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Older people living in nursing homes have complex care needs and frequently need specialists’ advice and support that can be challenging to deliver in a rural setting. The aim of this paper is to describe a model of integrated care in a rural area supported by a nurse case manager.

A real-world evidence study of people living in Ribes de Freser nursing home, was conducted between specific timeframes in 2019 and 2022, comparing the casemix and outcomes of a traditional care model with the integrated interdisciplinary model.

The integrated care model led to a significant reduction in transfers to the emergency department, hospitalisations, outpatient medical visits and a reduction in the number of medicines. In addition, the number of residents receiving end-of-life care at the nursing home showed a substantial increase.

This case study contributes valuable evidence supporting the implementation of an integrated model of nurse case manager support in nursing homes, particularly in the rural contexts, where access to specialist medical staff may be limited. The findings highlight the potential benefits of person-centred integrated care for older adults, addressing their complex needs and improving end-of-life care in nursing home settings.

This study investigates the frequency and specificity of health-related issues discussed during the East Java Indonesia Gubernatorial Election Campaign 2018.

The research utilized a mixed-methods approach, combining topic modeling and qualitative thematic analysis, to analyze 4,023 online news articles from March to June 2018. From the data sources obtained in terms of time frame, this research can be categorized as a retrospective study because it examines origins from events that have already occurred.

The study found that health issues accounted for only 6% of all gubernatorial election news in each selected online media portal. The health issues identified were categorised into eight groups: health financing and facilities, health workforce, malnutrition and stunting, leprosy, cigarettes and tobacco, healthy lifestyles, pregnancy and breastfeeding, and disability. The study also reveals a need for increased attention to health-related issues in political campaigns and media. By focusing on the health-related issues raised during the campaign, the study provides valuable insights into the gaps and priorities in addressing the health needs of the East Java population. The research framework used in this study offers a valuable approach for analyzing online data sources using qualitative analysis capacity. The study can improve health policies and outcomes in the local election campaign by raising awareness of health issues and promoting informed decision-making among voters.

This research limitation is a local political campaign case in Indonesia. The research indicates that health issues receive limited coverage during election campaigns, suggesting a lack of emphasis on health as a critical issue among East Java's electorate.

The study can improve health policies and outcomes in the local election campaign by raising awareness of health issues and promoting informed decision-making among voters.

The primary aim of this research was to investigate the mediating effect of the decision-making structure on the relationship between perceived environmental uncertainty and hospital performance.

Online and manual survey questionnaires were used to collect data in this study. The target population of this study consists of all middle managers within 11 COVID-19 referral hospitals in Surabaya. A total of 189 responses were collected, however, 27 incomplete responses were excluded from the final dataset. Data was analyzed using SEM-PLS.

The study's findings indicate that decision-making structure plays a role in mediating the link between perceived environmental uncertainty and hospital performance assessed via the Balanced Scorecard, highlighting the significance of flexible decision-making processes during uncertain periods. Moreover, based on our supplementary test, respondents' demographic characteristics influence their perceptions of hospital performance.

Hospital administrators can consider the significance of decision-making structures in responding to environmental uncertainties like the COVID-19 pandemic. By fostering adaptable decision-making processes and empowering middle managers, hospitals may enhance their performance and resilience in challenging situations. Additionally, based on supplementary tests, it is found that differences in the perception of the three Balanced Scorecard perspectives imply that hospitals categorized as types A, B, C, and D should prioritize specific areas to improve their overall performance.

This research adds substantial originality and value to the existing body of knowledge by exploring the interplay between decision-making structures, environmental uncertainty, and hospital performance. It contributes to the literature by specifically focusing on the Covid-19 pandemic, a unique and unprecedented global crisis.

This study aims to examine the learning experiences of indigenous West Papuan students studying accounting in Indonesia during the COVID-19 pandemic.

A qualitative approach was taken with 25 indigenous accounting students at five universities in the region who shared testimonies of their online learning experiences. The interview data collected were analysed using initial and selective coding and then interpreted under several themes.

The paper shows the personal, faculty and external challenges in indigenous students’ learning activities during university closures because of COVID-19. The interrelated challenges included students’ struggles to adapt their learning habits when using various online applications, difficulties in understanding how the faculty managed lectures, tutorials and evaluations without adequate access to learning materials, the lack of a learning infrastructure, issues with equipment, and obtaining internet data credits. Students’ economic struggles and health issues exacerbated these challenges. While enduring various struggles and being frustrated about their future, all students expected a change in offline learning policies by the government to lessen their strict physical distancing.

