Clinician acceptability of an antibiotic prescribing knowledge support system for primary care: a mixed-method evaluation of features and context

BACKGROUND

Overprescribing of antibiotics is a major concern as it contributes to antimicrobial resistance. Research has found highly variable antibiotic prescribing in (UK) primary care, and to support more effective stewardship, the BRIT Project (Building Rapid Interventions to optimise prescribing) is implementing an eHealth Knowledge Support System. This will provide unique individualised analytics information to clinicians and patients at the point of care. The objective of the current study was to gauge the acceptability of the system to prescribing healthcare professionals and highlight factors to maximise intervention uptake.

METHODS

Two mixed-method co-design workshops were held online with primary care prescribing healthcare professionals (n = 16). Usefulness ratings of example features were collected using online polls and online whiteboards. Verbal discussion and textual comments were analysed thematically using inductive (participant-centred) and deductive perspectives (using the Theoretical Framework of Acceptability).

RESULTS

Hierarchical thematic coding generated three overarching themes relevant to intervention use and development. Clinician concerns (focal issues) were safe prescribing, accessible information, autonomy, avoiding duplication, technical issues and time. Requirements were ease and efficiency of use, integration of systems, patient-centeredness, personalisation, and training. Important features of the system included extraction of pertinent information from patient records (such as antibiotic prescribing history), recommended actions, personalised treatment, risk indicators and electronic patient communication leaflets. Anticipated acceptability and intention to use the knowledge support system was moderate to high. Time was identified as a focal cost/ burden, but this would be outweighed if the system improved patient outcomes and increased prescribing confidence.

CONCLUSION

Clinicians anticipate that an eHealth knowledge support system will be a useful and acceptable way to optimise antibiotic prescribing at the point of care. The mixed method workshop highlighted issues to assist person-centred eHealth intervention development, such as the value of communicating patient outcomes. Important features were identified including the ability to efficiently extract and summarise pertinent information from the patient records, provide explainable and transparent risk information, and personalised information to support patient communication. The Theoretical Framework of Acceptability enabled structured, theoretically sound feedback and creation of a profile to benchmark future evaluations. This may encourage a consistent user-focused approach to guide future eHealth intervention development.

Expert's View on Central Components of the Actional Model of Older People's Coping with Health-Related Declines: A Pilot Study with Professional Caregivers

Abri & Boll (2022) proposed the "Actional Model of Older People´s Coping with Health-Related Declines" to explain the use of various action alternatives of older persons for dealing with diseases, functional declines, activity limitations, and participation restrictions. It draws on a broad knowledge base: an action-theoretical model of intentional self-development, models of the use of assistive technologies (ATs) and medical services, qualitative studies on reasons for using or not-using ATs, and quantitative studies on older people's health-related goals. The present study aims to gather evidence to further refine this model by additionally relying on expert knowledge from professional caregivers serving older people. Six experienced geriatric nurses working in mobile care services or residential care facilities were interviewed about key components of the above model in relation to 17 older people aged 70 to 95 with stroke, arthrosis, or mild dementia. The results revealed additional goals of reducing or preventing health-related discrepancies beyond those already included in the model (e.g., moving without pain, doing things alone, driving a car again, social return). Moreover, new motivating or demotivating goals for using certain action possibilities were found (e.g., to be at home, to be alone, to rest, to motivate other older people). Finally, some new factors were identified from the biological-functional (e.g., illness, fatigue), technological (e.g., pain inducing ATs, maladaptive devices), and social contexts (e.g., lack of staff time) that are likely to promote or hinder the use of certain action possibilities. Implications for refining the model and future research are discussed.

The Credibility of Physician Rating Websites: A Systematic Literature Review

OBJECTIVES

Increasingly, the credibility of online reviews is drawing critical attention due to the lack of control mechanisms, the constant debate about fake reviews and, last but not least, current developments in the field of artificial intelligence. For this reason, the aim of this study was to examine the extent to which assessments recorded on physician rating websites (PRWs) are credible, based on a comparison to other evaluation criteria.

METHODS

Referring to the PRISMA guidelines, a comprehensive literature search was conducted across different scientific databases. Data were synthesized by comparing individual statistical outcomes, objectives and conclusions.

RESULTS

The chosen search strategy led to a database of 36,755 studies of which 28 were ultimately included in the systematic review. The literature review yielded mixed results regarding the credibility of PRWs. While seven publications supported the credibility of PRWs, six publications found no correlation between PRWs and alternative datasets. 15 studies reported mixed results.

CONCLUSIONS

This study has shown that ratings on PRWs seem to be credible when relying primarily on patients' perception. However, these portals seem inadequate to represent alternative comparative values such as the medical quality of physicians. For health policy makers our results show that decisions based on patients' perceptions may be well supported by data from PRWs. For all other decisions, however, PRWs do not seem to contain sufficiently useful data.

Predicting and Mitigating Freshmen Student Attrition: A Local-Explainable Machine Learning Framework

With the emergence of novel methods for improving machine learning (ML) transparency, traditional decision-support-focused information systems seem to need an upgrade in their approach toward providing more actionable insights for practitioners. Particularly, given the complex decision-making process of humans, using insights obtained from group-level interpretation of ML models for designing individual interventions may lead to mixed results. The present study proposes a hybrid ML framework by integrating established predictive and explainable ML approaches for decision support systems involving the prediction of human decisions and designing individualized interventions accordingly. The proposed framework is aimed at providing actionable insights for designing individualized interventions. It was showcased in the context of college students' attrition problem using a large and feature-rich integrated data set of freshman college students containing information about their demographics, educational, financial, and socioeconomic factors. A comparison of feature importance scores at the group- vs. individual-level revealed that while group-level insights might be useful for adjusting long-term strategies, using them as a one-size-fits-all strategy to design and implement individual interventions is subject to suboptimal outcomes.

