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New public management (NPM) has transformed the public sector auditing context, although in quite different ways. Further, investigations into NPM’s impact on public sector auditors and audit institutions have been largely unconnected, with the exception of the critical examination of performance audits. We investigate the question of how public sector auditors’ roles and activities have changed as a result of NPM and later reforms.

We examine and synthesise public sector audit research examining reforms since the year 2000. The research presented considers changes to external and internal public sector audits as well as the development of public sector audit institutions – known as supreme audit institutions (SAIs).

Considerable changes have occurred. Many were influenced by NPM, but others have evolved from the eco-system of accounting, auditing and public sector management. External auditors have responded to an increase in demand for accountability. Additional management and governance techniques have been introduced from the private sector, such as internal auditing and audit committees. NPM has also led to conflicting trends, particularly when governments introduced competition to public sector auditing by contracting out but then chose to centralise to improve accountability. There is also greater international influence now through bodies like the International Organisation of Supreme Audit Institutions (INTOSAI) and similar regional bodies.

NPM reforms and the eco-system have impacted public sector auditing. Sustainability reporting is emerging as an area requiring more auditing attention; auditors also need to continue to develop better ways to communicate with citizens. Further, research into auditing in non-Western nations and emerging technologies is also required, especially where it provides learnings around more valuable audit practices. Empirical evidence is required of the strengths and weaknesses of SAIs’ structural variety.

This study intends to improve the quality of venous thromboembolism (VTE) prophylaxis practices including proper VTE risk assessment and the appropriate prophylaxis measures for surgical urology patients.

The authors applied the Six-Sigma define, measure, analyze, improve and control (DMAIC) improvement methodology in a pre–post interventional study that involved all adult patients above 18 years old indicated and scheduled for urology surgical interventions including endoscopic urological surgeries in a urology specialized 60-bed hospital. The pre-intervention sample included all patients meeting the inclusion criteria over a period of six months. Post-intervention sample included all patients meeting the inclusion criteria over a period of six months. The improvement areas included both the VTE risk assessment as well as the VTE prophylaxis prescription.

DMAIC methodology has achieved a substantial sustained improvement in surgical urology VTE prophylaxis practices with an average of 70% on both levels; VTE risk assessment practices and VTE prophylaxis prescribing practices were statistically significant. The post-intervention results also showed a statistically controlled process with no special cause variations. Based on the study results, the Six-Sigma DMAIC methodology can be considered of high value when applied in healthcare clinical practice improvement projects.

The project study includes some pitfalls that can be addressed as follows: 1. The lack of VTE rate incidence tracking. This limitation can be partly refuted when the authors conduct a literature review and explore that the VTE prophylaxis effectiveness had been proven with sufficient evidence to an extent that pushed several scientific societies to develop their own guidelines to support VTE prophylaxis. (Algattas et al., 2018). 2. Another limitation of this study can be that it handled only surgical patients and more specifically surgical urology patients. Of course, VTE prophylaxis is a crucial life-threatening problem not only for the surgical admitted patients but also for all the medical admitted patients either in hospital wards or ICUs. However, the prediction that surgical patients especially surgical urology patients are more prone to VTE development risk as they have -in several cases-two or three main additive risk factors which are age, procedure duration and malignancy in elderly men. (Tikkinen et al., 2014). So, the authors consider the study project to be a prototype that hopefully can be utilized for future study projects that will manage both other surgical specialty patients and medical patients on the national level and can track accurately and effectively report the VTE incidence rates.

