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Various health systems are challenged by a multifaceted crisis of increased service demand and workforce shortages. The effects are devastating and may end up in decreased access to care, poor quality of patient care and extreme demands on the workforce. The introduction of the physician assistant (PA) profession provided an avenue to address such challenges in several countries. In Germany, the integration of PAs has been proceeding slowly.

To understand the integration of the profession in Germany, we conducted 15 expert interviews to reveal how the PA profession is perceived among healthcare experts as well as the barriers and facilitators of integration in inpatient care.

Our results highlight a generally positive perception of PAs, particularly in terms of workload relief and bridging the gap between healthcare professionals. Nonetheless, barriers include resistance from healthcare workers unfamiliar with the PA role, while workforce shortages and collaborative teamwork facilitate integration.

These findings lay the groundwork for potential integration-enhancing strategies in Germany.

People donate to charities with the aim of improving society. Yet, many charities fail to use donations efficiently or have ineffective interventions. The authors explore the strategic operational priorities and processes that enable charities to efficiently implement their interventions and have a positive impact on society.

The authors first review the literature on charities to gain a deeper understanding of the current state of knowledge on charity operations. The authors then employ the lens of paradox theory and perform a qualitative investigation of six case studies to explore various aspects of the operations of charities that are known for being cost-effective.

The authors reveal how the strategic operational decisions of charities, as well as the processes they implement, help them resolve the tensions arising from the cost-effectiveness paradox. The authors show that cost-effective charities make strategic operational decisions that help maintain two diverging priorities: prioritizing the status quo and prioritizing change in how they deliver value. Another set of strategic decisions helps balance these two diverging priorities. The authors then show how these charities create and then maintain cost-effective operations.

The authors address recent calls for research on non-profit organizations in the field of operations management. To authors’ knowledge, it is the first in-depth study of exemplary charity operations. The results can be used by charity executives as a benchmarking tool when they develop and implement their charitable interventions and by government agencies and potential donors when they select charities for their donations. Finally, the results should have implications for other organizations trying to have a positive societal impact.

District-university partners increasingly rely on “grow-your-own” licensure programs to address teacher shortages. Because vacancies in special education represent a chronic issue, our district-university partnership developed LEAP – the Licensed Educators’ Accelerated Pathway, successfully preparing 26 paraprofessionals as special education teachers (SEs). We describe a model university-district partnership in which we collaborated to design and implement paraprofessionals’ SE licensure program.

In this general review, we describe a district-university partnership collaboration that resolved barriers experienced by paraprofessionals working toward licensure in special education (Essential #4, Reflection and Innovation). The specialized design and partnership solutions were grounded in SE preparation research literature.

25 (28 entered the program and 25 completed) paraprofessionals from one large urban and several regional districts completed special education licensure through LEAP. Slightly more than half of LEAP participants were Black or Hispanic (see Table 1), contributing to the diversification of SE workforce. University-district partnership was successful in designing and delivering a program that allowed participants: a) to remain employed, b) attend evening classes in their geographic region or online, c) complete all field experiences in sponsoring districts (Essential #2) and d) receive concierge advising from a “completion coach.” We describe solutions to barriers experienced by paraprofessionals and advocate for district-university collaboration to address chronic teacher shortages.

Limitations include lack of data on success of program completers during their first year of teaching as they began this work in Fall 2023. Further, because the participating district was large and urban, generalization of program details for small and rural districts is difficult.

Practical tips for developing grow-your-own special education licensure programs are providing. Detailed descriptions of barriers candidates experienced and ways the district-university partners resolved these issues are included. Programs like the one described has the potential to positively impact teacher pipeline issues.

The program described provided highly-trained teachers to fill chronic vacancies in special education in three participating districts/agencies. Because students receiving special education services are at risk for school failure and are disproportionately impacted by teacher turnover, addressing this area through grow-your-own licensure programs represents a diversity, equity and inclusion initiative. Further, upskilling diverse paraprofessionals to licensed teacher roles represent an economic boost, which they might not otherwise have achieved.

Available research literature signals alarm over persistent teacher shortages in hard-to-staff districts and lack of diversity in the teacher workforce, but few published accounts describe successful programs. Partner collaboration fostered a re-imagining of course formatting and delivery to accommodate adult learners, avoiding problems often reported with alternative programs.

Measuring shared value (SV) created in innovation ecosystems (IEs) is increasingly relevant but complex, given the multidimensional and multiactor nature of both concepts, which challenges traditional performance measurement systems (PMSs). Moving from this gap, the authors propose an integrated approach to extend the balanced scorecard (BSC) for measuring and monitoring SV creation at IE level.

The proposed approach combines the most recent contributions on PMS in IEs and SV to define perspectives and dimensions that are better suited to deal with the nature of both IEs and SV. The approach is also applied to the real case (Alpha) of an Italian IE through a step wise method. Starting from the IE vision, the authors identify in the strategy map the specific objectives related to each perspective/dimension combination and then associate a performance indicator with each objective.

The resulting SV BSC is composed of indicators interconnected along different perspectives and dimensions. The application of the approach to the real case proves its feasibility and highlights characteristics, advantages and disadvantages of the SV BSC when used at IE level. The authors also provide guidelines for its application to other IEs.

The study contributes to the research on PMS by introducing and applying to a real case an integrated approach to assess SV in IEs, overcoming the shortcomings of PMS framed for single firms. It can be of interest for both researchers in the field of ecosystems value creation and practitioners managing or promoting such complex structures.

