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PurposeIn recent years, consumers today recognise organic foods as high-quality products which can benefit them in various aspects. The tendency to switch consumption behaviours from conventional to ecological food products or organic food has largely been due to the claims that organic crops are grown in eco-friendly and sustainable environments. Thus, the study highlighted unique results on young consumers' purchasing intentions from a new perspective. The paper aims to investigate the factors influencing consumers' purchase decision towards organic food, particularly amongst Generation Y consumers.Design/methodology/approachThe underlying fuzzy set theory is employed to handle the fuzziness of consumers' perceptions since the attributes are usually expressed in linguistic preferences. Overall, the study focussed on five important aspects – health consciousness, environmental concern, social influencing and ethical concern – that also include twenty criteria that had been identified and introduced after a thorough review of related literature.FindingsThe results reveal that the most important criteria in the selected firm are environment protection, chemical instrument, buying attitude and animal testing. In comparison, the cause group includes criteria such as environment protection, natural food and support for training programmes, whilst the effect group includes production practices, monitoring protections and ethically produced food.Research limitations/implicationsThe sample collection from the study focussed on Generation Y consumers who consume organic food in Malaysia. This could lead to the limitation towards external generalisability. The study will provide numerous advantages to the communities. The policy maker should develop a proper marketing strategy to promote organic food as food that is healthier, better in nutrition and safer for society.Originality/valueUtilising fuzzy decision-making trial and evaluation laboratory (DEMATEL) in analysing the fuzziness of consumers' perceptions towards consumers' purchase decision can be expected to expand the breadth of knowledge to both academic and practical.

Standardized observation of bed baths and showers for 100 residents in 8 nursing homes revealed inadequate cleansing of body sites (88%–100% failure) and >90% process failure involving lather, firm massage, changing dirty wipes or cloths, and following clean-to-dirty sequence. Insufficient water warmth affected 86% of bathing opportunities. Bathing training and adequate resources are needed.

Background: Existing training for resident bathing in nursing homes (NHs) is brief and limited, likely because bathing is assumed to be intuitive. However, residents have complex skin issues, devices, dressings, and limited ability for self-care. We sought to assess bathing quality and to identify barriers to proper bathing techniques. Methods: We conducted a prospective observational study of bathing in 8 NHs in Orange County, California, involving a convenience sample of observed bed baths and showers conducted for quality improvement. NH staff were told that observation was occurring, and no feedback was given during or after bathing. Survey elements included cleansing of 6 specific body sites and adherence to bathing procedures (11 for bed baths and 17 for showers). Surveys also included queries to staff to further assess knowledge and perceived barriers. Observed lapses were documented, along with observer-determined reasons for noncompliance (ie, training issue, time pressure, facility issue (insufficient water temperature), resident refusal/behavior). Frequency of noncompliance with each element was tabulated for bed-baths and showers separately. Reasons for failure were displayed graphically. Results: In total, 50 bed baths (NH range, 5–8) and 50 showers (NH range, 4–7) were observed across 8 NHs. Lapses in bathing quality and process were extremely common for both bed baths and showers (Fig.). Inadequate body cleansing occurred for all observed body sites (88%–100% failure for bed baths, 58%–100% failure for showers). Most body areas were either skipped or sprayed with water without soaping. Procedural failures were high for both bed baths and showers (insufficient lather: 100% for bed bath and 40% for shower) lack of firm massage for cleaning (94% for bed bath and 90% for shower), failure to change wipes or cloths when dirty (100% for bed bath and 96% for shower), failure to follow clean-to-dirty sequence (100% for bed bath and 96% shower). In addition, failing to wrap or unwrap devices (73%) and failing to towel dry (94%) were common after showering. Reasons for failure were largely based on training or facility shortcomings (eg, insufficient hot water, inflexible showerhead attachment). Also, 86% of residents complained of being cold. Timing constraints and resident combativeness or refusal were rare. Staff-to-staff bathing advice most commonly involved competing for the “better shower” and “bathing early to get hot water.” Conclusions: Knowing how to appropriately bathe NH residents is not intuitive, and current training is brief and insufficient for high-quality resident care. Unacceptably high failures in proper bathing techniques in NHs necessitate re-evaluation of formal training and standardized practices to better cleanse residents. Moreover, common failures in facility processes for ensuring adequate water temperature and showerhead mobility for bathing or showering should be addressed. Disclosures: None