Artificial intelligence and real-world data for drug and food safety - A regulatory science perspective

In 2013, the Global Coalition for Regulatory Science Research (GCRSR) was established with members from over ten countries (www.gcrsr.net). One of the main objectives of GCRSR is to facilitate communication among global regulators on the rise of new technologies with regulatory applications through the annual conference Global Summit on Regulatory Science (GSRS). The 11th annual GSRS conference (GSRS21) focused on "Regulatory Sciences for Food/Drug Safety with Real-World Data (RWD) and Artificial Intelligence (AI)." The conference discussed current advancements in both AI and RWD approaches with a specific emphasis on how they impact regulatory sciences and how regulatory agencies across the globe are pursuing the adaptation and oversight of these technologies. There were presentations from Brazil, Canada, India, Italy, Japan, Germany, Switzerland, Singapore, the United Kingdom, and the United States. These presentations highlighted how various agencies are moving forward with these technologies by either improving the agencies' operation and/or preparing regulatory mechanisms to approve the products containing these innovations. To increase the content and discussion, the GSRS21 hosted two debate sessions on the question of "Is Regulatory Science Ready for AI?" and a workshop to showcase the analytical data tools that global regulatory agencies have been using and/or plan to apply to regulatory science. Several key topics were highlighted and discussed during the conference, such as the capabilities of AI and RWD to assist regulatory science policies for drug and food safety, the readiness of AI and data science to provide solutions for regulatory science. Discussions highlighted the need for a constant effort to evaluate emerging technologies for fit-for-purpose regulatory applications. The annual GSRS conferences offer a unique platform to facilitate discussion and collaboration across regulatory agencies, modernizing regulatory approaches, and harmonizing efforts.

Factors Influencing Consumers' Organic Food Continuous Purchase Intentions during the Post-Pandemic Era: An Empirical Investigation in China

During the evolutionary phases of the COVID-19 pandemic, consumers' eating habits and spending behaviours have progressively shifted to the pursuit of the safer and healthier food products, such as organic food. Therefore, this study investigated the factors affecting Chinese buyers' organic food continuous purchase intentions (CPI) during the post-pandemic era. To better adapt to the current consumption context in China, this study proposed a modified TPB framework (M-TPB), by replacing subjective norms with Chinese cultural variables, such as face consciousness and group conformity, and adding constructs of perceived value of organic food (PVOF), health consciousness, and the impact of COVID-19 (IOC). Convincingly, experimental results from a structural equation model analysis of 460 usable responses indicate that M-TPB has superior explanatory power (R² = 65%) compared with the TPB model (R² = 40%) for explaining organic food CPI during the post-pandemic period. The path analysis demonstrated that perceived behavioural control, attitude, face consciousness, group conformity, health consciousness, IOC, and PVOF had substantial positive effects on CPI, while subjective norms were not significantly related. Moreover, IOC exhibited a positive and significant relationship with health consciousness and PVOF. These findings can be useful for stakeholders in the Chinese organic food industry to generate timely promoting strategies during the post-pandemic period.

Designing and delivering digital learning (e-Learning) interventions in nursing and midwifery education: A systematic review of theories

AIMS /OBJECTIVES

To identify and synthesise theories that support the design and delivery of digital learning interventions in nursing and midwifery education.

BACKGROUND

A range of educational and other theories are used to support nursing and midwifery education, including when e-learning interventions are being designed and delivered. However, there is a limited understanding of how theory is applied across the wide range of digital learning interventions to inform pedagogical research and practice.

DESIGN

A systematic review.

METHODS

CINAHL, ERIC, MEDLINE and PubMed were searched using key terms. Studies were screened by independent reviewers checking the title, abstract and full text against eligibility criteria. Due to the theoretical focus of the review, critical appraisal was not undertaken. Data were extracted and synthesised using a descriptive approach.

RESULTS

Thirty-four studies were included. Twenty theories were identified from a range of scientific disciplines, with the Technology Acceptance Model and Theory of Self-Efficacy employed most often. Theoretical frameworks were used to inform and explain how the digital learning interventions were designed or implemented in nursing and midwifery education. The sample were mainly undergraduate nursing students and the digital learning interventions encompassed animation, blended approaches, general technologies, mobile, online, virtual simulation and virtual reality applications which were used mainly in university settings.

CONCLUSIONS

This systematic review found a range of theories that support the design and delivery on digital learning interventions in nursing and midwifery education. While a single theory, the Technology Acceptance Model, tended to dominate the literature, the evidence base is peppered with numerous theoretical models that need to be examined more rigorously to ascertain their utility in improving the design or implementation of digital forms of learning to improve pedagogical research and practice in nursing and midwifery.

