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A new triage method, MBCE (Medical Bio Social Ethics), is presented with social justice, bio, and medical ethics for critical resource distribution during a pandemic. Ethical triage is a complex and challenging process that requires careful consideration of medical, social, cultural, and ethical factors to guide the decision-making process and ensure fair and transparent allocation of resources. When assigning priorities to patients, a clinician would evaluate each patient’s medical condition, age, comorbidities, and prognosis, as well as their cultural and social background and ethical factors.

A statistical analysis shows no interactions among the ethical triage factors. It implies the ethical components have no moderation effect; hence, each is independent. The result also points out that medical and bioethics may have an affinity for interactions. In such cases, there seem to be some ethical factors related to bio and medical ethics that are correlated. Therefore, the triage team should be careful in evaluating patient cases. The algorithm is explained with case histories of the selected patient. A group of triage nurses and general medical practitioners assists with the triage.

The MBCE triage algorithm aims to allocate scarce resources fairly and equitably. Another ethical principle in this triage algorithm is the principle of utility. In a pandemic, the principle of utility may require prioritizing patients with a higher likelihood of survival or requiring less medical care. The research presents a sensitivity analysis of a patient’s triage score to show the algorithm’s robustness. A weighted score of ethical factors combined with an assessment of triage factors combines multiple objectives to assign a fair triage score. These distinctive features of the algorithm are reasonably easy to implement and a new direction for the unbiased triage principle.

The idea is to make decisions about distributing and using scarce medical resources. Triage algorithms raise ethical issues, such as discrimination and justice, guiding medical ethics in treating patients with terminal diseases or comorbidity. One of the main ethical principles in triage algorithms is the principle of distributive justice.

Variations in customer expectations pose a challenge to service quality improvement in the airline industry. Understanding airline customers' expectations and satisfaction help service providers improve their offerings. The extant literature examines airline passengers' expectations in isolation, neglecting the overall impact of online reviews on service quality improvement. This paper systematically evaluates the airline industry's passengers' expectations and satisfaction using expectation confirmation theory (ECT) and the SERVQUAL framework. The paper analyzes online reviews to examine the relationship between airline service quality attributes and passengers' satisfaction.

The SERVQUAL framework was employed to examine the effects of customer culture, the reason for traveling, and seat type on customer's expectations and satisfaction across a large sample of airline customers.

A total of 17,726 observations were gathered from the Skytrax review website. The lowest satisfaction ratings were from passengers from the USA, Canada and India. Factors that affect perceived service performance include customer service, delays and baggage management. Empathy and reliability have the biggest impact on the perceived satisfaction of passengers.

This research increases understanding of the consumer expectations through analysis of passengers' online reviews. Results are limited to a small sample of airline industries.

This study provides airlines with valuable information to improve customer service by analyzing online reviews.

This study provides the opportunity for airline customers to gain better services when airline companies utilize the findings.

This paper offers insights into passengers' expectations and their perceived value for money in relation to seat types. Previous studies have not investigated value for money as a construct for passengers' expectations and satisfaction relative to service quality dimensions. This paper addresses this need.

This study aims to determine the barriers hindering the incorporation of blockchain technology (BCT) in two key service industries – hotel and health care – as well as to assess their readiness for implementing BCT after overcoming the barriers.

The barriers of this study are determined through two phases: a review of prior literature and obtaining expert opinions, which are then analyzed to identify specific barriers that are impeding the incorporation of BCT. Moreover, to generate a blockchain implementation reluctance index (BIRI), this study presents an interval-valued intuitionistic fuzzy set (IVIFS) that uses graph theory and matrix approach (GTMA). The permanent function in the GTMA approach is computed using the PERMAN algorithm. Finally, to compare the readiness of the hotel and health-care industries to adopt BCT, the BIRI values are plotted and evaluated.

The barriers identified by this study are listed under five major headings, namely, financial, operational, behavioral, technical and legal. This study revealed that the operational and technical barriers of BCT are critically hindering its widespread integration in hotel and health-care industries. Furthermore, on comparing the BIRI values of both industries, the result suggested that the hotel industry needs to work more on these barriers to effectively incorporate BCT. Besides the comparison, the BIRI values clearly indicate that both industries have to put a lot of effort into the mitigation of the barriers found by this study to successfully integrate BCT.

The experts’ opinions are used to evaluate the identified barriers, which raises the chance that the opinions are prejudiced based on the experts’ perspectives and ideologies. The sensitivity of decision-maker loads toward preference outcomes is not analyzed in this manuscript. Therefore, any recent sensitivity analysis may be considered a prospective field for future research. This study applies a multicriteria decision-making (MCDM) approach, IVIFS–GTMA, which limits the evaluation of the influence caused by individual barriers on the integration of BCT in the hotel and health-care industries. Henceforth, in future investigations, alternative MCDM methods may be used to analyze individual barriers.

