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Most UK ambulance services undertake remote assessments of 999 calls with nurses and paramedics to manage demand and reduce inappropriate hospital admissions. However, little is known about the differences in the types of cases managed by the two professions comparatively, their clinical outcomes, and the quality and safety they offer.

The retrospective descriptive study analysed data collected at Welsh Ambulance Services University NHS Trust (WAST) from prioritisation, triage, and audit tools between the 17th May 2022 to 8th November 2022. A total of 21,076 cases and 728 audits were included for review.

There was little difference in the type and frequency of the presenting complaints assessed, and clinical outcomes reached in percentage terms. Whilst paramedics had more highly compliant call audits and fewer non-compliant call audits, there was, again, little difference in percentage terms between the two, indicating positive levels of safety across the two professional groups.

There continues to be a substantial difference between UK paramedics to those in the Middle East, the United States, and some African nations, which may limit the applicability of findings. This study also looked at a six-month window from only one UK service using one type of prioritisation and triage tool. Future research could explore longer periods from multiple services using various tools. It is important to note that this study did not link outcome data with primary, secondary or tertiary care settings. Thus, it is impossible to determine if the level of care aligned closely with the final diagnosis.

The practical implications of this work include better workforce planning for agencies who have perhaps only employed one type of clinician or a reaffirmation to those who have employed both. The authors suggest that the training and education of both sets of clinicians could remain general in nature, with no overt requirement for specificity based on professional registration alone. Commissioners and stakeholders in the wider health economy should consider ensuring equitable access to alternative pathways for patients assessed by both nurses and paramedics.

It has been posited that UK nurses and paramedics are, by virtue of their consistency in education, skill set, licensure, and general experience, both able to achieve safe and effective remote outcomes in 999 settings. This study provides evidence to support that hypothesis. These results say more about the two professions' ability to work together rather than just the professions themselves. The multidisciplinary team approach is well-established in acute care settings, and is broadly considered to improve communication, coordination decision making, adherence to up-to-date treatment recommendations, and be positive for shared learning and development for younger colleagues.

Most UK services use a mix of nurses and paramedics; however, little is known about the differences in the types of cases managed by the two professions comparatively, their clinical outcomes, and the quality and safety they each offer. The most recent studies of this nature were published in 2003 and 2004 and looked only at low-acuity 999 calls when remote assessment was not even an established role for UK paramedics. This study updates the literature, identifies areas for future research, and applies to the international setting for the most part.

The coronavirus disease (COVID-19) pandemic has been negatively affecting international trade between countries; however, there is a lack of empirical studies on developing countries such as Vietnam. This article aims to investigate how the COVID-19 cases and related deaths and policy response by Vietnam and trading partners to the pandemic affect Vietnam's export activities.

The authors use the monthly trade data from the General Department of Vietnam Customs and employ the Poisson pseudo-maximum-likelihood (PPML) estimator to empirically investigate the effects of COVID-19 and policy response to the pandemic on Vietnam's exports at aggregate and sectoral levels over a 33-month period.

In the first year of the pandemic (January–December 2020) as well as the whole study period (January 2019–September 2021), trading partners' COVID-19 burden adversely affected Vietnam's aggregate exports, and the effect of COVID-19 deaths is significantly larger than that of COVID-19 cases. In the first year of the pandemic, estimates show a negative effect of Vietnam's COVID-19 cases on its exports, while no evidence reveals the impact of Vietnam's COVID-19 deaths. However, during the entire study period, there are remarkable adverse effects of Vietnam's COVID-19 deaths on its exports. The effect of the COVID-19 burden in Vietnam and in its trading partners differs significantly across major subsectors. In the first year, there is a positive role of government response to the pandemic by Vietnam and its trading partners in Vietnam's aggregate exports, while in the whole study period, only a positive effect of Vietnam's government response is found. Economic support and free trade agreements (FTAs) have a positive effect on Vietnam's exports. In the first year of the pandemic, Vietnam's export losses due to COVID-19 outweighed its export gains from the pandemic. However, Vietnam's exports have significantly improved over the nine months of 2021.

Efforts should aim to reduce the number of COVID-19 deaths rather than focus on reducing the number of COVID-19 cases. The application of stringency measures by both exporters and importers should be minimized, or at least those measures need to be combined with health methods, such as testing policy and contact tracing, short-term investment in healthcare and especially investments in vaccines. In addition, economic support, particularly debt relief, needs to be widely applied to assist firms, especially those involved in international trade. The expansion of FTA networks and diversifying export destinations may be helpful in maintaining production networks and export activities.

In the long-term period, the application of stringency measures by both exporters and importers should be minimized, or at least those measures need to be combined with health methods such as testing policy and contact tracing, short-term investment in healthcare and especially investments in vaccines. In addition, economic assistance, particularly debt relief, needs to be widely applied to assist firms, especially those involved in international trade activities.