The spatiotemporal prediction method of urban population density distribution through behaviour environment interaction agent model

Based on the interrelationship between the built environment and spatial-temporal distribution of population density, this paper proposes a method to predict the spatial-temporal distribution of urban population density using the depth residual network model (ResNet) of neural network. This study used the time-sharing data of mobile phone users provided by the China Mobile Communications Corporation to predict the time-space sequence of the steady-state distribution of population density. Firstly, 40 prediction databases were constructed according to the characteristics of built environment and the spatial-temporal distribution of population density. Thereafter, the depth residual model ResNet was used as the basic framework to construct the behaviour-environment agent model (BEM) for model training and prediction. Finally, the average percentage error index was used to evaluate the prediction results. The results revealed that the accuracy rate of prediction results reached 76.92% in the central urban area of the verification case. The proposed method can be applied to prevent urban public safety incidents and alleviate pandemics. Moreover, this method can be practically applied to enable the construction of a "smart city" for improving the efficient allocation of urban resources and traffic mobility.

Entrepreneurship on Social Networking Sites: The Roles of Attitude and Perceived Usefulness

BACKGROUND

Social media platforms are a significant growth opportunity for enterprises, especially for microenterprises, due to the possibility of establishing direct contact with their customers. We investigate the psychological reasons that drive entrepreneurs towards the use of social networking sites (SNSs) for their business, following two important social psychology theories: the theory of planned behaviour and the technology acceptance model. We also tested for two personality traits: openness to experience and dominance.

METHODS

Data were acquired by examining 325 microentrepreneurs who decided to use either SNSs or traditional sales methods for their businesses.

RESULTS AND CONCLUSIONS

Our results confirm that of all the behavioural antecedents tested, perceived usefulness and attitude towards SNSs' effect on business proved to be the best predictors of the intention to use (or continue using) SNSs for business activity. Implications and suggestions for future research are also discussed.

A scale to measure the perceived quality of mHealth by elderly patients with hypertension in China

BACKGROUND

The elderly population in China is growing, with hypertension being the most prevalent chronic disease in older adults. Despite the rapid penetration and efficient management effect of mobile health on hypertension healthcare, elderly patients are often less adopted and continue to use mobile health services. Quality perception significantly affects an individual's satisfaction and continued intention to use mobile health services. The evaluation of the significant factors affecting mobile health quality perception by elderly individuals remains largely unexplored. The aim of this study was to develop and validate an evaluation scale to measure the perceived quality of mobile health applications for hypertension and determine the underlying influencing factors.

METHODS

A cross-sectional survey was conducted between November 2018 and October 2019. A quality evaluation scale with three factors and seven indicators was developed based on the Information Systems Success model. Data was analyzed using structural equations modelling (SEM) and one-way analysis of variance (ANOVA). All tests were two-sided and statistically significant at P < 0.05.

RESULTS

The proposed mobile health application quality evaluation scale from the perspective of the elderly was shown to be a hierarchical, multidimensional construct with valid reliability, convergent validity and discriminant validity, which consists of three factors and seven indicators. The SEM results suggested that information quality and service quality had a significant impact on the satisfaction of elderly individual's with mobile health applications for hypertension management. The results also suggest that the elderly individuals had a low evaluation of mobile medical service quality(4.06 ± 0.70), while the score of information quality was the highest, with an average score of 4.36(SD 0.83) out of 5. Male patients were shown to more readily accept mobile health applications, with their perception of system quality being 0.27 higher than female ones (95% CI 0.00 ~ 0.52; P < .05). Patients with 1-5 years hypertension histories assessed the system (95% CI 0.03 ~ 0.63; P < .05), information (95% CI 0.11 ~ 0.65; P < .05), and service quality (95% CI 0.00 ~ 0.47; P < .05) higher than those with hypertension histories > 10 years. Elderly patients who regularly visited primary hospitals assessed the information quality 0.13 higher (95% CI -0.08 ~ 0.34; P < .05) than those visited tertiary hospitals.

CONCLUSIONS

These findings have significant implications for theoretical and practical research on mobile health application quality evaluation, which will be helpful for policymakers and mobile health providers in improving the context and utilisation of mobile health to include elderly users. More mobile health applications attributes, such as timely information and interactive services that meet the characteristics of elderly patients with different mental and health demands need to be considered. Deeply embedding mobile health into primary health services is recommended to help increase the perceived quality of mobile health, and ensure the continuous use.

Factors affecting digital technology access in vocational education

If policies are not thoroughly designed, technology integration may fail. As a result, users' perceptions of technology, especially access to digital technology, are critical for technology integration in education. This study aimed to develop and validate a scale to model factors affecting digital technology access for instructional use in Indonesian vocational schools. The study also reports the structural model of the path analysis and tests of differences based on geographical areas. A scale adapted from prior studies was established, validated, and examined for its validity and reliability. A total of 1355 responses were measurable; partial least squares structural equation modeling (PLS-SEM) and t-test procedures were applied for the data analysis. The findings informed that the scale was valid and reliable. For the structural model, the strongest relationship emerged between motivational access and skills access, while the lowest existed between material access and skills access. However, motivational access has an insignificant effect on instructional use. The t-test results show that geographical areas were significantly different regarding all involved variables.

Psychosocial safety climate as a predictor of work engagement, creativity, innovation, and work performance: A case study of software engineers

Introduction

Creativity is vital for competitive advantage within technological environments facing the fourth industrial revolution. However, existing research on creativity has rarely addressed how a climate beneficial for worker psychological health, a psychosocial safety climate (PSC), could additionally stimulate the growth of workplace creativity, innovation, and performance in digital environments.

Method

To examine how individually perceived PSC influences subsequent work engagement promoting higher levels of computer-based radical and incremental creativity, innovation, and work performance, employees in a software engineering firm (N = 29, 86 observations) completed a weekly questionnaire for 4 consecutive weeks.

