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No matter the fact that it represents significant tourist contingents, Generation Z (Gen Z) is still insufficiently known regarding the main habits, fears or behaviours in changed circumstances. The main objective of this research is to examine the differences in travel risks perception among clusters of young tourists (Gen Z) after one year of the COVID-19 pandemic. The research was conducted during Serbia's primary tourism season in the first year of the pandemic (from June to October 2020), and just before Serbia's primary tourism season in the second year of the pandemic (May 2021). In 2020, responses of 206 participants were collected, while in 2021 there were 208 participants. Data were gathered from Tourism and Hospitality students at the University of Novi Sad (Serbia) by applying the questionnaire created for the specific purpose of this research. All respondents were representatives of Gen Z, born between 1997 and 2003. The main findings of the research are indicating the impact of the COVID-19 pandemic outbreak on young tourists' travel plans. Results are also indicating that average scores on health and non-health risks dimensions were significantly higher in the year 2020 than in 2021, as well as that all participants were more concerned with non-health risks than with health risks in both years of the pandemic. Gen Z tourists' response to the COVID-19 pandemic was consistent concern about non-health risks, denying health risks and expecting even some financial benefits from the crisis. The research findings are contributing to building a knowledge base for various tourism stakeholders in terms of developing the guidelines for tourism recovery strategies during and after the COVID-19 outbreak.

This study aims to construct a mental health service system for middle school students in the post-COVID-19 era with the framework of Six Sigma DMAIC (define, measure, analyze, improve and control) and analyze the influencing factors of the mental health service system to study the implementation strategies of quality-oriented mental health services in middle schools.

This study was conducted in Tianjin, China, from September to November 2022, and 350 middle school students from Tianjin Public Middle School were selected as subjects. A questionnaire survey was used to collect data. In this study, the Six Sigma DMAIC method, sensitivity analysis method, exploratory factor analysis and principal component analysis were used to analyze the mental health services provided to middle school students.

Based on the Six Sigma DMAIC framework, this study indicates that the contribution rate of the mental health service process factor is the largest in the post-COVID-19 era. The mental health cultivation factor ranks second in terms of its contribution. Mental health quality and policy factors are also important in the construction of middle school students’ mental health service system. In addition, the study highlights the importance of parental involvement and social support in student mental health services during the post-COVID-19 era.

To the best of the authors’ knowledge, a study on middle school students’ mental health in the post-Covid-19 era has not yet been conducted. This study developed a quality-oriented mental health system and analyzed the influencing factors of mental health for middle school students based on data analysis and the Six Sigma DMAIC method.

The purpose of this paper is to analyze the implementation of an organizational change initiative – Studer Group®’s Evidence-Based Leadership (EBL) – in two large, US health systems by comparing and contrasting the factors associated with successful implementation and sustainability of the EBL initiative.

This comparative case study assesses the responses to two pairs of open-ended questions during in-depth qualitative interviews of leaders and managers at both health systems. Qualitative content analysis was employed to identify major themes.

Three themes associated with success and sustainability of EBL emerged at both health systems: leadership; culture; and organizational processes. The theme most frequently identified for both success and sustainability of EBL was culture. In contrast, there was a significant decline in salience of the leadership theme as attention shifts from success in implementation of EBL to sustaining EBL long term. Within the culture theme, accountability, and buy-in were most often cited by interviewees as success factors, while sense of accountability, buy-in, and communication were the most reported factors for sustainability.

Cultural factors, such as accountability, staff support, and communication are driving forces of success and sustainability of EBL across both health systems. Leadership, a critical factor in several stages of implementation, appears to be less salient as among factors identified as important to longer term sustainability of EBL.

This paper aims to “identify,” “analyse” and “categorise” the readiness factors of lean sustainability in health-care organisation using total interpretive structural modelling (TISM).

To obtain the data, a closed-ended questionnaire was used in addition to a scheduled interview. To identify how the factors interact, the TISM approach was used, and the matriced’ impacts croise’s multiplication applique’e a UN classement (MICMAC) analysis was used to rank and categorise the lean sustainability readiness factors.

