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The study aims to explore the utilisation of Clinical Decision Support (CDS) tools in Tanzanian healthcare facilities by identifying the tools used, the challenges encountered and the adaptive strategies employed by healthcare practitioners. It utilises an Activity Theory (AT) approach to understand the dynamic interactions between healthcare providers, CDS tools and the broader healthcare system.

The research adopts a qualitative approach in two prominent regions of Tanzania, Dar es Salaam and Dodoma. It involves semi-structured interviews with 26 healthcare professionals and key stakeholders across ten healthcare facilities, supplemented by document reviews. The study employs AT to analyse the interactions between healthcare professionals, CDS tools and the broader healthcare system, identifying best practices and providing recommendations for optimising the use of CDS tools.

The study reveals that Tanzanian healthcare practitioners predominantly rely on non-computerised CDS tools, such as clinical guidelines prepared by the Ministry of Health. Despite the availability of Health Information Systems (HIS), these systems often lack comprehensive decision-support functionalities, leading practitioners to depend on traditional methods and their professional judgement. Significant challenges include limited accessibility to updated clinical guidelines, unreliable infrastructure and inadequate training. Adaptive strategies identified include using non-standardised tools like Medscape, professional judgement and reliance on past experiences and colleagues’ opinions.

The investigation was constrained by access limitations because it was challenging to get some respondents to share information. However, a sufficient number of individuals participated in the interviews, and their knowledge was very beneficial in understanding the procedures and tools for clinical decision support.

This study contributes to AT by extending its application to a low-resource healthcare setting, uncovering new dimensions of the theory related to socio-cultural and technological constraints in healthcare facilities in Tanzania. It provides valuable insights into the practical barriers and facilitators of HIS and CDS tool implementation in developing countries, emphasising the need for context-specific adaptations, robust training programs and user-centred designs. The findings highlight the resilience and imagination of healthcare practitioners in adapting to systemic limitations, offering recommendations to enhance clinical decision-making and improve patient care outcomes in Tanzania.

Purpose: This study investigates the role of telemedicine in sustaining healthcare systems in Europe, during the COVID-19 pandemic. It focusses on how telemedicine serves as a strategic response to modern healthcare challenges, emphasising its efficiency, accessibility, and patient-centred nature.

Need for the study: The need for this study arises from the escalating demands on healthcare systems, especially during the COVID-19 pandemic. It aims to understand the adoption of telemedicine practices across European Union (EU) countries and their impact on healthcare sustainability.

Methodology: This study employs hierarchical and K-Means clustering to analyse EU citizens’ attitudes towards teleconsultations during COVID-19. Principal component analysis (PCA) is used for data compression and insight extraction. Data is sourced from Eurofound’s 2020 and 2021 surveys, involving extensive participant responses across the EU.

Findings: The study’s findings reveal significant shifts towards digital healthcare solutions, such as an increase in online consultations and prescriptions. It identifies different patterns of telemedicine use across EU countries, influenced by socioeconomic and geographical factors. These findings offer insights into future healthcare policy and strategy development.

Practical implications: The findings provide valuable insights into the shifts in telemedicine adoption in the EU, highlighting the significance of economic and sociological factors in healthcare trends. This study stresses the importance of customising healthcare strategies to suit the unique needs and digital capabilities of different countries.

This study is a pilot study exploring the usefulness and ease of use of a prototype VR PetCPR system and discusses the possibility of using it to facilitate pet healthcare skills acquisition. The designed VR PetCPR training system aims to provide pet healthcare professionals with an inexpensive, accessible and reliable CPR training tool and refine their skills in a controlled and simulated environment.

The study was conducted in a one-day workshop. The workshop consisted of the morning section (Section A) and the afternoon section (Section B). Section A was the knowledge acquisition stage. Section B is the VR PetCPR stage. Trainees were then given 30 min to experience the VR PetCPR set. When trainees were ready, they were required to complete two trials of dog CPR practice. After the practice, trainees completed the questionnaire and reported their attitudes toward VR PetCPR practice.

