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This study aims to assess the efficiency of Brazil, Russia, India, China, South Africa (BRICS) countries in achieving sustainable development by analyzing their ability to convert resources and technological innovations into sustainable outcomes.

Using data envelopment analysis (DEA), the study evaluates the economic, environmental and social efficiency of BRICS countries over the period 2010–2018. It ranks these countries based on their sustainable development performance and compares them to the period 2000–2007.

The study reveals varied efficiency levels among BRICS countries. Russia and South Africa lead in certain sustainable development aspects. South Africa excels in environmental sustainability, whereas Brazil is efficient in resource utilization for sustainable growth. China and India, despite economic growth, face challenges such as pollution and lower quality of life.

The study’s findings are constrained by the DEA methodology and the selection of variables. It highlights the need for more nuanced research incorporating recent global events such as the COVID-19 pandemic and geopolitical shifts.

Insights from this study can inform targeted and effective sustainability strategies in BRICS nations, focusing on areas such as industrial quality improvement, employment conditions and environmental policies.

The study underscores the importance of balancing economic growth with social and environmental considerations, highlighting the need for policies addressing inequality, poverty and environmental degradation.

This research provides a unique comparative analysis of BRICS countries’ sustainable development efficiency, challenging conventional perceptions and offering a new perspective on their progress.

Previous research has focused on the outcomes of telework, investigating the advantages and disadvantages of teleworking for employees. However, these investigations do not examine whether there are differences between teleworkers when evaluating the advantages and disadvantages of teleworking. The aim of this study is to identify of distinct classes of teleworkers based on the advantages and disadvantages that teleworking has for them.

This study used secondary survey data collected by the Spanish National Statistics Institute (INE). A sample of 842 people was used for this study. To identify the distinct classes of teleworkers, their perceived advantages and disadvantages of teleworking were analyzed using latent class analysis.

Three different classes of teleworkers were distinguished. Furthermore, sociodemographic covariates were incorporated into the latent class model, revealing that the composition of the classes varied in terms of education level, household income, and the amount of time spent on teleworking per week. This study also examined the influence of these emergent classes on employees’ experience of teleworking.

This study contributes to previous research investigating if telework is advantageous or disadvantageous for teleworkers, acknowledging that teleworkers are not identical and may respond differently to teleworking.

Ulam is a traditional salad that contains high levels of antioxidants and is commonly consumed in raw form. However, the average ulam consumption among the low-income Malaysian population was only ½ serving daily. Thus, this study aimed to explore the motivators and barriers to ulam consumption among residents of low-cost housing areas (household income RM4849 or $1015.50) in Kuala Lumpur, Malaysia.

Six focus group discussions were conducted with 27 Malay residents aged 18–59 years in Kuala Lumpur, Malaysia. The researchers asked the participants a series of semi-structured questions. All the interviews were audio-recorded and transcribed verbatim. Two researchers coded the transcripts independently, and several themes were identified. The data were analysed using Nvivo version 12 software.

Three main factors for ulam consumption were identified in this study: personal, environmental and behavioural. The motivators and barriers were identified based on nine main themes and 16 sub-themes.

The results of this study identified potential areas for an effective intervention to increase ulam intake among residents in low-cost housing areas.

This work has the potential to identify the factors that have an impact on consumers' ulam preferences to help fulfil daily vegetable recommendations.

The purpose of this study is to investigate whether and how inter-firm cooperation and firm age moderate the relationship between family ownership and productivity.

We first estimate the total factor productivity (TFP) of a large sample of Italian firms observed over the period 2010–2018 and then apply a Poisson random effects model.

TFP is, on average, higher for non-family firms (non-FFs) than for FF. Furthermore, inter-organizational cooperation and firm age mitigate the negative effect of family ownership. In detail, it is found that belonging to a network acts as a moderator in different ways according to firm age. Indeed, young FFs underperform non-FF peers, although the TFP gap decreases with age. In contrast, the benefits of a formal network are high for older FFs, suggesting that an age-related learning process is at work.

The study provides evidence that FFs can outperform non-FFs when they move away from Socio-Emotional Wealth-centered reference points and exploit knowledge flows arising from high levels of social capital. In the case of mature FFs, networking is a driver of TFP, allowing them to acquire external resources. Since FFs often do not have sufficient in-house knowledge and resources, they must be aware of the value of business cooperation. While preserving the familiar identity of small companies, networks grant FFs the competitive and scale advantages of being large.

