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Many countries have a renewed focus on health inequalities since COVID-19. In England, integrated care systems (ICSs), formed in 2022 to promote integration, are required to reduce health inequalities. Integration is supported by population health management (PHM) which links data across health and care organisations to inform service delivery. It is not well-understood how PHM can help ICSs reduce health inequalities. This paper describes development of a programme theory to advance this understanding.

This study was conducted as a mixed-methods process evaluation in a local ICS using PHM. The study used Framework to analyse interviews with health and care professionals about a PHM tool, the COVID-19 vaccination uptake Dashboard. Quantitative data on staff Dashboard usage were analysed descriptively. To develop a wider programme theory, local findings were discussed with national PHM stakeholders.

ICS staff used PHM in heterogeneous ways to influence programme delivery and reduce inequalities in vaccine uptake. PHM data was most influential where it highlighted action was needed for “targetable” populations. PHM is more likely to influence decisions on reducing inequalities where data are trusted and valued, data platforms are underpinned by positive inter-organisational relationships and where the health inequality is a shared priority.

The COVID-19 pandemic accelerated a shift toward use of digital health platforms and integrated working across ICSs. This paper used an evaluation of integrated data to reduce inequalities in COVID-19 vaccine delivery to propose a novel programme theory for how integrated data can support ICS staff to tackle health inequalities.

This study examines the direct and indirect effects of organizational environmental orientation (EO)/culture, quality management practices (QMP) and sustainability experience (SE) on the relationship between organizational green practices (GP) and the triple bottom line (TBL) of sustainability performance (SuP).

To test the seven hypotheses, a structured questionnaire was used to collect data. The responses of 365 managers from various USA businesses in the service industries were analyzed using IBM SPSS and structural equation modeling (SEM)-AMOS.

The empirical results indicate that positive SuP in the economic, environmental and social dimensions and organizational GP can be improved by a strong culture of EO, effective QMP and substantial SE.

This research fills the gap in existing research between important organizational and environmental priorities and SuP. Consequently, the study provides managers with important strategic guidance: for environmental practices to achieve profitability and sustainability success, companies must promote an environmental-mindful culture and strategically invest in integrated QM systems.

This research is one of the first that explores how organizational environmental culture and QMP affect directly and indirectly the relationship between GP and SuP. These results provide empirical evidence to support the claim that environmental culture and QMP have significant direct and indirect effects on the relationship between GP and SuP dimensions.

The purpose of this research is to identify novel ways of tackling health inequalities of underserved populations. It explores the opportunities presented by the changes in health and social care legislation to employ historically underused services, such as police custody healthcare providers, in addressing health inequalities.

This research analyses the policy approaches to tackling health inequalities in the UK in the past 40 years with an emphasis on those experienced by the people detained in English police custodies. It analyses the current model of healthcare in police custody and proposes a novel integrated model of care and joint commissioning opportunities in funding it.

Policies to tackle health inequalities have largely failed, as they became entrenched. But recent changes in the health and social care legislation in England offer opportunities to address them by employing historically underused healthcare services, such as those operating in police custodies.

The research does not touch upon ethical considerations related to the patient privacy aspect of integrated care. Interventions by and interactions with police custody healthcare providers would be visible to all professionals with access to the patient’s health record. As with all novel interventions or innovative models of care, the effectiveness of such clinical interventions remains to be established by further research. It opens a new line of research on quality improvement through integration of care and explores understudied aspects of joint commissioning of integrated care.

It offers health commissioners and public health leaders the opportunity to employ police custody healthcare services in reaching their population health management objectives and meeting their health inequalities objectives at local level. It also gives police and crime commissioners the opportunity to address the health drivers of criminal behaviour that overlap with health inequalities. It offers funding opportunities presented by jointly commissioning services at lower costs to both police and health commissioners alike. It improves the health outcomes of historically underserved populations by facilitating access to health and social care services and facilities.

Reducing health inequalities and disparities in health outcomes can decrease the costs of the healthcare services over the long term and might contribute to reducing criminality by addressing inequities and some health drivers of criminal behaviour.

The paper explores understudied opportunities offered by the recent changes in health and social care legislation in England and includes underused resources to tackle health inequalities.

Given the importance of environmental protection and the crucial role of manufacturing firms in environmental degradation, the purpose of this research is to investigate the impact of green intellectual capital (GIC) on firms' green performance (GP), mediating effects of ambidextrous green innovation (GI) and moderating role of technological turbulence (TT).

The study employed a quantitative research approach with the partial least square structural equation modeling (PLS-SEM) methodology to assess the proposed relationships among the constructs on a sample of 334 executives from 134 medium and large-sized manufacturing firms.

The findings show that GIC significantly impacts different aspects of GP, including green management, green process and green product performance. Moreover, exploitative and exploratory GI serves as mediators between GIC and firms' GP. Finally, the findings demonstrate that TT moderation enhanced the effects of GIC on exploratory GI, while decreasing the effects of GIC on exploitative GI.

