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Background:Underrepresented persons are often not included in biomedical research. It is unknown if the general Asian American population is being represented in All of Us. The purpose of this study was to compare the Asian demographic data in the All of Us cohort with the Asian nationally representative data from the American Community Survey.Method:Demographic characteristics and health literacy of Asians in All of Us were examined. Findings were qualitatively compared with the Asian data in the 2019 American Community Survey 1-year estimate.Results:Compared with the national composition of Asians, less All of Us participants were born outside the United States (64% vs 79%), were younger, and had higher levels of education (76% vs 52%). Over 60% of All of Us participants reported high levels of health literacy.Conclusion:This study had implications for the development of strategies that ensure diverse populations are represented in biomedical research.

The All of Us Research Program seeks to advance precision medicine and reduce health disparities by recruiting people in demographic categories that are underrepresented in biomedical research. Asian Americans, Native Hawaiians and Pacific Islanders are the most understudied of all racial/ethnic groups in the United States. We propose a national engagement strategy for the recruitment of Asian Americans, Native Hawaiians and Pacific Islanders into biomedical research using a community-based participatory research approach.We partnered with Asian serving community-based organizations across the United States to increase education and awareness and developed a culturally and linguistically tailored approach for the engagement of AANHPIs into All of Us Research Program.In the first year, our national engagement strategy reached more than 35,000 AANHPIs through promotional events and educational sessions.Our success is a result of our equal and mutually beneficial partnership with community-based organizations who have access to rich, local knowledge and hold a unique role within the community.

Asian Americans have experienced compounding stressors during the pandemic as a result of racial discrimination. We aim of to investigate the prevalence of depression symptoms among Asian Americans before and during the COVID-19 pandemic and examine differences based on socio-demographic factors. Data are from a cross-sectional study (N = 636) among Chinese and South Asian adults in Chicago collected between February and May 2020. One cohort of participants were surveyed from each ethnic group before the pandemic and a second cohort of participants were surveyed during the pandemic. Depression symptoms increased more than two-fold, from 9% pre-pandemic to 21% during the COVID-19 pandemic. We found an increase in depression symptoms during the pandemic for South Asians, men and adults older than 30 years. These findings call for public health education that effectively addresses anti-Asian harassment and violence and ensure that culturally competent mental health services are provided to Asian Americans from diverse ethnic backgrounds.

BACKGROUND Breast cancer, the most commonly diagnosed cancer and second leading cause of cancer-related death in women in the United States, disproportionately affects women from minoritized or low socioeconomic backgrounds. The average woman has an approximately 12% lifetime risk of developing breast cancer. Lifetime risk nearly doubles if a woman has a first-degree relative with breast cancer, and the risk increases as multiple family members are affected. Decreasing sedentary behaviors through moving more and sitting less reduces breast cancer risk and improves outcomes for cancer survivors and healthy adults. Digital health solutions, such as mobile apps that are culturally appropriate, designed with input from the target audience, and include social support, are effective at improving health behaviors. OBJECTIVE This study aimed to develop and evaluate the usability and acceptability of a prototype app designed with a human-centered approach to promote moving more and sitting less in Black breast cancer survivors and their first-degree relatives (parent, child, or sibling). METHODS This 3-phase study consisted of app development, user testing, and evaluation of user engagement and usability. Key community stakeholders were engaged in the first 2 (qualitative) phases to provide input into developing the prototype app (MoveTogether). After development and user testing, a usability pilot was conducted. Participants were adult breast cancer survivors who identified as Black and agreed to participate with a relative. Participants used the app and a step-tracking watch for 4 weeks. App components included goal setting and reporting, reminders, dyad messaging, and educational resources. Usability and acceptability were assessed with a questionnaire that included the System Usability Scale (SUS) and semistructured interviews. Data were analyzed with descriptive statistics and content analysis. RESULTS Participants in the usability pilot (n=10) were aged 30 to 50 years (6/10, 60%), not married (8/10, 80%), and college graduates (5/10, 50%). The app was used on average 20.2 (SD 8.9) out of 28 days—SUS score of 72 (range 55-95)—and 70% (7/10) agreed that the app was acceptable, helpful, and gave them new ideas. Additionally, 90% (9/10) found the dyad component helpful and would recommend the app to friends. Qualitative findings suggest that the goal-setting feature was helpful and that the dyad partner (buddy) provided accountability. Participants were neutral regarding the cultural appropriateness of the app. CONCLUSIONS The MoveTogether app and related components were acceptable for promoting moving more in dyads of breast cancer survivors and their first-degree relatives. The human-centered approach, which involved engaging community members in the development, is a model for future technology development work. Future work should be done to further develop the intervention based on the findings and then test its efficacy to improve sedentary behavior while considering culturally informed strategies for adoption and implementation within the community. CLINICALTRIAL ClinicalTrials.gov NCT05011279; https://clinicaltrials.gov/ct2/show/NCT05011279

