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Purpose This study aims to determine the possible role of servant leadership (SL) in meliorating critical issues in the contemporary hospitality industry by synthesizing literature on SL, examining benefits and deriving future research propositions. Design/methodology/approach A systematic literature review of SL in hospitality was conducted to analyze, categorize and synthesize the state of research. A nomological framework of SL in hospitality was created, and research gaps were identified. Future directions and propositions were derived to investigate the antecedents of SL by applying the person-situation theoretical approach, and second, to address contemporary challenges in the industry. Findings SL theory in hospitality is examined across various themes with focus on outcome effects related to firm performance, and across different cultures, with observed dominance in Asia. All analyses demonstrate the positive effects on employers and firms and thus confirm the relevance of adopting SL in hospitality. A notable gap in hospitality research is the lack of empirical investigation of SL antecedents. Such an investigation is crucial in promoting related behaviors. Practical implications This study identifies the benefits of SL, especially in addressing contemporary issues, such as sustainability, talent shortage, competition, growing demand for experience and retention of hospitality graduates. Recommendations are elaborated for hospitality educators and industry managers to revise leadership practices. Originality/value This study is the first to review SL in hospitality and determine its role in ameliorating critical issues in the field.

Background Screening for the social determinants of health in clinical practice is still widely debated. Methods A scoping review was used to (1) explore the various screening tools that are available to identify social risk, (2) examine the impact that screening for social determinants has on health and social outcomes, and (3) identify factors that promote the uptake of screening in routine clinical care. Results Over the last two decades, a growing number of screening tools have been developed to help frontline health workers ask about the social determinants of health in clinical care. In addition to clinical practice guidelines that recommend screening for specific areas of social risk (e.g., violence in pregnancy), there is also a growing body of evidence exploring the use of screening or case finding for identifying multiple domains of social risk (e.g., poverty, food insecurity, violence, unemployment, and housing problems). Conclusion There is increasing traction within the medical field for improving social history taking and integrating more formal screening for social determinants of health within clinical practice. There is also a growing number of high-quality evidence-based reviews that identify interventions that are effective in promoting health equity at the individual patient level, and at broader community and structural levels.

Background Recommendations regarding cancer screening vary from country to country, and may also vary within countries depending on the organization making the recommendations. The goal of this study was to summarize the cancer screening recommendations from the 21 countries with the highest per capita spending on healthcare. Main body Cancer screening guidelines were identified for each country based on a review of the medical literature, internet searches, and contact with key informants in most countries. The highest level recommendation was identified for each country, in the order of national recommendation, cancer society recommendation, or medical specialty society recommendation. Breast cancer screening recommendations were generally consistent across countries, most commonly recommending mammography biennially from ages 50 to 69 or 70 years. In the USA, specialty societies generally offered more intensive screening recommendations. All countries also recommend cervical cancer screening, although there is some heterogeneity regarding the test (cytology or HPV or both) and the age of initiation and screening interval. Most countries recommend colorectal cancer screening using fecal immunochemical (FIT) testing, while only seven countries recommend general or selective screening for prostate cancer, and a similar number explicitly recommend against screening for prostate cancer. Screening for lung and skin cancer is only recommended by a few countries. Greater per capita healthcare expenditures are not associated with greater screening intensity, with the possible exception of prostate cancer. Conclusions Guidelines for cancer screening differ between countries, with areas of commonality but also clear differences. Recommendations have important commonalities for well-established cancer screening programs such as breast and cervical cancer, with greater variation between countries regarding prostate, colorectal, lung, and skin cancer screening. Ideally, recommendations should be made by a professionally diverse, independent panel of experts that make evidence-based recommendations regarding screening based on the benefits, harms, and available resources in that country’s context.

