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The Health Service Executive in Ireland seeks to further develop healthcare in the community. It has identified that this reform requires developing leadership amongst the staff. This study aims to identify what kind of leadership staff in community healthcare observe in practice and their leadership preferences. The core objective has been to identify the readiness of the organisation to implement the adopted national policy of integrated community care reform in terms of leadership development.

An online cross-sectional survey was conducted using the Organisational Cultural Assessment Instrument, based on the Competing Values Framework. This tool identifies four overarching leadership types: Clan (Collaborative), Adhocracy (Creative), Market (Competitive) and Hierarchy (Controlling). Participants (n = 445) were a representative sample of regional community health care employees. They were asked to identify presently observed leadership and preferred leadership in practice. The statistical analysis emphasised a comparison of observed and preferred leadership types.

Participants reported the current prevailing leadership type as Market (M = 34.38, SD = 6.22) and Hierarchical (M = 34.38, SD = 22.62), whilst the preferred or future style was overwhelmingly Clan (M = 40.38, SD = 18.08). Differences were significant (all p’s < 0.001). The overall outcome indicates a predominance of controlling and competitive leadership and a lack of collaborative leadership to implement the planned reform.

During reform in healthcare, leadership in practice must be aligned to the reform strategy, demonstrating collaboration, flexibility and support for innovation. This unique study demonstrates the importance of examining leadership type and competencies to indicate readiness to deliver national community health care reform.

Gender equality plans (GEPs) are currently the preferred approach to initiate structural change towards gender equality in research organisations. In order to achieve structural change, GEPs have to be more than just a formally adopted institutional policy. Effective GEPs lead to a transformation of gendered practices and thus to structural change. This chapter presents the innovative approach developed for an H2020 structural change project and its theoretical background. We argue that due to the dual logic, which characterises academic organisations, the organisational logic and the academic logic, change is a complex endeavour. To deal with this complexity, one of the main functions of a GEP is to provide space and initiate reflexivity at an individual as well as at an institutional level. A theory of change approach supports reflexivity in all stages of a GEP as it ensures that basic assumptions of the institutional change process are questioned and reflected on by the different stakeholder groups involved in the implementation.

Homelessness is a colossal issue, precipitated by a wide array of social determinants, and mirrored in substantial health disparities and a revolving hospital door. Connecting people to safe and secure housing needs to be part of the health system response. The paper aims to discuss these issues.

This mixed-methods paper presents emerging findings from the collaboration between an inner city hospital, a specialist homeless medicine GP service and Western Australia’s inaugural Housing First collective impact project (50 Lives 50 Homes) in Perth. This paper draws on data from hospitals, homelessness community services and general practice.

This collaboration has facilitated hospital identification and referral of vulnerable rough sleepers to the Housing First project, and connected those housed to a GP and after hours nursing support. For a cohort (n=44) housed now for at least 12 months, significant reductions in hospital use and associated costs were observed.

While the observed reductions in hospital use in the year following housing are based on a small cohort, this data and the case studies presented demonstrate the power of care coordinated across hospital and community in this complex cohort.

This model of collaboration between a hospital and a Housing First project can not only improve discharge outcomes and re-admission in the shorter term, but can also contribute to ending homelessness which is itself, a social determinant of poor health.

Coordinated care between hospitals and programmes to house people who are homeless can significantly reduce hospital use and healthcare costs, and provides hospitals with the opportunity to contribute to more systemic solutions to ending homelessness.

This study aims to explore how the COVID-19 pandemic has impacted parents of autistic children and their families in Ireland.

A qualitative thematic analysis methodology was applied using semi-structured interviews. A total of 12 parents (ten mothers, one father and one grandfather speaking on behalf of a mother) of autistic children were asked how the COVID-19 pandemic impacted them and their autistic child with a particular focus on how it has impacted their access to respite care. Interviews were completed remotely from July 2021 to October 2021.

Data analysis identified four themes that reflect an adverse pandemic impact. These were: world gone; alone and isolated; constantly fighting for help; and negative and positive impact of COVID-19 on child and family. Two parents reported positive outcomes of the pandemic such as social distance requirements. Five parents (42%) reported an increase in the amount of respite received. Three parents (25%) reported a decrease and four (33%) parents reported no change in their access to respite.

COVID-19 has turned a spotlight on mental health for politicians, policymakers and the public and provides an opportunity to make mental health a higher public health priority for autistic children and their families.

This study highlights the need for access to respite for autistic children and for respite services to be responsive to the ongoing needs, in particular, the mental health needs of autistic children and their family, particularly in a crisis situation.