To the best of the authors’ knowledge, the paper is among the first studies empirically investigating the impacts of COVID-19 and policy response to the pandemic on aggregate and sectoral exports from Vietnam. The paper also measures the absolute value of export gain and export loss due to the pandemic between Vietnam and trading countries.

Phonecards were largely used in African countries for telephone services. They have been collected by people around the world as a hobby. Images from several themes were printed in phonecards, including insects (beetles, butterflies, dragonflies, etc.). We hypothesized that the display of butterfly images in phonecards aimed to arise issues associated with butterfly endangerment and conservation status by protecting their natural habitat and/or butterfly beautifulness, and that they present “extinct” or “threatened” conservation status classification. The purpose of this study is to describe how butterfly images were used in African phonecards; to identify the butterfly species name through their images and information available in all African phonecards; and to record the most recent known geographical distribution and conservation status of butterflies.

Colnect database was assessed to identify all butterfly-themed African phonecards. International Union for Conservation of Nature database was also assessed to obtain information on the most recent known geographical distribution and conservation status of butterflies.

The species name of butterflies was identified from 6 out of 18 African phonecards. The most recent known geographical distribution of butterflies was wide across Africa and conservation status of most genera is classified as “least concern”.

The display of butterfly images in African phonecards is mostly associated with their beautifulness and least related with butterfly conservation, protection and endangerment status.

This study aims to propose resident-based brand equity models on green, creative and smart development themes through a multi-sample telephone survey on Hong Kong residents (n = 751).

This research adopted a quantitative approach with a round of questionnaire-based survey carried out anonymously on adult citizens who have stayed in Hong Kong for more than one year. Telephone survey was performed by a professional survey research centre with trained interviewers between May and July 2022.

The study identifies the magnitude of these city brand equity attributes and reconfigured their composition under separate samples of Hong Kong residents. The results reveal the relatively stronger brand equity for developing Hong Kong as a smart city brand compared with green and creative branding.

The research findings might carry a major limitation of varied interpretations and stereotypes of each city theme (green, creative and smart) by local residents. To minimize the expected bias, two core questions were added to provide respondents with information on each theme before the main survey questions. The questions’ wording was also simplified to ensure the constraint and inconsistency of layman effect.

The common attributes across the themes, including distinctiveness, uniqueness, confidence, positive image, liveability, long-term residence, feature familiarity and top-of-mind, indicate the most prominent aspects of brand equity formation and enhancement. Since urban sustainability does not follow a single path of strategies and infrastructure development, city brand process should also follow a selective approach, which clearly identifies a multiplicity of local interests that could create the best outcomes and the strongest brand equity for the city.

The factor allocation and regression analysis elucidate different configurations of the determining factors with a three-factor model for green city brand equity and two-factor models for the other ones. The findings encore some previous studies supporting the differentiation between common attributes and distinctive attributes, and the overlapping approach to unleash the strongest integration of attributes of brand equity.

Cardiovascular diseases are the leading cause of death worldwide. In Italy, acute myocardial infarction (AMI) is a major cause of hospitalization and healthcare costs. AMI is a myocardial necrosis event caused by an unstable ischemic syndrome. The Italian government has defined an indicator called “AMI: 30-day mortality” to assess the quality of the overall care pathway of the heart attacked patient. In order to guarantee high standards, all hospitals had to implement techniques to increase the quality of care pathway. The aim of the paper is to identify the root cause and understand the mortality rate for AMI and redesign the patient management process in order to improve it.

A Lean Six Sigma (LSS) approach was used in this study to analyze the patient flow in order to reduce 30-days mortality rate from AMI registered by Complex Operative Unit (COU) of Cardiology of an Italian hospital. Value stream mapping (VSM) and Ishikawa diagrams were implemented as tools of analysis.

Process improvement using LSS methodology made it possible to reduce the overall times from 115 minutes to 75 minutes, with a reduction of 35%. In addition, the corrective actions such as the activation of a post-discharge outpatient clinic and telephone contacts allowed the 30-day mortality rate to be lowered from 16% before the project to 8% after the project. In this way, the limit value set by the Italian government was reached.

The limitation of the study is that it is single-centered and was applied to a facility with a limited number of cases.

The LSS approach has brought significant benefits to the process of managing patients with AMI. Corrective actions such as the activation of an effective shared protocol or telephone interview with checklist can become the gold standard in reducing mortality. The limitation of the study is that it is single-centered and was applied to a facility with a limited number of cases.

LSS, applied for the first time to the management of cardiovascular diseases in Italy, is a methodology which has proved to be strategic for the improvement of healthcare process. The simple solutions implemented could serve as a guide for other hospitals to pursue the national AMI mortality target.

This paper draws on the results of telephone surveys conducted to assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on the young people of two longitudinal cohorts (aged 19 and 26 years old at the time) of the four countries that participate in the Young Lives research programme: Ethiopia, India, Peru and Vietnam. We first review the pandemic experiences of these four countries, which differed significantly, and report on the responses of the individual young people to the pandemic and the measures taken by governments. Our main focus is on how the pandemic and policy responses impacted on the education, work and food security experiences of the young people. Unsurprisingly the results show significant adverse effects in each of these areas, though again with differences by country. The effects are mostly more severe for poorer individuals. We stress the challenges that COVID-19 is creating for meeting the United Nations’ Sustainable Development Goals, in particular in making it more difficult to ensure that no one is left behind.