Background Many evidence-based interventions (EBIs) found to be effective in research studies often fail to translate into meaningful patient outcomes in practice. The purpose of this study was to identify facilitators and barriers that affect the implementation of three EBIs to improve colorectal cancer (CRC) screening in an urban federally qualified health center (FQHC) and offer actionable recommendations to improve future implementation efforts. Methods We conducted 16 semi-structured interviews guided by the Consolidation Framework for Implementation Research (CFIR) to describe diverse stakeholders’ implementation experience. The interviews were conducted in the participant’s clinic, audio-taped, and professionally transcribed for analysis. Results We used the five CFIR domains and 39 constructs and subconstructs as a coding template to conduct a template analysis. Based on experiences with the implementation of three EBIs, stakeholders described barriers and facilitators related to the intervention characteristics, outer setting, and inner setting. Implementation barriers included (1) perceived burden and provider fatigue with EHR (Electronic Health Record) provider reminders, (2) unreliable and ineffectual EHR provider reminders, (3) challenges to providing health care services to diverse patient populations, (4) lack of awareness about CRC screening among patients, (5) absence of CRC screening goals, (6) poor communication on goals and performance, and (7) absence of printed materials for frontline implementers to educate patients. Implementation facilitators included (1) quarterly provider assessment and feedback reports provided real-time data to motivate change, (2) integration with workflow processes, (3) pressure from funding requirement to report quality measures, (4) peer pressure to achieve high performance, and (5) a culture of teamwork and patient-centered mentality. Conclusions The CFIR can be used to conduct a post-implementation formative evaluation to identify barriers and facilitators that influenced the implementation. Furthermore, the CFIR can provide a template to organize research data and synthesize findings. With its clear terminology and meta-theoretical framework, the CFIR has the potential to promote knowledge-building for implementation. By identifying the contextual determinants, we can then determine implementation strategies to facilitate adoption and move EBIs to daily practice.

With funding from the Centers for Disease Control and Prevention’s Colorectal Cancer Control Program, The University of Chicago Center for Asian Health Equity partnered with a federally qualified health center (FQHC) to implement multiple evidence-based interventions (EBIs) in order to improve colorectal cancer (CRC) screening uptake. The purpose of this study is to determine the effectiveness and cost of implementing a provider reminder system entered manually and supplemented with patient reminders and provider assessment and feedback. The FQHC collected demographic characteristics of the FQHC and outcome data from January 2015 through December 2015 (preimplementation period) and cost from January 2016 through September 2017 (implementation period). Cost data were collected for the implementation period. We report on the demographics of the eligible population, CRC screening order, completion rates by sociodemographic characteristics, and, overall, the effectiveness and cost of implementation. From the preimplementation phase to the implementation phase, there was a 21.2 percentage point increase in CRC screens completed. The total cost of implementing EBIs was $40908.97. We estimated that an additional 283 screens were completed because of the interventions, and the implementation cost of the interventions was $144.65 per additional screen. With the interventions, CRC screening uptake in Chicago increased for all race/ethnicity and demographic backgrounds at the FQHC, particularly for patients aged 50 to 64 years and for Asian, Hispanic, and uninsured patients.

