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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.

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.

Despite the significance of a gender-diverse workforce, there is a lack of comprehensive review of gender diversity and women's career advancement literature. Moreover, past literature focuses on women-on-board and other subsets based on outcomes like firm financial and non-financial performance, corporate social performance and board interlocks. The purpose of this study is to examine the research on gender diversity and women's career advancement through an analysis of 143 articles published during past decade. Theoretical frameworks, contexts and constructs-based contribution to scholarship were reviewed. The authors attempt to highlight key theories, constructs and contexts and provide direction for future research.

A comprehensive systematic literature review of 143 articles spanning January 2008–March 2023 about gender diversity and women’s career advancement was conducted.

Majority of the past studies have focused on women on board and top management team, and most of them have been conducted in the context of the USA and China. There is no specific industry which has been covered extensively. Resource dependency, resource-based views and agency theories are the primary theoretical frameworks used in the past studies. Furthermore, these findings suggest the scope to further focus on women’s retention and career growth initiatives, especially at levels other than top levels, for a stronger leadership pipeline.

This study has been conducted with a focused analysis of the context, constructs and theoretical frameworks, enabling future researchers to decide how and where to focus, to now strengthen retention of women.

The purpose of this study is to reveal the mechanism of humble leadership inducing abusive supervision from the low-status compensation perspective, examining the mediation role of leader perceived thread to status. Besides, the moderation effect of regulatory focus on the mediation path is discussed.

This study conducted a three-wave longitudinal survey. The data was collected from 438 leaders and their employees in five Chinese enterprises. This study used Mplus 7.4 and adopted a bootstrapping technique for data analysis.

Humble leadership has a positive effect on leader perceived threat to status. Leader perceived threat to status plays a mediation role between humble leadership and leader abusive supervision. Leader regulatory focus is the “gate valve” that humble leadership fosters leader abusive supervision. That is, when the leader promotion focus is high, leader perceived threat to status bred by humble leadership is low, resulting in less abusive supervision. When the leader prevention focus is high, humble leadership brings relatively more abusive supervision through perceived threat to status.

This study explores why humble leadership breeds abusive supervision behaviors and reveals the mechanism behind the negative effect of humble leadership based on low-status compensation theory. This study not only promotes the continuous development of the field of humble leadership research through empirical research but also provides guidance for effectively suppressing the negative effects of humble leadership, promoting strengths and avoiding weaknesses and suppressing inappropriate management behaviors in management practice.

The theory of managerial discretion and the direct insights it provides in the understanding of the varying impact strategic and operational actions have on organizational change and business fortunes is an area of research potential underexplored in the UK. This study aims to establish whether the measurement of managerial discretion is constant between the two similar societal corporate frameworks of the UK and the USA listed markets.

The extant managerial discretion ranking model, established in the USA, is empirically assessed for its validity and effectiveness across a sample of high- and low-discretion companies from the FTSE 350.

Using accounting measures, a clear and significant difference is established between UK high and low managerial discretion entities. The results prove to be significant in enabling the differential comparative analysis of the institutional characteristics of corporates.

To the best of the authors’ knowledge, no study of this nature has been conducted previously in the UK context. While the original model developed in the USA is now several decades old, the UK results reflect similar industry rankings as found originally in the USA, subject to some differences considered to be a result of the changing nature of global business since the 1990s. This study opens a new seam of novel research, which has the potential to uncover, at a granular level, the differential mores and character of management ethics, styles and practices in such issues as organizational change, corporate culture, governance and social responsibility.

The issue of energy efficiency is becoming increasingly prevalent globally due to factors such as the expansion of the population, economic growth and excessive consumption that is not sustainable in the long run. Additionally, healthcare facilities and hospitals are facing challenges as their operational costs continue to rise. The research aim is to develop strategic frameworks for managing green hospitals, towards energy efficiency and corporate governance in hospitals and healthcare facilities.

This research employs a qualitative case study approach, with a sample of ten hospitals examined through interviews with senior management, executives and healthcare facilities managers. Relevant data was also collected from literature and analysed through critical appraisal and content analysis. The research methodology is based on the use of grounded theory research methodologies to build theories from case studies.

The research developed three integrated conceptual strategic frameworks for managing hospitals and healthcare facilities towards energy efficiency, green hospital initiatives and corporate governance. The research also outlined the concepts of green hospitals and energy efficiency management systems and best practices based on the conclusions drawn from the investigated case studies.