Several recommendations can be extracted from the research project that is summarized in the following points: Paying focused attention to continuous healthcare quality improvement initiatives and projects as a main approach for healthcare improvement especially for the public health-related problems. This might be achieved through periodic region-specific or specialty-specific focus groups from which public health problems could be addressed and prioritized to be considered as a part of country healthcare campaigns regarding cost-utility and feasibility studies. The adoption of a system thinking approach in dealing with the improvement strategies; all efforts and resources are to be employed to achieve a common objective. This includes the generation of a national-wide electronic health information system that can aid in healthcare resource allocation and direct the healthcare efforts towards the most important, high-priority public health problems. Electronic national-wide health record is really an effort, and resources consuming activity, but actually, it's worth exerting efforts, and its valuable outcomes may be seen several years later. 3. Development of unified national specialized VTE prophylaxis pathways to standardize the patient-specific VTE prophylaxis plans. Standardization of healthcare pathways enables healthcare professionals to follow an evidence-based practice which will be reflected on the improvement of healthcare quality level, cost-effectiveness enhancement, and timely patient care on all levels especially in high critical areas like ER and ICU. 4. Incorporation of VTE prophylaxis costs in the universal health insurance diagnosis-related group (DRG) insurance packages and service pricing. Universal health insurance is a nationwide strategy that is aiming to cover all Egypt residents by the year 2030. Universal health insurance is being following the DRG reimbursement policy that is thought to control all the healthcare-associated costs so, the VTE prophylaxis costs shall be added as the main cost item to encourage all healthcare facilities to follow an evidence-based VTE prophylaxis pathway taking into consideration the high-risk patient categories who will definitely represent a high-cost burden on the long run if they suffer a VTE event.

DMAIC improvement methodology applications in healthcare are still relatively limited, especially on the clinical level. The study can be considered one of a kind in Egypt dealing with a comprehensive DMAIC methodology application on the clinical level.

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.

People continue to become more liberated and individualised day by day. They look for ways to somehow get out of any situation that restricts them, tend to get rid of their typical holiday patterns and travel alone, without being stuck within anyone else's borders, precisely as they want. In addition, people can travel alone to discover themselves, meet different cultures, relieve stress and learn new skills. Women travel alone more than men, although they face more difficulties than men. The experiences of women solo travellers suggest that this form of travel can provide a meaningful foundation for advancing gender equality. By challenging gender roles and expectations, empowering women to assert their autonomy and agency and creating opportunities for community-building and solidarity, solo travel can help to transform social norms and promote gender equity.

This chapter aims to build a body of knowledge that will have a widespread impact based on available data on the relationship of women solo travellers to gender equality. It also examines the effects of women solo travellers on gender equality based on secondary data sources. This chapter, designed as conceptual research with descriptive analysis and document analysis, is important in revealing what the indirect gains of women solo travellers can be for gender equality, the fifth of the United Nations Development Programme (UNDP) Sustainable Development Goals.

This study aimed to detect the relationships between mindfulness and events participation, and then between the later and psychological empowerment.

The proposed model's underlying hypotheses were empirically tested with data collected through an online survey addressed to a convenience sample of frequent leisure participants (n = 199). The authors applied the structural equation model (SEM) to confirm the aforementioned relationships. To assess the adequacy of the psychometric properties of the measures, the authors performed a confirmatory factor analysis of the measurement model, with a maximum likelihood estimation method.

Under the effects of the lockdown period environment, the results express a positive relationship between a mindful state of mind – related to observation/attention – and the yearnings and perceptions about the participation in events. This relationship for consistency was proven to be moderated by the perception of the participation importance to the individual subjective well-being/mental health. Due to participation insights, there was a positive effect on psychological empowerment, supporting the relationship that had been hypothesized.

The authors propose and test a new model that contributes to the theory and examines how mindfulness behavior can effect more alluring and intense participation in events and what are the anticipated outcomes in terms of psychological empowerment.

The purpose of this study is to review empirical studies on the relationship between climate change and tourism for a period of 15 years, from 2007 to 2021. The main variables analyzed were research subjects, topics and economic development levels.

Literature review was used to analyze articles published on climate change and tourism from 2007 to 2021. A staged article selection process was followed using the Scopus database. Statistical comparison tests found differences among sub-groupings of articles.

The research articles on climate change and tourism continued their upward trajectory until 2021. The 893 articles analyzed were published in 254 different journals, with over 60% from non-tourism or cross-disciplinary journals. Significant differences were found by time period and between developed and developing countries.

Gaps in the literature were detected with respect to policy analysis and it was concluded that the research for developing nations remains insufficient. More research should be encouraged to focus on the situation and solutions to climate change and tourism in developing countries. Additional research is also needed on biodiversity declines in destinations because of climate change.