Background Screening, Brief Intervention and Referral to Treatment (SBIRT) is a public health framework approach used to identify and deliver services to those at risk for substance-use disorders, depression, and other mental health conditions. Primary care is the first entry to the healthcare system for many patients, and SBIRT offers potential to identify these patients early and assist in their treatment. There is a need for pragmatic “best practices” for implementing SBIRT in primary care offices geared toward frontline providers and office staff. Methods Ten primary care practices were awarded small community grants to implement an SBIRT program in their location. Each practice chose the conditions for which they would screen, the screening tools, and how they would provide brief intervention and referral to treatment within their setting. An evaluation team communicated with each practice throughout the process, collecting quantitative and qualitative data regarding facilitators and barriers to SBIRT success. Using the editing method, the qualitative data were analyzed and key strategies for success are detailed for implementing SBIRT in primary care. Results The SBIRT program practices included primary care offices, federally qualified health centers, school-based health centers, and a safety-net emergency department. Conditions screened for included alcohol abuse, drug abuse, depression, anxiety, child safety, and tobacco use. Across practices, 49,964 patients were eligible for screening and 36,394 pre-screens and 21,635 full screens were completed. From the qualitative data, eight best practices for primary care SBIRT are described: Have a practice champion; Utilize an interprofessional team; Define and communicate the details of each SBIRT step; Develop relationships with referral partners; Institute ongoing SBIRT training; Align SBIRT with the primary care office flow; Consider using a pre-screening instrument, when available; and Integrate SBIRT into the electronic health record. Conclusions and implications SBIRT is an effective tool that can empower primary care providers to identify and treat patients with substance use and mental health problems before costly symptoms emerge. Using the pragmatic best practices we describe, primary care providers may improve their ability to successfully create, implement, and sustain SBIRT in their practices.

Studies conducted in forests have resulted in much of the ecological theory we build upon today. However, our basic understanding of forest ecology comes almost exclusively from the study of trees, even though they represent only a small fraction of the plant diversity present in forests. In recent decades there has been an increasing number of studies of forest herbs, broadening our understanding of plant community ecology in forest ecosystems. Here we highlight ten recent studies examining patterns and drivers of, as well as threats to, herbaceous plant diversity in forests. We first examine local, regional, and global patterns of herbaceous diversity in forests and how such patterns differ for woody versus herbaceous species. We then focus on ecological mechanisms that contribute to forest herb diversity, including the role of abiotic and biotic interactions. We end by discussing some major anthropogenic impacts on forest herb diversity,identifying where herbs are particularly susceptible or particularly resilient to current and predicted changes in comparison to trees. The studies we feature demonstrate that patterns and drivers of diversity often differ between woody and herbaceous plant communities. To facilitate cross-site comparisons, there is great need for more standardized survey methods for herbaceous plants, for simultaneous measurements of multiple plant growth forms, and for incorporating herbs into long-term forest monitoring networks. In addition, the selected studies reveal how land-use history, overabundant herbivores, invasive species, and climate change are all impacting forest herb communities. Some common characteristics of herbaceous plants, such as limited dispersal and small stature, may make forest herb communities more susceptible to these anthropogenic impacts, while others (e.g., resprouting ability, clonal reproduction) may make them more resilient compared to forest trees. More research is needed from both plant ecologists and applied forest practitioners to predict how herbaceous forest diversity will change in the future.

