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This paper – the final paper of a series of three – aims to discuss the implications of the findings from a service user needs assessment of people experiencing homelessness in the Northwest of England. It will expand on the previous paper by offering a more detailed analysis and discussion of the identified key themes and issues. The service user needs assessment was completed as part of a review of local service provision in the Northwest of England against the backdrop of the COVID-19 pandemic.

Semi-structured questionnaires were administered and used by health-care professionals to collect data from individuals accessing the Homeless and Vulnerable Adults Service (HVAS) in Bolton. The questionnaires included a section exploring Adverse Childhood Experiences. Data from 100 completed questionnaires were analysed to better understand the needs of those accessing the HVAS.

Multiple deprivations including extensive health and social care needs were identified within the cohort. Meeting these complex needs was challenging for both service users and service providers. This paper will explore key themes identified by the needs assessment and draw upon further comments from those who participated in the data-gathering process. The paper discusses the practicalities of responding to the complex needs of those with lived experience of homelessness. It highlights how a coordinated partnership approach, using an integrated service delivery model can be both cost-effective and responsive to the needs of those often on the margins of our society.

Data collection during the COVID-19 pandemic presented a number of challenges. The collection period had to be extended whilst patient care was prioritised. Quantitative methods were used, however, this limited the opportunity for service user involvement and feedback. Future research could use qualitative methods to address this balance and use a more inclusive approach.

This study illustrates that the needs of the homeless population are broad and varied. Although the population themselves have developed different responses to their situations, their needs can only be fully met by a co-ordinated, multi-agency, partnership response. An integrated service model can help identify, understand, and meet the needs of the whole population and individuals within it to improve healthcare for a vulnerable population.

This study highlighted new and important findings around the resilience of the homeless population and the significance of building protective factors to help combat the multiplicity of social isolation with both physical and mental health problems.

The discussion provides an opportunity to reflect on established views in relation to the nature and scope of homelessness. The paper describes a contemporary approach to tackling current issues faced by those experiencing homelessness in the current context of the COVID-19 pandemic. Recommendations for service improvements will include highlighting established good practices including embedding a more inclusive/participatory approach.

This study aims to conceptualize the dimensions of resilient leadership and develop the resilient leadership scale (RLS) through three studies.

In Study 1, based on interviews with 77 leaders and 8 junior employees, a seven-factor resilient leadership model was constructed. In Study 2, exploratory factor analysis (n = 237) was conducted to refine the initial items. In Study 3, confirmatory factor analysis (n = 610) was performed to validate the dimensional structure identified in Study 2, and different types of validity of the RLS were assessed.

The validated RLS composed of seven dimensions: contingency planning, improvisation, adaptive instructing, contingency control, emergency care, adjustment recovery and mutual growth. The scale showed desirable measurement qualities in terms of reliability and validity. Resilient leadership and its dimensions significantly impact employee turnover intentions and employee resilience.

This research contributes to the literature on the resilience of hospitality and tourism enterprises and enriches the research scope and theoretical framework of resilient leadership.

This research revealed the resilient leadership responses to crisis in hospitality and tourism enterprises with practical implications for tourism enterprise leaders to deal with major crisis.

The purpose of this study was to investigate the factors impacting the intermediating variable of employee engagement toward employee performance in a hybrid working organization in Bangkok, Thailand.

This study uses secondary data analysis and an archival study; the primary data were gathered from 370 employees who are working in a hybrid model environment in a private agricultural machinery company. To construct a new conceptual framework, this study adopted four frameworks from the previous research.

Perceived organizational support and trust and respect in the organization are found to have a significant positive impact on employee engagement. Moreover, there is a significant positive impact of the employee engagement on employee performance in a hybrid working model.

For hybrid work environments, the research focused mainly on the emotional themes of perceived support, trust and respect in the organization. Therefore, there would be many factors that could possibly affect those dependence variables in any environment, which will have to be investigated more in future research. Either in the organization or in the company, many departments and business units operates for the company, but the researcher specifies only the business units or departments that now use the hybrid working model.

This study focuses on a case study of an agricultural machinery company, which likely produces different results than other industries, other industries may produce different results.

Hybrid working models can blur the boundaries between work and personal life, potentially leading to increased stress and burnout. Organizations should prioritize work-life balance and employee well-being by promoting flexible schedules, encouraging breaks and time off, and providing resources for mental health support.

The organization which is operating among a hybrid working model, the increasing of perceived organizational support and trust and respect level, has positively increase the employee engagement toward enhancing the employee performance.

This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and cut off from health-care services.

