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--- - |2 Abstract Bayesian methods incorporate model parameter information prior to data collection. Eliciting information from content experts is an option, but has seen little implementation in Bayesian item response theory (IRT) modeling. This study aims to use ethical reasoning content experts to elicit prior information and incorporate this information into Markov Chain Monte Carlo (MCMC) estimation. A six‐step elicitation approach is followed, with relevant details at each stage for two IRT items parameters: difficulty and guessing. Results indicate that using content experts is the preferred approach, rather than noninformative priors, for both parameter types. The use of a noninformative prior for small samples provided dramatically different results when compared to results from content expert–elicited priors. The WAMBS (When to worry and how to Avoid the Misuse of Bayesian Statistics) checklist is used to aid in comparisons. - Journal of Educational Measurement, Volume 55, Issue 3, Page 373-402, Fall 2018.

--- - |2 Abstract This study investigates the effect of multidimensionality on extraction of latent classes in mixture Rasch models. In this study, two‐dimensional data were generated under varying conditions. The two‐dimensional data sets were analyzed with one‐ to five‐class mixture Rasch models. Results of the simulation study indicate the mixture Rasch model tended to extract more latent classes than the number of dimensions simulated, particularly when the multidimensional structure of the data was more complex. In addition, the number of extracted latent classes decreased as the dimensions were more highly correlated regardless of multidimensional structure. An analysis of the empirical multidimensional data also shows that the number of latent classes extracted by the mixture Rasch model is larger than the number of dimensions measured by the test. - Journal of Educational Measurement, Volume 55, Issue 3, Page 403-420, Fall 2018.

--- - |2 Abstract Person reliability parameters (PRPs) model temporary changes in individuals’ attribute level perceptions when responding to self‐report items (higher levels of PRPs represent less fluctuation). PRPs could be useful in measuring careless responding and traitedness. However, it is unclear how well current procedures for estimating PRPs can recover parameter estimates. This study assesses these procedures in terms of mean error (ME), average absolute difference (AAD), and reliability using simulated data with known values. Several prior distributions for PRPs were compared across a number of conditions. Overall, our results revealed little differences between using the χ or lognormal distributions as priors for estimated PRPs. Both distributions produced estimates with reasonable levels of ME; however, the AAD of the estimates was high. AAD did improve slightly as the number of items increased, suggesting that increasing the number of items would ameliorate this problem. Similarly, a larger number of items were necessary to produce reasonable levels of reliability. Based on our results, several conclusions are drawn and implications for future research are discussed. - Journal of Educational Measurement, Volume 55, Issue 3, Page 421-432, Fall 2018.

--- - |2 Abstract This research derived information functions and proposed new scalar information indices to examine the quality of multidimensional forced choice (MFC) items based on the RANK model. We also explored how GGUM‐RANK information, latent trait recovery, and reliability varied across three MFC formats: pairs (two response alternatives), triplets (three alternatives), and tetrads (four alternatives). As expected, tetrad and triplet measures provided substantially more information than pairs, and MFC items composed of statements with high discrimination parameters were most informative. The methods and findings of this study will help practitioners to construct better MFC items, make informed projections about reliability with different MFC formats, and facilitate the development of MFC triplet‐ and tetrad‐based computerized adaptive tests. - Journal of Educational Measurement, Volume 55, Issue 3, Page 357-372, Fall 2018.

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Aim To cross‐culturally adapt and validate the Comprehensive Frailty Assessment Instrument (CFAI) among Chinese community‐dwelling older adults. Methods The Chinese CFAI was developed through forward–backward translations. An urban sample of 1235 community‐dwelling older adults received face‐to‐face interviews to examine the validity (construct validity and criterion validity) and reliability (internal consistency and test–retest reliability). Results The Chinese CFAI achieved semantic and idiomatic equivalence, and showed acceptable reliability and an expected factor structure, except for the social support domain. The exploratory factor analysis extracted five factors explaining 53.8% of the total variance of frailty. The confirmatory factor analysis showed that the data fit well to the second‐order factor theoretical model, with a root mean square error of approximation of 0.05, Tucker‐Lewis Index of 0.93 and Comparative Fit Index of 0.95. The receiver operating characteristic analysis presented an acceptable criterion validity using the Rockwood Frailty Index as an external criterion (area under the curve 0.80), with balanced sensitivity (65.31%) and specificity (81.19%) at the optimal 39‐point frailty cut‐off of the CFAI. Conclusions The Chinese CFAI has good validity and reliability as a practical frailty measure in Chinese community‐dwelling older adults.

Aim The aim of the present study was to investigate the relationship between physical activity (PA) and depressive symptoms in community‐dwelling older Japanese adults. Methods A cross‐sectional study design was used to obtain data from 3191 community‐dwelling older Japanese adults aged 70–95 years. Depressive symptoms were assessed using self‐reported scores on the Geriatric Depression Scale‐15. PA was objectively measured using an accelerometer worn for a maximum of 40 days, and average daily durations of light‐intensity PA (LPA), moderate‐to‐vigorous intensity PA (MVPA) and step count were calculated. PA was compared between participants with and without depressive symptoms by carrying out analysis of covariance and multivariable logistic regression analysis adjusted for all covariates by using propensity scores. Results Depressive symptoms were present in 598 participants (19.6%). A comparison of propensity‐score adjusted PA showed that step count (5059.6 ± 53.7 vs 5003.0 ± 112.1 count/day; P = 0.652) and moderate‐to‐vigorous intensity PA duration (23.0 ± 0.4 vs 23.8 ± 0.7 min/day; P = 0.358) were not significantly different between participants with and without depressive symptoms, respectively. However, participants without depressive symptoms had a significantly higher LPA duration than those with depressive symptoms (39.4 ± 0.3 vs 37.3 ± 0.7 min/day, respectively; P < 0.01). Conclusions The present results suggest that individuals with lower LPA have a higher risk of depressive symptoms. These findings imply that PA recommendations, especially for older adults, should emphasize LPA, which appears to be especially effective at preventing depressive symptoms.

Aim To evaluate the relationship between kidney function without diabetes and components of the frailty phenotype in community‐dwelling Japanese older adults. Methods Participants were 8343 residents who completed baseline assessments, classified into four categories according to eGFR. Frailty status was defined using five criteria: (i) slow gait speed; (ii) muscle weakness; (iii) low physical activity; (iv) exhaustion; and (v) unintentional weight loss. Results After multivariate adjustment, participants with the lowest kidney function were at higher risk of frailty (OR 1.57, 95% CI 1.02–3.50) than those with normal kidney function. In addition, after adjustment for multiple confounders, estimated glomerular filtration rate <30 was associated with a greater risk of the individual frailty components of weight loss (OR 2.14, 95% CI 1.11–4.12), low physical activity (OR 1.35, 95% CI, 1.01–2.54) and slowness (OR 1.82, 95% CI 1.36–3.77) compared with estimated glomerular filtration rate ≥60. Conclusions Lower kidney function was associated with a higher risk of weight loss, low physical activity and slowness among community‐dwelling Japanese older adults.

