The other side of the coin: advancing sustainability in the supply chain from a small supplier's standpoint

In recent years, increased attention has been devoted to exploring how sustainability practices can be implemented in supply chains and networks. Much of the operations management literature in this area has mainly focused on the large buying firms perspective, looking at how they devise standards and push suppliers to comply with them. Little has been done to uncover how small and medium size (SME) suppliers react to and cope with increasing sustainability requirements with limited capabilities in hand. This paper is an attempt to fill this gap and initiate conceptual thinking from a suppliers perspective. Qualitative insights from case studies of both developing and developed countries suppliers are offered. We draw on the sensemaking literature and propose the concept of "sustainability dissonance" to conceptualise the situation of uncertainty and ambiguity that SME suppliers are confronted to when facing multiplying sustainability requirements. A number of propositions are articulated related to suppliers interpretations and reactions when dealing with "sustainability dissonance". The article sets out a number of avenues for future research

Feminist contributions on sexual experiences of women with serious mental illness: a literature review

This paper aims to explore the contributions of research that include gender perspective in analysing the sexual experiences of women diagnosed with serious mental illness and to identify any barriers and systems that impede sexual fulfilment. We have developed a qualitative literature review using the PRISMA statement. The databases SCOPUS, WOS and PsychINFO were used in this review. Studies were included if they were published up to March 15, 2022, and only studies in English were included. An initial database search was preformed; upon screening for eligibility, there remained 16 studies that explored the sexual experiences of women with diagnoses of serious mental illness. The studies were analysed by a thematic synthesis. Data was coded line-by-line which generated descriptive themes, resulting in four synthesised findings. The four synthesised findings that derived from the reviewed studies were stigma and subjectivity, the experience of interpersonal relationships, the socialisation of women and the effects of psychiatric hegemony. A feminist perspective highlights the interrelationship between gender and stigma as it relates to serious mental illness and sexuality. A feminist perspective and an intersectional approach should be adopted at the intersubjective and structural level to account for the complexity of human experience and to subvert the heteropatriarchal system

Mechanisms of Carbapenemase-Mediated Resistance among High-Risk \u3cem\u3ePseudomonas aeruginosa \u3c/em\u3e Lineages in Peru

Objectives: Pseudomonas aeruginosa is one of the leading causes of healthcare-associated infections globally. High-risk carbapenemase-encoding P. aeruginosa clones are disseminating in many regions. The aim of this study was to learn more about the lineages and mechanisms of resistance of P. aeruginosa circulating in Peru. Methods: A total of 141 carbapenemase-producing isolates recovered from hospitalized and ambulatory patients in Lima were sequenced and analyzed to infer their lineages through whole-genome sequence typing (wgST) and to identify their antimicrobial resistance genes. Results: wgST identified nine sequence types (STs); ST111 and ST357 were the most frequently encountered (44.0% and 38.3%, respectively), followed by ST179 (8.5%), with the remaining six detected only sporadically. Among ST357 isolates, 96.3% carried the novel blaIMP-93 allele, whereas the remainder harbored blaIMP-74. 74.2% of ST111 isolates co-harbored blaIMP-18 and blaVIM-2, while the rest carried either of these genes individually. All other ST lineages carried a single carbapenemase, which was either blaIMP-16, blaIMP-74, or blaVIM-2. Conclusion: Our study shows that the high-risk P. aeruginosa clones ST357, which harbors the novel blaIMP-93, and ST111, which carries blaIMP-18 and blaVIM-2, have apparently become endemic in the region

Elevated expression of the chemokine-scavenging receptor D6 is associated with impaired lesion development in psoriasis

D6 is a scavenging-receptor for inflammatory CC chemokines that are essential for resolution of inflammatory responses in mice. Here, we demonstrate that D6 plays a central role in controlling cutaneous inflammation, and that D6 deficiency is associated with development of a psoriasis-like pathology in response to varied inflammatory stimuli in mice. Examination of D6 expression in human psoriatic skin revealed markedly elevated expression in both the epidermis and lymphatic endothelium in "uninvolved" psoriatic skin (ie, skin that was more than 8 cm distant from psoriatic plaques). Notably, this increased D6 expression is associated with elevated inflammatory chemokine expression, but an absence of plaque development, in uninvolved skin. Along with our previous observations of the ability of epidermally expressed transgenic D6 to impair cutaneous inflammatory responses, our data support a role for elevated D6 levels in suppressing inflammatory chemokine action and lesion development in uninvolved psoriatic skin. D6 expression consistently dropped in perilesional and lesional skin, coincident with development of psoriatic plaques. D6 expression in uninvolved skin also was reduced after trauma, indicative of a role for trauma-mediated reduction in D6 expression in triggering lesion development. Importantly, D6 is also elevated in peripheral blood leukocytes in psoriatic patients, indicating that upregulation may be a general protective response to inflammation. Together our data demonstrate a novel role for D6 as a regulator of the transition from uninvolved to lesional skin in psoriasis