This article provides an innovative defence of co-determination by way of exploring two of the most significant theorised objections to it from neo-liberal and libertarian perspectives, namely, the defence of the right to manage as freely chosen by employees and employers alike, and the right to manage being the most efficient, lowest transaction cost mode of employee governance. Instead, we focus upon management preference emanating from the endowment effect, and manifested in management style and ideology, as a more credible explanation for management’s support for its prerogative to manage. The endowment effect prompts both strong employer and manager objections to co-determination and weak employee willingness to seek it because humans place more value upon items currently in their possession than upon those they do not possess. We explore this argument by examining the experience of co-determination in Germany. The significance of our argument lies in identifying managerial preference as the key variable to be challenged and changed in order to pacify management opposition to co-determination through political, ideological and institutional means.

Key EU agencies have successfully urged member states to scale back employment protection legislation as a solution to unemployment. The economic arguments for this reform are mixed, with recent empirical evidence largely unsupportive. Critics have also raised doubts about the accuracy of the OECD’s Employment Protection Legislation Index, which is the principal method EU agencies use to target so-called high-protection regimes. This article supplements existing criticisms of the OECD index by arguing that it fails to account for procedural requirements in assessing the difficulties and costs of carrying out individual dismissals. Evidence from New Zealand, ostensibly a low-protection country, demonstrates procedural requirements can pose the main impediments to carrying out individual dismissals. This suggests the need for revision of the OECD Employment Protection Legislation Index or the use of other indices instead.

Background - Inhibitory sialic acid-binding immunoglobulin-type lectins (Siglecs) are a subset of the Siglec family of cell surface receptors that potentiate immune tolerance. A multitude of inhibitory Siglecs on myeloid cells become engaged in sialic acid-rich tumor microenvironments, suggesting that disrupting Siglec-sialic acid signaling could confer therapeutic benefit in cancer. To accomplish this, we designed AL009, an engineered Siglec-9 extracellular domain-Fc fusion molecule that acts as a sialic acid trap and a multi-Siglec inhibitor, repolarizing suppressive myeloid cells and activating an anti-cancer response. Methods - Cooperative binding of AL009 was analyzed by flow cytometry using cultured human tumor cell lines and myeloid-derived suppressor cells (MDSCs) differentiated from primary human monocytes. Monocytes, MDSCs, and macrophages differentiated from primary human monocytes were assessed for AL009 binding by flow cytometry. AL009m (AL009 with a mouse Fc) was fluorophore-labeled and intravenously injected into B6 mice to analyze biodistribution via ex vivo tissue imaging over time. Initial toxicology screening was conducted in cynomolgus monkeys in a non-terminal study. Results - AL009 displays cooperative binding with sialic acid and Fc gamma receptors on myeloid cells. When comparing binding among myeloid cell subsets, AL009 preferentially binds MDSCs. Analysis of the biodistribution of labeled AL009m in mice showed the greatest accumulation in the spleen, consistent with immune cell targeting in vivo. Further, Fc engineering of AL009 improved the pharmacodynamic profile compared to a non-engineered Fc. In cynomolgus monkeys, single doses of 80 mg/kg appeared safe and without clinically significant findings. Conclusions - The engineered structure of AL009 leads to preferential binding to an immunosuppressive subset of myeloid cells. This targeting leads to repolarization of myeloid cells and activates an innate and adaptive anti-cancer response. Pharmacologically relevant doses of AL009 appear well-tolerated in initial studies in non-human primates, supporting further development for entry into clinical studies. Citation Format: Sam Nalle, Helen Lam, Cheryl Barner, Hua Long, Spencer Liang, Arnon Rosenthal, Daniel Maslyar. AL009 is a multi-Siglec inhibitor engineered to bind myeloid cells that enhances innate and adaptive immunity to cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 613.