According to the findings, if the hotel or health-care industry aims to incorporate BCT in its supply chain operations, it is recommended to emphasize more on the operational barriers along with the technical and behavioral barriers. The barriers mentioned in this manuscript can be used as guidance for developers in their development activities, such as scalability concerns, establishment costs, the 51% attack and the inefficient nature of BCT. Furthermore, they may address the potential users’ negative perceptions about security, privacy, trust and risk avoidance through creatively developed blockchain solutions to promote BCT implementation.

To the best of the author’s knowledge, this is the first study that identifies barriers toward BCT incorporation in the major service industries, i.e. hotel and health care. Moreover, this is the first study that compares the preparedness of the hotel and health-care industries to determine the industry that requires more work to implement BCT.

The study aims to facilitate the medical tourists visiting emerging countries for various kinds of ailments by ranking the possible destinations to avail medical treatments.

A Fuzzy Analytical Hierarchical Process (FAHP) with a mixed-method approach is applied to analyze data collected from patients and substantiate it with medical tour operators in India to gain managerial insights on the choice-making patterns of the patients.

India is a preferred emerging market location due to the low cost and high medical staff quality. India offers value for money, whereas Singapore and Thailand are preferred destinations for quality and technology.

The study will facilitate the emerging markets' governments, hospitals and medical tourists to understand the importance of various determinants responsible for availing medical treatment outside their country.

The study recommends that cost and quality care are the patients' prime focus; government policies must provide clear guidelines on what the hospitals and country environment can offer and accordingly align the marketing strategies.

This study is the first attempt to rank various factors affecting medical tourism using the FAHP approach.

With global migration, the number of ethnic minority and migrant women receiving maternity health care in dominantly Anglo-European societies has increased significantly but they consistently have among the worst pregnancy and maternal outcomes. This paper aims to analyse gaps in structural (migration-related inequalities) and cultural (responsiveness to ethno-cultural practices) competencies among maternal health practitioners in Aotearoa New Zealand (NZ).

Using a semi-structured interview guide, in-depth interviews were conducted with 13 maternal health practitioners in NZ. Data were analysed using a thematic analysis framework.

The results highlight significant barriers around language and communication, cultural stereotyping by professionals, ethnic women’s own constraints around family and cultural expectations and their lack of knowledge about reproductive health. In addition, practitioners’ own ethnic differences are inseparable from their approach to structural and cultural competencies; there were instances of ‘over-’ or ‘under-’ reading of culture, practitioner constructions of ideal pregnancies and anti-racism concerns that shaped maternal care practices that were sensitive to, but also marginalised, ethnic migrant women who attended maternity services.

To the best of the authors’ knowledge, this is the only study in NZ that examines the impact of complex dynamics of migration and culture on knowledge, beliefs and values of practitioners, in context of their own personal biographies. Identifying strategies to improve the way diversity is practiced in hospital settings can be transformational in improving maternal outcomes for ethnic migrant women in NZ.

This paper aims to discover and analyze the challenges hampering blockchain technology’s (BT’s) implementation in the Indian health-care sector. A total of 18 challenges have been prioritized and modeled based on an extensive literature search and professional views.

An integrated multi-criteria decision-making approach has been used in two phases. Best worst method (BWM) is used in the first phase to prioritize the challenges with sensitivity analysis to validate the findings and eliminate a few challenges. In the second phase, interpretive structural modeling is applied to the remaining 15 challenges to obtain relative relationships among them with cross-impact matrix multiplication applied to classification analysis for their categorization.

The study’s results reveal that limited knowledge and expertise, cost and risk involved, technical issues, lack of clear regulations, resistance to change and lack of top management support are the top-ranked or high-intensity challenges according to the BWM. Interpretive structural modelling findings suggest that the lack of government initiatives has been driving other challenges with the highest driving power.

This work has been conducted in the Indian context, so careful generalization of the results is needed.

This work will give health-care stakeholders a better perspective regarding blockchain’s adoption. It will help health-care stakeholders, service providers, researchers and policymakers get a glimpse of the strategies for eradicating mentioned challenges. The analysis will help reduce the challenges’ impact on blockchain’s adoption in the Indian health-care sector.

The adoption of BT is a novel concept, especially in developing countries such as India. This is one of the few works addressing the challenges to BT adoption in the Indian health-care sector.