The use of generative artificial intelligence (genAi) language models such as ChatGPT to write assignment text is well established. This paper aims to assess to what extent genAi can be used to obtain guidance on how to avoid detection when commissioning and submitting contract-written assignments and how workable the offered solutions are.

Although ChatGPT is programmed not to provide answers that are unethical or that may cause harm to people, ChatGPT’s can be prompted to answer with inverted moral valence, thereby supplying unethical answers. The authors tasked ChatGPT to generate 30 essays that discussed the benefits of submitting contract-written undergraduate assignments and outline the best ways of avoiding detection. The authors scored the likelihood that ChatGPT’s suggestions would be successful in avoiding detection by markers when submitting contract-written work.

While the majority of suggested strategies had a low chance of escaping detection, recommendations related to obscuring plagiarism and content blending as well as techniques related to distraction have a higher probability of remaining undetected. The authors conclude that ChatGPT can be used with success as a brainstorming tool to provide cheating advice, but that its success depends on the vigilance of the assignment markers and the cheating student’s ability to distinguish between genuinely viable options and those that appear to be workable but are not.

This paper is a novel application of making ChatGPT answer with inverted moral valence, simulating queries by students who may be intent on escaping detection when committing academic misconduct.

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.

Although risk culture is a key determinant for an effective risk management, identifying the risk culture of a firm can be challenging due to the abstract concept of culture. This paper proposes a novel approach that uses unsupervised machine learning techniques to identify significant features needed to assess and differentiate between different forms of risk culture.

To convert the unstructured text in our sample of banks' 10K reports into structured data, a two-dimensional dictionary for text mining is built to capture risk culture characteristics and the bank's attitude towards the risk culture characteristics. A principal component analysis (PCA) reduction technique is applied to extract the significant features that define risk culture, before using a K-means unsupervised learning to cluster the reports into distinct risk culture groups.

The PCA identifies uncertainty, litigious and constraining sentiments among risk culture features to be significant in defining the risk culture of banks. Cluster analysis on the PCA factors proposes three distinct risk culture clusters: good, fair and poor. Consistent with regulatory expectations, a good or fair risk culture in banks is characterized by high profitability ratios, bank stability, lower default risk and good governance.

The relationship between culture and risk management can be difficult to study given that it is hard to measure culture from traditional data sources that are messy and diverse. This study offers a better understanding of risk culture using an unsupervised machine learning approach.

In this viewpoint article, the authors recognize the increased focus in health systems on co-design for innovation and change. This article explores the role of leaders and mangers in developing and enhancing a culture of trust in their organizations to enable co-design, with the potential to drive innovation and change in healthcare.

Using social science analyses, the authors argue that current co-design literature has limited focus on interactions between senior leaders and managers, and healthcare staff and service users in supporting co-designed innovation and change. The authors draw on social and health science studies of trust to highlight how the value-based co-design process needs to be supported and enhanced. We outline what co-design innovation and change involve in a health system, conceptualize trust and reflect on its importance within the health system, and finally note the role of senior leaders and managers in supporting trust and responsiveness for co-designed innovation and change.

Healthcare needs leaders and managers to embrace co-design that drives innovation now and in the future through people – leading to better healthcare for society at large. As authors we argue that it is now the time to shift our focus on the role of senior managers and leaders to embed co-design into health and social care structures, through creating and nurturing a culture of trust.

Building public trust in the health system and interpersonal trust within the health system is an ongoing process that relies upon personal behavior of managers and senior leaders, organizational practices within the system, as well as political processes that underpin these practices. By implementing managerial, leadership and individual practices on all levels, senior managers and leaders provide a mechanism to increase both trust and responsiveness for co-design that supports innovation and change in the health system.

This study examines the effect of female governors (gender effect) on environmental performance in terms of state-level carbon dioxide (CO2) emissions in United States.

The study used annual data from 1970 to 2020 to investigate the relationship between female political leadership and state-level CO2 emissions. Hypothesis was tested through ordinary least squares regression (OLS). The results of the study were also validated using propensity score matching and a difference-in-difference approach.

This study provides empirical insights into the relationship between female political leadership and state-level CO2 emissions. The findings indicate that female governors have a significant negative impact on state-level CO2 emissions per capita. These results suggest that female political leadership is associated with a reduction in CO2 emissions per capita at the state level. The results also show that states under the leadership of female governors experience lower levels of CO2 emissions than those with male governors, indicating female leadership’s potential to promote environmental sustainability.

The findings of this study have practical implications for policymakers, government officials, and other stakeholders involved in the formulation of strategies to promote environmental sustainability. This study highlights the significant role that female political leader play in mitigating CO2 emissions at the state level. It suggests that promoting female in political leadership positions can lead to more environmentally conscious policy decisions and actions, resulting in reduced CO2 emissions per capita. Policymakers should actively encourage women’s participation in leadership roles to utilize their potential contributions to advancing sustainability goals. Furthermore, organizations that focus on environmental issues should prioritize supporting and promoting female leaders who have demonstrated a commitment to environmental sustainability. Ultimately, this study highlights the need for female in political leadership as a potential strategy to address environmental challenges and advance a more sustainable future.

This study pioneers research on the links between female political leadership and state-level CO2 emissions. This study contributes to the literature by emphasizing the potential role of female political leaders in promoting environmental sustainability. Overall, this study enriches the social role and upper echelons theories literature through empirical evidence.