Overall, trainees held positive attitudes toward the effectiveness and usefulness of the VR PetCPR. After practicing skills via VR CPR, over half of the trainees responded that the system is effective in helping them understand the essential knowledge (e.g. operation status, operation positions, etc.) of performing CPR skills on a 30-pound dog. A significantly positive attitude was reported on trainees’ perceptions toward the ease of use of practicing their chest compression skills with the PetCPR. The positive attitudes significantly outnumbered the negative attitudes on explicit instruction and guidance, accessibility, convenience in practice and straightforward interface.

From data collected from 16 animal hospitals in the United States, Europe and Australia with 709 cases, 147 dogs (28%) and 58 cats (30%) temporarily attained ROSC during CPR, and 14 dogs (3%) and four cats (2%) survived to hospital discharge. Training veterinary CPR techniques and implementing RECOVER guidelines still have a long way to go. However, recent virtual reality simulations for CPR training were mainly designed for human patients CPR (Issleib et al., 2021; Liu et al., 2022; Almousa et al., 2019; Wong et al., 2018). The VR PetCPR remains a missing puzzle in the current VR training designs.

The service environment is becoming increasingly turbulent, leading to calls for a systemic understanding of it as a set of dynamic service ecosystems. This paper advances this understanding by developing a typology of service ecosystem dynamics that explains the varying interplay between change and stability within the service environment through distinct behavioral patterns exhibited by service ecosystems over time.

This study builds upon a systematic literature review of service ecosystems literature and uses system dynamics as a method theory to abductively analyze extant literature and develop a typology of service ecosystem dynamics.

The paper identifies three types of service ecosystem dynamics—behavioral patterns of service ecosystems—and explains how they unfold through self-adjustment processes and changes within different systemic leverage points. The typology of service ecosystem dynamics consists of (1) reproduction (i.e. stable behavioral pattern), (2) reconfiguration (i.e. unstable behavioral pattern) and (3) transition (i.e. disrupting, shifting behavioral pattern).

The typology enables practitioners to gain a deeper understanding of their service environment by discerning the behavioral patterns exhibited by the constituent service ecosystems. This, in turn, supports them in devising more effective strategies for navigating through it.

The paper provides a precise definition of service ecosystem dynamics and shows how the identified three types of dynamics can be used as a lens to empirically examine change and stability in the service environment. It also offers a set of research directions for tackling service research challenges.

This paper aims to illustrate how service ecosystem governance may provide a suitable ground to pursue holistic resilience to “wicked” socio-economic and ecological problems, for enhancing “place-based” sustainable performance outcomes through an organizational, interorganizational and context setting.

This work suggests the use of “place-based” collaborative ecosystem platforms driven by a dynamic performance governance approach as a setting where facilitated performance dialogue is carried out among networked stakeholders. This fosters a holistic view of performance sustainability where intangibles, inertial, cultural and behavioral factors play a key role in policy analysis.

The paper illustrates how different research streams framing stakeholder relationships under a business, hybrid organization and public sector perspective converge toward the “service ecosystem” construct, as a common field for sustainable “place-based” value creation. This performance governance perspective frames accountability for achieving sustainable outcomes through interconnected viewpoints, i.e. (1) time (short vs long-term), (2) subject (single organization, “theme-focused” service ecosystem and “place-based” service ecosystem) and (3) field (socio-economic, cultural and ecological).

This work has an interdisciplinary track. It recommends feedback and “stock-and-flow” modeling to enhance framing counterintuitive patterns of behavior of dynamic complex socio-economic, cultural and ecological subsystems within “place-based” collaborative ecosystem platforms. Combining an inside-out with an outside-in view triggers sustainable outcome-based dynamic performance governance through an organizational, interorganizational and context setting.