Background Screening for colorectal cancer (CRC) not only detects disease early when treatment is more effective but also prevents cancer by finding and removing precancerous polyps. Because many of our nation’s most disadvantaged and vulnerable individuals obtain health care at federally qualified health centers, these centers play a significant role in increasing CRC screening among the most vulnerable populations. Furthermore, the full benefits of cancer screenings must include timely and appropriate follow-up of abnormal results. Thus, the purpose of this study is to implement a multilevel intervention to increase rates of CRC screening, follow-up, and referral-to-care in federally qualified health centers, as well as simultaneously to observe and to gather information on the implementation process to improve the adoption, implementation, and sustainment of the intervention. The multilevel intervention will target three different levels of influences: organization, provider, and individual. It will have multiple components, including provider and staff education, provider reminder, provider assessment and feedback, patient reminder, and patient navigation. Methods This study is a multilevel, three-phase, stepped wedge cluster randomized trial with four clusters of clinics from four different FQHC systems. In the first phase, there will be a 3-month waiting period during which no intervention components will be implemented. After the 3-month waiting period, we will randomize two clusters to cross from the control to the intervention and the remaining two clusters to follow 3 months later. All clusters will stay at the same phase for 9 months, followed by a 3-month transition period, and then cross over to the next phase. Discussion There is a pressing need to reduce disparities in CRC outcomes, especially among racial/ethnic minority populations and among populations who live in poverty. Single-level interventions are often insufficient to lead to sustainable changes. Multilevel interventions, which target two or more levels of changes, are needed to address multilevel contextual influences simultaneously. Multilevel interventions with multiple components will affect not only the desired outcomes but also each other. How to take advantage of multilevel interventions and how to implement such interventions and evaluate their effectiveness are the ultimate goals of this study. Trial registration This protocol is registered at clinicaltrials.gov (NCT04514341) on 14 August 2020.

BackgroundSialic acid-binding immunoglobulin-type lectins (Siglecs) are a family of cell surface receptors expressed predominantly on myeloid cells that function to promote immune tolerance. Tumors increase the expression of sialic acid glycans and co-opt the immunosuppressive effects of Siglecs, driving tumor resident immune cells toward a cancer permissive phenotype. Due to the overlapping expression profile of Siglec family members on myeloid cells, targeting multiple Siglecs is required for robust efficacy. Here, we present data on AL009, an engineered Siglec-9 extracellular domain-Fc fusion molecule that acts as a sialic acid trap and repolarizes suppressive myeloid cells to activate an anti-cancer immune response.MethodsThe ability of AL009 to competitively block various Siglec-Fc fusion proteins was assessed using cultured human myeloid-derived suppressor cells (MDSCs). MDSC repolarization was analyzed by flow cytometry. MDSCs were co-cultured with activated CD8+ T cells with and without exposure to AL009 and functionally assessed for T-cell activation by flow cytometry and ELISA. In vivo tumor models, including the MC38 and E0771 murine syngeneic subcutaneous models and the B16F10 intravenous lung metastasis model, were used to assess AL009 engineered with a murine Fc (AL009m).ResultsAL009 competitively blocks the ability of at least 5 inhibitory Siglec family members to bind their corresponding sialic acid ligands. When incubated with MDSCs, AL009 promotes CD163 and CD206 downregulation and induces proinflammatory chemokine secretion, consistent with a repolarization effect. Further, AL009 potently relieves MDSC suppression of T cells in a co-culture system. In the MC38 and E0771 murine syngeneic subcutaneous tumor models, AL009m inhibits tumor growth as a monotherapy and in combination with the checkpoint inhibitor anti-PD-L1. In addition, AL009m combines with the tumor antigen targeting antibody TRP-1 in the B16F10 intravenous lung metastasis model to reduce tumor burden.ConclusionsAL009 represents a novel approach to targeting the myeloid cell compartment in oncology by directly repolarizing myeloid cells without cell depletion or limiting the targeting to specific suppressive subpopulations. AL009 has the potential to address tumors that are unresponsive or refractory to standard immunotherapies. These data support further development of AL009 in the clinic with IND enabling studies ongoing.

