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Conflict and violence are the main drivers of globally escalating humanitarian needs. Local grassroots initiatives are pivotal in distributing humanitarian supplies in the acute response phase until more established humanitarian aid organizations can enter. Nevertheless, scant research exists regarding the role of grassroots associations in providing humanitarian assistance during a military conflict. The purpose of this paper is to understand the role of grassroots associations and identify important themes for effective operations.

This paper adopts a case-study approach of three Ukrainian grassroots associations that began operating in the immediate days of the full-scale invasion of Ukraine. The findings are based on analyzing primary sources, including interviews with Ukrainian volunteers, and are supported by secondary sources.

Grassroots associations have local contacts and a contextual understanding of population needs and can respond more rapidly and effectively than large intergovernmental agencies. Four critical themes regarding the operations of grassroots associations emerged: information management, inventory management, coordination and performance measurement. Grassroots humanitarian response operations during conflict are challenged by personal security risks, the unpredictability of unsolicited supplies, emerging volunteer roles, dynamic transportation routes and shifting demands.

Grassroots responses are central to humanitarian responses during the acute phase of a military conflict. By examining the operations of grassroots associations in the early months of the 2022 war in Ukraine, the authors provide a unique perspective on humanitarian logistics. Nonetheless, more inclusive models of humanitarian responses are needed to harness the capacities and resilience of grassroots operations in practice.

This study aims to evaluate the quality of a speech and language therapy (SLT) swallow service provided to adults with intellectual disability (ID) by exploring the process and outcome factors; to explore the process of what is done to and for the patient including identifying dysphagia, choking and pneumonia risk, typical interventions and management; examine clinical outcomes; and explore the relationship of outcomes with risk factors, satisfaction with the service and the impact of the service on the number of choking incidents and admissions to acute hospital with swallow concerns.

There were three specific work packages: (1) collecting and scrutinising patient data from the clinical record for adults with ID referred to the SLT swallow service over a six-month period. The researcher created aims, defined the limits to achieve the aims, designed a standardised data collection form, set out where data was in the clinical record, piloted, set limits for collection and trained reviewers; (2) gathering experience and satisfaction surveys from patients, caregivers and referrers over the six-month study period; and (3) monitoring choking adverse incident reports and hospital admission with swallow concerns for the whole ID population.

Choking and hospital admission were the main reasons for referral, and pneumonia risk significantly predicted dysphagia impairment. The research highlighted common dysphagia risk factors, interventions and recommendations for this population. The SLT swallow service is a quality service that is highly valued by patients, their caregivers and referrers. The service achieves significant clinical improvements, helps identify dysphagia and provides management to reduce associated risks.

This study found common dysphagia risk factors, interventions and recommendations; it also found that the therapy outcome measures/Royal College of Speech and Language Therapy online outcome tool was a meaningful outcome measure, and that pneumonia risk significantly predicted dysphagia impairment, all of which could inform the identified dysphagia research priorities for this population.

Naming usual care in treatment and recommendations could help ensure a fair service and could help form quality indicators. People with ID, their caregivers and staff generated valuable ideas for improvement, and further involvement work could create a logic model for the service. Other future work could explore the use of screening tools, increase multidisciplinary team working, improve access to instrumental assessments, raise awareness of swallowing and promote important oral health and medication reviews. By using this information to shape quality improvement work and policies, one can work toward addressing high health-related inequalities and preventable deaths associated with dysphagia in this vulnerable population.

It may be useful to raise awareness that adults with ID age earlier and that one should not exclude them from older people’s services because of an age threshold, often set higher than their life expectancy. This study highlighted a possible inequality of access issue for adults with ID who do not have direct care or day care staff. There is a need to increase access to awareness training so caregivers and general practitioners can recognise swallow difficulties and know how to make a referral for a swallow assessment.

Overall, the evaluation of the swallow service to adults with ID suggests that SLT have a quality service for adults with ID that is highly valued and provides significant clinical improvements. By building on these strengths, SLT could extend the reach, influence and impact of their services to help those adults with ID who have emerging swallow difficulties or who do not access the service.

Teams across a wide range of contexts must look beyond task performance to consider the affective, cognitive and behavioral health of their members. Despite much interest in team health in practice, consideration of team health has remained scant from a research perspective. The purpose of this paper is to address these issues by advancing a definition and model of team health.

The authors review relevant literature on team stress, processes and emergent states to propose a definition and model of team health.

The authors advance a definition of team health, or the holistic, dynamic compilation of states that emerge and interact as a team resource to buffer stress. Further, the authors argue that team health improves outcomes at both the individual and team level by improving team members’ well-being and enhancing team effectiveness, respectively. In addition, the authors propose a framework integrating the job demands-resources model with the input-mediator-output-input model of teamwork to illustrate the behavioral drivers that promote team health, which buffers teams stress to maintain members’ well-being and team effectiveness.

This work answers calls from multidisciplinary industries for work that considers team health, providing implications for future research in this area.

Globally “non-urgent” health care services were ceased in response to the 2020 outbreak of COVID-19, until 2021, when restrictions were lifted. In the UK, this included speech and language therapy services. The implications of COVID-19 restrictions have not been explored. This study aimed to examine the impact of the UK’s COVID-19 response on speech and language therapy services.

An online survey of the practice of speech and language therapists (SLTs) in the UK was undertaken. This explored SLTs’ perceptions of the demand for their services at a time when COVID-19 restrictions had been lifted, compared with before the onset of the pandemic. The analysis was completed using descriptive statistics and content analysis.

