Assessing dysphagia via telerehabilitation: patient perceptions and satisfaction

To gain insight into factors which may infl uence future acceptance of dysphagia management via telerehabilitation, patients’ perceptions were examined before and after a telerehabilitation assessment session. Forty adult patients with dysphagia(M = 66 years, SD = 16.25) completed pre- and post-session questionnaires which consisted of 14 matched questions worded to suit pre- and post-conditions. Questions explored comfort with the use of telerehabilitation, satisfaction with audio and video quality, benefi ts of telerehabilitation assessments and patients’ preferred assessment modality. Questions were rated on a 5-point scale (1 = strongly disagree, 3 = unsure, 5 = strongly agree). Patients’ comfort with assessment via telerehabilitation was high in over 80% of the group both pre- and post-assessment. Pre-assessment, patients were unsure what to expect with the auditory and visual aspects of the videoconference, however there were signifi cant positive changes reported post-experience. In relation to perceived benefits of telerehabilitation services in general, most patients believed in the value of telerehabilitation and post-assessment this increased to 90 – 100% agreement. Although 92% felt they would be comfortable receiving services via telerehabilitation, 45% of patients indicated ultimate preference for a traditional faceto-face assessment. The data highlight that patients are interested in and willing to receive services via telerehabilitation; however, any concerns should be addressed pre-assessment

A framework for analyzing institutional gaps in natural resource governance

In this paper we present the Inter-Institutional Gap(IIG) Framework as a novel approach to conceptualizing the often-overlooked interconnectivity of different rule-levels between formal and informal institutions in a resource system. This framework goes beyond the existing concepts of legal pluralism, institutional void, structural hole, and cultural mismatch, each of which offer valuable insights to particular gaps between formal and informal institutions, but do not sufficiently address the interaction at every rule level (i.e. constitutional choice, collective choice and operational choice rules). In order to demonstrate the potential of our framework for better understanding the underlying causes of inter-institutional gaps, we apply it to four case studies that encompass diverse geographical locations, governance scales, and social-ecological systems. Results reveal inter-institutional gaps can be created when there are unintended, unforeseen or hidden gaps between different rule hierarchies in two or more simultaneously operating institutions. More specifically we observe that: i) inter-institutional gaps are co-existing, therefore if a certain gap is identified, other gaps may be expected; ii) certain gaps may reveal latent gaps; and iii) intermediaries may be key to addressing inter-institutional gaps. In many cases, sustainable natural resource management and regulation cannot be achieved without directly addressing the inter-institutional gaps that exist between formal and informal institutions operating in the same resource system. The Framework facilitates analysis and understanding of multi-level governance structures in pursuit of addressing complex natural resource management issues

Information Asymmetries and the Paradox of Sustainable Business Models: Toward an integrated theory of sustainable entrepreneurship

In this conceptual paper, the traditional conceptualization of sustainable entrepreneurship is challenged because of a fundamental tension between processes involved in sustainable development and processes involved in entrepreneurship: the concept of sustainable business models contains a paradox, because sustainability involves the reduction of information asymmetries, whereas entrepreneurship involves enhanced and secured levels of information asymmetries. We therefore propose a new and integrated theory of sustainable entrepreneurship that overcomes this paradox. The basic argument is that environmental problems have to be conceptualized as wicked problems or sustainability-related ecosystem failures. Because all actors involved in the entrepreneurial process are characterized by their epistemic insufficiency regarding the solving of these problems, the role of information in the sustainable entrepreneurial process changes. On the one hand, the reduction of information asymmetries primarily aims to enable actors to become critical of sustainable entrepreneurs’ actual business models. On the other hand, the epistemic insufficiency of sustainable entrepreneurs guarantees that information asymmetries remain as a source of new sustainable business opportunities. Three further characteristics of sustainable entrepreneurs are distinguished: sustainability and entrepreneurship-related risk-taking; sustainability and entrepreneurship-related self-efficacy; and the development of satisficing and open-ended solutions, together with multiple stakeholders

Cutaneous malakoplakia: case report and review

Malakoplakia is a rare acquired disease that can affect many systems but is more common in the urogenital tract. Cutaneous malakoplakia is even rarer. It is far more frequent in immunodeficient patients. We report a case of cutaneous malakoplakia in a kidney transplant patient who had recently stopped receiving immunosuppressive therapy to illustrate a review of the relevant recent literature