The paper examines the value‐generating strategies used in some of New Zealand's primary activities in a rapidly changing trading context in which the countries of East Asia increasingly figure. These strategies range from scaling up volume, with a consequent conspicuous impact on rural landscapes, to innovative value‐enhancing relationships linking producers, processors and consumers in processes which value landscapes for the contribution they make to provenance stories. Our argument is that higher‐value strategies are necessarily more intensely collaborative and involve a pursuit of engaged relationships, especially between onshore producers and manufacturers and consumers at a distance. We term this collaborative form of strategising as ‘the relationships economy’. We illustrate our argument using two case studies, dairying and merino. While there are great differences in scale between them, and dairying focuses significantly on volume‐generating capacity, there are players in dairying who are adopting higher‐value relationships‐based approaches similar to those developed in the merino industry. The common thread connecting the case studies is that of intentional enactment, which echoes earlier periods in New Zealand's trading history when considerable work was undertaken by industry participants to create new markets for primary products.

Objective To examine associations among substance use disorder (SUD) and measures of length of stay (LOS) and non‐psychiatric medical comorbidity (MEDCO) in older‐adult inpatients with serious mental illness (SMI), hypothesizing SUD would be related to worse clinical outcomes. Methods A cross‐sectional study analyzed medical records from 2010 to 2016 of 7258 inpatients with SMI ≥ age 50, obtained from a 274‐bed psychiatric hospital. Descriptive analyses examined prevalence rates for SUD status (+/−), individual drug classes, and total number of SUDs (polysubstance use disorders). Regression models examined the influence of 2 independent variables of interest: (1) SUD status (+/−) and (2) type of SUD (ie, specific drug), controlling for demographic factors and additional (non‐SUD) psychiatric disorders. Two dependent (outcome) variables were examined: LOS and MEDCO. Results The overall SUD rate was 26%; cocaine was the most common SUD (≈ 10%). SUD status and additional (non‐SUD) psychiatric diagnoses were significantly associated with longer LOS (both P < 0.001). For individual SUDs, cocaine, marijuana, opiates, and alcohol were all significantly associated with LOS (all P < 0.01). SUD status, age, sex, admission status, and race were significantly associated with MEDCO (all P < 0.002). For individual SUDs, barbiturates, opiates, and alcohol were all significantly associated with MEDCO (P < 0.01). Conclusions The prevalence of SUD in this sample underscores concerns related to treating older adults presenting providers with comorbid SUD and SMI. This combination may increase the burden and complexity of care, warranting further investigation into mechanisms and long‐term consequences.

Aim The aim of the present study was to evaluate whether the effect of one‐time brief additional counseling in periodic health examinations (PHE) through the National Screening Program for the Translational Ages in Korea is sustained after 2 years. Methods We collected data from National Screening Program for the Translational Ages participants in 2007 and 2008. To evaluate behavior change after 2 years, we collected the participants’ health behavior data 2 years later (2009 and 2010). We defined the basic group as participants who only received PHE, and the additional group as received PHE and counseling. We carried out propensity score matching to ensure that additional counseling was the only different variable affecting health behavior between the two groups. Results After propensity score matching, 50 630 remaining matched participants were matched for each group. Of these participants, 26.5% (26 855/101 260) were aged 66 years, and 60.9% (61 653/101 260) were men. The additional group showed a significant increase in odds of smoking cessation among the 66‐year‐olds (adjusted OR 1.173, 95% CI 1.003–1.372). This effect was significant, especially when the participants did not have hypertension or hypercholesterolemia (adjusted OR 1.193, 95% CI 1.000–1.423 for hypertension and adjusted OR 1.188, 95% CI 1.009–1.398 for hypercholesterolemia). However, there was no significant association for alcohol drinking and regular exercise. Conclusions The effect of one‐time brief counseling added to a PHE in cigarette smoking was observed only among the 66‐year‐olds. However, the effect was so small that it is doubtful to be clinically relevant. Repeated counseling is required to sustain the effect of the initial motivation of counseling. Geriatr Gerontol Int 2017; ••: ••–••

Many people believe that the abortion debate will end when at some point in the future it will be possible for fetuses to develop outside the womb. Ectogenesis, as this technology is called, would make possible to reconcile pro‐life and pro‐choice positions. That is because it is commonly believed that there is no right to the death of the fetus if it can be detached alive and gestated in an artificial womb. Recently Eric Mathison and Jeremy Davis defended this position, by arguing against three common arguments for a right to the death of the fetus. I claim that their arguments are mistaken. I argue that there is a right to the death of the fetus because gestating a fetus in an artificial womb when genetic parents refuse it violates their rights not to become a biological parent, their rights to genetic privacy and their property rights. The right to the death of the fetus, however, is not a woman's right but genetic parents’ collective right which only can be used together.

This article examines the “chicken‐egg” two‐way relationships between online consumer reviews and sales, and assesses the dual influencer and indicator roles of online consumer reviews in relation to purchase behavior. Considering the time factor, we adopt the methodology of Granger causality test and track 3,390 products on Amazon.com over a 2‐month period. The results reveal that a causality loop exists between online consumer review volume and sales. Specifically, our findings indicate that the volume of negative consumer reviews drive consumers' purchasing decisions, but the volume of positive consumers reviews only marginally affects purchasing decisions. Also, consumers generate more positive reviews than negative reviews after sales. Our results highlight the importance of negative consumer reviews; negative reviews not only lead to sales, but sales, in turn, lead to higher volume of negative reviews. The findings suggest an alternative strategy for practitioners to address negative online consumer reviews and highlight the awareness effect of online consumer review postings that can later convert into purchase behaviors.

This representative study of German search engine users (N = 1,000) focuses on the ability of users to distinguish between organic results and advertisements on Google results pages. We combine questions about Google's business with task‐based studies in which users were asked to distinguish between ads and organic results in screenshots of results pages. We find that only a small percentage of users can reliably distinguish between ads and organic results, and that user knowledge of Google's business model is very limited. We conclude that ads are insufficiently labelled as such, and that many users may click on ads assuming that they are selecting organic results.