The COVID-19 pandemic has caused severe challenges to ethnic minorities in the UK. While the experiences of migrants are both complex and varied depending on individuals' social class, race, cultural proximity to the host country and acculturation levels, more in-depth studies are necessary to fully understand how COVID-19 affects specific migrant groups and their health. Taiwanese migrants were selected because they are an understudied group. Also, there were widespread differences in pandemic management between the UK and Taiwan, making this group an ideal case for understanding how their acculturation journey can be disrupted by a crisis.

Qualitative data were collected at two different time points, at the start of the UK pandemic (March/April 2020) and six months on (October/November 2020), to explore migrant coping experiences over time. Theoretically, the authors apply acculturation theory through the lens of coping, while discussing health-consumption practices, as empirical evidence.

Before the outbreak of the pandemic, participants worked hard to achieve high levels of integration in the UK. The pandemic changed this; participants faced unexpected changes in the UK’s sociocultural structures. They were forced to exercise the layered and complex “coping with coping” in a hostile host environment that signalled their new marginalised status. They faced impossible choices, from catching a life-threatening disease to being seen as overly cautious. Such experience, over time, challenged their integration to the host country, resulting in a loss of faith in the UK’s health system, consequently increasing separation from the host culture and society.

It is important to note that the Taiwanese sample recruited through Facebook community groups is biased and has a high level of homogeneity. These participants were well-integrated, middle-class migrants who were highly educated, relatively resourceful and active on social media. More studies are needed to fully understand the impact on well-being and acculturation of migrants from different cultural, contextual and social backgrounds. This being the case, the authors can speculate that migrants with less resource are likely to have found the pandemic experience even more challenging. More studies are needed to fully understand migrant experience from different backgrounds.

Public health policymakers are advised to dedicate more resources to understand migrants' experiences in the host country. In particular, this paper has shown how separation, especially if embraced temporarily, is not necessarily a negative outcome to be corrected with specific policies. It can be strategically adopted by migrants as a way of defending their health and well-being from an increasingly hostile environment. Migrants' home country experience provides vicarious learning opportunities to acquire good practices. Their voices should be encouraged rather than in favour of a surprising orthodox and rather singular approach in the discussion of public health management.

The paper has clear public health policy implications. Firstly, public health policymakers are advised to dedicate more resources to understand migrants' experiences in the host country. Acknowledging migrants' voice is a critical first step to contribute to the development of a fair and inclusive society. Secondly, to retain skilful migrants and avoid a future brain-drain, policymakers are advised to advance existing infrastructure to provide more incentives to support and retain migrant talents in the post-pandemic recovery phase.

This paper reveals how a group of previously well-integrated migrants had to exercise “coping with coping” during the COVID crisis. This experience, over time, challenged their integration to the host country, resulting in a loss of faith in the UK’s health system, consequently increasing separation from the host culture and society. It contributes to the understanding of acculturation by showing how a such crisis can significantly disrupt migrants' acculturation journey, challenging them to re-acculturate and reconsider their identity stance. It shows how separation was indeed a good option for migrants for protecting their well-being from a newly hostile host environment.

This paper aims to extend insights about the relationship between inter-organizational collaboration and approaches to control from the perspective of decision-makers. We investigate the relationship between approaches to control and intended forms of integration between actors responsible for solving the complex problem of integrated person-centered care for elderly with diverse and significant needs.

The empirical study is based on a content analysis of contractual agreements. We have analyzed a total of 118 collaboration agreements and associative documents between all Swedish regions and municipalities.

The study shows that intended integration is subject to remarkable variation in intended forms of inter-organizational collaboration in this Swedish case. The paper illustrates that decision-makers’ intentions with proposed collaboration in each given context are important for the chosen approach to control. Regardless of intended forms of integration, our study suggests that an imminent soft approach to control is expressed alongside limited signs of hard control. Various forms of intended integration can be managed by the two approaches simultaneously insofar as the agreements appear to have a two-sided purpose.