Despite the wide but ambiguous body of research on the performance gap between FFs and non-FFs, little is known about the role of FFs’ heterogeneity. This study has proven successful in detecting age as a factor in heterogeneity, specifically to explain the network effect on the link between ownership and TFP. Based on a representative sample, the study provides a solid framework for FFs, policymakers and academic research on family-owned companies.

The purpose of this study is to identify the characterizations of business process management (BPM) methodology in hotel industry through an aggregate processing of the core cyclesteps (CCCs) of the highly-cited BPM life-cycle models in the literature aiming to highlight the major issues of the current methodological approach of BPM in hotels when to put the notion of service process into practice.

The paper identifies and examines the most popular BPM life-cycles models in the literature and locates 15 life-cycles that are highly cited. The paper then focuses on applying the theory on nine listed hotel companies in Egypt using a questionnaire in the form of a semi-structured interview technique.

The CCSs of BPM life-cycle model applied in hotels revealed a gap between BPM theory and practice in this sector. Utilizing this model of BPM life-cycle, the paper focuses on describing several of the main problems or pitfalls found in the methodological approach of BPM in hotels, which brings the essence of the whole operation management problems.

In light of these findings, the paper discusses the practical implications and focuses on recommendations on how to properly improve the methodological approach of BPM in hotels in order to get better business results.

The paper bridges the gap between BPM theory and practice and suggests recommendations that will assist hotel companies to eliminate the problems of poor process management (PM). There are also future research recommendations to enhance the knowledge of BPM theory in the service sector.

The purpose of this paper is to report on the implementation of the World Health Organization (WHO) trauma care checklist (TCC) (WHO, 2016) in an emergency department in a tertiary hospital in Nepal. This research was undertaken as part of a Hybrid International Emergency Medicine Fellowship programme (Subedi et al., 2020) across UK and Nepal, incorporating a two-year rotation through the UK National Health Service, via the Medical Training Initiative (MTI) (AoMRC, 2017). The WHO TCC can improve outcomes for trauma patients (Lashoher et al., 2016); however, significant barriers affect its implementation worldwide (Nolan et al., 2014; Wild et al., 2020). This article reports on the implementation, barriers and recommendations of WHO TCC implementation in the context of Nepal and argues for Transformational Leadership (TL) to support its implementation.

Explanatory mixed methods research (Creswell, 2014), comprising quasi-experimental research and a qualitative online survey, were selected methods for this research. A training module was designed and implemented for 10 doctors and 15 nurses from a total of 76 (33%) of clinicians to aid in the introduction of the WHO TCC in an emergency department in a hospital in Nepal. The quasi-experimental research involved a pre- and post-training survey aimed to assess participant’s knowledge of the WHO TCC before and after training and before the implementation of the WHO TCC in the emergency department. Post-training, 219 patients were reviewed after four weeks to identify if process measures had improved the quality of care to trauma patients. Subsequently six months later, a qualitative online survey was sent to all clinical staff in the department to identify barriers to implementation, with a response rate of 26 (n = 26) (34%) (20 doctors and 6 nurses). Descriptive statistics were used to evaluate quantitative data and the qualitative data were analysed using the five stepped approach of thematic analysis (Braun and Clarke, 2006).

The evaluation of the implementation of the WHO TCC showed an improvement in care for trauma patients in an emergency setting in a tertiary hospital in Nepal. There were improvements in the documentation in trauma management, showing the training had a direct impact on the quality of care of trauma patients. Notably, there was an improvement in cervical spine examination from 56.1% before training to 78.1%; chest examination 125 (57.07%) before training and 170 (77.62%) post-training; abdominal examination 121 (55.25%) before training and 169 (77.16%) post-training; gross motor examination 13 (5.93%) before training and 131 (59.82%) post-training; sensory examination 4 (1.82%) before training and 115 (52.51%) post-training; distal pulse examination 6 (2.73%) before training and 122 (55.7%) post-training. However, while the quality of documentation for trauma patients improved from the baseline of 56%, it only reached 78% when the percentage improvement target agreed for this research project was 90%. The 10 (n = 10) doctors and 15 (n = 15) nurses in the Emergency Department (ED) all improved their baseline knowledge from 72.2% to 87% (p = 0.00006), by 14.8% and 67% to 85%) (p = 0.006), respectively. Nurses started with lower scores (mean 67) in the baseline when compared to doctors, but they made significant gains in their learning post-training. The qualitative data reported barriers, such as the busyness of the department, with residents and medical officers, suggesting a shortened version of the checklist to support greater protocol compliance. Embedding this research within TL provided a steer for successful innovation and change, identifying action for sustaining change over time.