This research combines an integrated literature review and an instrumental case study. The literature review comprises two targeted reviews to provide insights: one on conflict zones and one on mobile clinics. The case study describes the process and challenges faced throughout a mobile clinic deployment during and after the Iraq War. The data was gathered using mixed methods over a two-year period (2017–2018).

Armed conflicts directly impact the populations’ health and access to health care. Mobile clinic deployments are often used and recommended to provide health-care access to vulnerable populations cut off from health-care services. However, there is a dearth of peer-reviewed literature documenting decision support tools for mobile clinic deployments.

This study highlights the gaps in the literature and provides direction for future research to support the development of valuable insights and decision support tools for practitioners.

The mental healthcare is experiencing an ever-growing surge in understanding the consumer (e.g., patient) engagement paradox, aiming to vouch for the quality of care. Despite this surge, scant attention has been given in academia to conceptualize and empirically investigate this particular aspect. Thus, drawing on the Stimulus-Organism-Response (S-O-R) paradigm, the study explores how patients engage with healthcare service providers and how they perceive the quality of the healthcare services.

Data were collected from 279 respondents, and the derived conceptual model was tested by using Smart PLS 3.2.7 and PROCESS. To complement the findings of partial least squares (PLS)-based structural equation modeling (SEM), the present study also applied fuzzy set qualitative comparative analysis (fsQCA) to identify the necessary and sufficient conditions to explore substitute conjunctive paths that emerge.

Findings show that patients’ perceived intimacy (PI), cohesion and privacy enhance the quality of mental healthcare service providers. The results also suggest that patients’ PI, cohesion and privacy have indirect effects on the perceived quality of care (PQC) by the service providers through consumer engagement. The fsQCA results derive that the relationship among conditions leading to patients’ perception of the quality of care in regard to mental healthcare service providers is complex and is best reflected as multiple and conjectural causation configurations.

The findings from this research contribute to the advancement of studies on patients’ experiences by empirically examining the unique dynamics of interaction between consumers (patients) and mental healthcare service providers, thereby enriching both the literature on social interactions and the understanding of the consumer–provider relationship.

The results of this study provide practical implications for mental healthcare service providers on how to combine the study variables to enhance the quality of care and satisfy more patients.

A significant research gap has ascertained the inter-relationship between PI, cohesion, privacy, engagement and PQC from the perspective of mental healthcare service providers. This research is one of the primary studies from a managerial and methodological standpoint. The study contributes by combining symmetric and asymmetric statistical tools in service marketing and healthcare research. Furthermore, the application of fsQCA helps to understand the interactions that might not be immediately obvious through traditional symmetric methods.

The purpose of this review paper was identifying barriers to the use of telemedicine systems in primary health-care individual level among professionals.

This study used Scopus and PubMed databases for scientific records identification. A systematic review of the literature structured by PRISMA guidelines was conducted on 37 included papers published between 2009 and 2019. A qualitative approach was used to synthesize insights into using telemedicine by primary care professionals.

Three barriers were identified and classified: system quality, data quality and service quality barriers. System complexity in terms of usability, system unreliability, security and privacy concerns, lack of integration and inflexibility of systems-in-use are related to system quality. Data quality barriers are data inaccuracy, data timeliness issues, data conciseness concerns and lack of data uniqueness. Finally, service reliability concerns, lack of technical support and lack of user training have been categorized as service quality barriers.

This review identified and mapped emerging themes of barriers to the use of telemedicine systems. This paper also through a new conceptualization of telemedicine use from perspectives of the primary care professionals contributes to informatics literature and system usage practices.

COVID-19 has affected the economies adversely from all sides. The sudden halt in production has impacted both the supply and demand sides. It calls for analysis to quantify the impact of the reduction in economic activity on the economy-wide variables so that appropriate steps can be taken. This study aims to evaluate the sensitivity of various sectors of the Indian economy to this dual shock.

The eight-sector open economy general equilibrium Global Trade Analysis Project (GTAP) model has been simulated to evaluate the sector-specific effects of a fall in economic activity due to COVID-19. This model uses an economy-wide accounting framework to quantify the impact of a shock on the given equilibrium economy and report the post-simulation new equilibrium values.

The empirical results state that welfare for the Indian economy falls to the tune of 7.70% due to output shock. Because of demand–supply linkages, it also impacts the inter- and intra-industry flows, demand for factors of production and imports. There is a momentous fall in the demand for factor endowments from all sectors. Among those, the trade-hotel-transport and manufacturing sectors are in the first two positions from the top. The study recommends an immediate revival of the manufacturing and trade-hotel-transport sectors to get the Indian economy back on track.

