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In France, integrated care is a recent process, initially experimented during the National Alzheimer Plan 2008-2012. One of the key measures of this policy concerned the training of case managers (CMs) for elderly subjects presenting complex situations at home. All CMs received the same formation; they began exercising between 2008 and 2015. Few data are available on their opinions and professional practices.Objectives: 1/description of CMs professional practices and 2/analysis of the influence of seniority and graduation on these practices and CMs opinions on their profession.Methods: A national survey was conducted by questionnaire sent to all CMs between January and February 2016; multivariate analysis of the influence of seniority and graduation on professional practices and opinions was performed.Results: Participation rate was 78% (n = 546). Among the participants, 93% were women (median age 35 years) and 48% had a seniority of more than 2 years. At the time of the survey 52% of the CMs were graduated. On average, each CM was monitoring 23 situations. The CMs whose seniority was > 24 months had more situations in charge: 27± 8 vs 18±9 when the seniority was ≤ to 24 months (p = 0.0005). Those who were graduated also had more situations in charge: 26±8 for graduated vs 17±9 for non-graduated (p = 0.0005).CMs whose seniority was > 24 months seemed less likely to continue with case management when they met with reluctance from the patient (OR 0.4 CI 0.23-0.72 p = 0.002), and reported less often to negotiate with the person upon refusal (OR 0.44 CI 0.22-0.89 p = 0.024). When they encountered difficulties, CMs declared to be more likely to discuss situations with their colleagues rather than with their superiors (OR 1.80 CI 1.01-3.22 p = 0.046). They expressed more frequently the wish to manage fewer situations (OR 1.56 CI 1.08-2.26 p = 0.017). They considered more often that one of the specific contributions of their profession was the strengthening of the ambulatory- hospital links (OR 1.95 CI 1.07-3.57 p = 0.03).Graduated CMs reported less systematic use of the Individualized Service Plan tool than non-graduated (OR 0.43 CI 0.25- 0.75 p = 0.003). They also expressed the wish to manage fewer situations (OR 1.57 CI 1.05-2.25 p = 0.026), and to have more ethical reflection (OR 1.97 CI 1.14-3.39 p = 0.014). They considered more often that the specific contribution of their profession was an improvement in the quality of life of the accompanied persons (OR 2.81 CI 1.07-7.37 p = 0.036). Graduated CMs declared more frequently that they wanted to stop this function in the future (OR 7.78 CI 2.05-29.48 p = 0.003).Conclusion: Seniority and graduation seem to favor certain arrangements with CMs practice and modify representations. Unexpectedly, the graduation does not seem to encourage the CMs in the pursuit of their task. More studies are needed to understand why training does not strengthen CMs in their professional practice.

Contemporary lifestyles are characterized by a multitude of factors that contribute to elevated levels of stress in the population, with work being a significant factor. This study addresses an important gap in social science research by examining work-related stress among industrial workers. The participating company was selected because it is emblematic in human resource management and psychosocial risk prevention. The Demands-Control-Support Questionnaire was used to determine the degree of job stress, and the socio-demographic variables of gender, age and seniority were also considered. The results showed that factory workers had minimal levels of job stress, with no differences between them and office workers. However, there was a significant discrepancy in job stress levels between men and women, with women having higher levels. Regarding age and seniority, job stress levels tend to decrease with increasing age and seniority.

PurposeGiven the popularity of online health communities (OHCs) and medical question-and-answer (Q&A) services, it is increasingly important to understand what constitutes useful answers and user-adopted standards in healthcare domain. However, few studies provide insights into how health information characteristics, provider characteristics and recipient characteristics jointly influence user information adoption decisions. To fill this research gap, this study examines the combined effects of physicians' certainty tone as information characteristics, seniority as provider characteristics and disease severity as recipient characteristics on patients' health information adoption.Design/methodology/approachDrawing on dual-process theory and information adoption model, an extended information adoption model is established in this study to examine the effect of attitude certainty on patients' health information adoption, and the moderating effects of online seniority and offline seniority, as well as patient motivation level—disease severity. Utilizing logit regression models, the authors empirically tested the hypotheses based on 4,224 Q&A records from a popular Chinese OHC.FindingsThe results show that (1) attitude certainty has a significant positive impact on patients' health information adoption, (2) the relationship between attitude certainty and information adoption is negatively moderated by physicians' online seniority, but is positively moderated by offline seniority; (3) there is a negative three-way interaction effect of attitude certainty, online seniority and disease severity on patients' health information adoption.Originality/valueThis study extends the information adoption model to examine the two-way interaction between argument quality and source reliability, as well as the three-way interaction with user motivation level, especially for health information adoption in the healthcare field. These findings also provide direct practical applications for knowledge contributors and OHCs.