Although profit-sharing is mostly associated with an economics perspective, its utilization as an employee incentive involves a psychological dimension, embedded in a broader socio-economic framework and reflected in organizational practices and management characteristics. The authors identify a list of conditions for profit-sharing’s effectiveness as an incentive scheme, informed by three theories, expectancy theory, reinforcement theory and goal-setting theory, and supported by substantial evidence from the literature on profit-sharing. Thus, this paper provides critical information for profit-sharing’s design and implementation, as well as offers some new practical insights into the contingencies and limitations of this incentive plan. Overall, it contributes to both theory and practice, integrating the three motivational frameworks regarding profit-sharing, and seeking to understand the insights such approaches afford to a socio-economic understanding.

With the ever‐increasing popularity of social media, whistle‐blowing, which generally refers to the disclosure of organisational wrongdoing, has entered a new era. Whistle‐blowing via virtual platforms has transformed not just the channel of disclosure, but also the associated motives, processes and outcomes. The impact on the whistle‐blower, the organisation and the public can often be accelerated and is seen as being more significant than traditional whistle‐blowing through internal means or external dedicated authorities or journalists. Yet systematic research on this changing phenomenon is just emerging, and regulation (e.g. for rewards, safeguards or protection) is lagging behind. In this paper, we specifically examine the impetus, as well as the benefits and drawbacks, of using online channels such as social media, blogging or websites, for whistle‐blowing by both employees and non‐employees, taking into consideration recent case law and development. A number of recommendations are proposed for virtual whistle‐blowers, organisations and governments.

Chinese Americans are one of the fastest-growing and largest Asian-American subgroups. Approximately 70% of Chinese Americans are immigrants with 46% being of limited English proficiency. Despite colorectal cancer (CRC) being the second leading cause of cancer death in Chinese Americans, Chinese Americans have lower CRC screening rates than other Asian subgroups, and only 40% of CRC cases among Chinese Americans are diagnosed early. Furthermore, CRC is the second most common cancer among Chinese American women. Race/ethnicity concordant providers may process culturally specific knowledge, skills, and experience that may facilitate better communication. Although using an interpreter can help to overcome language barriers between providers and patients, it may not achieve the same level of communication as a language concordant provider. The purpose of this study was to test a community education intervention, taking into account the racial/ethnic and language concordance of the presenter, to increase CRC screening uptake among foreign-born Chinese American women. This study used a quasi-experimental design and a convenience sample of 198 foreign-born Chinese-American women. Logistic regression was used to examine the effect of racial/ethnic and language concordance of the presenter on the return of completed FOBT kits for testing. The Chinese/English-speaking presenter had the highest return rate (73%), followed by the White/English-speaking presenter (61%), and the Chinese/Chinese-speaking presenter (48%), and the differences were statistically significant. Post-education intention to screen was also a significant predictor for returning the FOBT kit for testing. The use of an interpreter did not decrease the effectiveness of the educational intervention.

Educational data mining (EDM) is an applied field of research that combines data mining, machine learning, and statistics in the educational setting at, but not limited to, schools, universities and intelligent tutoring systems, and MOOCs. Methods are developing and improving for analyzing the vast amount of data available in education to better understand learning behaviors and pedagogical outcomes by applying theories of educational psychology in order to improve the learning environment.