This research dealt exclusively with empirical research studies in academic articles. It compared results across three different time periods and between developing and developed countries. Statistical tests supported the comparisons.

This study aims to undertake a theoretical and technical exploration of the literature on Work Readiness (WR) through the implementation of a systematic literature review and bibliometric analysis. The present study addresses seven distinct research questions: (1) an examination of the descriptive features characterizing the literature on WR, (2) an analysis of trends in annual scientific publications related to WR, (3) the identification of the most pertinent and high-impact sources contributing to WR, (4) the delineation of the globally cited articles exerting the most influence on WR, (5) the determination of the most relevant countries associated with WR, (6) an evaluation of the outcomes derived from Bradford’s Law of Scattering and Lotka’s Law of scientific productivity in the context of WR, and (7) the identification of the prevailing research avenues that hold significance for future studies on WR.

The present study employed Systematic Literature Review (SLR) and bibliometric analysis mapping techniques to analyze 521 articles extracted from the Scopus database. The analysis utilized Biblioshiny software and VOSviewer software as the primary tools.

The findings reveal that WR constitutes a steadily expanding subject discipline, showcasing a notable 9.12% annual growth in scientific production spanning from 1975 to 2023. Australia, the USA, and Canada emerged as the most productive countries within the field of WR, as evidenced by their cumulative scientific production. The thematic map of keyword analysis suggests several burgeoning pathways for future researchers in the WR domain, including workplace learning, functional capacity evaluation, graduate WR, digital literacy, blended learning, resilience, and curriculum.

This study contributes to the WR discourse by providing a comprehensive literature review. The findings of this study hold significance for graduates, universities, employers, the higher education industry, and the broader community.

This research sought to propose a theoretical model that analyzes the factors associated with unlearning (individual and organizational) and contributes to generating and realizing ideas among young people at the beginning of their careers based on the predominant type of structure.

The study had a sample (n = 971) and used the multivariate data analysis partial least squares - Structural Equation Modeling (PLS-SEM regular) and multigroup analysis (PLS-MGA) to identify significant differences between the estimates of the specific parameters of each group (a- Organic/b- Mechanistic).

All the direct relationships and formulated mediations were found to be supported, except for H6 (ET→EO) within the group that had a primarily mechanistic organizational structure. Thus, the more turbulent the environmental, the more initiative-taking, innovative and risk-taking a company tends to be. However, it remains to be seen whether the organizational structure plays a role in facilitating or hindering this relationship. H1 (IG→IR) indicates that predominantly organic organizations have a stronger and more consistent relationship with the knowledge developed through individual and organizational unlearning process. This knowledge contributes to the idea-generation process and ultimately leads to realizing those ideas.

The article contributes to literature by proposing an original and integrated theoretical model incorporating individual and organizational approaches to unlearning to understand the effect on idea generation and realization.

The ubiquity of the internet has extended immense informational power to patients around the world who previously had abysmal knowledge about the disease they are suffering from. With a large amount of information in their hands, these educated and well-informed patients are cultivating deeper relationships and engagement with their physicians through meaningful interactions. This study aims to investigate the influence of patients’ internet usage and their interactions on their intentions to revisit and foster relationships with their physicians.

A survey-based questionnaire was administered at four government hospitals in Pune, involving a sample size of 400. The study intends to use structural equation modelling (SEM) to examine the hypothesized relationships identified within the research analysis.

The findings of this study indicate that patients report higher levels of satisfaction and intention to revisit when they have a strong interaction with their physician.

This study provides valuable inputs to the hospital authorities and health-care-related policy makers. This study also contributes to the overall body of literature on health care information system, behavioural aspects of patients and doctors as well as other health-care-related staffs in hospitals.

The study adds values to the overall body of literature for both hospital information system, patient interaction and health care policy. To date, no research has examined the association between patient–physician interactions conducted through internet channels and subsequent behavioural intentions. Moreover, the study investigates the behavioural aspects of patients and health-care staffs, which adds value towards the body of knowledge in the extant literature.