Wind environment evaluation on major town of Malaysia

This study focus on wind flow or wind environment of residential areas in Peninsular Malaysia, Sabah and Sarawak. Natural wind flow is one of the most effective methods to help achieve the energy saving in large cities especially under the tropical climate like Malaysia. The weather in Malaysia is characterized by four monsoon regimes, namely, the southwest monsoon, northeast monsoon and two shorter periods of inter-monsoon seasons. For this study, the data of wind velocity in twentytwo (22) weather station in Malaysia obtained from Meteorological Department and considered in wind environment evaluations. Then that data of wind velocities will convert to 1.5 in height at all measuring points were calculated by using the law. The result compared by Table 2.2 in previous researches (Kubota and Miura et al., 2002). From the study, it was found out, in Malaysia there are only two type of wind. First type is weak wind means that area are discomfort thermal and the second type is comfort range to strong wind means that area are comfort thermal. The minimum value of mean wind speed from 2005 to 2009 is O.mis in mean temperature is over 2C at Sitiawan. For the maximum value of mean wind speed is I .7m/s in average value of mean temperature is 276C at Mersing. Base on results, it can be concluded that when considering wind flow at a residential area, terrace housing is not a suitable option for towns located on the south of the Peninsular. It was prefer for high-rise building because it was considered this location of towns was weak wind condition. On the other hand, the major towns exclude the south of the Peninsular including Sabah and Sarawak, they was under the comfort thermal. So, terrace housing or high-rise building is suitable option

Prevention and management of osteoporotic fractures by non-physician health professionals: a systematic literature review to inform EULAR points to consider

Objective To perform a systematic literature review (SLR) about the effect of non-pharmacological interventions delivered by non-physician health professionals to prevent and manage osteoporotic fractures. Methods Eight clinical questions based on two criteria guided the SLR: (1) adults >= 50 years at high risk of osteoporotic fracture and (2) interventions delivered by non-physician health professionals to prevent and manage osteoporotic fractures. Interventions focused on diagnostic procedures to identify risk of falling, therapeutic approaches and implementation strategies. Outcomes included fractures, falls, risk of falling and change in bone mineral density. Systematic reviews and randomised controlled trials were preferentially selected. Data were synthesised using a qualitative descriptive approach. Results Of 15 917 records, 43 articles were included. Studies were clinically and methodologically diverse. We identified sufficient evidence that structured exercise, incorporating progressive resistance training delivered to people who had undergone hip fracture surgery, and multicomponent exercise, delivered to people at risk of primary fracture, reduced risk of falling. The effectiveness of multidisciplinary fracture liaison services in reducing refracture rate was confirmed. There was insufficient evidence found to support the effectiveness of nutrients and falls prevention programmes in this patient population. Conclusion Despite study heterogeneity, our SLR showed beneficial effects of some interventions delivered by non-physician health professionals and the positive impact of multidisciplinary team working and patient educational approaches to prevent and manage osteoporotic fractures. These results informed a EULAR taskforce that developed points to consider for non-physician health professionals to prevent and manage osteoporotic fractures.This study was funded by the EULAR. Grant reference HPR 032.info:eu-repo/semantics/publishedVersio

Sexual and reproductive rights in women with a diagnosis of severe mental disorder: arguments and consensus of community mental health professionals

Con el objetivo de conocer los argumentos de profesionales de la salud mental en torno al ejercicio y/o vulneración de los derechos sexuales y reproductivos (DSR) de las mujeres con diagnóstico en trastorno mental grave (DTMG) y establecer prioridades para la investigación en intervención dentro del área, aplicamos el método Delphi para la obtención de información y un análisis del contenido temático para su análisis. Los resultados evidencian como el género interactúa con el estigma social asociado al DTMG como elementos que posicionan a las mujeres en situaciones de vulnerabilidad social, los cuales tienen efectos negativos sobre el ejercicio de sus DSR. Estos efectos están presentes tanto en el área de la sexualidad, caracterizada por el tabú y la medicalización, como en el área de la reproducción, caracterizada por la mirada incapacitante en torno a la maternidad y el control reproductivo. Asimismo, sitúan a las mujeres en posiciones de opresión que favorecen situaciones de abusos y maltratos. Se concluye destacando los elementos clave para la comprensión del fenómeno, los cuales serán de utilidad para el desarrollo de futuros análisis en el área: el estigma del DTMG, el ejercicio del poder simbólico sobre la construcción de la subjetividad y la reproducción de la exclusión social. Finalmente, proponemos líneas de acción social orientadas a revisar los recursos, el reconocimiento de la agencia de las mujeres con DTMG, y el establecimiento de procesos donde participen el saber científico y profesional, las mujeres y sus familias

Project INTEGRATE: An Integrative Study of Brief Alcohol Interventions for College Students