The present study has modified the existing GTAP model accounting framework through unemployment and output closures to account for the impact of change in sectoral output due to COVID-19 on the level of employment and other macroeconomic variables.

This study aims to observe and discuss an emerging disintermediation in transportation, finance and health care, and explain how these three key areas depend on intermediary institutions that are the fruit of modern corporate governance conditions that find their roots in classical sociological theory.

The authors review and incorporate a diversity of research literature to explain the likelihood for the development and continuation of disintermediation.

The authors map two sociological perspectives (Emile Durkheim’s theory of interdependence and Herbert Spencer’s theory of contracts) to two modern corporate governance theories (resource dependence theory and agency theory). The authors then discuss the challenging social situation resulting from modern corporate governance and show how these conditions create the potential for a continuum of disintermediation across the specific and crucial economic sectors of transportation, finance and health care.

The implications of this theoretical integration can help organizational leaders navigate complex social and strategic issues and prepare for the consequences that may result from the emerging disintermediation.

This study aims to facilitate access to vascular disease screening for low-income individuals living in remote and conflict areas based on the results of a pilot trial in Colombia. Also, to increase the amount of diagnosis training of vascular surgery (VS) in civilians.

The operation method includes five stages: strategy development and adjustment; translation of the strategy into a real-world setting; operation logistics planning; strategy analysis and adoption. The operation plan worked efficiently in this study’s sample. It demonstrated high sensibility, efficiency and safety in a real-world setting.

The authors developed and implemented a flow model operating plan for screening vascular pathologies in low-income patients pro bono without proper access to vascular health care. A total of 140 patients from rural areas in Colombia were recruited to a controlled screening session where they underwent serial noninvasive ultrasound assessments conducted by health professionals of different training stages in VS.

The plan was designed to be implemented in remote, conflict areas with limited access to VS care. Vascular injuries are critically important and common among civilians and military forces in regions with active armed conflicts. As this strategy can be modified and adapted to different medical specialties and geographic areas, the authors recommend checking the related legislation and legal aspects of the intended areas where we will implement this tool.

Different sub-specialties can implement the described method to be translated into significant areas of medicine, as the authors can adjust the deployment and execution for the assessment in peripheral areas, conflict zones and other public health crises that require a faster response. This is necessary, as the amount of training to which VS trainees are exposed is low. A simulated exercise offers a novel opportunity to enhance their current diagnostic skills using ultrasound in a controlled environment.

Evaluating and assessing patients with limited access to vascular medicine and other specialties can decrease the burden of vascular disease and related complications and increase the number of treatments available for remote communities.

It is essential to assess the most significant number of patients and treat them according to their triage designation. This management is similar to assessment in remote areas without access to a proper VS consult. The authors were able to determine, classify and redirect to therapeutic interventions the patients with positive findings in remote areas with a fast deployment methodology in VS.

Access to health care is limited due to multiple barriers and the assessment and response, especially in peripheral areas that require a highly skilled team of medical professionals and related equipment. The authors tested a novel mobile assessment tool for remote and conflict areas in a rural zone of Colombia.

The purpose of this study is to solve the problem of healthcare waste management in developing countries. The buildup of medical waste has attracted the attention of all spheres of society due to the expanding population and developing economy. Timely collection and processing of medical waste are extremely important due to its potential hazards. Although the problem of planning medical waste management has been addressed in developed countries, it persists in several developing countries. This research is motivated by an example of a city in India characterized by a dense population, abundant health-care facilities and a lack of planning for managing large medical waste generated daily.

The authors address the problem of designing the network of collection and processing facilities for medical waste and optimizing the vehicle route that collects and transfers the waste between facilities. Due to distinct topographic restrictions in the considered city, the collection and transfer process needs to be conducted in two echelons – from hospitals to collection centers using smaller vehicles and then to the processing facilities using trucks. This work addresses these two problems as a two-echelon location-routing problem.

A mixed-integer programming model is developed to minimize the cost of opening the facilities and transporting medical waste. Several managerial insights are drawn up to assist planners and decision-makers.

This study follows a case study approach to provide a descriptive and prescriptive approach to hospital waste management in the ancient city of Varanasi. The city has witnessed unplanned growth over the years and is densely populated. The health-care facilities in the city have a large catchment area and attract patients from neighboring districts. The situation analysis based on secondary data and unstructured interviews of the stakeholders suggests that the ad hoc approach prevails in present hospital waste management in the city.