Results

At the between-person level PSC was positively related to average future weekly individual fluctuations of creativity (radical and incremental), work engagement, and job performance. Additionally weekly work engagement was related to future creativity (radical and incremental). Work engagement also mediated the between-person relationship between PSC and future creativity (both radical and incremental). PSC did not predict innovation.

Discussion

This study contributes to the theory on PSC, creativity, and work performance by elucidating the individual perceived PSC-creativity relationship and suggesting PSC systems as meaningful antecedents to digital work performance.

Predicting Habitual Use of Wearable Health Devices Among Middle-aged Individuals With Metabolic Syndrome Risk Factors in South Korea: Cross-sectional Study

BACKGROUND

Prevention of the risk factors for metabolic syndrome (MetS) in middle-aged individuals is an important public health issue. Technology-mediated interventions, such as wearable health devices, can aid in lifestyle modification, but they require habitual use to sustain healthy behavior. However, the underlying mechanisms and predictors of habitual use of wearable health devices among middle-aged individuals remain unclear.

OBJECTIVE

We investigated the predictors of habitual use of wearable health devices among middle-aged individuals with risk factors for MetS.

METHODS

We proposed a combined theoretical model based on the health belief model, the Unified Technology of Acceptance and Use of Technology 2, and perceived risk. We conducted a web-based survey of 300 middle-aged individuals with MetS between September 3 and 7, 2021. We validated the model using structural equation modeling.

RESULTS

The model explained 86.6% of the variance in the habitual use of wearable health devices. The goodness-of-fit indices revealed that the proposed model has a desirable fit with the data. Performance expectancy was the core variable explaining the habitual use of wearable devices. The direct effect of the performance expectancy on habitual use of wearable devices was greater (β=.537, P<.001) than that of intention to continue use (β=.439, P<.001), and the total effect estimate of the performance expectancy was 0.909 (P<.001), including the indirect effect (β=.372, P=.03) on habitual use of wearable devices via intention to continue use. Furthermore, performance expectancy was influenced by health motivation (β=.497, P<.001), effort expectancy (β=.558, P<.001), and risk perception (β=.137, P=.02). Perceived vulnerability (β=.562, P<.001) and perceived severity (β=.243, P=.008) contributed to health motivation.

CONCLUSIONS

The results suggest the importance of the users' performance expectations for wearable health devices for the intention of continued use for self-health management and habituation. Based on our results, developers and health care practitioners should find better ways to meet the performance expectations of middle-aged individuals with MetS risk factors. They also should generate device use easier and find a way to encourage users' health motivation, thereby reducing users' effort expectancy and resulting in a reasonable performance expectancy of the wearable health device, to induce users' habitual use behaviors.

Who’s Watching TV?

This work addresses the problem of “user disambiguation”—estimating the likelihood of each member of a small group using a shared account or device. The specific focus is on television set-top box (STB) viewership data in multiperson households, in which it is impossible to tell with certainty which household members watch what. We formulate user disambiguation as a predictive problem and develop a solution for estimating the likelihood that each individual in a multiperson household watches each TV segment. This method learns priors for viewership in single-person households and then adapts them to the specifics of each multiperson household’s viewership history. We formalize two ad hoc heuristics that are currently used in industry (and research) for estimating audience composition of STB data and conduct a comparative analysis using three data sources: simulated data, real large-scale viewership data, and fully labeled panel data. The results show that our method has superior performance. This approach has practical value for both advertisers and researchers who seek better understanding of TV viewership. It also has applications beyond TV advertising, such as detecting the sharing of streaming passwords among multiple households or any other situation in which multiple users share devices or accounts.

Consequences of Enterprise Social Media Network Positions for Employees

Employees often use enterprise social media (ESM) for communication, collaboration, and knowledge sharing, leading to ESM networks–that is, social networks of interrelated employees based on ESM. Many organizations possess ESM networks, and there is increasing research on their consequences for employees depending on how these employees are positioned in such networks. ESM network research is complex and consists of various interrelated dimensions. However, a synthesis of the abovementioned studies is lacking. Therefore, the current body of knowledge may obfuscate how the different dimensions interrelate, impeding a more holistic understanding of the consequences that employees may experience depending on their network positions. Moreover, there is little understanding of which research topics in this area have been addressed to date and where further research is needed. This paper addresses these gaps by means of a literature review and research agenda that synthesizes past studies. The results emphasize that whether ESM are beneficial for and exert a positive influence on employees largely depends on the employees’ positions in the underlying networks.

How have firms transformed and executed IT-enabled remote work initiatives during the COVID-19 pandemic? Conceptualization and empirical evidence from Spain

This paper examines how firms have transformed and executed IT-enabled remote work initiatives during the COVID-19 pandemic. After examining archival data on a sample of 100 firms in Spain, we discover three types of IT-enabled remote work firm's strategies: leader, agile, and survival. Leader companies have a competitive advantage over agile companies, which in turn have a competitive advantage over survival organizations. We find that firm size was crucial to executing remote work firm's initiatives as a leader or survival. The industry significantly affected the implementation of remote work firm's initiatives during the three pivotal periods in the telecommunications industry.

