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This paper introduces a new mathematical model for analyzing the economic benefits of incorporating the fourth party logistics (4PL), which is a contractor (i.e. agent) for the supply chain coordination and construction based on the division of community and the outsourcing development. Based on the physical theory and the wave-particle duality, a supply chain is the special organization whose characteristic has wave-particle duality. The mathematical model enriches the connotation of 4PL and it broadens the thought for 4PL development. Secondly, the proposed mathematical model predicated on transaction costs, is supported by Transaction Cost Theory (TCT) and acts as the theoretical analysis tool of 4PL for coordinating 3-party generic supply chain. Through the model, some trendy conclusions can be drawn to provide theoretical support for 4PL’s practices. Finally, a case illustrates our conclusions.

This study aims to understand customer’s assessments of neighborhood stores during the COVID-19 pandemic through the influence of in-store environmental factors on patronage intention.

Online survey with 528 participants about the last shopping trip in neighborhood retail. The authors performed data analysis using structural equation modeling techniques.

High-perceived spatial crowding negatively influences shopping experience value perceptions, while human crowding influences patronage intentions through increased perceived hedonic value.

Results suggest that purchase experience at well-known neighborhood stores during a sanitary crisis is becoming less convenience-oriented and a substitute for leisure activities due to social distancing.

The findings elucidate the social function of neighborhood convenience retailing during the COVID-19 pandemic. The results emphasize that a pleasant shopping experience arising from a good relationship with shopkeepers and other customers is more influential on patronage intention than a good product assortment and store layout.

This paper contributes to the survival of small neighborhood businesses during the financial crisis installed due to Covid-19 by helping businesses become more attractive to their consumers and competitive in the new context.

The combined context of the health crisis due to COVID-19 and neighborhood retail of an emerging country raises the need for tests to better understand established marketing theories. Based on this rationale, this work intends to replicate and extend selected previous findings to the new environment dictated by the pandemic.

The study explores experiences of African immigrants in their self-employment journey. South Africa has been receiving many African immigrants seeking for socio-economic survival. This presents a gap to understand the self-employment journey of such immigrants post-settlement.

A qualitative inquiry is used with semi-structured interviews using a sample of African immigrants based in South Africa. Narrative enquiry was utilised in trying to understand the African immigrant self-employment journey.

The findings show strategies used by African immigrant entrepreneurs in their self-employment journey. These include immigrant relying on established relationships to respond to contextual challenges. Further, immigrant entrepreneurs turned to borrowing from family, including personal savings and using fronts as a capital generation strategy.

Based on the findings strategies are suggested as a useful precursor in advancing understanding of the African immigrant self-employment journey. This becomes useful especially considering ideals for assisting post-settlement of migrants.

The purpose of this paper is to illustrate delirium as a possible consequence of the application of symptom-triggered therapy for alcohol withdrawal and to explore alternative treatment modalities. In the management of alcohol withdrawal syndrome, symptom-triggered therapy directs nursing staff to regularly assess patients using standardized instruments, such as the Clinical Institute for Withdrawal Assessment of Alcohol, Revised (CIWA-Ar), and administer benzodiazepines at symptom severity thresholds. Symptom-triggered therapy has been shown to lower total benzodiazepine dosage and treatment duration relative to fixed dosage tapers (Daeppen et al., 2002). However, CIWA-Ar has important limitations. Because of its reliance on patient reporting, it is inappropriate for nonverbal patients, non-English speakers (in the absence of readily available translators) and patients in confusional states including delirium and psychosis. Importantly, it also relies on the appropriate selection of patients and considering alternate etiologies for signs and symptoms also associated with alcohol withdrawal.

The authors report a case of a 47-year-old male admitted for cardiac arrest because of benzodiazepine and alcohol overdose who developed worsening delirium on CIWA-Ar protocol.

While symptom-triggered therapy through instruments such as the CIWA-Ar protocol has shown to lower total benzodiazepine dosage and treatment duration in patients in alcohol withdrawal, over-reliance on such tools may also lead providers to overlook other causes of delirium.

This case illustrates the necessity for providers to consider using other available assessment and treatment options including objective alcohol withdrawal scales, fixed benzodiazepine dosage tapers and even antiepileptic medications in select patients.

Assistive technology (AT) has been highlighted as a tool that can support self-management for people living with schizophrenia. A gap in the literature exists regarding the views held by the stakeholders involved in the health care of an individual living with schizophrenia regarding the potential use of AT to enable the self-management of this condition. The purpose of this paper is to explore how individuals living with schizophrenia, their relatives and their mental health care professionals view AT as a tool to facilitate self-management.

This mixed methods research paper will discuss the findings of the second stage of a two-stage research study. The paper will discuss the findings of questionnaires that were disseminated to service users living with schizophrenia, their relatives and the health-care professionals of a community mental health service in the Greater Dublin area.