The research offers valuable insights and a novel strategy for manufacturing firms and policymakers to mitigate environmental degradation and attain sustainable GP by stimulating ambidextrous GI through green intangible resources.

This research adds to the current GIC, GI and GP literature by focusing on green environmental issues using the resource-based view (RBV) theory. This research also provides a significant theoretical and practical justification for explaining the relationships by differentiating ambidextrous GI between exploitative and exploratory GI's mediating effects and TT's moderating effects.

Lengthy and complex routes to specialist care may negatively affect clinical profiles of trauma survivors accessing mental health services. The purpose of this study was to describe the characteristics and referral pathways of a cohort of clients accepted by a specialist trauma service in England; and investigate the associations between referral pathways and clients’ clinical profiles, namely, pre-treatment levels of post-traumatic stress, depression, anxiety, stress and post-traumatic growth.

Data on 117 consecutive, accepted referrals were extracted from clients’ clinical records. Information on demographics, trauma histories, clinical presentations and referral pathways was synthesised through summary statistics. Correlational analyses were conducted to test associations with pre-treatment scores.

Clients accessing the service were highly complex and mostly experienced prolonged, interpersonal trauma. Pathways to the service varied, but 50% of the sample had at least four “steps” in their referral histories and seven previous clinical contacts. The average time between trauma and specialist referral was 16.34 years. The number of referral steps positively, significatively and moderately correlated with anxiety and stress at pre-treatment.

Limitations include issues around collecting past referral information, the small sample size for clients with available pre-treatment data and the lack of post-treatment scores.

This evaluation provides an informative overview of the characteristics and referral pathways of clients accessing a specialist trauma service. It also offers preliminary insights on the relationship between clients’ routes into the service and their clinical profiles. Practice, commissioning and research implications are discussed.

Refugees and asylum seekers worldwide face numerous barriers in accessing health systems. The evidence base regarding who and what helps refugees and asylum seekers facilitate access to and the navigation of the health system in the UK is small. This study aims to address this gap by analysing 14 semi-structured, in-depth interviews with refugees and asylum seekers of different countries of origin in the UK to identify where, when and how they came into contact with the health-care system and what the outcome of these interactions was.

Semi-structured, in-depth interviews were chosen as the key method for this study. In total, 14 individual interviews were conducted. A trauma-informed research approach was applied to reduce the risk of re-traumatising participants.

The paper identifies key obstacles as well as “facilitators” of refugees’ and asylum seekers’ health-care experience in the UK and suggests that host families, friends and third-party organisations all play an important role in ensuring refugees and asylum seekers receive the healthcare they need.

To the best of the authors’ knowledge, this is the first qualitative study in the UK that looks at comprehensive health journeys of refugees from their first encounter with health services through to secondary care, highlighting the important role along the way of facilitators such as host families, friends and third-party organisations.

The case has been developed as an illustrative case study using primary data. The data and images used for developing the case have been collected from the Alipurduar Division of Indian Railways with suitable permissions. The specific newspaper studies used in developing the case content have been referenced as footnotes on the relevant pages of the case study document.

Train operations in Alipurduar Division of Northeast Frontier Railway zone of Indian Railways are difficult. The division provides the vital rail link between the northeast states and the rest of India. Railway lines in the Alipurduar Division pass through several forests with a significant elephant population. As an outcome of train–elephant conflicts, train operations on one of the railway lines operate under severe speed restrictions. Moreover, the region is known for heavy rainfall and thunderstorms for almost six months every year. For the Divisional Railway Manager (DRM), the protagonist of the case, this implied repeated congestion, traffic disruptions, inadvertent delays and lack of time for critical maintenance of the tracks. A solution was planned several years ago for creating an alternative path to de-congest the traffic; however, it ran into a roadblock due to land acquisition issues.With all these limitations, could a solution be found and implemented? How could it be executed?The case illustrates how a simple yet innovative solution was proposed by the DRM in 2015 and implemented in 2016.With this case, students will be able to understand the innovation process that is embedded within long-term infrastructure projects. The case will help students understand how innovation can take place even in the later stages of project implementation, and how simple and creative solutions can have a long-term impact.

The case can be used in graduate and executive education courses in General Management and in Public Policy Management. It can also be used in Doctoral-Level Programmes such as those taught to scholars pursuing Fellow Programme in Management. Since the case brings out elements of problem framing and critical thinking, the case can be used for courses in strategic management. Many professionals, particularly those working in large organizations dealing with large infrastructure projects, will identify with the DRM and the challenges faced by him.

Two-level support with Level 1 consisting of a set of beams and Level 2 consisting of a tree-like structure is an efficient support structure for extrusion-based additive manufacturing (EBAM). However, the literature for finding a slim two-level support is rare. The purpose of this paper is to design a lightweight two-level support structure for EBAM.

