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The long-term financial stability of hospital systems represents a “grand challenge” in health care. New ownership forms, such as private equity (PE), promise to achieve better financial performance than nonprofit or for-profit systems. In this study, we compare two systems with many similarities, but radically different ownership structures, missions, governance, and merger and acquisition (M&A) strategies. Both were nonprofit, religious systems serving low-income communities – Montefiore Health System and Caritas Christi Health Care.

Montefiore's M&A strategy was to invest in local hospitals and create an integrated regional system, increasing revenues by adding primary doctors and community hospitals as feeders into the system and achieving efficiencies through effective resource allocation across specialized units. Slow and steady timing of acquisitions allowed for organizational learning and balancing of debt and equity. By 2019, it owned 11 hospitals with 40,000 employees and had strong positive financials and low reliance on debt.

By contrast, in 2010, PE firm Cerberus Capital bought out Caritas (renamed Steward Health Care System) and took control of the Board of Directors, who set the system's strategic direction. Cerberus used Steward as a platform for a massive debt-driven acquisition strategy. In 2016, it sold off most of its hospitals’ property for $1.25 billion, leaving hospitals saddled with long-term inflated leases; paid itself almost $500 million in dividends; and used the rest for leveraged buyouts of 27 hospitals in 9 states in 3 years. The rapid, scattershot M&A strategy was designed to create a large corporation that could be sold off in five years for financial gain – not for health care integration. Its debt load exploded, and by 2019, its financials were deeply in the red. Its Massachusetts hospitals were the worst financial performers of any system in the state. Cerberus exited Steward in 2020 in a deal that left its physicians, the new owners, holding the debt.

This chapter offers an inquiry into the emerging phenomenon of corporate social advocacy, also known as CEO activism, in a non-Western sociocultural context. It addresses gaps in CEO activism research, including a dearth of non-Western contexts, dominance of modernist perspectives, and omission of female activist CEO voices. I apply alternative theoretical lenses of Caritas, Ubuntu, Africapitalism, and postmodernism to examine facets of CEO activism in Ghana. Data were collected through long interviews with 24 activist CEO men and women and data underwent hermeneutic phenomenological theme analysis. Findings suggest that CEO activism in Ghana is motivated by a range of factors previously not articulated in the literature on CEO activism. Brand activism typologies adequately describe the causes/issues advocated by activist CEOs in Ghana – as findings advance perspectives of non-Western society CEO activists. Hence, this chapter internationalizes the CEO activism phenomenon for the public relations literature while extending diversity, equality, and inclusion, sustainability, postmodern values, and insider activist perspectives to also include Caritas, Ubuntu philosophy, and Africapitalism.

The purpose of this paper is to investigate the medical incident responses from two public hospitals in Hong Kong, namely, Kowloon Hospital and Caritas Medical Centre, in order to improve the strategic preparation for crisis management in hospitals.

The paper analyses two medical incidents using Situational Crisis Communication Theory by Coombs (2007). The two case studies presented herein demonstrate the importance of consistency in terms of crisis responses.

For the first case, the crisis responses from different parties after the incident, including Hospital Authority, the doctor and the nurses from Kowloon Hospital, are contradicting to each other. First, Hospital Authority confirmed that the incident is solely an accident which is a denial response. Second, the doctor passed the responsibility to the nurses which is a scapegoating response. Third, the nurses tend to reduce the responsibility for the death of patient by excusing strategy. As a whole, their responses are inconsistent to each other. For the second case, Caritas had initially denied the responsibilities, but finally had given partial apology under public pressure. That makes people think that Caritas does not really regret.

Rebuilding posture should be used instead of denial and diminishment posture. However, public organization and civil servants are reluctant to use a full apology due to possible legal consequences. The apology ordinance would ease the pressure to express regret and sympathy.