Objective The objective of this literature review was to summarise current research regarding how consumers seek health‐related information from social media. Primarily, we hope to reveal characteristics of existing studies investigating the health topics that consumers have discussed in social media, ascertaining the roles social media have played in consumers’ information‐seeking processes and discussing the potential benefits and concerns of accessing consumer health information in social media. Methods The Web of Science Core Collection database was searched for existing literature on consumer health information seeking in social media. The search returned 214 articles, of which 21 met the eligibility criteria following review of full‐text documents. Conclusion Between 2011 and 2016, twenty‐one studies published explored various topics related to consumer information seeking in social media. These ranged from online discussions on specific diseases (e.g. diabetes) to public health concerns (e.g. pesticide residues). Consumers’ information needs vary depending on the health issues of interest. Benefits of health seeking on social media, in addition to filling a need for health information, include the social and emotional support health consumers gain from peer‐to‐peer interactions. These benefits, however, are tempered by concerns of information quality and authority and lead to decreased consumer engagement.

Objective To investigate the impact on patient waiting times of a role substitution model introducing an advanced allied health practitioner as the first point of contact within a geriatric outpatient context. Methods A pre‐ to postintervention design was used to determine impact over a five‐year period (2008–2012). All patients referred to the geriatric specialist outpatient department were included (n = 1514). Data relating to waiting times were analysed using one‐way ANOVA and post hoc Tukey tests to determine effects on patient waiting times. Results Waiting times were reduced from an average of 82 to as low as 35 days, in a context of increasing referral rates. Medical specialist capacity was increased through improvements to available outpatient times and reduced appointment lengths. Patients seen within their designated triage category timeframe increased from 47 to 86%. Conclusion Health professional substitution in geriatrics can be an effective intervention for reducing patient waiting times and improving access to care.

There is no abstract available for this paper.

Aim To investigate whether being part of a community organization interfered with older adults’ overall functionality. The magnitude of responses to a community exercise program based on functional circuits in socially active and socially non‐active older adults was also investigated. Methods A total of 200 older adults aged ≥60 years from Requinoa, Chile, participated in the study. Participants were separated into two groups according to the level of social participation: socially active (SA) and socially non‐active (SNA). During an evaluation, data regarding the presence of comorbidities (Charlson Comorbidity Index), disability level (Modified Health Assessment Questionnaire), dynamic balance (Timed Up and Go test), muscle force (handgrip dynamometry) and sociodemographic conditions were collected. Participants followed an exercise program consisting of a functional exercise circuit including balance, resistance and aerobic exercises, twice a week, for 12 weeks. Results Both the Charlson Comorbidity Index and disability were higher in SNA compared with SA participants on inclusion. Both groups improved disability (Δ–0.25 patients [−0.5 – −0.0625 patients] for SNA and (Δ–0.125 patients [−0.5–0 patients] for SA) and balance (Δ–2 s [−3–0 s] for SNA and (Δ–1 s [−3–0 s] for SA) after training (P < 0.05 for all). Changes from baseline were statistically higher in the SNA group. Handgrip force improved only in participants in the SNA group (Δ1.7 kg [0.6–2.8 kg], P = 0.0001). No differences, however, were observed between the magnitude of improvements of handgrip between groups. Conclusions Although socially non‐active older adults had more comorbidity and disability than their socially active counterparts, they showed a higher response to a community exercise program. Geriatr Gerontol Int 2017; ••: ••–••.

This work extends the masspersonal communication model (MPCM; O'Sullivan & Carr, 2017) by introducing anticipated interaction as a way to understand variations within the masspersonal continuum. Drawing from Thompson's mediated communication framework (1995), we argue that anticipated interaction paves the way for establishing a communicative relationship between interactants. In social media, this relationship is rooted in a sender's expectations for audience response and the imagined responsive audience. Using experience sampling, we show that anticipated interaction varies across social media. Further, we outline the relational and situational factors associated with expecting response and the specificity of imagined responsive audience. These variations and their sources characterize masspersonal communication as a socially and technologically situated practice shaped by multiple intersecting influences.

This research focuses on the identification of social roles and an investigation of their influence in online context. Relying on a systemic approach for role conceptualization, we investigate member's activity, shared content and position in the network within a consumer to consumer social media‐based community (SMC) around a product. This investigation led to the identification of ten core roles, based on three key elements: object of interest (product, practice, and community), main contribution type (sharing information and seeking information), individual orientation (factual, emotional). We propose an explanation about how these roles, through their positioning, participate in the community dynamics and how they contribute to the creation and diffusion of cookery as a social practice, shaping the periphery around this practice.

Political information sharing in social media offers citizens opportunities to engage with news and express their political views, but how do different patterns of online political information exposure, including both incidental and selective exposure, affect sharing? Using two‐wave panel survey data collected in the United States, we examine the relationship between incidental and selective exposure and their consequent links to political information sharing, across different levels of strength of political party affiliation. Our results demonstrate that incidental exposure to counter‐attitudinal information drives stronger partisans to more actively seek out like‐minded political content, which subsequently encourages political information sharing on social media. The results highlight the need to consider both types of political information exposure when modeling citizens' political behavior online.

Introduction Neuropsychiatric symptoms (NPS) are common at all stages of Alzheimer disease (AD). Delusions in AD are associated with negative clinical consequences and may signal rapid disease progression. Hence, we sought to determine the prevalence of delusions in drug‐naïve (no cholinesterase inhibitor or neuroleptic medications) AD patients. Methods In this meta‐analysis, a search of the EMBASE, MEDLINE, and PsycINFO databases was performed. We selected studies reporting delusion prevalence measured by the Neuropsychiatric Inventory (NPI) in drug‐naïve AD patients. An aggregate delusion event rate with 95% confidence interval (CI) was calculated. The I2 statistic was used to assess the magnitude of between‐study heterogeneity. Single variable meta‐regressions allowed examination of the effect of moderating factors and heterogeneity. Quantitative measures were used to appraise for publication bias. Results We identified 6 studies with 591 participants allowing calculation of the aggregate delusional prevalence rate. Irrespective of dementia severity, the aggregate event rate for delusions was 29.1% (95% CI: 20–41%; I2 = 84.59). No publication bias was observed. Conclusion This meta‐analysis calculates a 29.1% prevalence rate of delusions in AD patients. There is a trend towards increasing delusion prevalence in concordance with increasing severity of dementia. Given delusions are associated with poorer outcomes, the obtained prevalence should motivate clinicians to screen carefully for delusions. Current literature limitations warrant future studies, with sub‐analyses on dementia severity, and other neurobiological factors known to influence the presence of delusions.

The asylum system faces problems on two fronts. States undermine it with populist politics, and migrants use it to satisfy their migration preferences. To address these problems, asylum services should be commodified. States should be able to pay other states to provide determination and protection‐elsewhere. In this article, I aim to identify a way of implementing this idea that is both feasible and desirable. First, I sketch a policy proposal for a commodification of asylum services. Then, I argue that this policy proposal is not only compatible with the right to asylum, but also supported by moral considerations. Despite some undesirable moral features, a market in asylum facilitates the provision of asylum to those who need it.