The Chicago south side, even more so than national populations, continues to be burdened with widening gaps of disparities in cancer outcomes. Therefore, Chicago community members were engaged in addressing the following content areas for a cancer disparities curriculum: (1) the south side Chicago community interest in participating in curriculum design, (2) how community members should be involved in designing cancer disparities curriculum, and (3) what community members believe the curriculum should address to positively impact their community.Eighty-six community members from 19 different zip code areas of Chicago attended the deliberative session. A survey composed of three quantitative and three short-answer content questions was analyzed.The majority of participants were from the south side of Chicago (62 %) and females (86 %). Most, 94 %, believed community members should be involved in cancer disparities curriculum development. Moreover, 56 % wanted to be involved in designing the curriculum, and 61 % reported an interest in taking a course in cancer disparities. Three categorical themes were derived from the qualitative questions: (1) community empowerment through disparities education-"a prescription for change," (2) student skill development in community engagement and advocacy training, and (3) community expression of shared experiences in cancer health disparities.The community provided valuable input for curricular content and has an interest in collaborating on cancer disparities curriculum design. Community participation must be galvanized to improve disparities curricular development and delivery to successfully address the challenges of eliminating disparities in health.

Purpose– The purpose of this paper is to use the theoretical and empirical pension literatures to question whether employers are likely to gain any competitive advantage from degrading or eliminating their employees’ defined benefit (DB) pensions.Design/methodology/approach– Critical literature review, bringing together and synthesizing the industrial relations, economics, social policy, and applied pensions literature.Findings– DB pension plans do deliver a number of potential performance benefits, most notably a decrease in turnover and establishment of longer-term employment relationships. However, benefits are more pronounced in some conditions than others, which are identified.Research limitations/implications– Most of the analysis of pension effects to date focuses primarily on DB plans. Yet, these are declining in significance. In the years ahead, more attention needs to be paid to the potential consequences of defined contribution plans and other types of pension.Practical implications– In re-evaluating DB pensions, firms have tended to focus on savings made through cost cutting. Yet, this approach tends to view a firm's people as an expense rather a potential asset. Attempts to abandon, modify, or otherwise reduce such schemes has the potential to save money in the short term, but the negative long-term consequences may be considerable, even if they are not yet obvious.Originality/value– This paper is topical in that it consolidates existing research evidence from a number of different bodies of literature to make a case for the retention of DB pension plans, when, in many contexts, they are being scaled back or discarded. It raises a number of important issues for reflection by practitioners, and highlights key agendas for future scholarly research.

In law firms, the number of hours that associates work reportedly plays a preponderant role in promotion decisions. We build on previous research in this area by distinguishing the effect of ‘development hours’ from ‘billable hours’ on promotions and by assessing the extent to which billable hours are still important criteria today, in digitalized environments where efficiency is, presumably, likely to matter more than working long hours. We also examine whether certain types of behaviours, like associates' interactions with technology, may be associated directly or indirectly with a higher likelihood of promotion. We studied these questions in the context of a large corporate law firm in continental Europe, focusing on the promotion of 93 lawyers between 2005 and 2010. We found that both billable and development hours are still significant positive predictors of promotions and that associates' ability to use the case firm's computer-mediated knowledge management system productively is indirectly rewarded by promotion. This research reasserts the fundamental role of billable hours as one of the primary means for evaluating lawyers' work and suggests that using knowledge management systems gives associates an edge in the race for promotion, particularly in law firms moving along the ‘evolutionary path’ of legal service, from bespoke to commoditized work (Susskind, R. (2010). The End of Lawyers? Rethinking the Nature of Legal Services. Oxford: Oxford University Press).

Asian Americans are now the most rapidly growing minority group in the USA. Over 60 % Asian Americans in the USA are immigrants. Cancer has been the leading cause of death among Asian American women since 1980. Understanding the barriers to screening is essential to reduce the unnecessary burden of cancer. Little is known about cancer screening behaviors among foreign-born Asian women and how socio-demographic factors may influence these behaviors. Even less is known about disaggregated Asian subgroups. Using data from the Chicago Asian Community Survey, a local health assessment survey of three Asian subgroups in Chicago, Chinese, Vietnamese and Cambodian, this study found that breast and cervical cancer screening rates were much lower among foreign-born Asian women, 48 and 49 %, respectively, than the national rates for the general population, 72 and 83 %, respectively. Furthermore, we studied disaggregated data to determine cancer screening differences between communities. Findings from this study provide a critical evidence base to inform future research, policy and targeted interventions for Asian ethnic-specific populations.