Réal Plourde helped to oil the Couche-Tard/Circle K machine for Alain Bouchard, speeding up the pace of acquisitions and smoothing out the integration of newly acquired chains. As an engineer and MBA graduate with extensive international experience, he brought considerable added value to Alain Bouchard's team. Among other things, he helped to train many of the organization's senior executives, including the current CEO, Brian Hannasch, who joined the company in 2001, working closely with Réal Plourde for nearly a decade before replacing him as Head of Operations in 2011 and ultimately taking over from Alain Bouchard as CEO in 2014.

Although officially retired for some years now, Réal Plourde continues to sit on the boards of several organizations. He also chairs the board of an engineering firm employing more than 2,000 engineers. His Foundation has received several awards for its social and community contributions.

We present the results of one of the only in-depth studies of a police agency’s internal and external response to the coronavirus pandemic of 2020 (COVID-19). This study emphasizes the importance of law enforcement agencies conducting comprehensive case studies and after-action assessments to prepare, prevent and respond to prolonged public health crises and showcases the profound (and lingering) effects of COVID-19 on police organizations.

This multi-method case study combines document analysis, a workforce survey, a community survey, interviews and analysis of administrative data to detail and assess the agency’s internal and operational responses to the pandemic and the reactions of employees and community members to those responses.

Despite agency strategies to mitigate the pandemic’s effects, employees cited very high stress levels one year after the pandemic and a third of sworn officers considered leaving the policing profession altogether during the first two years of the COVID-19 pandemic. Several policies intended by the agency to protect employee health and maintain staffing needs kept workforce levels steady but may have increased feelings of organizational injustice in both sworn and non-sworn individuals, with variation across racial and gender groups. A jurisdiction-wide community survey indicated general support for the police department’s responses but a preference for in-person rather than telephone-based responses to service calls. Officers, however, preferred continuing remote responses even after the pandemic subsided.

To the best of our knowledge, this is one of the only in-depth case studies that examine a police agency’s internal and external responses to COVID-19 and the sworn, non-sworn and community reactions to those responses.

The aim of this study is to examine the agency problems that arise between retail property owners and outsourced facility management (FM) service vendors in Ghana.

This study was carried out using telephone and face-to-face interviews. Nine facility managers (n =9) and six retail property owners (n = 6) purposively selected participated in the interviews. The responses from the interviews were analysed using content analysis. To begin with the analysis, the recorded audio for each respondent during the interviews was transcribed to augment what was written during the interviews. The next step was the development of a coding framework where each of the agency problems was assigned unique codes and grouped under themes. Each response was assigned a predefined code based on the agency problems identified in the literature. The research team discussed the consistency of the thematic codes assigned to each of the responses to ensure that each response was captured under the appropriate agency problem theme it best represents.

The results showed that agency problems in FM outsourcing in the Ghanaian retail sector are related to disagreement on expenditure associated with maintenance and repairs and improper tenant information sharing and use by FM service providers. Based on the findings, it is recommended that property owners explore the mixed approach to FM to mitigate the risks of complete outsourcing of FM services. It is also recommended that a clear path on how tenant information can be shared be pre-agreed in FM contracts.

This study provides new literature relating to agency problems in outsourcing and may be the first of its kind for FM in the Ghanaian retail industry. The findings could serve as a starting point for service providers and their principals to find common grounds to understand each other and mitigate the agency problems that could arise and their overall impact on performance.

The purpose of this study is to identify the factors that create value for the customer in the area of e-commerce logistics and to verify whether these factors impact online retailers' performance through customer satisfaction and customer loyalty in a business to customer (B2C) area.

For the purpose of the study, a model of logistics value in e-commerce was introduced. The model was proposed based on the literature review. A total of 592 correctly filled questionnaires from telephone and web interviews [computer-assisted telephone interview (CATI) and computer-assisted web interview (CAWI)] were studied. The exploratory factor analysis (EFA) and structural equation modeling (SEM) were conducted in the study.

It was confirmed that four of five defined logistics value dimensions have positive impact on customer satisfaction. These dimensions are communication of delivery status, convenience of receipt, reception experience and convenience of return. The influence of speed of delivery on customer satisfaction was not confirmed. It was also confirmed that customer satisfaction has a positive impact on customer loyalty and that customer loyalty positively impacts online retailers' performance.

The study contributes to the current understanding of the influence of logistics factors on online retailers' performance through customer satisfaction and customer loyalty. There have been few studies that concern logistics value in e-commerce, with particular emphasis on above-mentioned relations. It is especially an important issue due to the fact that logistics can potentially lead to gain a competitive advantage in e-commerce.