PurposeThis study explores how virtual learners perceive the use of humor in instructor-developed videos and their other factors for learning effectiveness in an online course.Design/methodology/approachThe study adopted a set of qualitative methods flowing from lesson study, to pilot study, to self-declaration of a learning style, to semi-structured interviews. Through the process, 142 undergraduate business students from the same online course, of different learning styles, discussed their perspectives on the instructor's use of humor and their learning preferences in online situations. Thematic analysis was performed.FindingsFirst, humor is deemed harmless, but its value is perceived at different degrees among the four styles of adult learners for their benefit of learning motivation toward an online course. Second, four common themes that respond to learning effectiveness online are addressed.Research limitations/implicationsSimilar studies with additional samples, including students in other countries, in different age groups and/or on different online courses, are encouraged to strengthen the current findings.Practical implicationsThe results provide evidence to school administrators, course developers and instructors on the importance of using a diverse pedagogy in online education. To motivate virtual learners, being humorous from instructors proves insufficient but developing the course with all respective features for different learners' styles is a clue.Originality/valueIt is among the first studies contextualizing a differential relationship between humor and learners' styles as well as evaluating the effectiveness of an online course from the learning-style standpoint.

Background: Recognizing problematic central-line insertion sites is an important activity for CNAs, LVNs, and RNs in nursing homes (NHs). Although CNAs are not responsible for assessing central lines, they are often the first line of defense for noticing and relaying problems with a line because of the greater amount of time they spend with residents. We sought to assess how well CNAs, LVNs, and RNs could identify problematic insertion sites in NHs. Methods: We conducted a prospective observational study of central-line care in 8 NHs in Orange County, California. A convenience sample of central lines with a range of problematic elements was selected for quality improvement purposes. Research staff used standardized observation forms to evaluate presence of redness, cloudy drainage, and dressing integrity and change date. NH CNAs, LVNs, and RNs were asked to directly observe devices and to comment on problems or concerns. Participants were also asked open-ended questions about elements for a “picture-perfect line” and standard frequency of line checks and dressing changes. Failures to recognize existing problematic elements were tabulated for CNAs and LVNs or RNs separately. Results: In total, 50 CNAs (nursing home range, 3–6) and 50 LVNs and RNs (NH range, 4–6) directly observed lines with 131 problematic elements, including redness (N = 36), cloudy drainage (N = 30), peeling dressings (N = 29), and inappropriately dated dressing (N = 36). Failure to identify problematic elements involved redness [CNAs (50%) and LVNs or RNs (53%)], cloudy drainage [CNAs (40%) and LVNs or RNs (39%)], peeling dressings [CNAs (100%) and LVNs or RNs (87%)], and inappropriately dated dressing [CNAs (71%) and LVNs or RNs (68%)]. For both CNAs and LVNs and RNs, recognition of redness and cloudy drainage improved with severity. Failure to recognize minimal erythema [CNAs (83%) and LVNs or RNs (58%)] was higher than substantial erythema [CNAs (54%) and LVNs or RNs (50%)]. Similarly, failure to recognize minimal cloudy drainage [(CNAs (67%) and LVNs or RNs (50%)] was higher than substantial cloudy drainage [CNAs (42%) and LVNs or RNs (36%)]. Overall, identification of problematic elements did not vary by whether the staff member was assigned to care for that resident. Descriptions of “picture-perfect lines” were uniformly poor, with respondents not knowing what elements to mention. Conclusions: Failure to recognize redness, cloudy drainage, peeling dressings, and lapses in dressing change dates was common for CNAs and LVNs and RNs in nursing homes. This lack of recognition could prevent proper response to early and late signs of localized infection at central-line sites. Dedicated training regarding key elements of a “picture-perfect line” is needed, including changing the threshold for concern for both small and large amounts of redness and pus. Disclosures: None

Purpose This paper gives executives new perspective on how well employee learning is being managed in their small and medium-sized enterprises (SMEs). Design/methodology/approach The study adopted a rigorous mixed-method approach through questionnaires and semi-structured interviews, from categorizing a sample of Hong Kong SMEs into appropriate growth stages (inception, high-growth or maturity) to exploring their respective learning practices in their workplaces. Findings The most popular learning practices in SMEs at each growth stage are compared accordingly with the most/least important learning practices perceived by their employees from another set of results (Tam and Gray, 2021). Differences or mismatches are noted for reporting. Research limitations/implications Additional samples of SMEs, including those in other countries, are encouraged to broaden the horizon. Practical implications The findings help SME executives understand the dynamics of employee learning in their workplaces across growth stages. Knowing what learning practices are offered by the firm and what learning practices are valued by the employee will practically improve the firm’s training/learning strategies to benefit organizational development. Originality/value It is among the first studies examining SME learning with firm growth as well as sorting the learning practices into some traceable patterns for managerial convenience.

