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Atomoxetine has been approved for the treatment of attention deficit/hyperactivity disorder in both adults and children. However, it is also being examined for several off-label uses in adults including mood disorders, eating disorders, cognitive dysfunction, and the treatment of addictions. Prior to such use it is important to examine the reported adverse events to see if this represents an appropriate level of risk. This is particularly important in the light of recent warnings from several regulatory bodies about an increase in blood pressure in a significant percentage of patients taking atomoxetine. To understand the risks a literature review was performed, and which identified the following potential problems. The first is that this drug should not be given in patients with known cardiovascular problems, and that all adult patients who receive atomoxetine should be monitored for changes in blood pressure throughout treatment. Secondly, there are several clinical situations in which atomoxetine should be closely monitored, or avoided, including patients who have a history or risk of narrow angle glaucoma, epileptic seizures, Tourette's syndrome, a history of urinary outflow obstruction, or who are pregnant or lactating. In conclusion, the current literature suggests that atomoxetine can be safely used off-label provided the above precautions are taken.

The purpose of this investigation is to gain insight into parents' perceptions of benefits vs burdens (value) of educational and healthcare service received for their child with ASD. Parents are the main integrators of long-term educational and healthcare service for their child with ASD.

Design/methodology/approach included (1) a sentiment analysis of discussion forum posts from an autism message board using a rule-based sentiment analysis tool that is specifically attuned to sentiments expressed in social media and (2) a qualitative content analysis of one-on-one interviews with parents of children diagnosed with ASD, complemented with interviews with experienced educators and clinicians.

Findings reveal the link between customized service integration and long-term benefits. Both parents and service providers emphasize the need to integrate healthcare and educational service to create holistic long-term care for a child with ASD. Parents highlight the benefits of varied services, but availability or cost are burdens if the service is not publicly provided, or covered by insurance. Service providers' lack of experience with ASD and people's ignorance of the challenges of ASD are burdens.

Ensuring health outcomes for a child with ASD requires an integrated service system and long-term, customer-centric service process because the scope of service covers the child's entire childhood. Customized educational and healthcare service must be allocated and budgeted early in order to reach the goal of a satisfactory service output for each child.

This is the first service research to focus on parents' challenges with obtaining services for their child with ASD. This paper provides service researchers and managers insight into parents' perceptions of educational and healthcare service value (i.e. benefits vs. burdens) received for their child with ASD. These insights into customer-centric perceptions of value may be useful to research and may help service providers to innovate and provide integrated service directly to parents, or indirectly to service providers, who serve children with ASD.

This paper aims to investigate whether and why the base of the pyramid (BOP) actors display passive innovation resistance because of which they reject service innovations without evaluation and forfeit potential to improve their well-being. The resourceness concept, referring to the outcome of how actors appraise and integrate resources in pursuit of a purpose at hand, is used as a theoretical lens to investigate the everyday consumption behaviour of BOP households and helps to investigate how and why passive innovation resistance occurs. The outcomes of the study help address important theoretical and practical considerations for the development of successful new service concepts at the BOP.

Narrative interviews with 29 households in Zambia provide data, from which patterns in how potential resources do or do not become real are identified and related to the concept of passive innovation.

Economic, social and other factors in the BOP context clearly influence non-random patterns of resource integration which are correlated with passive innovation resistance. This can lead to service innovations being ignored and/or misunderstood prior to evaluation for adoption. This is a risk to the potential positive impact of service innovation for poverty alleviation at the BOP.

Service innovation at the BOP must begin with a deep understanding of “how” and “why” consumers typically appraise and integrate potential resources to achieve a beneficial outcome in their context. To overcome the barrier of passive innovation resistance, marketing education must stimulate an understanding of potential benefits and motivation towards the change associated with the adoption of service innovation.

The findings support more successful service innovation strategies for the BOP, which can provide vital infrastructure for the alleviation of poverty.

The application of a service-dominant logic perspective in the BOP context and the conceptual linkage between resourceness and passive innovation resistance is novel. Valuable insights are gained for service practitioners at the BOP and for further conceptual development of innovation resistance in the BOP context.

The purpose of this paper is to look at the potential synergies between tourism and landscapes and examine the potential contribution of tourism to build social-ecological resilience in the Dutch Wadden.

The authors reveal how a social-ecological systems perspective can be used to conceptualize the Wadden as a coupled and dynamic system. This paper is a conceptual analysis that applies this approach to the Dutch Wadden. The data used for the inquiry primarily comes from a literature review.