To efficiently solve the problem, the lightweight design problem is split into two subproblems: finding a slim Level 1 support and a slim Level 2 support. To solve these two subproblems, this paper develops three efficient metaheuristic algorithms, i.e. genetic algorithm (GA), genetic programming (GP) and particle swarm optimization (PSO). They are problem-independent and are powerful in global search. For the first subproblem, considering the path direction is a critical factor influencing the layout of Level 1 support, this paper solves it by splitting the overhang region into a set of subregions, and determining the path direction (vertical or horizontal) in each subregion using GA. For the second subproblem, a hybrid of two metaheuristic algorithms is proposed: the GP manipulates the topologies of the tree support, while the PSO optimizes the position of nodes and the diameter of tree branches. In particular, each chromosome is encoded as a single virtual tree for GP to make it easy to manipulate Crossover and Mutation. Furthermore, a local strategy of geometric search is designed to help the hybrid algorithm reach a better result.

Simulation results show that the proposed method is preferred over the existing method: it saves the materials of the two-level support up to 26.34%, the materials of the Level 1 support up to 6.62% and the materials of the Level 2 support up to 37.93%. The proposed local strategy of geometric search can further improve the hybrid algorithm, saving up to 17.88% of Level 2 support materials.

The proposed approach for sliming Level 1 support requires the overhanging region to be a rectilinear polygon and the path direction in a subregion to be vertical or horizontal. This limitation limits the further material savings of the Level 1 support. In future research, the proposed approach can be extended to handle an arbitrary overhang region, each with several choices of path directions.

The details of how to integrate the proposed algorithm into the open-source program CuraEngine 4.13.0 is presented. This is helpful for the designers and manufacturers to practice on their own 3D printers.

The path planning of the overhang is a critical factor influencing the distribution of supporting points and will thus influence the shape of the support structure. Different from existing approaches that use single path directions, the proposed method optimizes the volume of the support structure by planning hybrid paths of the overhangs.

The global organic market is expanding, and India is in an advantageous position with the highest number of organic producers worldwide. Although many articles have been published on the value chain of organic products from India, no significant studies were found related to the value chain analysis of organic pineapple. This study aims to know the various aspects of the organic pineapple value chain, i.e. network structure, value addition at various stages of chain actors, value chain upgradation and governance structure.

The study is explorative in nature, and primary data from various actors involved in the chain is collected and analyzed. Primary data through a structured schedule and interviews are collected from farmers and traders. A multistage sampling plan has been adopted. A sample of 75 farmers was randomly selected from the study area. For traders, snowball sampling is used due to the nonavailability of the sampling frame. A total of 10 commission agents, 10 wholesalers and 20 retailers were thus selected for the study. For objectives 1 and 4, descriptive statistics are used. For objective 2, a modified formula described by (Murthy et al., 2007) is used to calculate farmer’s net price and marketing margin. For objective 3, Garrett’s ranking technique is used to identify various constraints in upgrading the organic pineapple value chain in Assam.

This study shows that the value chain of organic pineapple is in the initial stage and proper value addition is required to have a complete regulated value chain. Six marketing channel is identified, and products are sold through farmer producer company only in case of export and trade with distant buyers. The marketing efficiency for channels II and III is 1.69 and 0.99, respectively. The degree of value addition for channel II in the hands of the commission agent, wholesaler and retailer is 11.65%, 4.56% and 12.60%, respectively. In the various constraints in upgrading the value chain, farmers rank “policy support” as a major constraint. In the governance structure, trade with distant traders and exports is done formally and through written contracts.

The study performs value chain analysis of organic pineapple in Cachar district of Assam, India for the year January 2022–January 2023. Future studies are encouraged related to various aspects of the supply chain and value chain of organic pineapple from various northeastern states of India and other states.

The study will help policymakers and key actors to know the existing chain and frame a well-coordinated and regulated value chain.

This study is one of the first study to explore the value chain of organic pineapple of Cachar district of Assam, India. Implementation of these findings can help various actors to strengthen the existing value chain.

Mental health recovery across cultures lacks understanding and suitable measures. The Questionnaire about the Process of Recovery (QPR) is a self-report instrument measuring personal recovery outcomes for consumers of mental health services. However, the extent of its relevance among culturally and linguistically diverse (CALD) communities is unclear. This pilot study aimed to examine the relevance and utility of the QPR among CALD consumers of primary mental health services in Australia.

Eleven individual, semi-structured interviews were conducted with two general practitioners (GPs) and nine consumers from two clinics, at locations with high Iranian and Burmese refugee or asylum seeker populations. Interviews were transcribed and analysed using a thematic framework approach.

Although almost all consumers had little or no understanding of the concept of personal recovery, they found the QPR culturally acceptable and understandable. Using the QPR during mental health consultations can help with needs identification and goal setting. Challenges in using the QPR included completion time, cross-cultural differences in concepts and norms for some items, and need for careful translation. Consumers suggested additional items regarding family reputation, sexuality, and spirituality.

The QPR is potentially a valuable tool to support mental health consultations with CALD consumers, from the perspectives of both GPs and consumers.