Adolescent Aggressive Riding Behavior: An Application of the Theory of Planned Behavior and the Prototype Willingness Model

Cycling has always been popular in China, especially during the years when the government encouraged green travel. Many people participate in rides to ease traffic congestion and increase transfer convenience. Due to the disorganized and tidal nature of cycling, cyclists create many conflicts with other groups. Adolescents are vulnerable road users with a strong curiosity and risk-taking mindset. Identifying the factors influencing adolescents’ aggressive riding behavior can assist in developing strategies to prevent this behavior. An online questionnaire was used to collect data on bicycling among students in a middle school in Guangzhou, China. The theory of planned behavior (TPB) and prototype willingness model (PWM) have been applied to study travel behavior and adolescent risk behavior. To investigate the impact of psychological variables on adolescent aggressive behavior, we used TPB, PWM, TPB + PWM, and an integrated model. Behavioral intentions are greatly influenced by attitudes, subjective norms, and perceived behavioral control. Both descriptive and moral norms played a role in behavioral willingness. The integrated model explained 18.3% more behavioral variance than the TPB model. The social reactive pathway explained more variance in behavior than the rational path.

Emerging IT investments and firm performance: a perspective of the digital options

Purpose

This study aims to explore the mediating effect of digital options on the relationship between emerging information technology investments (ITIs) and firm performance (FP). In particular, it analyses the performance impacts of investments in five emerging technologies of IT or non-IT firms.

Design/methodology/approach

Secondary data are collected from Chinese A-share listed companies from 2010 to 2018. The authors propose an econometric model focusing on the impact of ITIs on a firm’s market value and profit. A propensity score matching model is applied to control endogeneity.

Findings

The ITIs’ effect on FP is found to be completely mediated by digital options, and the reach of digital options plays a more positive role in the relationship between ITIs and Tobin’s Q, whereas the richness of digital options is stronger between ITIs and return on net assets (ROE). The group study shows that the impact of process technologies such as cloud computing and the Internet of Things has a more profound impact on Tobin’s Q, and the knowledge technologies represented by artificial intelligence, blockchain and big data strongly affect ROE. In addition, the positive relationship between ITIs and FP is unrelated to IT/non-IT firms.

Research limitations/implications

First, the data are based on 219 publicly announced emerging ITIs in China and thus may not be generalizable to other cultural/national contexts. Second, there is a lack of a large sample data set of emerging ITI information in China, and the duration of this study is constrained to the relatively short rise of emerging technologies.

Practical implications

This study provides firm decision-makers with practical implications. The results imply that the effect of ITIs on FP depends on digital options, so both IT firms (e.g., Big Tech giants) and non-IT firms (e.g., incumbents) should discover how to balance firm value and profit in their management of emerging technology investment projects with digital options thinking.

Originality/value

To the best of the authors’ knowledge, this is the first empirical study to investigate the relationship between ITIs and FP from the perspective of digital options, exploring five emerging technologies and considering firm life, size, and state ownership in a sample of Chinese listed firms.

International business in the digital age: Global strategies in a world of national institutions

Digital technologies are changing how businesses strategize and organize internationally. They not only enable cost reduction in businesses crossing national boundaries but also enable novel types of products and business models. Yet, barriers to cross-border businesses persist or even re-emerge, such that the study of international business remains important in the digital age, but may have to shift focus. We argue that businesses operating internationally develop digital business strategies that are interdependent with their internationalization strategies. In doing so, they have to account for differences across national contexts including informal institutions, formal institutions, and resource endowments. We offer a conceptual framework linking external and internal antecedents to digital business and internationalization strategies. We focus in particular on three digital strategies: owning digital platforms, participating in digital platforms, and transforming traditional businesses for the digital world. On this basis, we discuss the contributions of the papers in this special issue and conclude by outlining an agenda for future research.

Antecedents and Consequences of Streamer Trust in Livestreaming Commerce

Livestreaming commerce has become the mainstream of e-commerce in recent years. The key difference between livestreaming commerce and traditional e-commerce lies in the presence of the streamer. However, there are few studies that examine the significant role of streamer trust in the focal context. In our study, based on the cognitive-affective-conative (C-A-C) framework, we develop a research model to explore antecedents of streamer trust and its important role in influencing consumers' purchasing behavior. Using the survey method, we find that (1) antecedents, including interactivity, informativeness, personal impulsiveness as well as the attitude toward livestreaming shopping are positively associated with streamer trust; (2) streamer trust is positively associated with consumers' purchasing intention; (3) livestreaming value has significant moderating effects on interactivity and informativeness but not on personal impulsiveness and attitude toward livestreaming shopping. Both theoretical and practical implications are discussed.

Which Enemy to Dance with? A New Role of Software Piracy in Influencing Antipiracy Strategies

This paper studies how software firms should determine their antipiracy efforts and product prices. There are two unique aspects of our model. First, antipiracy efforts have both a direct effect and a cross effect on software piracy. Second, we capture two types of competitions when piracy exists: one between a legitimate product and its pirated counterpart, and the other between two pirated products. We show that due to pirated products’ buffer effect not studied before, eliminating piracy does not necessarily mean higher profit for firms. This reveals an unexplored advantage of desktop software comparing with Software as a Service that can eliminate piracy. Direct and cross effects have different impacts on firms’ decisions and profits. Opposite to what one might expect, when a firm’s antipiracy effort becomes more effective in increasing the cost of pirating its own product but not its competitor’s product, the firm becomes worse off under certain conditions. By contrast, if the effort’s cross effect is higher, therefore increasing the cost of pirating its competitor’s product, a firm will always be better off. The managerial implication is that if a firm ignores the cross effect, it could under-invest in anti-piracy effort, causing its profit to suffer.

