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Current literature lacks qualitative information derived from distressed fathers. The aim of this study was to explore distressed fathers' experiences and needs in the early postpartum period. A descriptive qualitative study design was used. The study took place from October 2018 to December 2018 at the tertiary public hospital in Singapore. A purposive sample of 12 distressed Singaporean fathers were interviewed in this study. Audio recorded interviews were conducted face-to-face using a semistructured interview guide and thematic analysis was used to analyze the data. Six themes emerged from the thematic analysis: (a) facing the "real deal," (b) everyday woes, (c) "losing excitement," (d) "trying to be strong," (e) "reality check," and (f) supplementing help for fathers. This study highlights distressed father's agony and the urgent need for health care professionals and family members to seek acceptability and understanding of fathers' mental health difficulties in the early postpartum period.

Purpose Small- and medium-sized enterprises (SMEs) are key players in economic activities. Yet little research focuses on their management innovation's effect on innovation performance, this paper explores the impact of three sub-dimensions of management innovation (new organizational structure, new processes and new practices) on innovation performance (innovation outcome performance and innovation process performance) of SMEs in the manufacturing industry. It elucidates the mediating role of external knowledge search (search depth and search breadth) and identifies the moderating effect of digital capability.Design/methodology/approach By collecting primary data through a questionnaire survey, this paper employs Mplus and SPSS to analyze data.FindingsThis paper finds that management innovation positively affects innovation performance, with a greater impact on innovation outcome performance. Search breadth partially mediates the relationship between new organizational structure and innovation performance. Digital capability positively moderates the positive relationship between management innovation and external knowledge search.Originality/value The theoretical contribution of this study is to supplement the research on the consequences of management innovation and to improve the theoretical relationship between management innovation and external knowledge search based on firm behavior theory.

We examine how the performance of teams and of the individuals within them varies with disparity in team member ability and with the reward structure in place. We carry out an experiment on a sample of 240 participants which first played a Counter‐Strike Game to determine their level of proficiency, then played in three‐person teams made up of a high, a medium and a low level performer. We observed the effect of both a competitive reward and of a cooperative one on team performance. The results indicate that when the disparity in ability is large, teams compensated using a competitive reward outperform those subject to a cooperative reward, but when the disparity in ability is small, reward structure has no influence on team performance. Hierarchical Linear Modelling (HLM) analysis confirms these findings at the individual level. Our study has implications for optimal team composition and the structuring of rewards. Copyright © 2016 John Wiley & Sons, Ltd.

Bao-Dong Qin,* Xiao-Dong Jiao,* Ling-Yan Yuan, Ke Liu, Yuan-Sheng Zang Department of Medical Oncology, Changzheng Hospital, Second Military Medical University, Shanghai, China *These authors contributed equally to this work Introduction: Adenosquamous carcinoma (ASC) of the bile duct is a rare diagnosis with poorly understood clinicopathological characteristics and disease progression, so identification of the features associated with ASC patient survival is warranted. Materials and methods: A population cohort study was performed using prospectively extracted data from the Surveillance, Epidemiology and End Results (SEER) database for patients with histological diagnoses of ASC of the bile duct from 1973 to 2013. Results: A total of 106 patients with ASC of the bile duct were included (mean age 68.1±13.5 years). Lesions from 58 patients were in the extrahepatic bile duct and 34 were located at the ampulla of Vater. Fifty-seven patients were categorized with a regional stage, 15 had localized disease, and 30 had distant disease. Most (60.4%) patients received cancer-directed surgery, and radiation was performed in 14.1% of cases. The 1-year, 2-year, and 5-year overall survival (OS) for patients with ASC of the bile duct was 30.1%, 11.3%, and 3.7%, respectively. Cancer-directed surgery offered 10 additional months of OS for patients with ASC of the bile duct and median OS was 14.0, 6.0, and 6.0 months for ampulla of Vater, extrahepatic bile duct, and intrahepatic bile duct cases, respectively. A multivariate Cox analysis showed that lesions in the ampulla of Vater (HR=0.51, 95% CI 0.26–0.99) and having surgery (HR=0.34, 95% CI 0.14–0.81) were independent protective prognostic factors for these patients. Conclusion: Cancer-directed surgery and a primary lesion site of the ampulla of Vater may suggest favorable prognosis for patients with ASC of the bile duct. Keywords: adenosquamous carcinoma, bile duct, prognosis, SEER database