Search results

In 2011, community nursing services were reorganised in England in response to a national policy initiative, but little is known about the impact of these changes. A total of three dominant approaches emerged: (1) integration of community nursing services with an acute hospital provider, (2) integration with a mental health provider and (3) the establishment of a stand-alone organisation, i.e. without structural integration. The authors explored how these approaches influenced the trends in emergency hospital admissions and bed day use for older people.

The methodology was a longitudinal ecological study using panel data over a ten-year period from April 2006 to March 2016. This study’s outcome measures were (1) emergency hospital admissions and (2) emergency hospital bed use, for people aged 65+ years in 140 primary care trusts (PCTs) in England.

The authors found no statistically significant difference in the post-intervention trend in emergency hospital admissions between those PCTS that integrated community nursing services with an acute care provider and those integrated with a mental health provider (IRR 0.999, 95% CI 0.986–1.013) or those that did not structurally integrate services (IRR 0.996, 95% CI 0.982–1.010). The authors similarly found no difference in the trends for emergency hospital bed use.

PCTs were abolished in 2011 and replaced by clinical commissioning groups in 2013, but the functions remain.

The authors found no evidence that any one structural approach to the integration of community nursing services was superior in terms of reducing emergency hospital use in older people.

As far as the authors are aware, previous studies have not examined the impact of alternative approaches to integrating community nursing services on healthcare use.

The purpose of this paper is to reflect on research evidence and practice experience of transforming primary care to a more integrated and holistic model.

It is based on a scoping review which has been guided by primary care stakeholders and synthesises research evidence and practice experience from ten international case studies.

Adopting an inter-professional, community-orientated and population-based primary care model requires a fundamental transformation of thinking about professional roles, relationships and responsibilities. Team-based approaches can replicate existing power dynamics unless medical clinicians are willing to embrace less authoritarian leadership styles. Engagement of patients and communities is often limited due to a lack of capacity and belief that will make an impact. Internal (relationships, cultures, experience of improvement) and external (incentives, policy intentions, community pressure) contexts can encourage or derail transformation efforts.

Transformation requires a co-ordinated programme that incorporates the following elements – external facilitation of change; developing clinical and non-clinical leaders; learning through training and reflection; engaging community and professional stakeholders; transitional funding; and formative and summative evaluation.

This paper combines research evidence and international practice experience to guide future programmes to transform primary care.

This study aims to ascertain the personal characteristics of a group of successful academic entrepreneurs in a South African university enterprise and the prevalent barriers and enablers to their entrepreneurial endeavour.

The authors used a Delphi process to identify and rank the characteristics, enablers, barriers and behaviours of entrepreneurial academics, with a Nominal Group Technique applied to establish challenges they encounter managing their enterprise and to propose solutions.

Perseverance, resilience and innovation are critical personal characteristics, while collaborative networks, efficient research infrastructure and established research competence are essential for success. The university’s support for entrepreneurship is a significant enabler, with unnecessary bureaucracy and poor access to project and general enterprise funding an impediment. Successful academic entrepreneurs have strong leadership, and effective management and communication skills.

The main limitation is the small study participant group drawn from a single university enterprise, which complicates generalisability. The study supported the use of Krueger’s (2009) entrepreneurial intentions model for low- and middle-income country (LMIC) academic entrepreneur investigation but proposed the inclusion of mitigators to entrepreneurial activation to recognise contextual deficiencies and challenges.

Skills-deficient LMIC universities should extensively and directly support their entrepreneurial academics to overcome their contextual deficiencies and challenging environment.

This study contributes to addressing the paucity of academic entrepreneur research in LMIC contexts by identifying LMIC-specific factors that inhibit the entrepreneur’s movement from entrepreneurial intention to entrepreneurial action.

Breast cancer is a global public health dilemma and the most prevalent cancer in the world. Effective treatment plans improve patient survival rates and well-being. The five-year survival rate is often used to develop treatment selection and survival prediction models. However, unlike other types of cancer, breast cancer patients can have long survival rates. Therefore, the authors propose a novel two-level framework to provide clinical decision support for treatment selection contingent on survival prediction.