Purpose This paper aims to provide owner/managers with access to an evidence-based study for the purpose of improving practice in performance measurement (PM) in their small and medium-sized enterprises (SMEs). Design/methodology/approach As a qualitative case study, it adopted semi-structured interviews to explore the best practices in PM from 32 SMEs in Malaysia. The interviewees were the owner/manager, the supervisor and/or the person who is responsible for human resources in the firm. Thematic analysis was conducted. Findings First, it should be no surprise, as the study echoes previous research, that the traditional, complex PM systems are not functionally suitable for most SMEs. Second, the study identifies five common capabilities (5Cs) in human capital that these SMEs require in their PM practice, all of which are claimed to contribute critically to SME success and sustainability. Research limitations/implications While qualitative studies can obtain in-depth results, it is encouraged to continue similar research with additional samples for comparison, including quantitative studies and SMEs in other countries. Practical implications The findings help SME owners/managers benchmark their current practices in PM and improve toward what peer firms have been doing well to benefit organizational development in a feasible tone. Originality/value This research informs SME practitioners of the 5Cs mechanism found to be effective for long-term organizational survival – including during unprecedented times such as an economic downturn or a pandemic.

To compare patients with autopsy-confirmed Alzheimer disease (AD) and dementia with Lewy bodies (DLB) on the frequency of behaviors related to frontal system dysfunction and the association of these behaviors with dementia severity. We performed a cross-sectional survey of a longitudinal cohort at a university research center for AD on a volunteer sample of 19 DLB and 38 AD participants with autopsy-confirmed diagnoses, similar in age (DLB: 77.3, AD: 77.5), education (DLB: 15.2, AD: 14.7), and Mini-Mental State Examination (MMSE) score (DLB: 20.6, AD: 20.5), with impairment ranging from mild deficits to moderate dementia. The Frontal Systems Behavior Scale (FrSBe)-Family Rating Form assessing patient apathy, disinhibition, and executive dysfunction by a knowledgeable informant was used. A two-way analysis of variance with the FrSBe total as the dependent variable revealed a significant MMSE by diagnosis interaction (F(1,53) = 9.34, p = 0.004). Mean FrSBe total for AD patients showed significant impairment across the range of dementia severity, whereas it was relatively preserved for DLB patients in the early stage of disease. The interaction term showed the same pattern for the executive dysfunction (F(1,53) = 7.62, p = 0.008), disinhibition (F(1,53) = 4.90, p = 0.031), and apathy (F(1,53) = 9.77, p = 0.003) subscales. Although frontal behavioral symptoms in AD patients were present regardless of stage of dementia, DLB patients showed significant frontal dysfunction only in later stages. Results suggest that frontal subcortical circuits associated with behaviors assessed by the FrSBe are affected early in AD but not until later stages in DLB. Assessing specific behaviors related to frontal systems, coupled with stage of cognitive decline, may aid in clinical differentiation of AD and DLB.

Purpose This article reveals a managerial issue that multinational corporations (MNCs) in China are at a strategic crossroad where their employees are competing with the same sources of guanxi networks for different business deals simultaneously. Design/methodology/approach Triggered by a real company case in China and guided by a literature review on business guanxi, the author bridged them into a specific inquiry, as little was known and should be further examined. Findings The author identified a paradoxical/applied scenario in MNCs between the use of guanxi and overall firm performance damaged by overusing it. Research limitations/implications Empirical studies are deemed necessary to seek more understanding between the role of guanxi and MNCs in China. Practical implications Guanxi is not a straightforward guarantee of business achievements in China. Management should note the influence of its actors – own employees – who can potentially diminish the positive returns of guanxi on overall firm’s achievements because of non-obvious interplays among employees and “contacts” on the overlapping guanxi networks. The larger the organisation, the higher the risk is. Originality/value This article proposes a new line of thoughts for practitioners about the effect of business guanxi on overall firm performance and serves as a starting point for academics to explore empirical research. The concept of overlapping guanxi networks is institutionalised and discussed. A three-step rule is also suggested for MNCs as a basic solution.