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Clozapine, whilst associated commonly with a transient and benign increase in liver enzymes, has also been associated with varying presentations of hepatitis in existing case reports. This report describes what we believe to be the first documented case of acute liver injury and pleural effusion associated with clozapine, resolving after cessation of the agent. The case supports existing literature in advocating a high index of suspicion, particularly in the 4-5 weeks following clozapine initiation, when considering nonspecific clinical symptoms and signs.

An extensive research base supports the positive effects of self-monitoring interventions on a number of student outcomes, both academic and behavioral. While the vast majority of this research base relied on traditional paper-and-pencil forms of self-monitoring, advances in technology have created significant opportunities to develop technology-based self-monitoring (TBSM) systems that may offer a number of benefits in terms of efficiency and data management, storing, and graphing. Technology-based self-management applications have evolved and been studied extensively in health-related fields, but research and development for such applications is only beginning in the field of education. In this chapter we (1) provide a brief overview of the literature on traditional forms of self-monitoring, (2) examine how educators and educational researchers may apply lessons learned about TBSM from the medical field, (3) summarize emerging literature on TBSM for students with or at risk for emotional/behavioral disorders in particular, and (4) offer suggestions for future research and development in TBSM.

Smart card-based E-payment systems are receiving increasing attention as the number of implementations is witnessed on the rise globally. Understanding of user adoption behavior of E-payment systems that employ smart card technology becomes a research area that is of particular value and interest to both IS researchers and professionals. However, research interest focuses mostly on why a smart card-based E-payment system results in a failure or how the system could have grown into a success. This signals the fact that researchers have not had much opportunity to critically review a smart card-based E-payment system that has gained wide support and overcome the hurdle of critical mass adoption. The Octopus in Hong Kong has provided a rare opportunity for investigating smart card-based E-payment system because of its unprecedented success. This research seeks to thoroughly analyze the Octopus from technology adoption behavior perspectives.

Cultural impacts on adoption behavior are one of the key areas that this research posits to investigate. Since the present research is conducted in Hong Kong where a majority of population is Chinese ethnicity and yet is westernized in a number of aspects, assuming that users in Hong Kong are characterized by eastern or western culture is less useful. Explicit cultural characteristics at individual level are tapped into here instead of applying generalization of cultural beliefs to users to more accurately reflect cultural bias. In this vein, the technology acceptance model (TAM) is adapted, extended, and tested for its applicability cross-culturally in Hong Kong on the Octopus. Four cultural dimensions developed by Hofstede are included in this study, namely uncertainty avoidance, masculinity, individualism, and Confucian Dynamism (long-term orientation), to explore their influence on usage behavior through the mediation of perceived usefulness.

TAM is also integrated with the innovation diffusion theory (IDT) to borrow two constructs in relation to innovative characteristics, namely relative advantage and compatibility, in order to enhance the explanatory power of the proposed research model. Besides, the normative accountability of the research model is strengthened by embracing two social influences, namely subjective norm and image. As the last antecedent to perceived usefulness, prior experience serves to bring in the time variation factor to allow level of prior experience to exert both direct and moderating effects on perceived usefulness.

The resulting research model is analyzed by partial least squares (PLS)-based Structural Equation Modeling (SEM) approach. The research findings reveal that all cultural dimensions demonstrate direct effect on perceived usefulness though the influence of uncertainty avoidance is found marginally significant. Other constructs on innovative characteristics and social influences are validated to be significant as hypothesized. Prior experience does indeed significantly moderate the two influences that perceived usefulness receives from relative advantage and compatibility, respectively. The research model has demonstrated convincing explanatory power and so may be employed for further studies in other contexts. In particular, cultural effects play a key role in contributing to the uniqueness of the model, enabling it to be an effective tool to help critically understand increasingly internationalized IS system development and implementation efforts. This research also suggests several practical implications in view of the findings that could better inform managerial decisions for designing, implementing, or promoting smart card-based E-payment system.

Procedures can be categorized as certain surgeries based on their necessity and outcomes while others are classified as uncertain surgeries based on these areas. To account for this variance, policies such as the Affordable Care Act (ACA) call for health care providers to engage in shared decision making (SDM) with patients to ensure they are informed of treatment options and asked their preferences. Yet, gender may influence the decision-making process. Thus, this project examines the decision process and how gender impacts patients’ participation in decisions to undergo certain surgeries compared to uncertain surgeries.

This research project analyzed data from the National Survey of Medical Decisions 2006–2007 which surveyed the medical decisions of US residents 40 and older.

First, the data reveals that women felt more informed having uncertain surgeries compared to men. Second, patients were less likely asked their preference for surgery when undergoing certain surgeries compared to uncertain surgeries. Third, compared to men, women having uncertain surgeries were less likely to make the final decision to have surgery, compared to sharing the final decision with health care providers.

Due to the sample size, this project could not perform three-way interactions between gender, race, and surgery type.

Gender influences the level patients feel informed having uncertain surgeries. Though policy calls for SDM, health care providers are less likely to ask patients their preference for surgery regarding certain surgeries, relative to uncertain surgeries. Gender impacts the final decision-making process regarding whether patients should have uncertain surgeries.

Researchers recommend a reorganization of the medical profession into larger groups with a multispecialty mix. We analyze whether there is evidence for the superiority of these models and if this organizational transformation is underway.

We summarize the evidence on scale and scope economies in physician group practice, and then review the trends in physician group size and specialty mix to conduct survivorship tests of the most efficient models.