A review on the sequential ordered behaviour of users’ experiential values, flow state and continuing use of mobile apps

This study investigates whether experiential values, such as escapism, enjoyment, social affiliation, visual appeal and entertainment, affect users’ cognitive flows, as suggested by the grand theories. Meanwhile, this study dismisses the inverse relationship in which flow states affect experiential values. Instead, this study demonstrates that pleasure and enjoyment are antecedent factors of cognitive involvement. In other words, it can be constructed to show that experiential values are an antecedent factor of users’ involvement. Furthermore, this study found that its sequential order had more reasonable validity than the inverted association. Moreover, it explains that the experiential values influencing users’ cognitive flows are relevant in occupational and cognitive behavioural therapies. Thus, the authors infer that a firm could pervasively influence users’ experiential values, and this process will end with their cognitive flows. Therefore, it implies that ordered logic construction is practical when it can affect users’ experiential values, flow states and usage.

Evaluating patient and neurosurgeon perspectives on virtualisation of neurosurgery clinics in the COVID-19 era: a prospective mirror survey study

BACKGROUND

The COVID-19 pandemic has compelled a global shift in healthcare service delivery towards virtualisation, including in Neurosurgery. Our study aims to elucidate the patient and neurosurgeon perceptions of virtual neurosurgery consultations (VNCs) and formulate a guidance algorithm based on our experience.

METHODS

Between June 2020 and December 2020, we prospectively surveyed patients and neurosurgeons following their VNCs using a 10-item survey (four qualitative and six five-point Likert scale questions). Non-parametric hypothesis testing and grounded coding with inter-coder agreement was used to analyse quantitative and qualitative data, respectively.

RESULTS

106 patients and 10 neurosurgeons completed the survey. Wilcoxon rank-sum test revealed a statistically significant difference between the neurosurgeon and patient responses (p < 0.001). Patients perceived VNCs benefits to be enhanced efficiency (n = 142) and communication (28); and VNCs drawbacks as safety (46), technological (32), and administration (15) issues. Neurosurgeons perceived VNCs benefits to be enhanced efficiency (13), reduced COVID-19 exposure (2); and VNCs drawbacks as examination practicality (14), technological (6), and concerns for patients (6). Neurosurgeons perceived the relative indications for VNCs as postoperative follow-up clinics, and scan result discussions; and relative contraindications as neuro-oncology, new patients, and patients with worsening neurological symptoms.

CONCLUSIONS

Our mirror-survey study provides preliminary evidence that VNCs render increased efficiency, communication, and safety in the current COVID-19 era. Going forward, we believe that further improvements in technology and administration are necessary, greater neurosurgeon appreciation of the patient-perceived benefits of VNCs is required, and neurosurgeons are to exercise clinical discernment on when to use VNCs.Key PointsWhat are the perceptions of patient and consultant neurosurgeons towards virtual neurosurgery consultations (VNCs)?Patient-perceived benefits of VNCs: enhanced efficiency/communication; VNC drawbacks: safety, technological, and administration issues. Neurosurgeon-perceived VNCs benefits of VNCs: enhanced efficiency, reduced COVID-19 exposure; VNC drawbacks: examination practicality, technological, and concerns for patients.Post-operative reviews and scan result discussions are perceived relative indications for VNCs; whereas new patient consultations, neuro-oncology and patients with new-onset neurological deficits are perceived relative contraindications for VNCs.Improvement in technology and administration is necessary; greater neurosurgeon appreciation of patient-perceived VNCs benefits is required, and neurosurgeons are to exercise clinical discernment on when to use VNCs.

Tensions between the Professions: How Integrated Care Can Benefit from Better Understanding and Managing Conflicting Perspectives and Demands

In the transition from fragmented to integrated care, tensions are inevitable. Contradictions between the actors of the different professions involved can have negative but also positive effects on change processes in the healthcare system. This is especially true for integrated care, where collaboration among the workforce is pivotal. Therefore, efforts should not be made to avoid tensions from the outset, if this is at all possible, but to deal with them constructively. The attention of leading actors must be increased to recognize, analyse, and successfully manage tensions. The creative potential of tensions can be harnessed to successfully implement integrated care and engage the diverse workforce.

Perceptions of information continuity key to understanding quality of post-acute care transitions

BACKGROUND

Skilled nursing facilities' (SNFs) ability to provide optimal post-acute care depends on effective receipt of information from hospitals ("information continuity"). Little is known about how SNFs perceive information continuity and how it may relate to upstream information sharing processes, organizational context, and downstream outcomes.

PURPOSE

First, this study aims to identify how SNF perceptions of information continuity may be shaped by hospital information sharing practices, including measures of completeness, timeliness, and usability, as well as characteristics of the transitional care environment (i.e., integrated care relationships and/or consistency of information sharing practices across different hospital partners). Second, we analyze which of these characteristics are associated with quality of transitional care (measured by 30-day readmissions).

APPROACH

A cross-sectional analysis of nationally representative SNF survey ( N = 212) linked to Medicare claims was performed.

RESULTS

SNF perceptions of information continuity are strongly and positively associated with hospital information sharing practices. Adjusting for actual information sharing practices, SNFs that experienced discordance across hospitals reported lower perceptions of continuity (β = -0.73, p = .022); evidence of stronger relationships with a given hospital partner appears to help facilitate resources and communication that helps to close this gap. Perceptions of information continuity, more so than the upstream information sharing processes reported, exhibited a more reliable and significant association with rates of readmissions as an indicator of transitional care quality.

CONCLUSION

SNF perceptions of information continuity are strongly associated with patient outcomes and are reflective of both hospital information sharing practices as well as characteristics of the transitional care environment that can mitigate or amplify the cognitive and administration challenge of their work.