The study is limited to the initiatives and experiences of the healthcare facilities studied in the Middle East and North Africa (MENA) region.

The research findings, conclusions, recommendations and proposed frameworks and concepts contribute significantly to the existing body of knowledge. This research also provides recommendations for hospital managers and policymakers on how to effectively implement and manage energy efficiency initiatives in healthcare facilities.

This study aims to investigate how social entrepreneurial role models influence social entrepreneurial self-efficacy, social entrepreneurial intent and social entrepreneurial action, with moral obligation as a moderator.

A cross-sectional survey of 261 pupils in the South African province of the Eastern Cape was used in the research study. Structural equation modeling was used to test hypotheses.

The research revealed that having social entrepreneurial role models has a positive impact on both social entrepreneurial self-efficacy and social entrepreneurial intent. In addition, a connection was found between social entrepreneurial intent and entrepreneurial action. The influence of moral obligation was found to be a positive and a significant moderator. Moreover, the association between social entrepreneurial role models and social entrepreneurial intent was mediated by social entrepreneurial self-efficacy.

The findings are not generalizable to nonstudent samples because students constituted the sample for gathering data. Future study therefore requires considering nonstudents to generalize the outcomes. This research should be replicated in other South African provinces and other developing countries for comparative outcomes.

Since social entrepreneurial role models have been practically linked to social entrepreneurship intent and entrepreneurial efficacy, understanding the factors that influence student’s decision to start a social enterprise is critical in South Africa to develop targeted interventions aimed at encouraging young people to start new businesses. Policymakers, society and entrepreneurial education will all benefit from the findings.

This study contributes to bridging the knowledge gap as it investigates how social entrepreneurial role models influence social entrepreneurial self-efficacy, social entrepreneurial intent and social entrepreneurial action, with moral obligation as a moderator. Encouraging social entrepreneurship among South African youth would also help address societal issues. This is a pioneering study in the context of an emerging economy such as South Africa, where social entrepreneurship is so integral.

By merging good countryside and rural capitals frameworks, a model for reimagining the island's development is formulated, which is then applied to the female perspective to provide valuable insights from a group that is often marginalized in rural areas. As Croatian islands are highly tourism-oriented, this study finds it important to explore possibilities for future island development that can provide balanced and vibrant settlements on the islands.

The present paper synthesizes Shucksmith's (2018) model of a good countryside, which serves as a goal, with Gkartzios et al.'s (2022) capitals framework, which is viewed as a means of attaining a good countryside, specifically a good island. The research is delimited to the island of Brac, Croatia. By conducting interviews with female respondents, this study aims to capture the female perspective on envisioning potential futures of “good” island living, a perspective that is frequently underestimated despite its significant contributions to the creation of an ideal locale.

The results demonstrate that there is a substantial amount of socio-cultural rural capital that is leveraged to strengthen relatedness and rights as development objectives. However, low levels of economic, built and land-based rural capital pose challenges to achieving repair and re-enchantment, which are crucial for settlements that rely on tourism.

These findings bear immense implications for policymakers and planners, underscoring the imperative to account for the perspectives and needs of diverse social groups, including women, in the design and implementation of development strategies for islands. By doing so, a sustainable and equitable future, rich in tourism potential, can be cultivated on the island.

This paper aims to introduce the Theory of Ethical Leadership as a possible means of actualizing the mission and vision statements of the American Physical Therapy Association as well as individual professional objectives. Specific examples of how this can be applied directly to the profession of physical therapy will be presented.

Leadership influences can profoundly affect a profession, an organization and an individual. This has led to exploring which leadership style would be most effective in moving their organization forward. Through a review of the literature, this viewpoint paper compares leadership theories present in the health-care literature, as well as why they may fall short of actualizing the mission and vision statements of the American Physical Therapy Association as well as individual professional objectives.

Most research has separated ethics from leadership, but all agree that to be successful, the leader needs to exhibit a strong moral compass and demonstrate positive ethical behavior. At the intersection of ethics and leadership is the emerging theory of ethical leadership. Ethical leadership is based on the premise that employees look outside of themselves for ethical guidance and that leaders have an opportunity to provide this moral awareness by making an ethical message sufficiently salient to be recognized in the organizational context as well as allowing the leader to stand out against an ethically neutral ground.

This paper is an original work and has not been published previously, either in whole or in part. Additionally, this paper is not under consideration for publication by any other journal.

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.