Most influenza vaccines are produced in hens' eggs and may undergo ‘egg adaptation’, whereby mutations within the haemagglutinin protein that result in adaptation to the avian cells undergo positive selection. It is well established that egg adaptation can impact antigenicity and vaccine effectiveness (VE) by causing mismatches between the vaccine virus and circulating viruses. However, few studies have investigated the potentially long-lasting impact of childhood vaccination with an egg-adapted vaccine on the immunological memory. Prior exposure history shapes subsequent immune responses, such that memory responses to previously encountered antigens trigger stronger immune responses than those elicited by de novo antigen exposure. This phenomenon is called immune imprinting, when referring specifically to the impact of the first lifetime exposure, and antigenic seniority, when referring to exposures after the first, which also shape an individual's antibody repertoire according to how early and how often they are encountered. Crucially, if an individual's first influenza exposure is via an egg-adapted vaccine, this imprinting event could adversely affect antibody responses to circulating viruses in future seasons, reducing the benefit of influenza vaccination. Using alternative types of vaccines that avoid egg adaptation is particularly important now that the World Health Organization (WHO) recommend immunising children aged ≥6 months against influenza. In this review, we cover the historical frequency and nature of egg adaptations and the impact of egg adaptation, immune imprinting and antigenic seniority on the clinical effectiveness of seasonal influenza vaccinations. We discuss the impact of interactions between egg adaptation and immune imprinting, examine how egg-adapted vaccines can lead to suboptimal imprinting and potentially reduce VE throughout an individual's lifetime, and identify how we can address this issue in future. [Display omitted] •A person's first exposure to influenza has a life-long impact on immune response.•To improve effectiveness, vaccine viruses should closely match circulating strains.•Egg adaptations can alter the antigenicity of the vaccines and reduce effectiveness.•Egg adaptations have been identified in most egg-based influenza vaccine viruses.•Childhood immunisation with non-egg-based vaccines could optimise immune imprinting.

Nuclear isomers are the metastable excited states of nuclei. The isomers can be categorized into a few classes including spin, seniority, K, shape and fission isomers depending upon the hindrance mechanisms. In this paper, we aim to present an overview of seniority isomers, which is a category related to the seniority quantum number. The discussion is mainly based on the concepts of seniority and generalized seniority. Various aspects of seniority isomers and their whereabouts have been covered along with the situations where seniority mixing prevents the isomerism.

Oral arguments at the U.S. Supreme Court are important—they affect case outcomes and constitute the only opportunity for outsiders to directly witness the behavior of the Justices of the highest court. This Article studies how the Justices compete to have influence at oral argument, by examining the extent to which the Justices interrupt each other; it also scrutinizes how advocates interrupt the Justices, contrary to the rules of the Court. We find that judicial interactions at oral argument are highly gendered, with women being interrupted at disproportionate rates by their male colleagues, as well as by male advocates. Oral argument interruptions are highly ideological, not only because ideological foes interrupt each other far more than ideological allies do, but also because, as we show, conservatives interrupt liberals more frequently than vice versa. Seniority also has some influence on oral arguments, but primarily through the female Justices learning over time how to behave more like male Justices, avoiding traditionally female linguistic framing in order to reduce the extent to which they are dominated by the men. We use two separate databases to examine how robust these findings are: a publicly available database of Roberts Court oral arguments, and another that we created, providing in-depth analysis of the 1990, 2002, and 2015 Terms. This latter data allows us to see whether the same patterns held when there were one, two, and three female Justices on the Court, respectively. These two sets of analyses allow us to show that the effects of gender, ideology, and seniority on interruptions have occurred fairly consistently over time. It also reveals that the increase in interruptions over time is not a product of Justice Scalia's particularly disruptive style, as some have theorized, nor of the political polarization in the country generally arising from the 1994 Republican Revolution. We also find some evidence that judicial divisions based on legal methodology, as well as ideology, lead to greater interruptions.

PurposeSocial media facilitates the communication and the relationship between healthcare professionals and patients. However, limited research has examined the role of social media in a physicians' online return. This study, therefore, investigates physicians' online economic and social capital return in relation to physicians' use of social media and consumer engagement.Design/methodology/approachUsing ordinary least squares (OLS) regression with fixed effects (FE) and panel data collected from Sina Weibo and Sina Health, this study analyzes the impact of physicians' social media use and consumer engagement on physicians' online return and the moderation effect of professional seniority.FindingsThe results reveal that physicians' use of social media and consumer sharing behavior positively affect physicians' online economic return. In contrast, consumer engagement positively impacts physicians' online social capital return. While professional seniority enhances the effect of physicians' social media use on online economic return, professional seniority only enhances the relationship between consumers' sharing behavior to the posts and physicians' online social capital return when professional seniority comes to consumer engagement.Originality/valueThis study reveals the different roles of social media use and consumer engagement in physicians' online return. The results also extend and examine the social media affordances theory in online healthcare communities and social media platforms.

PurposeSince the success of online communities depend on physicians' participation, understanding factors that influence community participation and content contribution are critical for online health communities (OHCs). Drawing on the self-determination theory (SDT), an empirical model was proposed to explore the effects of social returns and economic returns on physicians' community participation, private content contribution and public content contribution, and the moderating effect of their online seniority. This paper aims to address these issues.Design/methodology/approachEmpirical data of 4,343 physicians were collected from a Chinese OHC, and ordinary least squares (OLS) and negative binomial regression models were employed to verify the proposed theoretical model.FindingsThe authors’ results indicate that both social and economic returns have a positive effect on physicians' community participation and private content contribution, and their online seniority strengthens the positive effects of economic returns on community participation and private content contribution.Originality/valueThe authors’ research extends physicians' community participation by dividing content contribution into private and public, and enhances our understanding of the determinants of physicians' participation in OHCs by exploring the effects of social and economic returns, as well as the moderating effect of online seniority. Their findings contribute to the literature on e-Health and user participation, and provide management implications for OHC managers.Peer reviewThe peer review history for this article is available at https://publons.com/publon/10.1108/OIR-11-2021-0615/