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In this paper, we explore system dynamics as a useful approach to consolidate findings from case studies on business process change (BPC) projects. We compile data from 65 BPC case studies to develop a system dynamics simulation model that helps us to investigate ‘employee morale’ as an important construct in BPC projects. We show that such simulation models consolidate the complex and often non-linear findings from BPC case studies in a way that makes it available to discourse among researchers, lecturers and students as well as BPC professionals. Thus, this paper contributes to knowledge management and learning by suggesting system dynamics as a valuable approach to illustrate and convey the complex relationships between important constructs in BPC. This paper also contributes to the domain of business process management by demonstrating the benefits of system dynamics as a way to review and consolidate the abundance of BPC case studies.

This work seeks to support scholars interested in non-face-to-face modalities of higher education in making decisions about the use of digital and educational technologies (DET) to promote educational transformation (ET) in the context of their organizations. This organizational change deals with the implementation of technology-based flexible educational practices, focused on helping students develop competencies of interest for their personal and professional growth. With this in mind, in 2018 we identified and followed six leading higher education institutions on three continents that, for years, have carried out educational innovation experiences with the support of technology. Two of the analyzed experiences make use of eLearning, another of bLearning, and the others combine eLearning and bLearning as a complement to the face-to-face modality. The meta-analysis of the cases, carried out in 2019, followed suggestions from (Stake in The art of case study research, Sage Publications Inc., 1995) as well as from qualitative research that seeks to understand what is behind the cases from three dimensions: education, technology, organization. For each one, we determined what they do, how they do it, and what success factors must be considered. As the data was collected before the 2020 pandemic and this issue produced structural imbalances in society and in higher education, it was considered pertinent, at the end of 2020, to check the pulse of the ET mediated with DET in three of the six institutions studied. The purpose was to refine the findings of the meta-analysis and learn from the decisions made in the situation of forced change in environments, means, and strategies to continue providing quality higher education.

This paper discusses the research and development of a modeling tool that provides a graphical approach to the definition, validation and generation of XML schemas. Although XML has had a ubiquitous web presence for a number of years the strength of its underlying validation framework is often not leveraged to its maximum potential. Additionally the design process followed when developing XML data formats is often rather ad-hoc and driven by technical requirements of the application rather than a conceptual level analysis of the problem domain. This work contributes to research knowledge by proposing and validating a mechanism for allowing non-programmers to easily visualise and design the rules to which XML documents should comply. The use of an underlying meta-case platform provides a unique opportunity to allow highly customisable support and automatic code generation for any number of schema definition languages, thus providing a test-bed for future research activities.

Background: The relationship between serum calcium levels and pregnancy-induced hypertension is controversial. This work aimed to evaluate the relationship between serum calcium levels and the risk of pregnancy-induced hypertension. Methods: The following database: Chinese National Knowledge Infrastructure and PubMed, were searched to identify articles on the relationship between serum calcium levels and pregnancy-induced hypertension. The meta-analysis was conducted by using Review Manager (RevMan) [Computer program]. Results: A total of twenty one articles included in the present study. The meta-analysis revealed that patients with pregnancy-induced hypertension (PIH) had lower calcium levels (standardized weighted mean difference (SMD) = –0.68; 95% (–0.79, –0.56); p < 0.05). Conclusions: Our study suggests that serum calcium levels may be associated with the risk of pregnancy-induced hypertension.

Background：Studies on the association between spicy food intake and cancer risk have reported inconsistent results.We quantitatively assessed this association by conducting a meta-analysis based on evidence from case-control studies.Methods：PubMed,EMBASE,and the Cochrane Library were searched for eligible publications.Combined odds ratios （ORs） with their 95% confidence interval （CI） were calculated using a random-or fixed-effects model.The methodological quality of the included articles was assessed using the Newcastle-Ottawa scale （NOS）.All data were analyzed using STATA 1 1.0 software （version 11.0;StataCorp.,College Station,TX,USA）.Subgroup analyses were also performed with stratification by region,sex,number of cases,cancer subtype,source of the control group,and NOS score.Results：A total 39 studies from 28 articles fulfilled the inclusion criteria for the meta-analysis （7884 patients with cancer and 10,142 controls）.Comparison of the highest versus lowest exposure category in each study revealed a significant OR of 1.76 （95% CI =1.35-2.29） in spite of significant heterogeneity （P 〈 0.00l）.In the subgroup analyses,this positive correlation was still found for gastric cancer,different regions,different numbers of cases,different sources of the control group,and high-quality articles （NOS score of≥ 7）.However,no statistically significant association was observed for women,esophageal cancer,gallbladder cancer,or low-quality articles （NOS score of〈7）.No evidence of publication bias was found.Conclusions：Evidence from case-control studies suggested that a higher level of spicy food intake may be associated with an increased incidence of cancer despite significant heterogeneity.More studies are warranted to clarify our understanding of the association between high spicy food intake and the risk of cancer.