This study identified ten lean sustainability readiness factors for health-care organisation. The identified factors are resources utilization practice (F1), management commitment and leadership (F2), operational flexibility (F3), workforce engagement and time commitment (F4), sustainability motivational factors (F5), awareness of lean and sustainable practice (F6), hospital design (F7), energy efficiency practices in hospitals (F8), responsible autonomy (F9) and new system adoptability training (F10). The key/driving factors are identified in this study are operational flexibility, sustainability motivational factors, management commitment and leadership, new system adoptability training.

The study focussed primarily on lean sustainability factors for the health-care sector.

This research will aid key stakeholders and academics in the better understanding the readiness factors that influence lean sustainability in health-care organisation. This study emphasises the factors that must be considered when applying lean sustainable practices in health care as a real-world application in a health-care organisation. These readiness factors for lean sustainability can be used by an organization to comprehend more about the concept and the components that contribute to health-care lean sustainability.

This study proposes the TISM technique for health care, which is a novel attempt in the subject of lean sustainability in this sector.

Due to land resource scarcity, sustainable urban development in high-density cities has long been challenging. As such, many cities are formulating plans to “dig deep”, resulting in more citizens working and/or staying underground for longer periods of time. However, owing to the particularities of underground space, the factors involved in the creation of a healthy environment are different from those involved in aboveground developments. This study thus aims to investigate the influences of various underground environment factors on users' health through a holistic approach.

To achieve this aim, 12 underground sites and 12 corresponding aboveground sites are selected for a large-scale questionnaire survey, resulting in 651 survey samples. The survey covers post-occupancy evaluation of health (physical and psychosocial), underground environmental quality (visual, thermal, acoustic comfort, indoor air quality and ventilation), space design and greenery. Independent-sample T-test, Pearson correlation, multiple regression modelling and structural equation modelling are used to investigate whether significant differences exist between health of underground and aboveground users, and to develop an underground environment-health model for unveiling the significant associations between underground environment factors and users' health. To cross validate the results, an objective field measurement study is further conducted on six underground sites. The objective measurement results are used to cross validate the survey results.

The questionnaire results provide the following evidence: (1) health of underground users is significantly poorer than that of their aboveground counterparts; (2) underground development users' health is significantly affected by space design, greenery and environmental quality in terms of thermal comfort, indoor air quality, ventilation and acoustic comfort but not visual comfort; and (3) amongst the various identified factors, space design has the strongest predicting effects on human health. The field study echoes the survey findings and further unveils the relationships between different environmental factors and human health.

The results shed light on the importance of distinguishing between underground developments and aboveground ones in various guidelines and standards, especially those related to space management.

Health tourism is a relatively new branch of international tourism that has developed more rapidly than other tourism sectors in recent years. This study aimed to investigate the effect of government supports on health tourism development by considering the mediating role of internal and external infrastructures.

The study population consisted of all experts of two hospitals in Iran, which are frequently visited by foreign tourists (N = 151). A questionnaire, developed by combining standard and researcher-made questionnaires, was used to collect the data. The confirmatory factor analysis (CFA) model was developed in SmartPLS 3 to test the hypotheses.

The main hypothesis test results indicated that government supports positively affect the development of health tourism. Internal and external infrastructures were also found to mediate the relationship between government supports and health tourism development. In addition, the sub-hypothesis test results showed that internal and external infrastructures are positively affected by government supports, which puts forth the development of health tourism. As the results explained, the most important aspects of internal infrastructures affected by government support were health service quality, cost of health services and applying advanced medical technologies, respectively. Also, different aspects of external infrastructures affected by government supports are as follows: economic, infrastructures and cultural factors.

This study is the first of its kind to examine the impact of both medical and non-medical factors on health tourism and signifies the crucial role of governments in the development of health tourism.

This study aims to identify the agile-sustainability readiness factors and analyze them in the context of health-care organization. In this study, agile-sustainability refers to “adapt to the changing environment and respond quickly by maximum using the resources as well as supporting the three pillars of sustainability”.