In this article, I ask whether a principle analogous to the principle of clinical equipoise should govern the design and conduct of RCTs evaluating the effectiveness of policy interventions. I answer this question affirmatively, and introduce and defend the principle of policy equipoise. According to this principle, all arms of a policy RCT must be, at minimum, in a state of equipoise with the best proven policy that is also morally and practically attainable and sustainable. For all arms of a policy RCT, policy experts must either (1) reasonably disagree about whether the trial arms are more effective than this policy, or (2) know that they are.

Objective Despite the benefits of physical activity (PA) in older people with depression, many do not comply with the International PA guidelines. Thus, we investigated what factors influence PA participation among 915 community‐dwelling older adults (aged ≥65 years) with depression in 6 low‐income and middle‐income countries (LMICs). Methods Cross‐sectional data were analyzed from the World Health Organization's Study on Global Ageing and Adult Health. The sample was restricted to those with DSM‐IV depression or receiving depression treatment in the last 12 months. PA was assessed by the Global Physical Activity Questionnaire. Participants were dichotomized into low (ie, not meeting 150 minutes of moderate PA per week) and moderate‐to‐high physically active groups. Associations between PA and a range of correlates were examined using multivariable logistic regressions. Results The prevalence of low PA was 40.4% (95%CI = 34.8%–46.1%). After adjusting for age, sex, and country, larger household size and unemployment were significant sociodemographic correlates of low PA. Former smoking (vs never), anxiety, mild cognitive impairment (MCI), lower body mass index, bodily pain, asthma, chronic back pain, chronic obstructive pulmonary disease, hearing problems, stroke, slow gait, poor self‐rated health, higher levels of disability, and lower levels of social cohesion were identified as significant negative correlates of PA. Conclusions The current data provide guidance for future interventions across LMICs to assist older people with depression engage in regular PA. The promotion of social cohesion may increase the efficacy of future public health initiatives, while from a clinical perspective, somatic co‐morbidities, MCI, pain, and slow gait need to be considered. Key points More than 40% of older people with depression in low‐income and middle‐income countries do not meet physical activity guidelines. Somatic co‐morbidities, lower body mass index, pain, and slow gait need to be considered. The promotion of social cohesion may increase the efficacy of future public health initiatives.

Objective To determine how older people with dementia and their family caregivers experience dementia assessment services and preferences for future configuration of diagnostic services. Methods Qualitative, semistructured in‐depth interviews were conducted with nine individuals with dementia. In seven instances, the caregiver also took part in the interview, and on two occasions, the interview was with the person with dementia only. Results An important contact during assessment of dementia was the general practitioner, in particular working in a way or timeframe which provides clarity and comfort to the person with dementia and their family members. A problematic factor in clear diagnosis was when probable dementia was suspected during hospitalisation for another complaint. Participants expressed a wide range of views in terms of preferred settings for diagnostic services. Conclusion These findings highlight some key considerations, which should be included in future research leading to decisions about the design of dementia client services.

Crowdsourcing has attracted increasing attention as a means to enlist online participants in organisational activities. In this paper, we examine crowdsourcing from the perspective of its ethical use in the support of open innovation taking a broader system view of its use. Crowdsourcing has the potential to improve access to knowledge, skills, and creativity in a cost‐effective manner but raises a number of ethical dilemmas. The paper discusses the ethical issues related to knowledge exchange, economics, and relational aspects of crowdsourcing. A guiding framework drawn from the ethics literature is proposed to guide the ethical use of crowdsourcing. A major problem is that crowdsourcing is viewed in a piecemeal fashion and separate from other organisational processes. The trend for organisations to be more digitally collaborative is explored in relation to the need for greater awareness of crowdsourcing implications.

Given the comprehensive influence of mindfulness on human thought and behavior, and the importance of moral reasoning in business decisions, we examine the role of mindfulness as an antecedent to moral reasoning through two studies. In Study 1, we propose and test a theoretically derived model that links mindfulness and moral reasoning, mediated by compassion and egocentric bias using a survey design. In Study 2, we examine whether mindfulness training enhances moral reasoning using an experimental design with graduate students of business management. The findings of Study 1 substantiate the positive association of mindfulness with moral reasoning. We found that this relationship is fully mediated by compassion and egocentric bias. The results of Study 2 suggest that mindfulness meditation training has a positive impact on individuals' states of mindfulness, compassion, and moral reasoning, and decreases egocentric bias. We relate the findings of the study with contemporary neurological research and discuss the theoretical, pedagogical, and managerial implications.

In April 2005, Lucio Gutiérrez was removed from office in the context of a fast‐growing economy. With no economic hardship to fuel social outrage, the failure of Gutiérrez illustrates how political and institutional factors can be the most important forces determining presidential survival. In this article, we qualitatively analyse the path toward confrontation between Gutiérrez and the congressional opposition which led to his political demise. We find that Ecuador's weak democratic tradition working through more proximate causes – radicalism, normative preference for democratic institutions and a negative institutional equilibrium – coupled with other institutional and political variables accelerated Lucio Gutiérrez's fall from power.

The explosive growth of mobile apps makes it difficult for users to find their needed apps in a crowded market. An effective mechanism that provides high quality app recommendations becomes necessary. However, existing recommendation techniques tend to recommend similar items but fail to consider users’ functional requirements, making them not effective in the app domain. In this article, we propose a recommendation architecture that can generate app recommendations at the functionality level. We address the redundant recommendation problem in the app domain by highlighting users’ functional requirements, an element that has received scant attention from existing recommendation research. Another main feature of our work is extracting app functionalities from textural user reviews for recommendation. We also propose an effective approach for functionality extraction. Experiments conducted on a real‐world dataset show that our proposed AppRank method outperforms other commonly used recommendation methods. In particular, it doubles the recall value of the second best method under an extremely sparse setting, increases the overall ranking accuracy of the second best method by 14.27%, and retains a high diversity of 0.99.

For diversity and novelty evaluation in information retrieval, we expect that the novel documents are always ranked higher than the redundant ones and the relevant ones higher than the irrelevant ones. We also expect that the level of novelty and relevancy should be acknowledged. Accordingly, we expect that the evaluation algorithm would reward rankings that respect these expectations. Nevertheless, there are few research articles in the literature that study how to meet such expectations, even fewer in the field of biomedical information retrieval. In this article, we propose a new metric for novelty and relevancy evaluation in biomedical information retrieval based on an aspect‐level performance measure introduced by TREC Genomics Track with formal results to show that those expectations above can be respected under ideal conditions. The empirical evaluation indicates that the proposed metric, geNov, is greatly sensitive to the desired characteristics above, and the three parameters are highly tuneable for different evaluation preferences. By experimentally comparing with state‐of‐the‐art metrics for novelty and diversity, the proposed metric shows its advantages in recognizing the ranking quality in terms of novelty, redundancy, relevancy, and irrelevancy and in its discriminative power. Experiments reveal the proposed metric is faster to compute than state‐of‐the‐art metrics.