In order to meet the housing need that emerged in Turkey after the devastating earthquake of 17th August 1999, new residential areas were established in various regions. This has led to the questioning of how social sustainability of new settlements can be achieved and to a search for solutions. In this context, participatory approaches are among the first to come to mind. This study starts from the hypothesis that enabling user participation in the construction process of the housing units would contribute to the social cohesion and satisfaction levels of the neighborhood in question. In the study, the impact of user participation on the social sustainability of the construction process of residential projects developed following a disaster has been tested. In this context, the research was conducted in Caritas houses built near Gümüşpınar Village in the Province of Düzce and Umcor houses constructed on the same land with user participation to meet the needs of the victims for shelter after the 17th August 1999 earthquake. The study is comprised of the observations, questionnaires and face-to-face interviews conducted after the literature review. Questionnaires and interviews were conducted to measure the satisfaction with the housing, the immediate housing environment and the neighborhood as well as the feeling of belonging were tested regarding the two settlements which differed in terms of their construction methods and physical characteristics despite having been constructed side by side by two different charities. The results of the Likert type questionnaires were evaluated with the “Independent samples T test” using the SPSS program. As a result of the research, it has been found that there is no significant relationship between user participation and the criteria of social sustainability; namely, satisfaction with the housing, satisfaction with the neighbors and that of the residence neighborhood. Another result of the research is that the physical and psychological comfort is of priority for the individuals compared to relationship with neighbors or participation in the establishment of their residential environment. Furthermore, the research findings also revealed that disagreements among users increased which had a negative impact on social cohesion in cases where the physical characteristics of the residential neighborhood and the housing did not satisfy the users.

The purpose of this paper is to investigate humanitarian supply chains in the context of the Ukrainian crisis as example of complex emergency. The paper focuses on a selection of support modes: in-kind donations, cash-based assistance and local procurement.

This paper adopts a case-study approach and interpretive paradigm. Findings are based on the analysis of primary sources including interviews with three Polish humanitarian organizations, internal documents, and secondary sources such as published reports.

Findings indicate that in a middle-income urbanized country such as Ukraine non-standard modes such as cash transfer programs and local procurement can be employed, since the necessary infrastructure and market are operational. However, each mode has limitations, so they should match the local context and the needs of diverse social groups.

The findings and recommendations are specific to the case analyzed, Ukraine, and its socio-economic context. The research contributes to discussions about mode selection, stressing the links between mode, stage of the disaster response and local context.

Applying cash transfers and local procurement can reduce supply chain costs, such as transport and warehousing. Shortened supply chains enable faster responses and increased agility.

Cash transfers and procurement involve the local community and beneficiaries, and can better fulfill needs maintaining people’s dignity. However, for vulnerable groups and those in conflict zones, in-kind goods are a better option.

The author argues that the much-discussed dichotomy of cash or goods does not reflect reality; local and regional procurement should be added as important support modes in middle-income countries in crisis.

The purpose of the article is to analyse the Italian anti-trafficking system by examining its effectiveness in the protection of trafficked people.

The article examines the protection of trafficked people in Italy, focusing in particular on the implementation of Article 18 of the “Consolidated Act of Measures Governing Immigration and Norms on the Condition of Foreign Citizens” (Legislative Decree n. 286/1998), which provides victims with protection and a residence permit independent of their cooperation with the competent authorities in criminal proceedings against offenders.

The article demonstrates that, though the Italian legal framework on trafficking is considered one of the most innovative and advanced, especially in the area of victim protection, a number of inadequacies in its implementation undermine the effectiveness of the measures aimed at protecting trafficked people. These concern the absence of a clear and appropriate victim identification procedure; the lack of adequate training in trafficking among professionals; the incomplete application of a procedure called the “social path” for the issuing of the residence permit; the narrow interpretation by competent authorities of the requirements for the residence permit granted to victims; the long lapse of time for the issuing of the residence permit; difficulties in the conversion of the residency permit granted to victims into a work permit; and the scarcity of economic resources.

The article contributes to scientific and political debates on the effectiveness of anti-trafficking policies.

Purpose – Young people exhibiting serious behavior problems represent an enormous challenge for municipal child welfare services in Norway. In working with these youngsters, it is vital to create opportunities for them to participate in the decisions affecting their lives. The study aims to explore the dilemmas involving issues of participation on the one side and protection on the other: it is one where the child welfare worker is being required, on the one hand, to provide youths with an opportunity to participate in decisions affecting them while at the same time being required to protect those youths in their care from harming themselves in various ways. These two concerns of participation and protection are spelled out specifically in Article 12 of the UN Convention on the Rights of Children of which Norway is a signatory.