PRACTICE IMPLICATIONS

Improving transitional care quality requires that hospitals improve information sharing behaviors but also invest in capacity for learning and process improvement in the SNF environment.

Development of the information quality scale for health information supply chain type 2 diabetes mellitus management using exploratory factor analysis

Background

Research on the quality scale of the healthcare supply chain is still limited. This study aimed to assess the information quality of the supply chain model with a focus on construct validity. Studies related to information quality measurement generally focus on measuring the dimensions of the completeness of medical records and consumer perspectives. We intended to assess the scale based on doctors needed as care coordinators on type 2 diabetes mellitus or the Non-Insulin-Dependent-Diabetes-Mellitus (NIDDM) program in primary healthcare.

Methods

Sixty-four primary healthcare doctors with an age range of 24-51 years were involved in this research. The scale obtained was formed from the assessment of the point of view of a panel of experts through the content validity index (CVI). The exploratory factor analysis (EFA) method was used to explore the scale of information quality in the information supply chain model for the NIDDM chronic disease management program.

Result

The data analysis results indicated three main factors that affected the quality of the information supply chain model of NIDDM, namely accessibility, safety, and efficiency of information related to NIDDM. The results of the validity and reliability of the data showed that the scale used in this research was valid and reliable with a Cronbach alpha coefficient of 0.861.

Conclusion

The scale developed in this research could be used to explore the quality of the information supply chain of NIDDM management in primary healthcare. Each item on the scale could explain the variables according to their respective groups.

Explaining Firm Performance During the COVID-19 With fsQCA: The Role of Supply Network Complexity, Inventory Turns, and Geographic Dispersion

The COVID-19 pandemic has significantly affected firm performance. As a result, many studies have examined the significance of supply network complexity. Our paper uses the fuzzy set qualitative comparative analysis (fsQCA) method to investigate the causal relationships among the supply network complexity, geographic dispersion, inventory turns, and firm performance. Using a sample of 263 Chinese listed firms, we find that no single factor is necessary to achieve high firm performance during COVID-19 and reveal four paths to produce high performance: operational level driven, supply base complexity driven, and customer base complexity driven with supplier distance, and supply network complexity absence. Furthermore, our findings suggest that supply-based complexity-driven and customer-based complexity-driven can improve firm performance, but not all supply network complexity dimensions can improve firm performance. Hence, firms need to choose the suitable path based on their specific situations.

The effect of fear and situational motivation on online information avoidance: The case of COVID-19

During the COVID-19 pandemic, a plethora of online sources for information and news dissemination have emerged. Extant research suggests that very quickly, individuals become disinterested and begin avoiding the information. In this study, we investigate how an individual's fear and situational motivation impact Online Information Avoidance. Using the self-determination theory and information avoidance theories, we argue that fear and external regulation are associated with increased Online Information Avoidance. We also argue that intrinsic motivation and identified regulation are associated with a decrease in Online Information Avoidance. Our findings suggest that fear, intrinsic motivation, and external regulation drive Online Information Avoidance, where intrinsic motivation is the most significant driver. We also found that identified regulation is a crucial inhibitor of Online Information Avoidance. While focusing on COVID-19, our study contributes to the broader information systems research literature and specifically to the information avoidance literature during a pandemic or a prolonged crisis. Our study's findings will be useful for governments, health organizations, and communities that utilize online platforms, forums, and related outlets to reach larger audiences for disseminating pertinent information and recommendations during a crisis.

How digitalization reinvented entrepreneurial resilience during COVID-19

The emergence of new digital technologies has transformed entrepreneurship and, very likely, enabled many new and established ventures to avoid bankruptcy throughout the COVID-19 pandemic. Digital technologies are key to identifying, evaluating and exploiting opportunities, scaling a venture's competitiveness, improving efficiency and innovating, especially during uncertain times. We explore how digital technologies reinvented entrepreneurial resilience during the COVID-19 pandemic and distill the digital artifacts, platforms and infrastructures used by entrepreneurs to demonstrate entrepreneurial resilience. We analyzed 42 reflective interviews featuring successful entrepreneurs from How I Built This "Resilience Series" podcast that explore how entrepreneurs responded to the COVID-19 crisis. We adopted a systematic approach to identify and describe the behaviors, actions and strategies related to digitalization to reinvent the business in the uncertain and resource-constrained context of COVID-19. The data analysis yielded thirteen first-order codes categorized into five second-order themes: creative digital pivoting, digital infrastructures, social impact through digital technology, burdens to digital adoption, and growth through digitalization. These second-order themes reveal to function as both enablers and barriers to entrepreneurial resilience in this adverse context. Our exploratory analysis suggests how digitalization influences entrepreneurial resilience.

Empirical study of factors that influence the perceived usefulness of online mental health community members

Online mental health communities have become a major platform where individuals can talk about their mental health problems and obtain social support. This study aims to understand the antecedents of perceived usefulness among members in an online mental health community, while providing reference for the managers and users of online mental health communities. We obtained a total of 143,190 posts from ReachOut.com released by the CLPsych2017 shared task. Then, we used text mining to derive the independent and dependent variables. Next, a structural equation model observing the perceived usefulness of online mental health community members was constructed from the perspective of an information adoption model. The informativeness of help-seeking posts had a significant positive relationship with the information quality of reply posts; the information quality of reply posts was a significant positive predictor of perceived usefulness, with the information quality of reply posts partially mediating the relationship between the informativeness of help-seeking posts and perceived usefulness. The information provided by online mental health community members' help-seeking posts and the quality of replies were found to be the factors that influenced perceived usefulness. This study highlights the importance of the information quality of reply posts and provides useful insights for administrators who can help users to improve their response quality and obtain the support they need.

