe (PDBe; pdbe.org) is actively involved in managing the international archive of biomacromolecular structure data as one of the partners in the Worldwide Protein Data Bank (wwPDB; wwpdb.org). PDBe also develops new tools to make structural data more widely and more easily available to the biomedical community. PDBe has developed a browser to access and analyze the structural archive using classification systems that are familiar to chemists and biologists. The PDBe web pages that describe individual PDB entries have been enhanced through the introduction of plain-English summary pages and iconic representations of the contents of an entry (PDBprints). In addition, the information available for structures determined by means of NMR spectroscopy has been expanded. Finally, the entire web site has been redesigned to make it substantially easier to use for expert and novice users alike. PDBe works closely with other teams at the European Bioinformatics Institute (EBI) and in the international scientific community to develop new resources with value-added information. The SIFTS initiative is an example of such a collaboration—it provides extensive mapping data between proteins whose structures are available from the PDB and a host of other biomedical databases. SIFTS is widely used by major bioinformatics resources.

The Cochrane Collaboration

The Cochrane Collaboration is an international, not-for-profit organisation that aims to help people make well-informed decisions about health care by preparing, maintaining and promoting the accessibility of systematic reviews of the effects of health-care interventions. Cochrane systematic reviews are prepared according to predefined, explicit methodology, and published in The Cochrane Library. The abstracts and plain English summaries of the reviews are freely available on the Internet. All reviews are prepared and maintained under the editorial control of 50 Cochrane Collaborative Review Groups that focus on (groups of) health problems. The work of Collaborative Review Groups is supported, among others, by people working in Cochrane Fields. Cochrane Fields focus on dimensions of health care other than health problems. To date, the issue of nutrition has not been addressed sufficiently in The Cochrane Collaboration. Nutrition issues are very important for day-to-day health care and the initiatives to establish a new Cochrane Diet and Nutrition (Sub)Field will help to promote the preparation of systematic reviews of nutritional interventions by the variety of Collaborative Review Groups to whom such interventions are relevant. Many issues regarding nutritional interventions, however, are complex, and methodological challenges will have to be overcome. A Cochrane Diet and Nutrition (Sub)Field with experts on nutritional research can help fill this gap and make those reviews more possible.