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Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower health literacy, rural healthcare systems also experience significant resource shortages, as well as issues with recruitment and retention of healthcare providers, particularly specialists. These factors combined result in complex change management-focused challenges for rural healthcare systems. Change management initiatives are often resource intensive, and in rural health organizations already strapped for resources, it may be particularly risky to embark on change initiatives. One way to address these change management concerns is by leveraging socio-technical simulation models to estimate techno-economic feasibility (e.g., is it technologically feasible, and is it economical?) as well as socio-utility feasibility (e.g., how will the changes be utilized?). We present a framework for how healthcare systems can integrate modeling and simulation techniques from systems engineering into a change management process. Modeling and simulation are particularly useful for investigating the amount of uncertainty about potential outcomes, guiding decision-making that considers different scenarios, and validating theories to determine if they accurately reflect real-life processes. The results of these simulations can be integrated into critical change management recommendations related to developing readiness for change and addressing resistance to change. As part of our integration, we present a case study showcasing how simulation modeling has been used to determine feasibility and potential resistance to change considerations for implementing a mobile radiation oncology unit. Recommendations and implications are discussed.

The process of chronic pain (CP) and strategies is to improve the patient’s health and well-being. CP is a frequent medical problem that presents a major challenge to healthcare providers because of its complex natural history, imprecise aetiology, and inadequate response to pharmacological treatment. Although different definitions exist it is widely accepted that CP is an ongoing pain that lasts more than 3 months or that persists longer than the reasonably expected healing time for the involved tissues. Also, it is acknowledged that its treatment is much different than the treatment for acute pain. When addressing a person with CP, one should always keep in mind that pain is much more about the individual than the underlying medical condition. Every person is different, and healthcare providers should take a tailor-made approach to managing their pain. This is the only way to ensure good results in pain treatment. Treatment goals should be discussed and adapted to the patient profile. It is fundamental to have clear goals from the beginning and to ensure these are realistic, individualized, and measurable. Effective treatment for CP is only achieved through a holistic framework in which the patient’s well-being is the first concern and an interdisciplinary and societal approach is implemented from the first day.

The current era of the fourth industrial revolution has attracted significant research on the use of digital technologies in improving construction project delivery. However, less emphasis has been placed on how these digital tools will influence the management of the construction workforce. To this end, using a review of existing works, this chapter explores the fourth industrial revolution and its associated technologies that can positively impact the management of the construction workforce when implemented. Also, the possible challenges that might truncate the successful deployment of digital technologies for effective workforce management were explored. The chapter submitted that implementing workforce management-specific digital platforms and other digital technologies designed for project delivery can aid effective workforce management within construction organisations. Technologies such as cloud computing, the Internet of Things, big data analytics, robotics and automation, and artificial intelligence, among others, offer significant benefits to the effective workforce management of construction organisations. However, several challenges, such as resistance to change due to fear of job loss, cost of investment in digital tools, organisational structure and culture, must be carefully considered as they might affect the successful use of digital tools and by extension, impact the success of workforce management in the organisations.

Drawing on both the stakeholder theory and Carroll’s Corporate Social Responsibility Pyramid, this chapter explores sustainability practice challenges of a gold minning multinational enterprise in Ghana. Primary data was collected through observation and the interviewing of multi-stakeholder groups. We found that internal stakeholders perceive sustainability expenditure as costly. However, while employees of the case enterprise see the cost as depleting shareholders’ wealth, managers view them as investment with possible long-term benefits. Meanwhile, the external stakeholders perceive the gold mining enterprise’s sustainability expenditure as meagre and that beneficiary communities are not economically empowered to sustain those investments. Again, we found that government’s inability to clamp down illegal gold mining threatens economic and environmental sustainability. Additionally, members of the host community identify the lack of adequate employment opportunities within the entity as a hindrance to their economic empowerment. We submit that the resolution of the sustainability challenges would contribute to the balancing of stakeholders’ expectations: the conduct of ethical business through compliance to environmental laws; promotion of host communities’ social well-being; and improved economic returns for shareholders. By meeting the needs of stakeholders, gold mining enterprises could gain acceptance in their host communities and boost corporate reputation.

