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Strategic agility in the B2B sharing economy ecosystem of emerging economies: Empirical insights from the Middle East
No full textStrategic agility plays a critical role in enhancing business competitiveness. However, research on how business-to-business (B2B) organizations develop and implement strategic agility within the sharing economy ecosystem remains limited. This study, based on semi-structured interviews with 27 business owners and service/product providers from Egypt who engage in B2B interactions on sharing platforms, identifies two key dimensions of agility that strengthen brand identity and image in emerging markets: (1) the establishment and stabilization of payment frameworks between platforms and providers, and (2) the reinforcement of regulatory measures to ensure a stable working environment. Additionally, the paper examines business activities that facilitate rapid adaptation to external changes, enabling swift responses in B2B exchanges of goods, services, or resources. These findings enhance our understanding of the impact of strategic agility on B2B firms in the sharing economy of emerging markets and offer valuable implications for both research and practice
Accuracy of interpretation of nasogastric tube position on chest radiographs by diagnostic radiographers: A multi-case, multi-reader study
Get PDFIntroduction
Feeding via a misplaced nasogastric tube (NGT) is a common but preventable cause of patient harm. The aim of this study was to determine the accuracy of diagnostic radiographers’ assessment of NGT position on chest radiographs (CXRs) and safe-to-feed decisions.
Methods
A multi-case, multi-reader study was conducted using an online image interpretation platform. A test bank consisting of 15 CXRs with an NGT in-situ was created. Diagnostic radiographers without formal qualifications in CXR interpretation were recruited via two international conferences. Participants placed an electronic marker on each CXR to identify the location of the tip of the NGT and indicated whether or not they believed that the tube was safely positioned.
Results
68 participants were recruited. Each participant reviewed 15 CXRs, providing 1020 unique image assessments. 76 % (n = 778/1020) image assessments were completely correct (both the position of the tip of the NGT was accurately located and an appropriate safe-to-use decision made). In 5 % (n = 56/1020) of cases the NGT was safely positioned and the location of the tip was correctly identified by the participant but the tube was erroneously determined to be unsafe for feeding. In a further 6 % (n = 59/1020) of cases the participant correctly located the tip of an NGT in an unsafe position but indicated that the tube was safe to use. Participants failed to correctly identify the tip of the NGT in the remaining 12 % (n = 127/1020) of cases.
Conclusion
Consistent with previous studies involving other staff groups, diagnostic radiographers without formal qualification in CXR interpretation can assess NGT positioning on radiographs with moderate accuracy but require further training, including strategies for the identification of poorly-visualised tube tips, to achieve the 100 % accuracy necessary for this safety-critical task.
Implications for practice
A bespoke training programme which includes teaching on image quality, tube tip identification and assessment of tube positioning using the National Patient Safety Agency (NPSA) four criteria, should be delivered prior to implementation of a radiographer-led NGT CXR evaluation service
Learning to swim with back pain: A qualitative study of swimmers with chronic low back pain
No full textPurpose
Swimming is one form of exercise advised to people with chronic low back pain (CLBP), there is limited research, however, supporting this recommendation and describing the experience and use of swimming in this population. The aim of this study was to explore the experience of people who use swimming to manage CLBP.
Methods
Semi-structure interviews were conducted with 14 swimmers who were using swimming to manage CLBP. Thematic analysis was used to analyse the interview data, and the themes were mapped onto the capability, opportunity, motivation and behaviour (COM-B) model to understand the behavioural factors.
Results
Five common themes were developed during the analysis: (1) My back pain journey; (2) Learning to swim with back pain; (3) How swimming looks for me; (4) What I gain from swimming; and (5) Keep calm and carry-on swimming. The themes mapped onto all three COM-B domains.
Conclusions
The participants found that swimming was a valuable self-management tool for CLBP. The findings from the thematic and COM-B analysis indicate that learning to swim with CLBP can be a complex journey, influenced by several interrelated behavioural factors. In the absence of multi-professional support, inclusive swimming communities and accessible swimming venues, swimming participation rates may be affected
Exploring staff's experiences of advice and recommendations in mental health
No full textClinical guidelines have been used within mental health services for many years. Research has shown that implementing guidelines can help to improve treatment outcomes as well as staff and client satisfaction. However, there is evidence to show that guidelines are not routinely implemented within services, even when staff have the capacity and resources to do so. This suggests that there may be a barrier related to staff’s attitude towards guidelines that then affects whether they are implemented. This review sought to gather the current evidence on staff’s attitudes towards mental health guidelines and to identify what aspects they find helpful and unhelpful. A systematic search revealed 16 papers that were suitable for inclusion. All papers were qualitative studies and were analysed using thematic synthesis in order to extract themes which appeared across studies. Themes identified included: guidelines being tools for improving standards of care; guidelines being untrustworthy; guidelines failing to see the bigger picture; and guidelines being a threat to professional identity. Overall, it appeared that staff did find guidelines to be helpful in improving standards of care, but there were concerns around the applicability of guidelines within clinical practice especially around adapting standardised recommendations to individual clinical situations
Is assisted dying really a matter for medical regulation?