Understanding smart education continuance intention in a delayed benefit context: An integration of sensory stimuli, UTAUT, and flow theory

Smart education is a combination of AI and education, and its benefits are delayed. Existing research lacks an understanding of smart education continuance intention in the context of this delayed benefit. Thus, this study aimed to examine users' continuance intention in a delayed benefit context by integrating sensory stimulus, the extended UTAUT, and flow theory. The study focused on a mobile-based smart education (MBSE) system (Liulishuo) and collected data on 494 MBSE users. The PLS-SEM analysis suggested that the model is largely supported. Identifying MBSE's technical attributes as sensory stimuli, the extended UTAUT as primary information processing, flow as secondary information processing, and continuance intention as a decision, this study verifies the relationships between various constructs and their influence on MBSE continuance intention. The results also indicate that a user's flow state plays a crucial role in strengthening continuance intention and realizing the delayed benefits of smart education. Thus, this study provides a deeper understanding of continuous usage mechanisms as they relate to smart education.

Critical risk and success factors for sustainability of an electronic health data capture, processing and dissemination platform for Uganda

Several studies have investigated challenges that have marred success or even caused the failure of eHealth implementations in Uganda; however, none has focused on the risks and success factors of their sustainability. This study explored critical risk and success factors for the sustainability of an electronic health data capture, processing and dissemination platform for Uganda. A mixed-method research design was followed involving collecting empirical data from all four regions of Uganda. A purposive sampling strategy was used to select the study districts per region, health facilities per district, and respondents/participants per facility or district. Findings revealed several risks and success factors for sustainability, including; bad leadership, corruption, lack of sustainable maintenance programs, lack of suitable sustainability plans, lack of ICT infrastructure investment, poor management systems, funds, stakeholder buy-ins, data sharing and access rights. The success factors included reinvestments as a partial sustainability plan for ICT infrastructure. These factors can be leveraged to ensure the continued operation of eHealth implementations in Uganda. Every electronic health project aiming at success should always make due consideration/sustainability plan at the onset of project conceptualisation; as lack of such a plan has often resulted in failed projects after the initial funds have been withdrawn.

Perceived household financial decline and physical/mental health among adolescents during the COVID-19 crisis: Focusing on gender differences

COVID-19 has worsened adolescents' mental and physical health. Several studies have reported that the effect may be greater in girls; however, relevant socio-ecological factors have not been examined. This study aimed to examine the factors associated with physical and mental health status among adolescents and the moderating role of gender on the relationship between physical and mental health status and perceived household financial decline. We analyzed the cross-sectional 2020 Korea Youth Risk Behavior Web-based Survey (KYRBS) collected between August and November 2020 in South Korea. It included 54,809 adolescents (28,269 males and 26,540 females), on average aged 15.1. We conducted ordinary least squares (OLS) regressions to examine the factors associated with physical and mental health outcomes. Gender differences were observed in associated factors. Then, we tested the moderating effect of gender by including an interaction term between gender and perceived household financial decline due to the COVID-19 pandemic. Perceived household financial decline due to COVID-19 negatively affected both groups. Perceiving moderate and severe financial decline due to COVID-19 is negatively associated with self-rated health among female adolescents than male counterparts. Female adolescents were also more vulnerable to mental health outcomes (i.e., distress, anxiety, and loneliness) when they perceived severe or moderate household financial decline due to COVID-19 compared to their male peers. Our findings suggest that female adolescents are more vulnerable to household financial shocks due to COVID-19, especially in households that have experienced a severe decline. We suggest the need for gender-sensitive policy interventions for adolescent mental health.

Impact of uncertainty intolerance on clinical reasoning: A scoping review of the 21st-century literature

RATIONALE, AIMS AND OBJECTIVES: Clinical reasoning is currently extensively studied to find out how to make proper diagnoses. Literature indicates that intolerance of uncertainty (IU) may have a strong negative impact on clinical reasoning. We summarize the various consequences of IU on clinical reasoning.

METHODS

A scoping review was conducted using relevant keywords to scientific databases (i.e., Google Scholar, Medline, PsycINFO and PBSC) from September to November 2021. Complementary research included relevant articles and articles retrieved through Google Scholar's alert system. We included articles about healthcare professionals as defined by the French Public Health Code (As defined here: https://www.vie-publique.fr/fiches/37855-categories-de-professionnels-de-sante-code-se-la-sante-publique), and articles reporting on the impact of IU or uncertainty management on clinical reasoning.

RESULTS

We retrieved 1853 articles, of which 8 were kept for final analysis considering our inclusion criteria. Two behaviour categories were affected by uncertainty intolerance: investigative and prescriptive behaviours. Regarding the investigation process, mismanagement of uncertainty appeared to lead to reasoning bias, potentially resulting in diagnostic errors. IU was associated with withholding information, more referrals to peers and less use of new medical interventions. Regarding prescription behaviours, IU among health professionals could lead to overprescribing unnecessary or dangerous tests. IU was also associated with more antibiotic prescriptions for conditions where antibiotics are to be used carefully.

CONCLUSION

Few studies have yet addressed the impact of IU on clinical reasoning. IU's influence is primarily observed on investigative and prescribing behaviours. More studies are needed to fully understand the impact of IU on clinical reasoning itself, and not only on practical consequences.