The study is a single-centre study that involved trauma patients in an emergency department in one hospital in Nepal. There is a lack of internationally recognised trauma training in Nepal and very few specialist trauma centres; hence, it was challenging to teach trauma to clinicians in a single 1-h session. High levels of transformation of health services are required in Nepal, but the sample for this research was small to test out and pilot the protocol to gain wider stakeholder buy in. The rapid turnover of doctors and nurses in the emergency department, creates an additional challenge but encouraging a multi-disciplinary approach through TL creates a greater chance of sustainability of the WHO TCC.

International protocols are required in Nepal to support the transformation of health care. This explanatory mixed methods research, which is part of an International Fellowship programme, provides evidence of direct improvements in the quality of patient care and demonstrates how TL can drive improvement in a low- to medium-income country.

The Nepal/UK Hybrid International Emergency Medicine Fellowships have an opportunity to implement changes to the health system in Nepal through research, by bringing international level standards and protocols to the hospital to improve the quality of care provided to patients.

To the best of the authors’ knowledge, this research paper is one of the first studies of its kind to demonstrate direct patient level improvements as an outcome of the two-year MTI scheme.

The various quality improvement (QI) frameworks and maturity models described in the health services literature consider some aspects of QI while excluding others. This paper aims to present a concerted attempt to create a quality improvement maturity model (QIMM) derived from holistic principles underlying the successful implementation of system-wide QI programmes.

A hybrid methodology involving a systematic review (Phase 1) of over 270 empirical research articles and books developed the basis for the proposed QIMM. It was followed by expert interviews to refine the core constructs and ground the proposed QIMM in contemporary QI practice (Phase 2). The experts included academics in two academic conferences and 59 QI managers from the New Zealand health-care system. In-depth interviews were conducted with QI managers to ascertain their views on the QIMM and its applicability in their respective health organisations (HOs).

The QIMM consists of four dimensions of organisational maturity, namely, strategic, process, supply chain and philosophical maturity. These dimensions progress through six stages, namely, identification, ad-hoc, formal, process-driven, optimised enterprise and finally a way of life. The application of the QIMM by the QI managers revealed that the scope of QI and the breadth of the principles adopted by the QI managers and their HOs in New Zealand is limited.

The importance of QI in health systems cannot be overstated. The proposed QIMM can help HOs diagnose their current state and provide a guide to action achieving a desirable state of quality improvement maturity. This QIMM avoids reliance on any single QI methodology. HOs – using the QIMM – should retain full control over the process of selecting any QI methodology or may even cherry-pick principles to suit their needs as long as they understand and appreciate the true nature and scope of quality overstated. The proposed QIMM can help HOs diagnose their current state and provide a guide to action achieving a desirable state of quality improvement maturity. This QIMM avoids reliance on any single QI methodology. HOs – using the QIMM – should retain full control over the process of selecting any QI methodology or may even cherry-pick principles to suit their needs as long as they understand and appreciate the true nature and scope of quality.

This paper contributes new knowledge by presenting a maturity model with an integrated set of quality principles for HOs and their extended supply networks.

CPTED’s premise to the improvement of quality of life (QOL) is crime prevention and safety, and yet there is little concern for the impact of CPTED implementation to QOL when the crime increases after the interventions.

This study systematically analyzed articles both quantitatively and qualitatively.

This study found that the CPTED–QOL relationship discussion was highly inadequate in research. Improvement of QOL has been elevated to an unquestionable and certain truth of CPTED and yet the evidence on this is highly inconclusive.

This study is a contribution to the CPTED–QOL discussion that has been lacking.

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.