The distribution of physician groups exhibits two interesting tails. In the lower tail, a large percentage of physicians continue to practice in small, physician-owned practices. In the upper tail, there is a small but rapidly growing percentage of large groups that have been organized primarily by non-physician owners.

While our analysis includes no original data, it does collate all known surveys of physician practice characteristics and group practice formation to provide a consistent picture of physician organization.

Our review suggests that scale and scope economies in physician practice are limited. This may explain why most physicians have retained their small practices.

Larger, multispecialty groups have been primarily organized by non-physician owners in vertically integrated arrangements. There is little evidence supporting the efficiencies of such models and some concern they may pose anticompetitive threats.

This is the first comprehensive review of the scale and scope economies of physician practice in nearly two decades. The research results do not appear to have changed much; nor has much changed in physician practice organization.

That the introduction of the Control system should have given rise to a considerable amount of criticism, both appreciative and adverse, was naturally to be expected. The appreciative remarks which have appeared in the press, and those also which have been privately communicated to the directors, indicate that the subject has been intelligently considered, and in some cases carefully investigated and studied. The opinions given are worth having on account of the position and influence of hose who have given them, and on account of the obvious freedom from bias which has characterised them. This is so far satisfactory, and goes to show that the success which has attended the working of the Control system abroad may well be expected to attend it in this country as soon as it is sufficiently well known to be appreciated by the manufacturers and vendors of good and genuine products, and by the general public, whose best interests it cannot but serve.

The long-term financial stability of hospital systems represents a “grand challenge” in health care. New ownership forms, such as private equity (PE), promise to achieve better financial performance than nonprofit or for-profit systems. In this study, we compare two systems with many similarities, but radically different ownership structures, missions, governance, and merger and acquisition (M&A) strategies. Both were nonprofit, religious systems serving low-income communities – Montefiore Health System and Caritas Christi Health Care.

Montefiore's M&A strategy was to invest in local hospitals and create an integrated regional system, increasing revenues by adding primary doctors and community hospitals as feeders into the system and achieving efficiencies through effective resource allocation across specialized units. Slow and steady timing of acquisitions allowed for organizational learning and balancing of debt and equity. By 2019, it owned 11 hospitals with 40,000 employees and had strong positive financials and low reliance on debt.

By contrast, in 2010, PE firm Cerberus Capital bought out Caritas (renamed Steward Health Care System) and took control of the Board of Directors, who set the system's strategic direction. Cerberus used Steward as a platform for a massive debt-driven acquisition strategy. In 2016, it sold off most of its hospitals’ property for $1.25 billion, leaving hospitals saddled with long-term inflated leases; paid itself almost $500 million in dividends; and used the rest for leveraged buyouts of 27 hospitals in 9 states in 3 years. The rapid, scattershot M&A strategy was designed to create a large corporation that could be sold off in five years for financial gain – not for health care integration. Its debt load exploded, and by 2019, its financials were deeply in the red. Its Massachusetts hospitals were the worst financial performers of any system in the state. Cerberus exited Steward in 2020 in a deal that left its physicians, the new owners, holding the debt.

This article describes the aims and philosophy of a research centre focusing on the needs of older people and their family carers in West Sweden (ÄldreVäst Sjuhärad). The Centre aims to promote partnerships between older people, their carers and service agencies in order to improve the quality of life and quality of care. In achieving this aim it has adopted a model of working based on principles taken from a constructivist approach to research and evaluation. The quality or ‘authenticity’ criteria of this approach underpin the Centre's modus operandi and, it is suggested, could from the basis of a more user‐friendly perspective on research.

Teacher retention and continued teacher growth and development have long been critical global issues in education. The recent pandemic crisis and subsequent “great resignation” (Lodewick, 2022) have returned our attention to the need for positive and enriching educational landscapes that promote teacher collaborative reflection, knowledge, and growth in order to sustain teachers in the field. This chapter explores the ongoing teacher learning that has occurred within two knowledge communities (Craig, 1995b) in the United States. It begins with an overview of Craig's early work with teachers, during which her conceptualization of knowledge communities emerged. According to Craig, knowledge communities are safe, collaborative spaces that cohere around teachers' intra/inter-school dialogue and their storying/restorying (Clandinin & Connelly, 1996, 1998) of experiences. Additionally, knowledge communities (Craig, 1995b) begin with originating events, allow teachers' experiences (Dewey, 1938) to resonate with others in the group, feature reciprocity of members' mindful responses, and promote the development of shared ways of knowing. Equally important, knowledge communities evolve and change, fuel ongoing reflection in community, and bring moral horizons into view. Employing these knowledge community qualities as our lens, we examine the interactions of the Portfolio Group and the Faculty Academy. The Portfolio Group is a teacher/teacher educator/researcher group formed in 1998 during a US education reform era (Craig, Curtis et al., 2020). Its sister group, the Faculty Academy, is a cross-institutional, cross-discipline higher education group of teacher educators/researchers formed in 2002 (Craig, Turchi et al., 2020). Employing a parallel stories representation (Craig, 1999), exemplars (Mishler, 1990) from both groups show how teacher collaborative groups have the capacity to be safe spaces in which critical professional dialogue, reflective exchanges, and generous scholarship occur among members. Furthermore, they are nurturing spaces in which teachers can thrive and be their best-loved selves (Craig, 2013; Schwab, 1954/1978). These two groups exemplify the ways in which knowledge communities support teacher collaboration, promote ongoing teacher growth and development, and foster teacher sustainability.