Short breaks enable unpaid carers to have a life alongside caring, supporting their physical and emotional well-being. In the UK, short breaks are usually explored during a Carers Assessment. The conversations underpinning these assessments require considerable skill and presently there are few tools to support the exploration of short break needs, desired outcomes and options. Images are used in other conversations to enhance communication, help people consider options and broaden thinking. This study aims to explore whether and how stakeholders thought images might support short break conversations.

To improve access to meaningful short breaks, we need to be guided by the insights of unpaid carers, those they support, practitioners, commissioners and policymakers. We hosted two online involvement events, designed to facilitate the exchange of perspectives and ideas amongst diverse stakeholders. The events explored the acceptability, facilitators and challenges of using images to enhance unpaid carer short break conversations.

The online events were attended by 47 short break stakeholders. These stakeholders saw merit in using images to support short break conversations. They identified several facilitators and challenges to introducing images into practice. The paper highlights how this learning can inform future research and practice development.

Supporting the well-being of older unpaid carers is a pertinent concern as the number of older unpaid carers continues to grow. This paper reports on how stakeholders have informed the earliest stages of practice and research development in a relevant area and provides a model of involvement that others can emulate.

For decades, conflict resolution (CR) educators working cross-culturally have struggled with a fundamental dilemma – whether to offer western, evidence-based approaches through a top-down (prescriptive) training process or to use a bottom-up (elicitive) strategy that builds on local cultural knowledge of effective in situ conflict management. This study aims to explore which conditions that prompted experienced CR instructors to use more prescriptive or elicitive approaches to such training in a foreign culture and the implications for training outcomes.

There are two parts to this study. First, the authors conducted a literature review to identify basic conditions that might be conducive to conducting prescriptive or elicitive cross-cultural CR training. The authors then tested the identified conditions in a survey with experienced CR instructors to identify different conditions that afforded prescriptive or elicitive approaches. Exploratory factor analysis and regression were used to assess which conditions determined whether a prescriptive or elicitive approach produced better outcomes.

In general, although prescriptive methods were found to be more efficient, elicitive methods produced more effective, culturally appropriate, sustainable and culturally sensitive training. Results revealed a variety of instructor, participant and contextual factors that influenced whether a prescriptive or elicitive approach was applied and found to be more suitable.

This study used empirical survey data with practicing experts to provide insight and guidance into when to use different approaches to CC-CR training effectively.

This study proposes strategies for vaccine center allocation for coronavirus disease (COVID) vaccine by determining the number of vaccination stations required for the vaccination drive, location of vaccination station, assignment of demand group to vaccination station, allocation of the scarce medical professional teams to station and number of optimal days a vaccination station to be functional in a week.

The authors propose a mixed-integer nonlinear programming model. However, to handle nonlinearity, the authors devise a heuristic and then propose a two-stage mixed-integer linear programming (MILP) formulation to optimize the allocation of vaccination centers or stations to demand groups in the first stage and the allocation of vaccination centers to cold storage links in the second stage. The first stage optimizes the cost and average distance traveled by people to reach the vaccination center, whereas the second stage optimizes the vaccine’s holding and storage and transportation cost by efficiently allocating cold storage links to the centers.

The model is studied for the real-world case of Chandigarh, India. The results obtained validate that the proposed approach can immensely help government agencies and policymaking body for a successful vaccination drive. The model tries to find a tradeoff between loss due to underutilized medical teams and the distance traveled by a demand group to get the vaccination.

To the best of our knowledge, there are hardly any studies on a vaccination program at such a scale due to sudden outbreaks such as Covid-19.

This paper investigates the current psychological state of Chinese tourism practitioners and their career resilience during the ongoing COVID-19 pandemic. It empirically examines the effects of COVID-19 on Chinese tourism practitioners' professional attitudes and their career belief in the future. The study is intended to guide enterprises and governments to design effective strategies/policies to deal with the effect of this unfavorable environment.

The sample consists of 442 tourism practitioners in 313 tourism enterprises in China. The data were collected via a targeted online survey based on a well-structured questionnaire. The data were analyzed using statistical procedures including multilevel regression analysis.

The study results show that Chinese tourism practitioners have strong career resilience in the face of current turbulent time. After testing, the model shows that career beliefs and social support have a significant positive impact on the professional attitudes of tourism practitioners, and that career resilience has a partial mediating effect on their career beliefs, social support and professional attitude.

This study enriches the existing literature on career belief, social support and career resilience. It provides a new interpretation on how career belief and social support impact career resilience and thus shape tourism practitioners' professional attitudes during pandemics.