Methodology – This study draws from a qualitative reanalysis of interview data from a 15-year longitudinal study of 85 child welfare clients in Norway. They were followed up at three points in time: first when they became clients (age 14–15), next when they were young adults (age 20), and finally when they were 30 years old. All of these 85 informants had initially come to the attention of child protection authorities owing to the severity of their behavior problems.

Findings – The chapter describes how these young people experienced both participation and protection of the child welfare services at the time they were provided and later on when they had become adults. One important finding of the study is that, as adults, their opinions had changed and they then believed that the protection usually in the form of guardianship earlier provided to them as youngsters had been beneficial to them.

In current economic systems, the role played by non-profit and voluntary organisations is relevant. Several studies analyse the development of these organisations and suggest reasons related to the dissemination of policies that first consider public intervention and then ‘the third way’ of the economy as a way to increase wealth and support economic development. In this context, it should be noted that:

• Modern non-profit organisations (NPOs) take the form of enterprises encouraging the development of capabilities to satisfy human needs in terms of production of goods and utilities.

• A systematic cooperation with the local context (i.e. enterprises and Public Administration) is becoming increasingly more important for the survival and development of NPOs.

• Excellent opportunities for economic and social growth and for mutual development can develop from this type of cooperation.

• Starting from this premise, the purpose of the research is to suggest some insight on the theme of cooperation between for-profit and non-profit world in the light of the thought of Church’s Social Doctrine, and in particular, of the Encyclical Letter of Benedict XVI, Caritas in Veritate – On Integral Human Development in Charity and Truth. In this sense, the contribution is a conceptual work; the study could improve with empirical research concerning the level of diffusion and the form of collaborations for-profit/non-profit in the Italian context.

Modern non-profit organisations (NPOs) take the form of enterprises encouraging the development of capabilities to satisfy human needs in terms of production of goods and utilities.

A systematic cooperation with the local context (i.e. enterprises and Public Administration) is becoming increasingly more important for the survival and development of NPOs.

Excellent opportunities for economic and social growth and for mutual development can develop from this type of cooperation.

Starting from this premise, the purpose of the research is to suggest some insight on the theme of cooperation between for-profit and non-profit world in the light of the thought of Church’s Social Doctrine, and in particular, of the Encyclical Letter of Benedict XVI, Caritas in Veritate – On Integral Human Development in Charity and Truth. In this sense, the contribution is a conceptual work; the study could improve with empirical research concerning the level of diffusion and the form of collaborations for-profit/non-profit in the Italian context.

From a methodological point of view, after a literature review on NPOs and corporate social responsibility, the chapter analyses reasons, strategies and tools of collaborations between non-profit and for-profit worlds (the role of Public Administration and hybrid organisation is excluded). Then, focus moves up on Church’s Social Doctrine and Encyclical Letter Caritas in Veritate with particular attention to the topic analysed in this chapter (collaboration for-profit/non-profit enterprises). The vision emerging from the Encyclical is that the dichotomy between for-profit and NPOs should be resolved by striving for the development of a ‘civil economy’ with the capacity to promote the overall development of the human being. The research highlights the importance of dissemination of initiatives promoted predominantly by NPOs, with the objective of stimulating and supporting the implementation of forms of structured collaboration; we are sure that a ‘connection point’ between for-profit and non-profit is now necessary.

The purpose of this paper is to develop a case study of niche governance to analyze the governance of rainwater systems in the Amazon.

A visualization of the interactions of stakeholders was made with the use of social network analysis, where data were collected through interviews to experts from the region. A framework based on niche management and the safe, resilient and sustainable (Safe and SuRe) principles were used to interpret the results.

The work identifies key players and issues influencing governance for the implementation of rainwater systems; and capture of decision-making powers by agents making evident redundancies in the management of rainwater in the region; highlighting issues of lack of inclusion in the decision-making process, planning and implementation; threatening the sustainability, resilience and governance of rainwater systems in Belem.

Methodologically, this work is the first of its kind for the amazon and contributes to the exploration of tools and frameworks to assess governance in the implementation of rainwater systems.