The purpose of this study is to develop new type of reverse mortgage contract. How to provide adequate services and housing for an increasing number of people that are dependent on the help of others is a crucial question in the European Union (EU). The housing stock in Europe is not fit to support a shift from institutional care to the home-based independent living. Some 90% of houses in the UK and 70%–80% in Germany are not adequately built, as they contain accessibility barriers for people with emerging functional impairments. The available reverse mortgage contracts do not allow for relocation to their own adapted facilities. How to finance the adaptation from housing equity is discussed.

The authors have extended the existing loan reverse mortgage model. Actuarial methods based on the equivalence of the actuarial present values and the multiple decrement approach are used to evaluate premiums for flexible longevity and lifetime long-term care (LTC) insurance for financing adequate facilities.

The adequate, age-friendly housing provision that is appropriate to support the independence and autonomy of seniors with declining functional capacities can lower the cost of health care and improve the well-being of older adults. For financing the development of this kind of facilities for seniors, the authors developed the reverse mortgage scheme with embedded longevity and LTC insurance as a possible financial instrument for better LTC services and housing with care in assisted-living facilities. This kind of facilities should be available for the rapid growth of older cohorts.

The numerical example is based on rather crude numbers, because of lack of data, as the developed reverse mortgage product with LTC insurance is a novelty. Intensity of care and probabilities of care in certain category of care will change after the introduction of this product.

The model results indicate that it is possible to successfully tie an insurance product to the insured and not to the object.

The introduction of this insurance option will allow many older adult with low pension benefits and a substantial home equity to safely opt for a reverse mortgage and benefit from better social care.

While currently available reverse mortgage contracts lapse when the homeowner moves to assisted-living facilities in any EU Member State, in the paper a new method is developed where multiple adjustments of housing to the functional capacities with relocation is possible, under the same insurance and reverse mortgage contract. The case of Slovenia is presented as a numerical example. These insurance products, as a novelty, are portable, so the homeowner can move in own specialised housing unit in assisted-living facilities and keep the existing reverse mortgage contract with no additional costs, which is not possible in the current insurance products. With some small modifications, the method is useful for any EU Member State.

As after-hours technology-mediated work (ATW) becomes common in organizations, the increased workload and interference to life caused by ATW has induced employee turnover. This research develops a mediated moderation model to explain how employees' intrinsic and extrinsic motivations for ATW affect their turnover intention through work–life conflict.

A survey was conducted to collect data of 484 employees from Chinese companies. Partial Least Square was used to perform data analysis.

The results show that intrinsic motivation for ATW has an indirect negative impact on turnover intention via work–life conflict, whereas extrinsic motivation for ATW has both a positive direct impact and a positive indirect impact (via work–life conflict) on turnover intention. This study also helps find that time spent on ATW can strengthen the positive impact of extrinsic motivation for ATW on turnover intention but has no moderation effect on the impact of intrinsic motivation for ATW. Furthermore, this study reveals that the interaction effect of time spent on ATW and extrinsic motivation on turnover intention is mediated by employees' perceived work–life conflict.

By discovering the distinct impact of employees' intrinsic and extrinsic motivations for ATW on turnover intention, this research provides a contingent view regarding the impact of ATW and offers guidance to managers regarding how to mitigate ATW-induced turnover intention through fostering different motivations.

The purpose of this paper is to explore an association between women experience lifetime intimate partner violence (IPV) and women decision making with utilization of reproductive and maternal health services in Cambodia.

An analysis of secondary data of Cambodia Demographic and Health Survey (CDHS) 2014. The total number of sample size was 1,539 married women who had birth in the last five years prior to the time of interview and completed the domestic violence module in the CDHS 2014 questionnaire. χ² test and binary logistic regression were performed in this study.

Results give an evidence that emotional violence had significant impact on receiving sufficient antenatal care (ANC) (OR: 0.7, 95%CI: 0.43–0.86) while physical violence had significant association with deliver with skilled birth attendance (SBA) (OR: 0.5, 95%CI: 0.27–0.79). Further, women’s participation in household decision making played as important factor in enabling women revive sufficient ANC (OR: 1.7, 95%CI: 1.19–2.29), and utilization of modern contraceptive method (OR: 1.5, 95%CI: 1.09–1.97).

This study provides significant finding on the impact of IPV and women’s decision making on reproductive and maternal health in Cambodia. Result has drawn an attention to policy makers, related ministries and stakeholder to promulgate and effectiveness of policies and program implementation within the country.