The “total interpretive structural modelling” (TISM) is used to examine the interrelationships of the identified readiness factors, and to classify the identified readiness factors based on its power to drive and depend on other factors, “Matrice d’impacts croisés multiplication appliquée á un classment (MICMAC) analysis” was used.

This study used a “literature review and experts’ opinion” to identify ten agile-sustainability preparedness characteristics. Organizational leadership, multi-skilled and multi-knowledgeable employees and decision-making autonomy were identified as critical elements in this study.

The research focuses primarily on readiness for agile-sustainability in health-care sector.

This research aids health-care administrators and managers in their decision-making. This study suggests that the evaluation of the readiness factors would promote in raising service standards, ensuring an agile and sustainable health-care operations. The readiness elements that support effective implementation of agile-sustainability in health care require a higher priority from health-care management.

This study created a structural model for health-care organizations based on the TISM-based preparedness for agile-sustainability framework, which is a novel effort for adopting agile-sustainability in health care.

All staff at the University of New England were sent a personal particulars form and questionnaires designed to obtain information about job‐related factors which acted as stressors for them, their general stress, their emotional health, and their physical health. Factor analysis of the job stressors questionnaires revealed that six factors, namely, job significance, workload, work politics, interpersonal dealings at work, work conditions, and university reorganization, were the major stressors for the staff. In general, younger staff members reported more job stress than older staff. Staff belonging to the Faculty of Education, Nursing and Professional Studies at the Armidale campus and general staff at the Armidale campus reported more job stress than other staff. There was some indication that staff employed at the higher job levels were less stressed than those employed at the lower job levels and support staff. Both the job stress and non‐work stress were associated with poor physical health, poor emotional health, and high job dissatisfaction.

The primary purpose is to examine the factors that affect the use of nutritional facts, nutrient content claims and health claims on food label use in the United Kingdom.

The paper reports the results of a survey of over 300 face‐to‐face interviews with shoppers of Asda, Morrisons and Sainsbury – three of the major supermarkets in the UK.

Product class involvement factors, individual characteristics, health‐related factors (nutritional knowledge, health locus of control, perceived need of dietary change), situational, attitudinal and behavioral factors were found to be significant factors affecting the use of nutritional information and nutritional and health claims on food labeling. While the use of nutritional information and health claims increases with the stated importance of “nutrition” and “family preferences”, it is less likely among shoppers for whom “taste” is an important driver of food purchasing behaviour. There is also evidence of mistrust in health claims, as indicated by the negative relationship between the consideration of such claims and the stated importance of “quality” and perceived need to “change dietary quality” – the more discerning shoppers are the least likely to consider health claims.

The study provides evidence that a wider range of product class involvement factors is necessary to predict the use of nutritional information and nutritional and health claims on food labeling. It also offers a conceptualization of health‐related factors to include health locus of control as a predictor of the acquisition of nutrition and health information.

Green lean six sigma (GLSS) is a sustainable development approach that leads to improved patient care with improved safety and quality of service to patients. This study aims to identify, study, model and analyze GLSS success factors for the Indian health-care facility.

Interpretive structural modeling (ISM) and Impact Matrix Cross-Reference Multiplication Applied to a Classification analyses have been used to understand the hierarchical structure among the GLSS success factors. This enabled the development of dependency relationships between success factors, in particular, which factors support the development of other factors.

Specifically, this study found that the success factors “commitment of management” and “financial availability” are the most critical to GLSS implementation success, as they support the development of all other success factors. Meanwhile “embedding sustainable measures at each stage of the service”; “the capability and effectiveness of real-time data collection”; and “feedback and corrective actions” most directly support the GLSS implementation in the health-care facility and serve as the final indicators of implementation progress.

The major implication of this research work lies in suggesting a direction for practitioners to execute the GLSS approach through a systematic understanding of classification and structural relationships among different enablers. This study also facilitates health-care managers to explore different GL wastes in hospitals and challenges to sustainability pursuits in health-care that assist in an organization’s efforts toward sustainable development.

This research work is the first of its kind that deals with the identification and analysis of the prominent factors that foster the inclusive implementation of GLSS within the health-care facility.