There is a growing phenomenon of brand advocacy, where brands pressure a producer country government to take pro‐worker actions such as respecting the rights of activists and raising minimum wages. This article examines the potential and limits of brand advocacy by developing a conceptual framework and analysing three recent cases of brand advocacy in Cambodia's garment industry. The study shows that brands' action and influence are shaped by issue salience, mobilization structures, political opportunities/contexts, and resource dependency. This article makes both empirical and theoretical contributions. This is one of the first studies delving into the advocacy role of brands in promoting labour rights and conditions vis‐à‐vis government. Moreover, the article develops a testable framework specifying the conditions under which brands are likely to respond, act collectively, and influence government for pro‐worker change. It also offers novel insights by applying social movement lenses and casting brands as social movement actors.

Journal of Knowledge Management, Volume 21, Issue 5, Page 1013-1034, September 2017.
Purpose The aim of this paper is to frame the stakeholder-driven system mapping approach in the context of climate change, building on stakeholder knowledge of system boundaries, key elements and interactions within a system and to introduce a decision support tool for managing and visualising this knowledge into insightful system maps with policy implications. Design/methodology/approach This methodological framework is based on the concepts of market maps. The process of eliciting and visualising expert knowledge is facilitated by means of a reference implementation in MATLAB, which allows for designing technological innovation systems models in either a structured or a visual format. Findings System mapping can contribute to evaluating systems for climate change by capturing knowledge of expert groups with regard to the dynamic interrelations between climate policy strategies and other system components, which may promote or hinder the desired transition to low carbon societies. Research limitations/implications This study explores how system mapping addresses gaps in analytical tools and complements the systems of innovation framework. Knowledge elicitation, however, must be facilitated and build upon a structured framework such as technological innovation systems. Practical implications This approach can provide policymakers with significant insight into the strengths and weaknesses of current policy frameworks based on tacit knowledge embedded in stakeholders. Social implications The developed methodological framework aims to include societal groups in the climate policy-making process by acknowledging stakeholders’ role in developing transition pathways. The system map codifies stakeholder input in a structured and transparent manner. Originality/value This is the first study that clearly defines the system mapping approach in the frame of climate policy and introduces the first dedicated software option for researchers and decision makers to use for implementing this methodology.

Journal of Knowledge Management, Volume 21, Issue 5, Page 1035-1052, September 2017.
Purpose The purpose of this paper is to explore and characterize knowledge integration approaches for integrating external knowledge of suppliers into new product development projects. Design/methodology/approach This paper is based on a multiple, in-depth case study of six product development projects at three knowledge-intensive manufacturing firms. Findings Firms make purposeful choices to devise knowledge integration approaches when working in collaborative buyer – supplier projects. The knowledge characteristics of the supplier input guide the choice of either coupling knowledge sharing and combining across firms or decoupling knowledge sharing (across firms) and knowledge combining (within firms). Research limitations/implications This study relies on a limited number of case studies and considers only one supplier relationship in each project. Further studies could examine the challenge of knowledge integration in buyer – supplier relationships in different contexts, i.e. in relation to innovation complexity and uncertainty. Practical implications Managers need to make choices when designing knowledge integration approaches in collaborative product development projects. The use of coupled and decoupled approaches can help balance requirements in terms of joint problem-solving across firms, the efficiency of knowledge integration and the risks of knowledge leakage. Originality/value The conceptualization of knowledge integration as knowledge sharing and knowledge combining extends existing perspectives on knowledge integration as either a transfer of knowledge or as revealing the presence of pertinent knowledge without entirely transmitting it. The findings point to the complexity of knowledge integration as a process influenced by knowledge characteristics, perspectives on knowledge, openness of firm boundaries and elements of knowledge sharing and combining.

Journal of Knowledge Management, Volume 21, Issue 5, Page 1053-1076, September 2017.
Purpose Although mobile devices are ubiquitous among employees, their awareness and readiness to use mobile technologies for competence development is still not widespread and therefore requires further exploration. The purpose of this study is to propose a conceptual model based on the unified theory of acceptance and use of technology (UTAUT) to explain the determinants that affect employees’ intention to use mobile devices and software for knowledge transfer during the process of knowledge management. Design/methodology/approach A conceptual model based on the UTAUT with new variables concerning relative usability (RU) and user autonomy (UA) and new connections between the determinants was developed as a result of a subject matter literature review. A structural equation modelling approach was used to validate the model on the basis of data collected via a survey collected from 371 employees from 21 sectors, both public and private. Findings The UTAUT model extended by new variables like RU and UA explains employee acceptance of mobile technologies for knowledge transfer reasonably well. New proposed variables highlighted that the usability of technology compared to other solutions and user autonomy in the selection and the use of applications have the strongest impact on the employees’ intention to use mobile devices and software for knowledge transfer. Research limitations/implications This model explains the 55 per cent behavioral intention of employees to use mobile technologies for knowledge transfer. Even though it is quite high in terms of acceptance theories, some new variables should be explored. Furthermore, study does not verify whether m-learning acceptance for knowledge transfer is sector-specific. Practical implications Mobile technologies used for knowledge transfer by employees should allow for high UA through their ability to select solutions that they find convenient, use of preferred platforms, personalize applications and utilize devices and software in various environments. They should not be simplified and should have the same functionality and efficiency of use as alternative solutions like web and desktop applications, even if additional effort to learn them would be required. Mobile technologies that take into account UA and RU support the process of employees capturing, distributing and effectively using knowledge. Originality/value The elaborated model provides a valuable solution with practical implications for increasing mobile technologies acceptance for knowledge transfer. The study results contribute both to knowledge management and technology acceptance research fields by introducing two new determinants for the acceptance of technologies in knowledge transfer, such as UA and RU with several additional connections between existing UTAUT variables.