Respondents were mostly employed by the UK’s National Health Service (NHS) or the private sector. Many participants reported that demands on their service had increased compared with before the onset of the pandemic. The need to address the backlog of cases arising from shutdowns was the main reason for this. Contributing factors included staffing issues and redeployment. Service users were consequently waiting longer for NHS therapy. Private therapy providers reported increased demand, which they directly attributed to these NHS challenges.

This presents the only focused account of the impact of the national response to COVID-19 on speech and language therapy services in the UK. It has been identified that services continue to face significant challenges, which indicate a two-tier system is emerging. Healthcare system leaders must work with service managers and clinicians to create solutions and prevent the system from being overwhelmed.

Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a shift from acute, episodic and reactive hospital-centered care toward longitudinal, person-centered and proactive home-centered care. The purpose of this paper is to contribute to the knowledge of a comprehensive development strategy for designing and providing home-centered care of older people.

The study design is based on qualitative research with an inductive approach. The authors study development initiatives at the national, regional and local levels of the Swedish health and social care system. The data collection methods included interviews (n = 54), meeting observations (n = 25) and document studies (n = 59).

The authors describe findings related to policy actions and system changes, attempts to achieve collaboration, integration and coordination, new forms of care offerings, characteristics of work settings at home and differences in patients' roles and participation at home and in the hospital.

The authors suggest home-centered care as a solution for providing person-centered and integrated care of older people and give examples of how this can be achieved.

The authors outline five propositions for research and development related to national policies, service modularity as a solution for customized and coordinated care, developing human resources and infrastructure for home settings, expanding services that enable older people living at home and patient co-creation.

The global resolution of embracing dynamic and intertwined production systems has made it necessary to adopt viable systems like circular economy (CE) to ensure excellency in the business. However, in emerging countries, it is challenging to implement the CE practices due to the existing problems in the supply chain network, as well as due to the vulnerable financial condition of the business after the deadly hit of COVID-19. The main aim of this research is to determine the barriers to implementing CE considering the recent pandemic and suggest strategies to organizations to ensure CE for a cleaner environment and greener economy.

After an extensive literature review and validation from experts, 24 sub-barriers under the class of 6 main barriers are finalized by Pareto analysis, which is further analyzed via the best-worst method to determine the weight and rank of the barriers Further, fuzzy-Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method is used to rank the proposed startegies to overcome the analysed barriers.

The results identified “unavailability of initial funding capital”, “need long time investment”, “lack of integrating production system using advance technology” and “lack of strategic planning” as the most acute sub-barriers to CE implementation. Further, fuzzy TOPSIS method is used to suggest the best strategy to mitigate the ranked barriers. The results indicated “integrated design facility to CE”, “ensuring large scale funding for CE facility” as the best strategy.

This study will motivate managers to implement CE practices to enjoy proper utilization of the resources, sustainable benefits in business, and gain competitive advantage.

Periodically, a lot of work is done on CE practices but none of them highlighted the issues in the domain of the leather products industry (LPI) and COVID-19 toward achieving sustainability in production and consumption. Thus, some significant barriers and strategies to implement CE for achieving sustainability in LPI are highlighted in this study, which is a unique contribution to the literature.

A region’s transforming care partnership identified that autistic adults without an intellectual disability (ID) may be falling through gaps in services when presenting with a significant emotional and/or behavioural need in the absence of a mental health diagnosis. The region’s intensive support teams (ISTs) for adults with ID therefore piloted a short-term “behavioural support service” for this population. The purpose of this paper is to evaluate this pilot.

This study represents a mixed-methods service evaluation over a four year pilot period. The quantitative component examined referral rates and demographic data of accepted and declined referrals; and length of referral episodes and Health of The Nation Outcomes Scores (HoNOS) for accepted referrals. The qualitative component used thematic analysis to identify key themes relating to reasons for referral, clinical/therapeutic needs, and the models of support that most informed assessments and interventions at individual and systems levels.

The ISTs accepted 30 referrals and declined 53. Most accepted referrals were male (83%), and under 24 years old (57%). Average HoNOS scores were above the thresholds generally associated with hospital admission. Key qualitative themes were: transitional support; sexual risks/vulnerabilities; physical aggression; domestic violence; and attachment, trauma and personality difficulties. Support mostly followed psychotherapeutic modalities couched in trauma, attachment and second- and third-wave cognitive behavioural therapies. Positive Behaviour Support (PBS) did not emerge as a model of preference for service users or professionals.

This project represents one of the first of this type for autistic adults without an ID in the UK. It provides recommendations for future service development and research, with implications for Transforming Care policy and guidance.

Health care systems aspire to adopt integration strategies shifting the focus from acute care to a broader focus on community-based health and social services. Real-world examples demonstrating effective delivery of integrated care are essential.

In this article, we introduce UHN Connected Care Hub, an innovative model of care comprising an interdisciplinary team designing sustainable, shareable practices across the continuum of care alongside community and health organization partnerships.

We describe UHN Connected Care Hub’s ability to identify patients from high-risk population and collaborate to delivery timely care, in detailing the real world experience of this model of care in the organization of a centralized system of micro-clinics to administer a therapeutic for pre-exposure prophylaxis against COVID-19 (Tixagevimab/cilgavimab [Evusheld]) in a population of immunocompromised patients.

Having a centralized system of micro-clinics for care delivery presents opportunities for increased adaptability, patient accessibility, enhanced community partnerships and integratedness. Expansion in the scope of services could also create new opportunities in preventative therapies for optimizing the cost effectiveness and quality of health care provided at the population level.

There is limited evidence on how to efficiently deliver integrated care, particularly to vulnerable and co-morbid patients. We discuss how dynamic organizations with proper infrastructure and a network of healthcare partnerships may allow a more fluid response to rapidly changing policies and procedures and facilitate preparedness for future health care crises or pandemics.