Background Screening is an important part of preventive medicine. Ideally, screening tools identify patients early enough to provide treatment and avoid or reduce symptoms and other consequences, improving health outcomes of the population at a reasonable cost. Cost-effectiveness analyses combine the expected benefits and costs of interventions and can be used to assess the value of screening tools. Objective This review seeks to evaluate the latest cost-effectiveness analyses on screening tools to identify the current challenges encountered and potential methods to overcome them. Methods A systematic literature search of EMBASE and MEDLINE identified cost-effectiveness analyses of screening tools published in 2017. Data extracted included the population, disease, screening tools, comparators, perspective, time horizon, discounting, and outcomes. Challenges and methodological suggestions were narratively synthesized. Results Four key categories were identified: screening pathways, pre-symptomatic disease, treatment outcomes, and non-health benefits. Not all studies included treatment outcomes; 15 studies (22%) did not include treatment following diagnosis. Quality-adjusted life years were used by 35 (51.4%) as the main outcome. Studies that undertook a societal perspective did not report non-health benefits and costs consistently. Two important challenges identified were (i) estimating the sojourn time, i.e., the time between when a patient can be identified by screening tests and when they would have been identified due to symptoms, and (ii) estimating the treatment effect and progression rates of patients identified early. Conclusions To capture all important costs and outcomes of a screening tool, screening pathways should be modeled including patient treatment. Also, false positive and false negative patients are likely to have important costs and consequences and should be included in the analysis. As these patients are difficult to identify in regular data sources, common treatment patterns should be used to determine how these patients are likely to be treated. It is important that assumptions are clearly indicated and that the consequences of these assumptions are tested in sensitivity analyses, particularly the assumptions of independence of consecutive tests and the level of patient and provider compliance to guidelines and sojourn times. As data is rarely available regarding the progression of undiagnosed patients, extrapolation from diagnosed patients may be necessary.

In 2019 Professor Ahmet Kuru published his acclaimed Islam, Authoritarianism, and Underdevelopment: A Global and Historical Comparison. I say ‘acclaimed’ not as an endorsement but merely to point to accolades it received, such as the jointly awarded and prestigious 2020 American Political Science Association’s Jervis-Schroeder Book Award. Moreover, it was keenly promoted by Kuru and publishers via a global book tour including Harvard, on top of receiving reviews in Foreign Affairs and numerous political science and history journals. More recently, its arguments featured in a widely reported op-ed penned by former UK Prime Minister Tony Blair in the wake of the Taliban reconquest of Afghanistan, where he characteristically decries ‘Islamism’ as “a first-order security threat to the west”.

Twitter is a free, open access social media platform that is widely used in medicine by physicians, scientists, and patients. It provides an opportunity for advocacy, education, and collaboration. However, it is likely not utilized to its full advantage by many disciplines in medicine, and pitfalls exist in its use. In particular, there has not been a review of Twitter use and its applications in the field of neurology. This review seeks to provide an understanding of the current use of Twitter in the field of neurology to assist neurologists in engaging with this potentially powerful application to support their work.

The growing numbers of refugees and immigrants from conflict-prone areas settling throughout the world bring several challenges for those working in the mental health care system. Immigrants and refugees of all ages arrive with complex and nuanced mental health histories of war, torture, and strenuous migration journeys. Many of the challenges of addressing the health care needs for this growing population of immigrants and refugees are often unfamiliar, and thus practices to address these challenges are not yet routine for care providers and health care organizations. In particular, complex trauma can make mental health assessments difficult for health care organizations or care providers with limited experience and training in transcultural or trauma-informed care. Using a transcultural approach can improve assessment and screening processes, leading to more effective and high-quality care for immigrant and refugee families experiencing mental health disorders. This paper presents findings from an assessment of current mental health services focusing on current practices and experiences with immigrant and refugee patients and families. The difficulties in developing shared understandings about mental health can hinder the therapeutic process; therefore, it is imperative to ensure an effective assessment right from the beginning, yet there is limited use of existing cultural formulation tools from the DSM-IV or DSM-5. The paper outlines current practices, approaches, challenges, and recommendations shared by mental health care providers and program leaders in addressing the mental health care needs of immigrants and refugees. The results from this study demonstrate that there are many challenges and inconsistencies in providing transcultural, trauma-informed care. Respondents emphasized the need for a thorough yet flexible and adaptive approach that allows for an exploration of differences in cultural interpretations of mental health. Our study concluded that ensuring a mindful, reflexive, transcultural, and trauma-informed health care workforce, and a learning environment to support staff with education, resources, and tools will improve the health care experiences of immigrants and refugees in the mental health care system.