The findings can inform the importance of integrating accounting students’ learning challenges and needs into curriculum development.

This study highlights the learning challenges of indigenous accounting students during the COVID-19 pandemic and how approaches to online learning need to consider the experience of these students.

Background: Hyperglycemia in pregnancy (HIP) is a common medical complication during pregnancy and is associated with several short and long-term maternal-fetal consequences. We aimed to determine the prevalence and factors associated with HIP among Ugandan women.

Methods: We consecutively enrolled eligible pregnant women attending antenatal care at Kawempe National Referral Hospital, Kampala, Uganda in September 2020. Mothers known to be living with diabetes mellitus or haemoglobinopathies and those with anemia (hemoglobin <11g/dl) were excluded. Random blood sugar (RBS) and glycated hemoglobin A1c (HbA_1c) were measured on peripheral venous blood samples. HIP was defined as an HbA1c ≥5.7% with its subsets of diabetes in pregnancy (DIP) and prediabetes defined as HbA1c_1c of ≥6.5% and 5.7–6.4% respectively. ROC curve analysis was performed to determine the optimum cutoff of RBS to screen for HIP.

Results: A total of 224 mothers with a mean (±SD) age 26±5 years were enrolled, most of whom were in the 2^nd or 3^rd trimester (94.6%, n=212) with a mean gestation age of 26.6±7.3 weeks. Prevalence of HIP was 11.2% (n=25) (95% CI: 7.7–16.0). Among the mothers with HIP, 2.2% (n=5) had DIP and 8.9% (n=20) prediabetes. Patients with HIP were older (28 years vs. 26 years, p=0.027), had previous tuberculosis (TB) contact (24% vs. 6.5%, p=0.003) and had a bigger hip circumference (107.8 (±10.4) vs. 103.3 (±9.7) cm, p=0.032). However only previous TB contact was predictive of HIP (odds ratio: 4.4, 95% CI: 1.2–14.0; p=0.022). Using HbA_1c as a reference variable, we derived an optimum RBS cutoff of 4.75 mmol/L as predictive of HIP with a sensitivity and specificity of 90.7% and 56.4% (area under the curve=0.75 (95% CI: 0.70–0.80, p<0.001)), respectively.

Conclusions: HIP is common among young Ugandan women, the majority of whom are without identifiable risk factors.

This paper aims to examine lean thinking in medical commodities supply chains by considering its applications and success factors. It determines the drivers and wastes of medical commodity supply chain, and the existing lean tools and practices together with their application in the supply chain processes. The paper also examined the challenges and success factors for effective lean application in the medical commodities supply chains.

The study used qualitative approaches, in-depth interviews and focus group discussions with key informants to form the basis for data collection. Through thematic analysis, the collected data were analyzed by developing themes reflecting the objectives of the study.

The main drivers for waste associated with the supply chain were demand management, supplier development, institutional framework and governance. The wastes were observed at the level of inventory, operation costs, transaction costs, delays in terms of service, commodity delivery time and quality. Digitalization, information technology and standardization were the tools for medical supply chain. Poor infrastructure, unreliable internet supply, environmental uncertainty and poor management support were challenges to realizing an effective supply chain.

Although the qualitative approach used in the study provides detailed information, a quantitative study covers a larger sample for generalization.

Capacity building and professionalism should be given a priority because the philosophy of lean focuses on waste removal and continuous improvement, which highly depends on the quality of human resource (Brito et al., 2020). Limited human resource capabilities in supply chain management will, therefore, result into poor operational efficiency, which are wasted. Moreover, systems interoperability is key waste minimization and, therefore, demands interventions.

The government under the Ministry of Health and other key sector ministries such as local and regional governments should better understand the role of the waste drivers and adopt system-wide reforms to support improvements to remove waste in the medical supply chain. For example, the current institutional framework creates an administrative block and hence leads to wastes. This bureaucratic procedure should be removed to minimize wastes along the chain.

This study is among the first studies to determine applicability and implementation of lean in a resource-constrained context. The paper identifies contextual factors for lean implementation. This paper focused on a holistic view of the entire supply chains to enhance a well-functioning supply chain in delivering health commodities.

This paper aims to understand the maternal health vulnerabilities of migrant women in slums and explore their challenges during and after childbirth.