One option for reversing US union decline, requiring no legislative change, would involve re-legitimizing non-majority or minority union representation, allowing unions to organize without running the gauntlet of union certification. Such minority representation, applicable only to workplaces without majority union support on a members-only basis, could run in parallel with the existing system of exclusive representation in workplaces where majority support is achieved. The increased representation in the currently unrepresented workplaces would inevitably promote workers’ collective voice and contribute to union revival. However, minority unionism has been criticized for breeding union competition because it is non-exclusive. In this paper, the nature and extent of inter-union conflict under minority unionism are re-examined, using survey data from unions in New Zealand which already has non-exclusive, minority union representation. The low levels and consequences of conflict suggest that the benefits of minority unionism far outweigh any potentially unfavourable effects.

BACKGROUND The present analysis was conducted in response to inconsistent epidemiologic studies on the relation between consumption of tea and cardiovascular diseases. OBJECTIVE We undertook a literature review of the consistency and strength of the associations between tea and cardiovascular diseases on the basis of published observational studies and meta-analyses addressing tea or tea flavonoids and cardiovascular disease risk. DESIGN We performed a search in 3 databases for meta-analyses and compared them with studies they subsumed. We performed an additional search for subsequent studies to determine whether the conclusions were consistent. RESULTS Many epidemiologic studies have been conducted and summarized in 5 meta-analyses on either tea consumption or flavonoid consumption and cardiovascular disease or the subset of stroke. Heterogeneity of effect was seen when the outcome included all cardiovascular diseases. In the case of stroke, a consistent, dose-response association with tea consumption on both incidence and mortality was noted with RRs of 0.80 (95% CI: 0.65, 0.98) for flavonoids and 0.79 (95% CI: 0.73, 0.85) for tea when high and low intakes were compared or the addition of 3 cups/d was estimated. CONCLUSION Thus, the strength of this evidence supports the hypothesis that tea consumption might lower the risk of stroke.

A systematic literature review of human studies relating caffeine or caffeine-rich beverages to cognitive decline reveals only 6 studies that have collected and analyzed cognition data in a prospective fashion that enables study of decline across the spectrum of cognition. These 6 studies, in general, evaluate cognitive function using the Mini Mental State Exam and base their beverage data on FFQs. Studies included in our review differed in their source populations, duration of study, and most dramatically in how their analyses were done, disallowing direct quantitative comparisons of their effect estimates. Only one of the studies reported on all 3 exposures, coffee, tea, and caffeine, making comparisons of findings across studies more difficult. However, in general, it can be stated that for all studies of tea and most studies of coffee and caffeine, the estimates of cognitive decline were lower among consumers, although there is a lack of a distinct dose response. Only a few measures showed a quantitative significance and, interestingly, studies indicate a stronger effect among women than men.

Digital disruption has touched almost every industry and sector imaginable including the education sector. One disruption in the education sector comes from the rise and acceptance of distance and online education, including massively open online courses (MOOCs), and the technological changes associated with course delivery and student interaction. Moreover, the rapid changes in digital technology have also led to the new breed of “cheats” who use the same digital technology causing disruption to cheat the system for better results. This paper looks at the evolution of cheating and suggests that the solutions may require a fundamental shift in how institutions conduct learning assessment in business education. Specifically, we posit that cheating is a function of two main factors: motivation and opportunities. While the motivation factor has not changed much by the digital advances, the opportunities for cheating have skyrocketed in this digital era, and it is this latter factor that warrants heightened attention. The paper, therefore, examines how digital technology has impacted the traditional assessment tools and how assessment can be modified in a digital world to ensure that students are achieving programme-learning goals.