Journal of Knowledge Management, Volume 21, Issue 5, Page 1077-1097, September 2017.
Purpose This study aims to investigate how psychological motivations influence the knowledge-sharing intention of employees and how these effects are moderated by traditional Chinese culture. Design/methodology/approach A questionnaire survey was conducted in China to test the research model. The target samples comprised MBA students who have enough practical experience, as well as considerable academic experience. Findings The results suggest that anticipated reciprocal relationships, anticipated extrinsic rewards and sense of self-worth exert different effects on knowledge-sharing intention. In addition, traditional Chinese culture plays different roles in the relationships among these three psychological motivations and knowledge-sharing intention. Specifically, guanxi orientation positively moderates the effect of anticipated reciprocal relationships and negatively moderates the effect of sense of self-worth. Face gaining negatively moderates the effect of anticipated reciprocal relationships and positively moderates the effect of sense of self-worth. Face saving negatively moderates the effect of anticipated reciprocal relationships and sense of self-worth. Originality/value A few studies in extant knowledge management (KM) literature provided insights into how traditional Chinese culture could directly affect knowledge sharing. The authors depart from these studies by integrating these characteristic indigenous concepts (i.e. face and guanxi orientation) into this study. The authors offer an indigenous cultural view of how these indigenous concepts truly influence an individual’s psychological states and inclination in KM literature. Through this approach, the results confirm that these cultural factors do play an important role during the formation of knowledge-sharing intention and reveals several important research findings.

Journal of Knowledge Management, Volume 21, Issue 5, Page 1098-1119, September 2017.
Purpose The aim of this study is to empirically test the link between employee ambidexterity and two supportive organizational cultures, namely, a perceived culture of empowerment and a knowledge-sharing culture. Furthermore, the paper addresses the mechanisms through which these supportive organizational cultures work to enable employees to engage in ambidextrous behaviour. Specifically, the role of intrinsic motivation is investigated. Design/methodology/approach Data were obtained from 136 managers employed in the five main Belgian service sectors. Findings The findings indicate that a perceived culture of empowerment is positively related to intrinsic motivation, which in turn facilitates employee ambidexterity. Also, a moderating effect of extrinsic motivation on employee ambidextrous behaviour is found. At the same time, a perceived knowledge-sharing culture is having no effect on ambidexterity or intrinsic motivation. Research limitations/implications Insights into the roles of individuals in achieving ambidexterity help to advance the theoretical understanding of how a supportive organizational context may enhance employee ambidexterity. Originality/value Despite the growing body of research on antecedents of ambidexterity, there is still lack of thorough understanding of how a supportive organizational context may enhance employee ambidexterity and the roles of individuals in achieving ambidexterity. This is one of the first studies that investigate these factors in relation to individual level ambidexterity (as opposed to organization level ambidexterity).

Journal of Knowledge Management, Volume 21, Issue 5, Page 1120-1141, September 2017.
Purpose This paper was aimed at investigating the impact of knowledge management (KM) procedures on enriching human resources in Water and Waste Water Company in East Azerbaijan, Iran. Design/methodology/approach The samples used in this study included the employees of Water and Waste Water Company in Tabriz, East Azerbaijan, Iran. A questionnaire was used for collecting data from the employees of the abovementioned company. Its reliability and validity were first examined and checked. Then, Smart partial least squares 2.0 was used for analyzing the structural model. Findings The results acknowledged the validity of the introduced model for enriching human resources. The findings indicated that five variables, namely, kind of knowledge, top managers, information technology, culture and organization of knowledge, have significant impact on enriching human resources. Research limitations/implications It is undoubtable that research studies might have specific limitations which should be pointed out and addressed in future studies. The followings are the major limitations of the study: because the present study was carried out in Water and Wastewater Company in Tabriz, East Azerbaijan, hence, generalizing the findings of this study to other professional contexts and organizations should be made with caution. In fact, the present study need to be replicated in other context to find whether the same or different results are obtained. In other words, different cultural, contextual and professional conditions might result differently from the ones reported here. Inasmuch as the present study was a cross-sectional study and the data were collected via questionnaire, a longitudinal study with a longer observation and investigation might shed more light on the efficacy of KMS in organizations. The present study focused on a specific dependent variable (human resource empowerment) which was explained by different dimensions of an independent variable, i.e. KM. However, the impact and efficacy of KMS can be investigated on other organizational variables and parameters. In this study, due to certain logistic and real-life limitations such as the limited time of the staff members of the target organization, we had to use only one data-collection instrument. Nevertheless, future studies can use data triangulation so as to better capture professional contexts of the study. Furthermore, another limitation of the study is related to the individual variables of the employees which remained untouched. That is, whether employees’ personal, emotional and cognitive variables can modify the impact of KM on human resource empowerment was not investigated in the present study. Practical implications Organizational managers are recommended to provide the background for employees to share their experiences. Organizations should invest on designing and developing patterns and strategic perspectives in human resource empowerment as a key factor toward becoming knowledge-based organizations. Originality/value This paper is one of the few applied studies which acknowledged the relationship between knowledge management initiatives and empowering human resources. It addresses the gap between knowledge management and human resource empowerment.

Journal of Knowledge Management, Volume 21, Issue 5, Page 1142-1162, September 2017.
Purpose Although most of the literature supports the existence of a substitutive relationship between exploration and exploitation, some authors suggest that this relationship is complementary (ambidexterity), and others argue that there is no relationship. This paper aims to introduce organizational innovation into the analysis and discusses which of these three relationships prevails. Design/methodology/approach Analyses were performed using data from Spanish Technological Innovation Panel for the period 2008-2013. It should be emphasized that the use of panel data is essential in the analysis of the interaction of exploration and exploitation, as exploration only makes sense in the long run. Econometric strategy uses a two-stage selection model, estimated using the Wooldridge’s (1995) consistent estimator for panel data with sample selection. To perform the test, the hypothesis uses the approach of complementarity. Findings The results show that the relationships exploration-organizational innovation and exploitation-organizational innovation are complementary, provided that the analysis is performed on companies that simultaneously carry out exploration and exploitation activities, respectively. This indicates that the achievement of ambidexterity is strongly conditioned by the simultaneous realization of organizational innovations. Practical implications Managers and policymakers should be aware that the simultaneous implementation of exploration and exploitation yields better results when the corresponding organizational innovations are also implemented. Originality/value This paper extends the empirical investigation of the relationship between exploration and exploitation, seen in conjunction with organizational innovation, and using the complementarity approach as a research tool.