The study used a qualitative approach, including in-depth interviews through purposive and snowball sampling techniques. Thematic analysis was used for analysing data. The consolidated criteria for reporting qualitative studies (COREQ)-32 items were followed for reporting this study.

The study found that migrant women were highly susceptible to adverse birthing outcomes due to risks involved in birthing, lack of care and hygiene, lack of skilled care in dealing with complicated pregnancies and exposure to domestic and obstetric violence.

The study intends to highlight the narratives of female migrants’ birthing and maternal health challenges. The entire process of childbirth in slums with consequences can result in maternal and infant morbidities and mortalities.

This study aimed to investigate the sensemaking strategies employed by early-career employees working within organizationally constrained environments.

Grounded in the sensemaking-as-accomplishment framework, a longitudinal multi-case study was conducted, involving three early-career employees. These participants were interviewed multiple times concerning tasks they themselves identified as anomalous and ambiguous.

The study's findings illuminate how early-career employees utilize sensemaking strategies to accomplish anomalous-ambiguous tasks. These strategies are interwoven with deliberate efforts to mitigate organizational constraints that exist in the organization or arise during the execution of complex tasks.

Notable limitation pertains to the time gap between task completion and the interviews. Conducting real-time interviews concurrently with task execution or immediately afterward was not feasible due to constraints in participant availability. This research has implications for organizational learning initiatives, particularly those encompassing employee-driven self-learning components. Insights derived from studies like this can inform the development of effective self-learning schemes within organizations.

Previous sensemaking research focused on what takes place in high-reliability organizations. This study explored sensemaking strategies in workplaces that are organizationally constrained.

The UK Mental Health Act (MHA) Reform (2021) on race and ethnicity promotes new governmental strategies to tackle inequalities faced by ethnically racialised communities detained under the MHA. However, there is a scarcity in personality disorder and ethnicity research. This study aims to investigate what is available in the UK in relation to prevalence, aetiology and treatment provisions of personality disorder for ethnically diverse patients, and to understand their interconnectedness with mental health and criminal justice service provisions. Three key areas of investigations were reviewed, (1) UK prevalence of personality disorder amongst ethnically diverse individuals; (2) aetiology of personality disorder and ethnicity; (3) treatment provisions for ethnically diverse individuals diagnosed with personality disorder.

A scoping study review involved a comprehensive scanning of literature published between 2003 and 2022. Screening and data extraction tools were co-produced by an ethnically diverse research team, including people with lived experience of mental health and occupational expertise. Collaborative work was complete throughout the review, ensuring the research remained valid and reliable.

Ten papers were included. Results demonstrated an evident gap in the literature. Of these, nine papers discussed their prevalence, three papers informed on treatment provisions and only one made reference to aetiology. This review further supports the notion that personality disorder is under-represented within ethnic minority populations, particularly of African, Caribbean and British heritage, however, the reasons for this are multi-facetted and complex, hence, requiring further investigation. The evidence collected relating to treatment provisions of personality disorder was limited and of low quality to reach a clear conclusion on effective treatments for ethnically diverse patients.

The shortage of findings on prevalence, aetiology and treatment provisions, emphasises the need to prioritise further research in this area. Results provide valuable insights into this limited body of knowledge from a UK perspective.

Hearing aid (HA) using is an option for enhancing the sound transmission. It effectively improves hearing ability during communication. In Thailand, two-third of hearing impaired persons were elders, while the utilization of an HA was low. This study aims to explore how the decision was made on the use of HA among the hearing impaired elderly.

Mixed-methods sequential explanatory design was used by starting with a retrospective study to identify the prevalence of HA use and influencing factors including demographic and clinical data. Total, 199 elders with moderate to severe hearing impairment were enrolled. Qualitative data collection for thematic analysis was conducted by interviewing 28 participants to reveal elders’ subjective reasoning.

It was found that 25.63% of elders used an HA, whereas age, types of health insurance and disability registration were significant influencing factors. Six themes of subjective reasoning emerged including social activities, disability perspective, social support, medical and personnel, rights and accessibility and benefit of HA, which determined the elders’ decisions on HA use.

This study broadened insights of the elders’ decision process on HA use, which was mutually made by both health-care professional and care recipients. The elders themselves would make the final decision. Not only objective indications but also subjective reasoning of users played significant roles on HA acquisition. To enhance HA use among hearing impaired elders, patient engagement in decision-making was crucial while hearing counselling and elimination of reimbursement barriers became essential.