No full textThis paper considers whether assisted suicide and euthanasia (AS/E) is an area for medical regulation or whether there is a better alternative regulatory mechanism to govern it. Drawing from empirical evidence across a range of jurisdictions where it is legalized, the paper argues that there are at least four good reasons to consider demedicalizing AS/E: 1) pragmatic ethical issues of infrastructural weakness in AS/E service provision in already overstretched healthcare systems globally; 2) challenges of medicalization; 3) regulatory complexities concerning medical law (including pharmaceutical law) and criminal law; 4) the risk that AS/E becomes more easily susceptible to healthcare economics. The paper suggests several recommendations concerning a possible ‘demedicalized model.
AI-driven triage in emergency departments: A review of benefits, challenges, and future directions
No full textEmergency Departments (EDs) are critical in providing immediate care, often under pressure from overcrowding, resource constraints, and variability in patient prioritization. Traditional triage systems, while structured, rely on subjective assessments, which can lack consistency during peak hours or mass casualty events. AI-driven triage systems present a promising solution, automating patient prioritization by analyzing real-time data, such as vital signs, medical history, and presenting symptoms. This narrative review examines the key components, benefits, limitations, and future directions of AI-driven triage systems in EDs. This narrative review analyzed peer-reviewed articles published between 2015 and 2024, identified through searches in PubMed, Scopus, IEEE Xplore, and Google Scholar. Findings were synthesized to provide a comprehensive overview of their potential and limitations. The review identifies substantial benefits of AI-driven triage, including improved patient prioritization, reduced wait times, and optimized resource allocation. However, challenges such as data quality issues, algorithmic bias, clinician trust, and ethical concerns are significant barriers to widespread adoption. Future directions emphasize the need for algorithm refinement, integration with wearable technology, clinician education, and ethical framework development to address these challenges and ensure equitable implementation. AI-driven triage systems have the potential to transform ED operations by enhancing efficiency, improving patient outcomes, and supporting healthcare professionals in high-pressure environments. As healthcare demands continue to grow, these systems represent a vital innovation for advancing emergency care and addressing longstanding challenges in triage. [Abstract copyright: Copyright © 2025 The Author(s). Published by Elsevier B.V. All rights reserved.
E. Borzova, B. F. Gibbs
No full textLactate is a ubiquitous and pleiotropic signalling molecule, with important functional effects in tissue and cellular metabolism. As an exerkine, lactate is not only substantially released from tissues during exercise but may also play a role in exercise-related medical conditions. Since exercise is a known co-factor in anaphylaxis, this may suggest a mechanistic relevance for lactate release during anaphylactic events. Here, we evaluated in vitro and in vivo evidence for lactate release from mast cells (MCs) from preclinical microdialysis studies, animal models and clinical data in anaphylaxis. Lactate levels are markedly elevated in both animal models of anaphylaxis and patients with anaphylaxis. Although not causative, lactate is clearly relevant to many different steps in anaphylaxis, including MC activation, vascular permeability and gastrointestinal dysfunction, but currently lacks a comprehensive interpretation framework in anaphylaxis. As a result, lactate cannot be currently considered a biomarker of anaphylaxis per se. However, given its wide dynamic range, a plethora of available lactate biosensors, and the ease of measurement in various biological fluids, lactate may be a potential candidate for biomarker development. At present, lactate’s contribution to anaphylaxis, which was discovered a century ago by Zunz and La Barre, has not been fully elucidated. Unresolved issues in anaphylaxis include the patient’s metabolic state; the kinetics of lactate release and its biological actions; MC bioenergetics and metabolome; activation thresholds; and feedback mechanisms, as well as an expression of lactate-metabolizing enzymes. A closer focus on these known unknowns may demystify the contribution of lactate in anaphylaxis and beyond. Graphical Abstract: Lactate in anaphylaxis. There are various clinical scenarios for lactate measurements in anaphylaxis: (1) exercise-induced anaphylaxis, (2) fatal or near-fatal anaphylaxis, (3) anaphylaxis in mastocytosis and (4) epinephrine-induced lactic acidosis. First, there is likely to be an overlap in early signalling events and pre- and post-translational processes mediated by lactate in the context of exercise in healthy subjects and in patients with exercise-induced urticaria/anaphylaxis, which may well be further complicated by abnormal MC reactivity, activation threshold and, possibly, feedback mechanisms in the latter. This underlines a commonality in metabolic pathways that may involve, at least in part, MC-derived histamine and its subsequent hemodynamic effects involved in anaphylaxis. Second, elevated serum lactate was demonstrated to be associated with anaphylaxis severity [54], especially in relation to fatal anaphylaxis in critical care settings [31]. This is in keeping with circumstantial evidence from a variety of previous reports from case studies and animal models. Furthermore, lactate release parallels histamine release in a MC activation event in a patient with mastocytosis [147]. Finally, lactate acidosis may rarely occur following multiple epinephrine injections in patients with anaphylaxis
Teamwork, co-regulation, and socially shared regulation skills within engineering education studies: A genAI-assisted scoping review
No full textThis work presents a GenAI-Assisted Scoping Review conducted to map research activity on teamwork skills, co-regulation, and socially shared regulation of learning in higher engineering education over the last three years. This paper makes a methodological contribution in evaluating how Generative Artificial Intelligence (GenAI) tools, specifically ChatGPT® and NotebookLM®, can be reliably integrated into the scoping and systematic literature review process. GenAI's performance is compared against human reviewers in tasks like duplicate detection, abstract screening, and data extraction, ultimately concluding that GenAI can significantly assist in these stages. The work also identifies a research gap concerning socially shared regulation of learning within engineering teamwork
The role of artificial intelligence in blood-borne virus opt-out testing in emergency departments.