Our paper proposes an empirically driven taxonomy of intended forms of integration initiatives. The taxonomy provides resources for studies about how collaboration can be managed when it is stipulated by national legislation but local self-governance gives actors considerable freedom to decide on how to organize and manage services. By presenting the taxonomy and relating this to approaches of control, our iterative study builds on and adds to a recent stream of research arguing that the relationship between collaboration and approaches to control may by fuzzier and more complex than originally thought.

This paper examines the efforts of National Health Service (England) (NHSE) to respond to employee-based racial inequalities via its Workforce Race Equality Standard (WRES). The WRES constitutes a hybridised accountability initiative with characteristics of the moral and imposed regimes of accountability.

The study conceptualises the notion of responsive race accountability with recourse to Favotto et al.’s (2022) moral accountability model and critical race theory (CRT), and through it, examines the enactment of WRES at 40 NHSE trusts using qualitative content analysis.

Despite the progressive nature of the WRES that seeks to nurture corrective actions, results suggest that trusts tend to adopt an instrumental approach to the exercise. Whilst there is some evidence of good practice, the instrumental approach prevails across both the metric reporting that trusts engage in to guide their actions, and the planned actions for progress. These planned actions not only often fail to coalesce with the trust-specific data but also include generic NHSE or equality, diversity and inclusion initiatives and mimetic adoptions of best practice guidance that only superficially address racial concerns.

Whilst the WRES is a laudable voluntary achievement, its moral imperative does not appear to have translated into a moral accountability within individual trusts.

Responding to calls for more research at the accounting-race nexus, this study uniquely draws on CRT to conceptualise and examine race accountability.

This study aims to examine the effects of Internet of Things (IoT) technology on efficiency and patient care in Italian and Israeli intensive care units (ICUs). The goal is to study how IoT might improve care settings by controlling health dynamics and responding to life-threatening circumstances.

This survey-based research explores IoT use, challenges and adaptability in ICUs in both countries. Interviews and surveys of ICU health-care workers are used to get both quantitative and qualitative data on integrating experiences and perspectives.

The research found significant variations between Italy and Israel due to technology infrastructures and health-care practices. Israel shows a more concentrated deployment in a major medical centre with advanced but limited uptake, whereas Italy shows application throughout ICUs highlighting regional health-care system disparities. Interoperability, data security and IoT training are common difficulties.

This research has limitations. One drawback is the geographical dispersion of study sites, with a bigger sample size in Italy than in Israel. This discrepancy may affect findings applicability. However, these preliminary findings provide a foundation for further research into the complexities of deploying IoT in various health-care settings.

This study compares IoT integration in two national health-care systems, adding to health-care technology literature. Regional variations affect technology adoption, but IoT may enhance ICU operations and patient care, according to one research. This study helps health-care practitioners, academics and policymakers understand the pros and cons of IoT in health care.

In the context of modern urbanization, optimizing resources such as energy, materials, water and labour is no longer solely an environmental concern but a strategic economic necessity. This chapter underscores the vital connection between smart cities and resource efficiency, highlighting sustainable practices as crucial amidst the ever-expanding urban landscape. This chapter commences by demystifying key terms like ‘smart city,’ ‘data analytics,’ ‘artificial intelligence’ and ‘resource efficiency.’ It illuminates how these concepts intertwine and emphasizes their pivotal roles in shaping urban sustainability. Furthermore, this chapter unravels the multifaceted components of smart cities, showcasing their real-world use cases and the techniques of data analytics and artificial intelligence (AI) driving transformative changes. It draws from an extensive body of research, exemplifying how various data analytics techniques have been leveraged in the realm of smart cities. Towards its conclusion, this chapter provides a comprehensive overview of these techniques and their applications, shedding light on their potential to revolutionize resource management in urban environments. In essence, this chapter serves as a valuable compendium of knowledge, offering insights into the critical synergy between smart cities, data analytics, AI and resource efficiency. It underscores the imperative for cities to harness data-driven insights and technological advancements to achieve sustainable and prosperous urban futures.