Dismissal is a major issue for distributive justice at work, because it normally has a drastic impact on an employee’s livelihood, self-esteem and future career. This article examines distributive justice under the US’s employment-at-will (EAW) system and New Zealand’s just-cause dismissal system, focusing on the three main categories of dismissal, namely misconduct, poor performance and redundancy. Under EAW, employees have limited protection from dismissal and remedies are restricted to just a few so-called exceptions. Comparatively, New Zealand’s just-cause system delivers much more just outcomes, both in terms of remedies and punishments. Despite a few shortcomings, it should be considered as a reasonable reference for policy changes in the US.

Pyridostigmine bromide (PB) has been used to protect soldiers from the toxic effects of soman, a chemical warfare agent. Recent research shows that pyridostigmine bromide protects a significant percentage of acetylcholinesterase in isolated human intercostal muscle. Findings presented here indicate that red blood cell acetylcholinesterase is similarly protected by pyridostigmine bromide from the action of diisopropyl fluorophosphate and several organophosphate pesticides including chlorpyrifos-oxon, diazinon-oxon, and paraoxon, but not malaoxon, using the bovine red blood cell as a subject. These findings suggest that pretreatment with PB may protect growers, farmworkers, first responders, and the public, in general, from the effects of selected pesticides.

Since 1997, when the political sovereignty of Hong Kong reverted to China, the integration of the two economies has steadily increased. This article examines the economic and institutional differences between mainland China and Hong Kong, and considers the spillover benefits for the provinces adjacent to Hong Kong. The economic and productivity growth of mainland China and Hong Kong are decomposed into four attributes: input growth, adjusted scale effect, technical progress, and efficiency growth. A stochastic frontier model is used to estimate the growth attributes, and a human capital variable is incorporated in the production function. The empirical study compares the growth, productivity, and efficiency performance of mainland China and Hong Kong.

PurposeIn light of the low‐union density and a huge representation gap in the US representation system. The purpose of this paper is to examine the effectiveness of the system under majority rule and to provide some empirical evidence on how much union membership would increase in the USA if a policy of non‐exclusive representation, as adopted in New Zealand, are to be implemented.Design/methodology/approachThe sample for the study consists of 227 New Zealand organizations, employing over 180,000 workers. Logistic regression is used for the analysis with the dichotomous dependent variable indicating whether there is majority union support.FindingsIf the USA allowed and supported minority unionism, union membership could increase by 30 percent or more. Workers in smaller, private‐sector organizations outside healthcare, education, and manufacturing are most disadvantaged by the majority‐rule system.Practical implicationsGiven that many workers' needs for representation have not been addressed by the current US majority rule system, consideration of minority representation to enhance representation effectiveness and understanding its implications are of critical importance, especially for a democratic society.Originality/valueThe paper offers empirical data on the implications of a change of the US representation system and proposes three options for incorporating minority representation.

This study analyses the degree to which change in the organizational context , content and location ( both of the individual within the organization and the organization within the field ) of professional work has contributed to variation in attitudes toward professional ideology and institutions. Through an online survey of Canadian chartered accountants we observe that, contrary to current accusations, a majority of accounting professionals remain committed to their profession, despite profound changes in the context, content and location of their work. We do find, however, that the strongest espoused deviation from core professional values and logics has occurred in traditional work contexts (i.e. public accounting firms), and for the distinctive value of commitment to independence enforcement, the deviation is most pronounced in the elite core of the profession – the Big Four professional service firms. Accountants in higher ranks also tend to identify more with commercialistic values. We speculate on the implications these findings hold for the professional project of accountancy.

The present union certification system has many faults, the most important of which is its failure to deliver employee representation to all but a small and declining minority of workers. As an alternative, compulsory proportional representation (CPR) would have many advantages, particularly when compared with other reform proposals, most of which are designed to only reinvigorate, modify, or supplement the existing system. Would CPR have any disadvantages? We identify four potential concerns: reduced freedom to contract, increased interunion competition and raiding, depleted union strength, and compromised union independence. However, we argue that some of these problems would be more imagined than real, some less serious than expected, and some would have secondary effects to compensate any shortcomings.