No full textBlood-borne viruses (BBVs) such as HIV, hepatitis B, and hepatitis C continue to pose serious public health concerns, particularly within emergency departments (EDs), where patient volume and turnover are high. While opt-out testing strategies, where individuals are tested unless they specifically decline, have shown effectiveness in increasing diagnosis rates, their adoption in EDs is limited by challenges such as inefficient workflows, data fragmentation, and suboptimal patient engagement. This narrative review aims to explore the application of Artificial Intelligence (AI) in enhancing BBV opt-out testing in EDs, focusing on how AI can address current operational and clinical challenges while supporting ethical and equitable implementation. A structured narrative review approach was used following established guidelines. We searched PubMed, EMBASE, Web of Science, and grey literature from 2010 to 2024 using terms related to AI, blood-borne viruses, opt-out testing, and emergency departments. A total of 32 articles were included in the final synthesis. AI demonstrates theoretical potential with limited BBV-specific empirical evidence in improving BBV testing outcomes through automated patient identification and risk stratification using electronic health records. Evidence from broader healthcare AI applications suggests workflow improvements may be possible through automated test ordering, real-time alerts, and adaptive scheduling systems. Data analysis tools have shown promise in other healthcare contexts for accurate test result interpretation and epidemiological trend identification. AI-driven patient communication tools such as chatbots and mobile apps show potential to enhance patient understanding and reduce opt-out rates. Follow-up and continuity of care could potentially be strengthened via automated notifications and predictive adherence models. AI offers potential opportunities to improve the scalability, efficiency, and equity of BBV opt-out testing in EDs. However, successful integration depends on addressing ethical issues, algorithmic bias, and system interoperability, supported by interdisciplinary collaboration and continuous evaluation. Further research with BBV-specific evidence is urgently needed to validate these theoretical applications. [Abstract copyright: Copyright © 2025 The Author(s). Published by Elsevier B.V. All rights reserved.
‘Where is the help for me here?’ Female domestic violence survivors’ narratives of navigating and receiving secondary-care mental health services in the United Kingdom
No full textBackground
Mental health (MH) services are uniquely positioned not only to contribute to the identification of domestic violence but also to provide support. Survivors of domestic violence regularly access secondary-care MH services. Although several studies and reviews have been conducted globally, the limited literature exploring survivors’ experiences of MH services in England has focused on the acceptability of routine enquiry within MH services, MH service responses to domestic violence and abuse (DVA), and the facilitators and barriers to disclosure within community MH teams.
Objectives
This study explores domestic violence survivors’ narratives of navigating and receiving secondary-care MH services in the United Kingdom.
Design
A qualitative study was undertaken with seven women who had experienced domestic violence. The study adopted a feminist, qualitative, narrative approach to enable in-depth exploration of survivors’ accounts of secondary-care MH services.
Method
Seven participants were recruited from three community-based third sector DVA services in the United Kingdom. Women participated in a face-to-face narrative inquiry interview ranging from 45 to 90 min. Interviews were transcribed verbatim and analysed in two distinct phases using the Voice-Centred Relational Method and thematic analysis, respectively
Results
Results suggest that MH professionals (MHPs) consistently missed the connection between abuse and women’s presenting distress. The structure of MH services resulted in superficial interventions and relationships, with key windows of opportunity for support missed. Whilst all women found a ‘safe haven’ where they felt heard, understood and supported, this was consistently outside of statutory MH services.
Conclusion
Women’s experiences of secondary-care MH services often paralleled their experiences of abuse and were experienced as re-traumatising. Our findings suggest that adopting trauma-informed approaches, developing more integrated support, and considering alternative conceptualisations of distress beyond diagnosis could enable survivors to find safety and support