Global pandemic and business performance: impacts and responses

The COVID-19 pandemic is anticipated to continue to the year 2022 and could lead to several business failures if entrepreneurs do not respond adequately. Thus, the purpose of this study is to introduce a framework that captures the impacts and potential responses to the ongoing pandemic. To do that, we conducted telephone interviews with ten entrepreneurs who operate enterprises within Nigeria. Data collected for analysis were transcribed, chronologically arranged, coded, and thematically analyzed using NVivo. Our findings revealed that, during the pandemic, businesses experienced limited opening hours, a decline in their clients' patronage, lower turnover, and employee demotivation. In response, business owners should consider re-strategizing their business activities, maintaining connections with clients, and exploiting available support measures. Our findings have profound theoretical and practical implications. For entrepreneurs and policymakers, they offer insights into the form of challenges confronting businesses during a pandemic. It also provides response activities that entrepreneurs could adopt to mitigate the impact of an epidemic on their enterprises’ performance. For the field of entrepreneurship, it advances the need to integrate public health (health-related issues) into entrepreneurship study and consider its multiple levels of influence on the performance of businesses

Baseline self-report 'central mechanisms' trait predicts persistent knee pain in the Knee Pain in the Community (KPIC) cohort.

OBJECTIVES: We investigated whether baseline scores for a self-report trait linked to central mechanisms predict 1 year pain outcomes in the Knee Pain in the Community cohort. METHOD: 1471 participants reported knee pain at baseline and responded to a 1-year follow-up questionnaire, of whom 204 underwent pressure pain detection thresholds (PPTs) and radiographic assessment at baseline. Logistic and linear regression models estimated the relative risks (RRs) and associations (β) between self-report traits, PPTs and pain outcomes. Discriminative performance for each predictor was compared using receiver-operator characteristics (ROC) curves. RESULTS: Baseline Central Mechanisms trait scores predicted pain persistence (Relative Risk, RR = 2.10, P = 0.001) and persistent pain severity (β = 0.47, P < 0.001), even after adjustment for age, sex, BMI, radiographic scores and symptom duration. Baseline joint-line PPTs also associated with pain persistence (RR range = 0.65 to 0.68, P < 0.02), but only in univariate models. Lower baseline medial joint-line PPT was associated with persistent pain severity (β = -0.29, P = 0.013) in a fully adjusted model. The Central Mechanisms trait model showed good discrimination of pain persistence cases from resolved pain cases (Area Under the Curve, AUC = 0.70). The discrimination power of other predictors (PPTs (AUC range = 0.51 to 0.59), radiographic OA (AUC = 0.62), age, sex and BMI (AUC range = 0.51 to 0.64), improved significantly (P < 0.05) when the central mechanisms trait was included in each logistic regression model (AUC range = 0.69 to 0.74). CONCLUSION: A simple summary self-report Central Mechanisms trait score may indicate a contribution of central mechanisms to poor knee pain prognosis

Knee pain and related health in the community study (KPIC): a cohort study protocol

Background: The incidence, progression and related risk factors for recent-onset knee pain (KP) remain uncertain. This study aims to examine the natural history of KP including incidence and progression and to identify possible phenotypes and their associated risk factors. Methods: A prospective community-based cohort of men and women aged 40 years or over within the East Midlands region (UK) will be recruited via a postal questionnaire from their general practices. The questionnaire will enquire about: presence and onset of KP; pain severity (0–10 numerical rating scale (NRS)); pain catastrophizing and neuropathic-like pain (NP) using the painDETECT questionnaires (definite NP scores ≥19–38); risk factors for KP and/or osteoarthritis (OA) (age, body mass index, constitutional knee alignment, nodal OA, index: ring finger length (2D4D) ratio); quality of life (SF12); and mental health (Hospital Anxiety and Depression Scale). Clinical assessments will be undertaken in a sample of 400 participants comprising three groups: early KP (≤3 year’s duration), established KP (>3 years) and no KP. Assessments will include knee radiographs (standing semi-flexed and 300 skyline views); knee ultrasound (synovial effusion, hypertrophy, and Doppler activity); quantitative sensory testing; muscle strength (quadriceps, hip abductor, and hand-grip); balance; gait analysis (GAITrite); and biomarker sampling. A repeat questionnaire will be sent to responders at years 1 and 3. The baseline early KP group will undergo repeat assessments at year 1 (apart from radiographs) and year 3 (with radiographs). Any incident KP individuals identified at year 1 or 3 questionnaires will have clinical and radiographic assessments at the respective time points. Discussion: Baseline data will be used to examine risk factors for early onset KP and to identify KP phenotypes. Subsequent prospective data, at least to Year 3, will allow examination of the natural history of KP and risk factors for incidence and progression. Trial registration: The study was registered on the clinicaltrials.gov portal: NCT02098070) on the 14th of March 2014

Women’s entrepreneurship, health-related crisis and a gender-sensitive crisis management model for sustainable development

