Reflections on context in service research

Purpose: To examine the nature of context and its implications for theory and research in service. Approach: This is a conceptual paper based on exploring existing research and theory related to context in service research. Findings: The characteristics of service make context both important and challenging, there is great contextual diversity in service research as reflected for example in ecosystems made up of multiple contextual variables. There is a need to identify the context specific nature of middle range theory and the contextual logic of general theory. We explore the challenges of context for service theory and how we might learn from theory in a particular context and test or adapt it in other contexts. Value: The findings of this paper are of value to researchers seeking to develop and justify theory in service research, (general, middle range or theory in use)

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Historas (co) movedoras: Historia Oral e estudos de migrac?o

This article intends to review the contribution which oral history has made to migration studies over the last quarter century, mainly between Britain and Australia. The title "moving stories" in an useful pun about the oral history of migration because is centered on the physical experience of movement between places, as well as is deeply moving for the narrator and for his or her audience

Alcohol Consumption Inhibits Bone Growth and Development in Young Actively Growing Rats

Adolescence is an age of widespread alcohol abuse, but the effect of alcohol consumption on bone formation has not been studied in the young population. This study addresses the effect of alcohol on the early phases of bone growth and development in an animal model. Four‐week‐old, female Sprague‐Dawley rats were divided into three groups. Alcohol‐treated animals were fed a modified Lieber‐DeCarli diet ad libitum containing 35% ethanol‐derived calories, whereas the pair‐fed animals (weight‐matched to ethanol rats) received an iso‐caloric liquid diet in which maltose‐dextrin substituted calories supplied by ethanol. Chow animals were fed a standard rat chow ad libitum. Proximal tibiae (primarily cancellous bone) and femora (primarily cortical bone) were removed for analysis after 2, 4, 6, or 8 weeks on the diets. Serum was collected for analysis of calcium levels, osteocalcin, corticosterone, growth hormone, parathyroid hormone, and 25‐hydroxyvitamin D. The most rapid weight gain occurred between 6 and 8 weeks of age, and it was significantly delayed in alcohol and pair‐fed animals. Almost all morphological parameters of bone were lower in the alcohol groups. No significant difference in serum calcium levels, osteocalcin, or growth hormone levels were found, and small difference in calciotropic hormone levels was found between groups. The results indicate that chronic alcohol consumption during the age of bone development reduces bone density and peak bone mass in both cortical and cancellous bone. The mechanism whereby this effect occurs is not fully understood, but, our results suggest that the negative impact of alcohol on growing bone is not due to the secondary effects of altered bone mineral regulating hormones

Empagliflozin in Patients with Chronic Kidney Disease

Background The effects of empagliflozin in patients with chronic kidney disease who are at risk for disease progression are not well understood. The EMPA-KIDNEY trial was designed to assess the effects of treatment with empagliflozin in a broad range of such patients. Methods We enrolled patients with chronic kidney disease who had an estimated glomerular filtration rate (eGFR) of at least 20 but less than 45 ml per minute per 1.73 m(2) of body-surface area, or who had an eGFR of at least 45 but less than 90 ml per minute per 1.73 m(2) with a urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) of at least 200. Patients were randomly assigned to receive empagliflozin (10 mg once daily) or matching placebo. The primary outcome was a composite of progression of kidney disease (defined as end-stage kidney disease, a sustained decrease in eGFR to < 10 ml per minute per 1.73 m(2), a sustained decrease in eGFR of & GE;40% from baseline, or death from renal causes) or death from cardiovascular causes. Results A total of 6609 patients underwent randomization. During a median of 2.0 years of follow-up, progression of kidney disease or death from cardiovascular causes occurred in 432 of 3304 patients (13.1%) in the empagliflozin group and in 558 of 3305 patients (16.9%) in the placebo group (hazard ratio, 0.72; 95% confidence interval [CI], 0.64 to 0.82; P < 0.001). Results were consistent among patients with or without diabetes and across subgroups defined according to eGFR ranges. The rate of hospitalization from any cause was lower in the empagliflozin group than in the placebo group (hazard ratio, 0.86; 95% CI, 0.78 to 0.95; P=0.003), but there were no significant between-group differences with respect to the composite outcome of hospitalization for heart failure or death from cardiovascular causes (which occurred in 4.0% in the empagliflozin group and 4.6% in the placebo group) or death from any cause (in 4.5% and 5.1%, respectively). The rates of serious adverse events were similar in the two groups. Conclusions Among a wide range of patients with chronic kidney disease who were at risk for disease progression, empagliflozin therapy led to a lower risk of progression of kidney disease or death from cardiovascular causes than placebo