Strategic decisions leaders make involving organizational changes such as mergers and acquisitions (M&A), divestitures, and downsizing, which can influence and/or interact with other organizational factors. For example, within the context of M&A, changes impact financial performance, firm behaviors, and organizational culture. In addition, strategic decisions for these types of change can also interrelate with other more intrapersonal factors, including both leaders’ and employees’ health and well-being. Employee stress, also referred to as “merger syndrome,” outlines individual negative impacts of the changes including, but not limited to, cynicism and distrust, change wariness, and burnout, all accumulating to psychological effects including increases in detachment to work, stress, and sick leave. In this chapter, the authors outline the different impacts M&A phases have on stress and well-being and how they interrelate with the strategic decisions leaders make. The authors also outline future research opportunities and practical implications for how leaders and employees could better manage future major changes such as M&A activities.

Research with vulnerable groups is crucial to get their input into public policy design that will directly impact on them. However, there are many methodological and ethical challenges involved in encouraging participation from groups with a wide range of intellectual, cognitive and physical capacities while ensuring that the rights and well-being of participants are protected. Rather than exploring ethical theories, this chapter is a case study describing the practical ethical considerations that were involved in designing and holding a series of focus groups with adult health and social care service users from vulnerable cohorts. It is based on a series of focus groups which the Institute of Public Health (IPH) held with specified cohorts as part of a policy development process on adult safeguarding for the Department of Health (DOH) in Ireland. The four cohorts were people with intellectual disability, cognitive impairments, significant mental health challenges and nursing home residents. This chapter does not describe the findings of the focus groups but outlines the ethical and methodological considerations that arose in designing and conducting this research, and the practical ethical safeguards employed to mitigate risk and comply with Irish and EU General Data Protection Regulation (GDPR) legislation governing health research. It outlines the ethical issues around protecting confidentiality and using incentives to encourage participation, how individuals' capacity to give informed consent was maximized, the risk-assessment and mitigation procedures used to prevent harms arising and the measures put in place to provide follow-up emotional support to participants.

In response to a critical need for uniform school crisis preparedness and response efforts across districts, the National Association of School Psychologists developed PREPaRE, a model and training curriculum aimed to equip school-based professionals to engage in comprehensive school crisis prevention and intervention practices. The PREPaRE acronym stands for: Prevent/Prepare for psychological trauma; Reaffirm physical health, security, and safety; Evaluate psychological trauma; Provide interventions (and) Respond to psychological needs; and Examine the effectiveness of prevention and intervention efforts. The model spans four crisis preparedness phases: Prevention, Mitigation, Response, and Recovery. This chapter provides a detailed overview of the development and structure of the PREPaRE model's core components and the organizational framework of the Incident Command System. It delineates elements of the basic school crisis response plan, assessment of mental health risk following a crisis event, and the provision of crisis interventions within a multitiered system of support framework. Additionally, it summarizes ongoing effectiveness and implementation research used to evaluate and improve the model based on immediate training outcomes assessed through pre and postmeasures and training transfer to applied school contexts. Implications for research and public policy regarding school safety and crisis prevention and intervention, as well as the future of PREPaRE curriculum development, are discussed.

Behavioral threat assessment and intervention is a violence prevention strategy that has become widely used in US schools. Instead of relying on a zero tolerance disciplinary approach that often leads to school exclusion of students with disabilities, schools can use a multidisciplinary threat assessment team to assess the seriousness and context of a student's behavior and identify appropriate interventions and supports. This process is especially valuable for students with disabilities who are identified as threatening violence. This chapter describes an evidence-based model of threat assessment, the Comprehensive School Threat Assessment Guidelines (CSTAG), ¹ reviews some common misunderstandings of threat assessment, and presents a case example illustrating the value of threat assessment in preventing school exclusion, and provides services for a student with a disability.