A crisis often impacts women’s entrepreneurship in ways different from their male counterparts, highlighting the need for a customised response strategy specific to women entrepreneurs. Thus, the purpose of this study is to introduce a crisis management model that can guide the formulation of policies to facilitate the sustainability of women’s entrepreneurial activities before, during, and after a health-related crisis within developing economies. To address the purpose of this study, we utilised a case study research design that involved the in-depth interview of four women entrepreneurs who operated small businesses in Lagos, Nigeria. The interview sessions were audio-recorded and transcribed verbatim. NVivo was used to code and analyse the transcripts thematically. This study contributes to the crisis management literature by introducing a gender-sensitive perspective to manage health crises. Such a gender-sensitive framework is crucial as it offers stakeholders the foundation for building customised policies that can profoundly affect women-owned businesses. For women entrepreneurs, this study offers insights into strategies that can be put in place before and during a crisis to mitigate the adverse impacts of the crisis. Thus, this study advances a gender-sensitive perspective as a much more practical approach to better understand women’s entrepreneurial activities during a crisis

A clinical assessment tool to improve the use of pain relieving treatments in knee osteoarthritis

Purpose: Approximately 1 in 4 individuals in the UK over the age of 55 experience knee pain (KP), predominantly due to osteoarthritis (OA). Following treatment targeted at the affected knee, pain relief is reported in only 60%–80% of individuals with painful knee OA. This suggests that mechanisms occurring within the central nervous system (central mechanisms) also influence the KP experience. Although reduced pressure pain detection thresholds (PPTs) at sites distal to the affected joint can indicate central mechanisms, application of PPTs to clinical practice and population-based studies is limited. A feasible, validated questionnaire-based tool to help identify people with KP who may benefit more from centrally acting treatments could prove useful. This study aimed to develop a self-report scale which represents traits associated with central mechanisms in people with KP.Methods: Participants: 9506 individuals completed the Knee Pain and related health In the Community (KPIC) baseline survey. 2152 participants reporting KP were included in this study. 322 individuals with current KP and 98 with no pain undertook PPT assessment at the proximal tibia, distal to the index knee. Questionnaires: The KPIC baseline survey included self-report questionnaires for pain catastrophizing (Pain Catastrophizing Scale), pain patterns (ICOAP), neuropathic-like pain (modified pain DETECT), quality of life (SF-12), and mental health (Hospital Anxiety and Depression Scale). Also included were individual questions addressing the presence and onset of KP, pain severity, risk factors for KP and/or OA, fatigue, cognitive impact, pain distribution (Manikin), sleep. Item Selection: Items related to central mechanisms were selected according to predefined criteria (See Fig. 1): (i) strength of association to constructs measured by the host scale, using exploratory structural equation modelling (ESEM); (ii) expert opinion on relevance to central mechanisms (inter-rater agreement k* ≥ 0.60); (iii) adequate targeting indicated b

Additional file 2: of Knee pain and related health in the community study (KPIC): a cohort study protocol

Modified body pain mannequin used to identify fibromyalgia (DOCX 163 kb

Investigating musculoskeletal health and wellbeing; A cohort study protocol

© 2020 The Author(s). Background: In an ageing population, pain, frailty and disability frequently coexist across a wide range of musculoskeletal diagnoses, but their associations remain incompletely understood. The Investigating Musculoskeletal Health and Wellbeing (IMH&W) study aims to measure and characterise the development and progression of pain, frailty and disability, and to identify discrete subgroups and their associations. The survey will form a longitudinal context for nested research, permitting targeted recruitment of participants for qualitative, observational and interventional studies; helping to understand recruitment bias in clinical studies; and providing a source cohort for cohort randomised controlled trials. Methods: IMH&W will comprise a prospective cohort of 10,000 adults recruited through primary and secondary care, and through non-clinical settings. Data collection will be at baseline, and then through annual follow-ups for 4 years. Questionnaires will address demographic characteristics, pain severity (0-10 Numerical Rating Scale), pain distribution (reported on a body Manikin), pain quality (McGill Pain Questionnaire), central aspects of pain (CAP-Knee), frailty and disability (based on Fried criteria and the FRAIL questionnaire), and fracture risk. Baseline characteristics, progression and associations of frailty, pain and disability will be determined. Discrete subgroups and trajectories will be sought by latent class analysis. Recruitment bias will be explored by comparing participants in nested studies with the eligible IMH&W population. Discussion: IMH&W will elucidate associations and progression of pain, frailty and disability. It will enable identification of people at risk of poor musculoskeletal health and wellbeing outcomes who might be suitable for specific interventions, and facilitate generalisation and comparison of research outcomes between target populations. The study will benefit from a large sample size and will recruit from diverse regions across the UK. Purposive recruitment will enrich the cohort with people with MSK problems with high representation of elderly and unwell people. Trial registration: Clinicaltrials.gov NCT03696134. Date of Registration: 04 October 2018