The results indicate that the introduction of AT for the self-management of schizophrenia would be accepted by key stakeholders.

As AT continues to develop, it is clear from the findings presented in this paper that the main stakeholder groups involved in the care of an individual living with schizophrenia are amenable to the use of AT to facilitate the self-management of this condition. Further research is required to explore correct policing and management of its implementation.

This study is the first study of its kind within an Irish context to explore the use of assistive technology as a tool for self-management from the perspective of those experiencing schizophrenia, their relatives and the health-care professionals working alongside them.

The purpose of this paper is to provide insights into the implications of board human capital heterogeneity for company innovation by focusing on the educational and the functional background of directors. Moreover, it examines the moderating effect of the CEO expertise-overlap within the innovation domain on the relationship between board human capital heterogeneity and firm innovation.

The hypotheses are tested through a set of ordinary least squares regressions on a unique dataset of 149 Italian high-tech companies observed between 2012 and 2015.

Findings show that the educational and the functional background heterogeneity of directors increase both the innovation input and output. However, results highlight that these relationships are negatively moderated by the CEO expertise-overlap within the innovation domain.

The paper emphasizes the importance of appointing directors with different and specific educational and functional backgrounds to foster the company innovation.

The paper fills a gap in the literature as it has devoted limited attention to the performance implications of board human capital heterogeneity in the high-tech industry where knowledge and skills are the primary sources of value. Moreover, the paper integrates the research on the CEO-board interface by shedding light on how the CEO expertise within the innovation domain affects the contribution of heterogeneous boards to company innovation.

Clozapine is often considered the gold standard for the treatment of schizophrenia. Clinical guidelines suggest a gradual titration over 2 weeks to reduce the risks of adverse events such as seizures, hypotension, agranulocytosis, and myocarditis. The slow titration often delays time to therapeutic response. This raises the question of whether, in some patients, it may be safe to use a more rapid clozapine titration. The following case illustrates the potential risks associated with the use of multiple antipsychotics and rapid cloza-pine titration. We present the case of a young man with schizophrenia who developed life threatening neuroleptic malignant syndrome (NMS) during rapid clozapine titration and treatment with multiple antipsychotics. We were unable to find another case in the literature of NMS associated with rapid clozapine titration. This case is meant to urge clinicians to carefully evaluate the risks and benefits of rapid clozapine titration, and to encourage researchers to further evaluate the safety of rapid clozapine titration. Rapid clozapine titration has implications for decreasing health care costs associated with prolonged hospitalizations, and decreasing the emotional suffering associated with uncontrolled symptoms of psychosis. Clozapine is considered the most effective antipsychotic available thus efforts should focus on developing strategies that would allow for safest and most efficient use of clozapine to encourage its utilization for treatment resistance schizophrenia.

Attempted and completed self-enucleation, or removal of one's own eyes, is a rare but devastating form of self-mutilation behavior. It is often associated with psychiatric disorders, particularly schizophrenia, substance induced psychosis, and bipolar disorder. We report a case of a patient with a history of bipolar disorder who gouged his eyes bilaterally as an attempt to self-enucleate himself. On presentation, the patient was manic with both psychotic features of hyperreligous delusions and command auditory hallucinations of God telling him to take his eyes out. On presentation, the patient had no light perception vision in both eyes and his exam displayed severe proptosis, extensive conjunctival lacerations, and visibly avulsed extraocular muscles on the right side. An emergency computed tomography scan of the orbits revealed small and irregular globes, air within the orbits, and intraocular hemorrhage. He was taken to the operating room for surgical repair of his injuries. Attempted and completed self-enucleation is most commonly associated with schizophrenia and substance induced psychosis, but can also present in patients with bipolar disorder. Other less commonly associated disorders include obsessive-compulsive disorder, depression, mental retardation, neurosyphilis, Lesch-Nyhan syndrome, and structural brain lesions.

This chapter presents an exploratory study of specific experiences among Central Asian grandparents who adopt and raise their firstborn grandchild as their own youngest child. The practice, referred to as ‘nebere aluu’, is deemed an ethnonational tradition of the Kyrgyz and Kazakh people and appears to be widely accepted among men and women, young and old. Drawing on in-depth interviews with grandparents themselves, I describe this phenomenon as situated within and dynamically responding to the shifting social, economic and political context of contemporary Central Asia. Drastic transformations in the everyday lives, while destabilizing and disorienting, may have supplanted nebere aluu with unique significance. Contemporary expressions of nebere aluu point to it being a complex social system of intergenerational reciprocal care, continuity and responsibility that provides a meaningful space for reconciling conflicting ideas about family, marriage, love and child-rearing. This discursive space is open for debate and negotiations and raises important questions about power and gender politics inherent to it.