This paper provides an overview of a study that synthesizes multiple, independently collected alcohol intervention studies for college students into a single, multisite longitudinal data set. This research embraced innovative analytic strategies (i.e., integrative data analysis or meta-analysis using individual participant-level data), with the overall goal of answering research questions that are difficult to address in individual studies such as moderation analysis, while providing a built-in replication for the reported efficacy of brief motivational interventions for college students. Data were pooled across 24 intervention studies, of which 21 included a comparison or control condition and all included one or more treatment conditions. This yielded a sample of 12,630 participants (42% men; 58% first-year or incoming students). The majority of the sample identified as White (74%), with 12% Asian, 7% Hispanic, 2% Black, and 5% other/mixed ethnic groups. Participants were assessed two or more times from baseline up to 12 months, with varying assessment schedules across studies. This paper describes how we combined individual participant-level data from multiple studies, and discusses the steps taken to develop commensurate measures across studies via harmonization and newly developed Markov chain Monte Carlo algorithms for two-parameter logistic item response theory models and a generalized partial credit model. This innovative approach has intriguing promises, but significant barriers exist. To lower the barriers, there is a need to increase overlap in measures and timing of follow-up assessments across studies, better define treatment and control groups, and improve transparency and documentation in future single, intervention studies

Derechos sexuales y reproductivos en mujeres con diagnóstico de trastorno mental grave: argumentos y consensos de profesionales en salud mental comunitaria

This study explores the arguments of mental health practitioners around the exercise or infringement of sexual and reproductive rights of women with a severe mental health diagnosis, in order to both gain insight and establish priorities for further research and intervention actions in the field. Data has been collected applying the Delphy method and a thematic content analysis has been carried out.  The results and analysis show evidence that gender interacts with the social stigma associated with severe mental health conditions, positioning these women in vulnerable social situations, which has a negative effect on exercising their sexual and reproductive rights. These negative effects become evident both in the ambit of their sexuality, which appears characterized by taboo and medicalisation, and in the reproductory sphere, which is characterized by reproductive control and where they are seen as incompetent mothers. Because of the above generated views, these women are placed in oppressive and abusive situations.  In conclusion, the following elements have been identified for further research: stigma attached to diagnosis of the severe mental health condition, the exercise of the symbolic power over the construction of subjectivity and there production of social exclusion.  Finally, social action guidelines are proposed, leading to the revision of resources, the recognition of women with severe mental health conditions and the establishment processes with the participation of scientific and professional fields as well as the women and their families. Con el objetivo de conocer los argumentos de profesionales de la salud mental en torno al ejercicio y/o vulneración de los derechos sexuales y reproductivos (DSR) de las mujeres con diagnóstico en trastorno mental grave (DTMG) y establecer prioridades para la investigación en intervención dentro del área, aplicamos el método Delphi para la obtención de información y un análisis del contenido temático para su análisis.Los resultados evidencian como el género interactúa con el estigma social asociado al DTMG como elementos que posicionan a las mujeres en situaciones de vulnerabilidad social, los cuales tienen efectos negativos sobre el ejercicio de sus DSR. Estos efectos están presentes tanto en el área de la sexualidad, caracterizada por el tabú y la medicalización, como en el área de la reproducción, caracterizada por la mirada incapacitante en torno a la maternidad y el control reproductivo. Asimismo, sitúan a las mujeres en posiciones de opresión que favorecen situaciones de abusos y maltratos.Se concluye destacando los elementos clave para la comprensión del fenómeno, los cuales serán de utilidad para el desarrollo de futuros análisis en el área: el estigma del DTMG, el ejercicio del poder simbólico sobre la construcción de la subjetividad y la reproducción de la exclusión social. Finalmente, proponemos líneas de acción social orientadas a revisar los recursos, el reconocimiento de la agencia de las mujeres con DTMG, y el establecimiento de procesos donde participen el saber científico y profesional, las mujeres y sus familias

2019 EULAR points to consider for non-physician health professionals to prevent and manage fragility fractures in adults 50 years or older

Objective To establish European League Against Rheumatism (EULAR) points to consider for non-physician health professionals to prevent and manage fragility fractures in adults 50 years or older. Methods Points to consider were developed in accordance with EULAR standard operating procedures for EULAR-endorsed recommendations, led by an international multidisciplinary task force, including patient research partners and different health professionals from 10 European countries. Level of evidence and strength of recommendation were determined for each point to consider, and the mean level of agreement among the task force members was calculated. Results Two overarching principles and seven points to consider were formulated based on scientific evidence and the expert opinion of the task force. The two overarching principles focus on shared decisions between patients and non-physician health professionals and involvement of different non-physician health professionals in prevention and management of fragility fractures. Four points to consider relate to prevention: identification of patients at risk of fracture, fall risk evaluation, multicomponent interventions to prevent primary fracture and discouragement of smoking and overuse of alcohol. The remaining three focus on management of fragility fractures: exercise and nutritional interventions, the organisation and coordination of multidisciplinary services for post-fracture models of care and adherence to anti-osteoporosis medicines. The mean level of agreement among the task force for the overarching principles and the points to consider ranged between 8.4 and 9.6. Conclusion These first EULAR points to consider for non-physician health professionals to prevent and manage fragility fractures in adults 50 years or older serve to guide healthcare practice and education.HPR 032info:eu-repo/semantics/publishedVersio