Journal of Knowledge Management, Volume 21, Issue 5, Page 1163-1182, September 2017.
Purpose In downturns, social enterprises (SEs) arise as a resilience business model. The authors focus on knowledge absorptive capacity (KAC) as a key dynamic capability to create shared value (SHV). The purpose of this study is to analyze whether it exists a cause-effect relationship between KAC and SHV creation in SEs. Design/methodology/approach The research model relates KAC and SHV creation. SHV creation involves two components: economic value (EV) and social value (SV). The authors argue that KAC has a positive effect on EV and SV creation, considering SV as a mediator variable. The model is tested by means of PLS-SEM. Findings The results reveal the existence of a positive and significant relationship between KAC and SHV creation, as well as the mediating role of SV creation. Research limitations/implications The sample comprises 127 SEs from the Euro-Mediterranean region (euro-region comprising areas from France and Spain), it would be interesting to include other euro-regions in future research. Practical implications The authors confirm KAC as an important antecedent of SHV creation and also that SEs create EV by means of SV, pointing to the existence of direct and indirect effects. This way, confirming the existence of a mediating effect. Originality/value It points the importance of KAC in SEs, something that has not been addressed before by the literature. It also goes beyond performance by considering SHV creation as a measure of SEs’ outcomes, as well as the definition of the variable SHV including not only social related issues but also environmental (green) issues.

Journal of Knowledge Management, Volume 21, Issue 5, Page 1183-1201, September 2017.
Purpose The purpose of this paper is to discuss how the management of collective intellectual capital (CIC) occurs in a seaport through the actions of the network coordinator. Design/methodology/approach A case study was conducted in a seaport, focusing on the actions taken by a network coordinator – a port authority – to develop the seaport’s CIC. The seaport is conceptualised as a meta-organisation, composed by interdependent actors which may possess different interests and different levels of power. Findings Evidence suggests that the mobilisation of different dimensions of power, in both coercive and non-coercive ways, is needed to promote a higher level of collaboration. Indeed, by mobilising non-coercive dimensions of power, the network coordinator can foster a sense of community within the meta-organisation, grounded in a trust-based collective culture that can potentiate collaboration, and thus allow the attainment of a more “sustainable” type of CIC. Research limitations/implications Despite the validity of the interpretations provided by the case study, generalisation of this study should only be conducted in a theoretically framed manner. Practical implications The findings can provide network coordinators with a better understanding of the consequences of using different dimensions of power to leverage its intangible assets and enhance the meta-organisation’s performance. Originality/value The paper focus on the IC management of a specific type of meso-level unit, which possess some particular characteristics of its own: a seaport. Also, the paper aims to fill a gap in literature regarding the management of different dimensions of power and its effects over IC creation.

Journal of Knowledge Management, Volume 21, Issue 5, Page 1202-1217, September 2017.
Purpose The purpose of this paper is to empirically examine the moderating effect of competitive advantage on the resource value and rareness combination and firm performance. Design/methodology/approach The authors adopted a quantitative research method to achieve the aims of this study. The data collected came from a sample of footwear firms and the hypotheses assessed by multivariate analysis. Findings The findings provide insights into previously inconsistent findings regarding the exploitation of resources and capabilities and contribute to resolving these issues by considering the conditions under which the resource value and rareness combination contributes to firm performance levels and the effects of competitive advantage on this relationship. Interestingly, the authors find that it cannot be inferred that the rarer the resources and capabilities combination, the greater the probability of attaining competitive advantage. Research limitations/implications As limitations, the authors would highlight the fact that the results are specific to one particular industrial sector, and thus not susceptible to the drawing of generalisations as well as the fact that the study does not make recourse to triangulating its methodology (for example, through interviews), which would generate more precise, detailed and objective information. The findings have important managerial implications and the authors close by presenting future research directions. Originality/value This study offers an explanation for previous mixed findings on the relationship between the resource value and rareness combination and firm performance and makes a contribution regarding how such combinations are of great relevance to the organisation and business strategy to turn in better performance levels.

Journal of Knowledge Management, Volume 21, Issue 5, Page 1218-1239, September 2017.
Purpose The purpose of this paper is to identify the factors influencing the growth of healthcare virtual communities of practice (VCoPs) through a seven-year longitudinal study conducted using metrics from social-network and semantic analysis. By studying online communication along the three dimensions of social interactions (connectivity, interactivity and language use), the authors aim to provide VCoP managers with valuable insights to improve the success of their communities. Design/methodology/approach Communications over a period of seven years (April 2008 to April 2015) and between 14,000 members of 16 different healthcare VCoPs coexisting on the same web platform were analysed. Multilevel regression models were used to reveal the main determinants of community growth over time. Independent variables were derived from social network and semantic analysis measures. Findings Results show that structural and content-based variables predict the growth of the community. Progressively, more people will join a community if its structure is more centralised, leaders are more dynamic (they rotate more) and the language used in the posts is less complex. Research limitations/implications The available data set included one Web platform and a limited number of control variables. To consolidate the findings of the present study, the experiment should be replicated on other healthcare VCoPs. Originality/value The study provides useful recommendations for setting up and nurturing the growth of professional communities, considering, at the same time, the interaction patterns among the community members, the dynamic evolution of these interactions and the use of language. New analytical tools are presented, together with the use of innovative interaction metrics, that can significantly influence community growth, such as rotating leadership.

Journal of Knowledge Management, Volume 21, Issue 5, Page 1240-1253, September 2017.
Purpose The purpose of this paper is to investigate the impacts of absorptive capacity, learning motivation and acquired knowledge on knowledge transfer from business schools to business organizations, as it has been realized that in-service training business students can serve as a channel as well as a source in this type of knowledge transfer. The study also examines the mixed moderating role of job autonomy in the relationship between acquired knowledge and knowledge transfer. Design/methodology/approach A sample of 344 in-service training business students in Vietnam was surveyed to collect data. Confirmatory factor analysis was used to validate the measures, and structural equation modeling was used to test the hypotheses. Findings The findings reveal that absorptive capacity positively affects acquired knowledge but it does not have an effect on knowledge transfer. Learning motivation, however, has positive effects on both acquired knowledge and knowledge transfer. The findings also indicate that acquired knowledge is a determinant of knowledge transfer. Finally, job autonomy plays the role of a mixed moderator in the relationship between acquired knowledge and knowledge transfer. Practical implications This study signals the participating parties –business schools, business organizations and in-service training business students –that absorptive capacity, learning motivation, acquired knowledge and job autonomy are critical to the transfer of knowledge from business schools to business organizations. Originality/value This study contributes to the literature on university-to-industry knowledge transfer by providing empirical evidence for key determinants of knowledge transfer from business schools to business organizations through a new channel of knowledge transfer – in-service training business students.