Background: The profession would benefit from greater and routine generation of causal evidence pertaining to the impact of music therapy interventions on client outcomes. Objective: One way to meet this goal is to revisit the use of Single Case Designs (SCDs) in clinical practice and research endeavors in music therapy. Given the appropriate setting and goals, this design can be accomplished with small sample sizes and it is often appropriate for studying music therapy interventions. Methods: In this article, we promote and discuss implementation of SCD studies in music therapy settings, review the meaning of internal study validity and by extension the notion of causality, and describe two of the most commonly used SCDs to demonstrate how they can help generate causal evidence to inform the field. Results: In closing, we describe the need for replication and future meta-analysis of SCD studies completed in music therapy settings. Conclusions: SCD studies are both feasible and appropriate for use in music therapy clinical practice settings, particularly for testing effectiveness of interventions for individuals or small groups.

Pica is an eating disorder characterized by consumption of nonfood items or compulsive eating of edible and nonedible items. This chapter summarizes the various conceptual models of pica and employs both descriptive and single‐case experimental meta‐analytic methods to identify evidence‐based practice for the clinical treatment of pica. Three specific interventions strategies were identified as being evidence‐based: environmental enrichment, noncontingent reinforcement, and overcorrection. Several other intervention strategies were identified as being clinically promising but as having insufficient empirical evidence to be labeled as evidence‐based (i.e., physical restraint, nutritional treatments, and response blocking). No difference in clinical efficacy was found between studies that conducted a pretreatment functional assessment (e.g., analog‐functional analysis) and those that did not. Recommendations for future research and contemporary clinical practice are provided.

Anorexia nervosa (AN) is a complex and heritable eating disorder characterized by dangerously low body weight. Neither candidate gene studies nor an initial genome-wide association study (GWAS) have yielded significant and replicated results. We performed a GWAS in 2907 cases with AN from 14 countries (15 sites) and 14 860 ancestrally matched controls as part of the Genetic Consortium for AN (GCAN) and the Wellcome Trust Case Control Consortium 3 (WTCCC3). Individual association analyses were conducted in each stratum and meta-analyzed across all 15 discovery data sets. Seventy-six (72 independent) single nucleotide polymorphisms were taken forward for in silico (two data sets) or de novo (13 data sets) replication genotyping in 2677 independent AN cases and 8629 European ancestry controls along with 458 AN cases and 421 controls from Japan. The final global meta-analysis across discovery and replication data sets comprised 5551 AN cases and 21 080 controls. AN subtype analyses (1606 AN restricting; 1445 AN binge–purge) were performed. No findings reached genome-wide significance. Two intronic variants were suggestively associated: rs9839776 ( P =3.01 × 10 −7 ) in SOX2OT and rs17030795 ( P =5.84 × 10 −6 ) in PPP3CA . Two additional signals were specific to Europeans: rs1523921 ( P =5.76 × 10 − 6 ) between CUL3 and FAM124B and rs1886797 ( P =8.05 × 10 − 6 ) near SPATA13 . Comparing discovery with replication results, 76% of the effects were in the same direction, an observation highly unlikely to be due to chance ( P =4 × 10 −6 ), strongly suggesting that true findings exist but our sample, the largest yet reported, was underpowered for their detection. The accrual of large genotyped AN case-control samples should be an immediate priority for the field.

Objective: To better understand the role of fish and shellfish on thyroid cancer risk, we systematically re-analyzed the original data from 13 case-control studies conducted in the US, Japan, China, and Europe. Methods: A total of 2497 cases (2023 women, 474 men) and 4337 controls (3268 women, 1069 men) were considered. Odds ratio (OR) and corresponding 95% confidence interval (CI) were estimated for each study by logistic regression models, conditioned on age and sex, and adjusted for history of goiter, thyroid nodules or adenomas, and radiation. Combined ORs were computed as the weighted average of the estimates from each study. Results: The ORs for the highest level of total fish consumption (three or more times per week) as compared to the lowest one (less than once per week) was above unity in Hawaii, Connecticut, Japan, Norway, Tromsø, and Vaud. Conversely, the ORs for the studies in Los Angeles, Shanghai, southeastern Sweden, Uppsala, northern Sweden, northern Italy, and Athens were below one. The pattern of risk for salt water fish and shellfish was not substantially different from that of total fish. Fish was not associated with thyroid cancer risk in all studies combined (OR = 0.99, 95% CI 0.85-1.2 for moderate, and OR = 0.88, 95% CI 0.71-1.1 for high total fish consumption), but there was a suggestion of a protective effect in endemic goiter areas (OR = 0.65, 95% CI 0.48-0.88). Conclusion: This combined analysis indicates that relatively elevated fish consumption does not appreciably increase thyroid cancer risk, and may have a favorable influence in areas where iodine deficiency is, or was, common.