The authors argue that the social-ecological systems perspective is a useful approach and could be used to improve the governance of multi-functional socio-ecological systems in coastal areas. Opportunities for synergies between tourism and landscapes have been overlooked. The authors consider that tourism and nature protection are potentially compatible and that the synergies should be identified.

This paper is only a conceptual application rather than an empirical case study. Further research to actually apply the methodology is needed.

Managers of protected areas should consider applying a social-ecological systems approach.

The views of a wide variety of stakeholders should be considered in landscape planning.

The value of this paper lies in the articulation of the social-ecological systems perspective as a way to identify and understand the complex interactions between tourism and landscape, and the potential synergies between them.

In North America, delegated practice “medical direction” models are often used as a proxy for clinical quality and safety in paramedic services. Other developed countries favor a combination of professional regulatory boards and clinical governance frameworks that feature paramedics taking lead clinician roles. The purpose of this paper is to bring together the evidence for medical direction and clinical governance in paramedic services through the prism of paramedic self-regulation.

This narrative synthesis critically examines the long-established North American Emergency Medical Services medical direction model and makes some comparisons with the UK inspired clinical governance approaches that are used to monitor and manage the quality and safety in several other Anglo-American paramedic services. The databases searched were CINAHL and Medline, with Google Scholar used to capture further publications.

Synthesis of the peer-reviewed literature found little high quality evidence supporting the effectiveness of medical direction. The literature on clinical governance within paramedic services described a systems approach with shared responsibility for quality and safety. Contemporary paramedic clinical leadership papers in developed countries focus on paramedic professionalization and the self-regulation of paramedics.

The lack of strong evidence supporting medical direction of the paramedic profession in developed countries challenges the North American model of paramedics practicing as a companion profession to medicine under delegated practice model. This model is inconsistent with the international vision of paramedicine as an autonomous, self-regulated health profession.

This article is premised on the idea that social networks represent an important, but often overlooked, unit of analysis in management and entrepreneurship studies. The concept of embeddedness, emphasizing the significance of social relationships, is of particular relevance as more and more frequently minorities and immigrants engage in small businessownership. This article borrows from the ethnicity and social network traditions, and offers that an analysis of the ethnic homogeneity of an entrepreneur's strong and weak social ties would be fruitful in gauging entrepreneurial success.

In a move characterized by ambiguity, Facebook changed its name to Meta in October 2021, announcing a new era of social interaction, enabled by the metaverse technology that appears poised to become the future center of gravity for online social interactions. At first glance, the communicated change signals a radically new business model (BM) based on an unprecedented configuration of the three following components: value creation, value proposition and value capture. The purpose of this paper is to analyze Facebook’s announced changes in its BM to clarify whether the change is as radical as communicated or rather represents an incremental transformation of the current BM.

This investigation adopted an in-depth case study research method. The process included using a structured approach to collect 153 data points, including academic studies and publicly available information, followed by qualitative content analysis.

The results of our analysis of Facebook’s entrepreneurial journey indicate that the communicated strategic refocusing does not correspond to a radical BM innovation pattern. Even though Facebook’s BM might evolve into the innovation phase, as the current changes appear very futuristic, the authors estimate that the core elements of the BM will change incrementally. The investigation indicates that the underlying logic of the straightforward communicative efforts primarily serves two purposes: to improve the external perception of the company and to disseminate an internal change signal within the organization.

This paper is the first study that takes an entrepreneurship and BM perspective in analyzing Facebook’s approach in rebranding to Meta and refocusing its strategy on building the metaverse. The academic and practical relevance, as well as the potential future impact on business and society, makes the investigation of this case an intriguing prospect. Additionally, the study illuminates the difference between the communicated vision and the real impact on the business, suggesting critical questions about future large-scale rebranding efforts and their effects.

This paper investigates how academic teachers engage in identity work and make sense of entrepreneurship and academia in an entrepreneurship training programme.

By employing a sensemaking approach, the paper inductively analyses materials from a business idea development camp organised for academic teachers.

In collective sensemaking during the camp, non-academic facilitators strongly influenced the reflection-in-experience via normative ideas of entrepreneurship and their othering of entrepreneurship from academic work. In their post-camp individual essays, the academic teachers reflect-on-experience and draw parallels between entrepreneurship and academic work constructing sameness.

Longitudinal research is needed in identity work and sensemaking among academic teachers in relation to entrepreneurship.

Universities need to offer arenas for teachers and other faculty to support identity work and sensemaking.

This study generates new understanding of how academic teachers engage in identity work and make sense of entrepreneurship in training when interacting with others. It underscores the importance of time needed for reflection-on-action.