Journal of Knowledge Management, Volume 21, Issue 5, Page 1254-1271, September 2017.
Purpose The purpose of this paper is to construct and investigate relationships between knowledge-sharing factors, attitude and the intention to share of UK academics, as research on knowledge sharing in higher education is extremely sparse. Design/methodology/approach A research model and hypotheses were constructed from individual and organisational factors that were identified to affect knowledge sharing. Questionnaire data were obtained from 367 academics concerning their attitude and intention towards knowledge sharing. This was then used in a two-stage structural equation modelling approach where the measurement model was used for confirmatory factor analysis. The structural model was used to measure and test the hypothesised relationships. Findings Findings indicate that, in general, individual beliefs amongst academics were more influential on their knowledge-sharing attitudes than organisational culture. Furthermore, leadership was the most influential factor within the overall organisational culture whereas autonomy demonstrated the weakest relationship. Belief in the possibility of rewards through associations was found to be a highly significant individual factor. The relationship between attitude and intention was relatively weak although still statistically significant. Originality/value The research demonstrates that management should ensure that departmental leaders promote knowledge sharing and that valued rewards are linked to sharing within the department.

Journal of Knowledge Management, Volume 21, Issue 5, Page 1272-1291, September 2017.
Purpose The purpose of this paper is to analyze the issue of knowledge transfer in the context of international asymmetric alliances. The objective is mainly to identify the barriers that can impede the knowledge transfer between asymmetric partners and to analyze the solutions adopted to overcome these barriers. Design/methodology/approach The authors use a qualitative study involving six cases of asymmetric alliances between Tunisian small-and-medium enterprises (SMEs) and European multinational corporations (MNCs). Findings The results of this research highlight a set of obstacles related to the context of asymmetric alliance itself and the nature of knowledge transferred by partners. The study emphasizes the importance of translation using artefacts by both partners and proximity with its geographical, organizational and technological dimensions to overcome these obstacles. Research limitations/implications The investigation of knowledge transfer in asymmetric alliances was based on the role played by only three proximity dimensions (geographical, organizational and technological), while other factors, such as institutional, social and cultural issues, were not considered. Indeed, future research may take these variables into account in studying solutions to overcome knowledge-transfer barriers in asymmetric alliances. Practical implications The paper calls the attention of asymmetric alliance managers to the importance of translation to perform work processes, facilitate knowledge transfer and overcome linguistic barriers. Managers should use virtual artefacts to reduce the constraints resulting from their geographical remoteness and to strengthen cooperation. Further, reinforcing geographical, organizational and technological proximity between partners involved in an international alliance is essential to facilitate knowledge transfer, essentially of tacit knowledge, and to accelerate innovation. Originality/value This study emphasizes the importance of the simultaneous role of artefacts, translation and proximity in overcoming obstacles related to the asymmetric alliance itself and the nature of knowledge transferred by partners. The results shed light on the issue of knowledge generation in asymmetric alliances.

Objective To identify which specific depressive symptoms predict remission to aripiprazole augmentation in late‐life treatment resistant depression. Methods This is a secondary analysis of data from a late‐life treatment resistant depression trial examining the safety and efficacy of aripiprazole augmentation. Participants aged 60 and above were randomized to aripiprazole augmentation (N = 91) versus placebo (N = 90). The main outcome was depression remission. Clinical predictors included individual Montgomery‐Asberg Depression Rating Scale (MADRS) item scores categorized as symptomatic (scores >2) or nonsymptomatic (scores ≤2). Results Three MADRS items predicted depression remission with aripiprazole augmentation: symptomatic scores on sleep disturbance and nonsymptomatic scores on apparent sadness and inability to feel. The 2‐way and 3‐way interaction terms of these MADRS items were not significant predictors of remission; therefore, the models' ability to predict remission was not improved by combining the significant MADRS items. Conclusions The identification of specific depressive symptoms, which can be clinically assessed, can be used to inform treatment decisions. Older adults with treatment resistant depression that present with sleep disturbances, lack of apparent sadness, or lack of inability to feel should be considered for aripiprazole augmentation.

Objective The purpose of this study was to examine the impact of being exposed to a multimedia campaign on stigmatic beliefs towards a person with Alzheimer's disease (AD). Methods A cross‐sectional posttest online survey was conducted immediately after the campaign among 510 Jewish participants aged 40 and above. Results Most the participants reported being exposed to the campaign. The campaign elicited significantly higher positive than negative emotions. Exposure to the campaign was not significantly associated with any of the stigmatic beliefs as a direct or moderating variable. Worry about developing AD was associated with increased stigmatic beliefs. Conclusions More research is needed to better understand which types of media campaigns work best to increase awareness and reduce stigma associated with AD.

Objective As not speaking English as a first language may lead to increased difficulties in communication with staff and other residents, we (1) tested our primary hypotheses that care home residents with dementia speaking English as a second language experience more agitation and overall neuropsychiatric symptoms, and (2) explored qualitatively how staff consider that residents' language, ethnicity, and culture might impact on how they manage agitation. Methods We interviewed staff, residents with dementia, and their family carers from 86 care homes (2014–2015) about resident's neuropsychiatric symptoms, agitation, life quality, and dementia severity. We qualitatively interviewed 25 staff. Results Seventy‐one out of 1420 (5%) of care home residents with dementia interviewed spoke English as a second language. After controlling for dementia severity, age, and sex, and accounting for care home and staff proxy clustering, speaking English as a second language compared with as a first language was associated with significantly higher Cohen‐Mansfield Agitation Inventory (adjusted difference in means 8.3, 95% confidence interval 4.1 to 12.5) and Neuropsychiatric inventory scores (4.1, 0.65 to 7.5). Staff narratives described how linguistic and culturally isolating being in a care home where no residents or staff share your culture or language could be for people with dementia, and how this sometimes caused or worsened agitation. Conclusions Considering a person with dementia's need to be understood when selecting a care home and developing technology resources to enable dementia‐friendly translation services could be important strategies for reducing distress of people with dementia from minority ethnic groups who live in care homes.

Objective The purpose of this study was to analyze the age and sex‐related differences in socio‐demographic factors that influence suicide ideation and attempts in the elderly. Methods The total number of subjects was 93 151, of whom 8441 belonged to the high suicide‐risk group (2064 male; 6377 female). Following this identification, we investigated their socio‐demographic information, health status, and depressive symptoms, which might have influenced their suicide ideation and attempts. Results Residence in an urban area was identified as a risk factor for both male and female elderly in their 60s and 70s and female elderly in their 80s. Marital status showed a different influence on suicide ideation depending on age and sex. A negative perception of one's own health status was a significant risk factor that increased the likelihood of suicide ideation in all ages, except the female elderly in their 60s. No factor was identified that significantly influenced suicide attempts in the male elderly. However, in the female elderly, residence in an urban area and a negative perception of one's own health status were identified as significant risk factors. Conclusions This study revealed that factors known to influence suicide ideation in the elderly from previous studies, such as residence area, separation from a spouse, education level, religion, and drinking, show changed influence as the elderly reach their 70s and 80s. However, a negative perception of one's own health status was a risk factor that encompassed most ages and sexes.