The first level classifies patients into different survival periods using machine learning algorithms. The second level has two models with different survival rates (five-year and ten-year). Thus, based on the classification results of the first level, the authors employed Bayesian networks (BNs) to infer the effect of treatment on survival in the second level.

The authors validated the proposed approach with electronic health record data from the TriNetX Research Network. For the first level, the authors obtained 85% accuracy in survival classification. For the second level, the authors found that the topology of BNs using Causal Minimum Message Length had the highest accuracy and area under the ROC curve for both models. Notably, treatment selection substantially impacted survival rates, implying the two-level approach better aided clinical decision support on treatment selection.

The authors have developed a reference tool for medical practitioners that supports treatment decisions and patient education to identify patient treatment preferences and to enhance patient healthcare.

This research examines what motivates professional truck drivers to engage in eco-driving by linking their self-reports with objective driving scores.

Theory of Planned Behavior (TPB) is illustrated in an embedded, single-case study of a Finnish carrier with 17 of its truck drivers. Data are obtained through in-depth interviews with drivers, their fuel-efficiency scores generated by fleet telematics and a focus group session with the management.

Discrepancies between drivers’ intentions and eco-driving behaviors are illustrated in a two-by-two matrix that classifies drivers into four categories: ideal eco-drivers, wildcards, wannabes and non-eco-drivers. Attitudes, subjective norms and perceived behavioral control are examined for drivers within each category, revealing that drivers’ perceptions did not always align with the reality of their driving.

This study strengthens the utility of TPB through data triangulation while also revealing the theory’s inherent limitations in elucidating the underlying causes of its three antecedents and their impact on the variance in driving behaviors.

Managerial insights are offered to fleet managers and eco-driving solution providers to stipulate the right conditions for drivers to enhance fuel-efficiency outcomes of transport fleets.

This is one of the first studies to give a voice to professional truck drivers about their daily eco-driving practice.

The green logistics literature remains undecided on how collaboration between shippers (i.e. logistics buyers) and logistics service providers (LSPs) may facilitate green logistics practices (GLPs). This paper identifies two types of collaboration mechanisms, relation specific and knowledge sharing, to systematically examine their influence on facilitating the different types of GLPs – as seen by shippers versus LSPs.

Survey responses of 169 shippers and 162 LSPs in Sweden were collected and analysed using exploratory- and confirmatory factor analysis, followed by multiple regression analysis.

The findings reveal that neither of the actors consistently favour a certain type of collaboration mechanisms for facilitating all types of GLPs. Although it was found that both actors share the same view on the role of collaboration mechanisms for some GLPs, their views took contrasting forms for others.

This study contributes to the green logistics literature by incorporating a trilateral distinction to present collaboration recommendations for GLPs, based on (1) the collaboration mechanism at play, (2) the actor's perspective and (3) the GLP in question.

Insights are offered to managers at shipper/LSP firms to apply the right (“fit for purpose”) collaboration mechanisms in their relationships with their logistics partners with respect to the desired GLPs.

This is one of the first large-scale studies to systematically reveal in what way collaboration can facilitate the different types of GLPs.

The purpose of this paper is to determine the role of service quality (SQ), trust and commitment to customer loyalty (CL) for telecom service users. Further, the moderating role of gender, marital status and connection type within the model was tested.

A measurement model was created based on valid 615 responses from Indian TSUs for SQ, trust, commitment and loyalty with the help of partial least squares structural equation modeling (PLS-SEM). Multi-group analysis (MGA) was conducted to understand the moderating effect of marital status, gender and connection type within the model.

The results suggest that, out of five dimensions of SQ, only responsiveness, assurance and empathy have a significant positive relationship with both commitment and trust. Tangibility has a significant positive relationship with trust only. Both commitment and trust have a significant impact on loyalty. It was noticed that both commitment and trust act as mediators between three SQ dimensions (assurance, empathy and responsiveness) and CL. MGA revealed that empathy and responsiveness positively induce trust in telecom users who are single. Whereas, assurance increases commitment toward telecom service providers in married users. Assurance and empathy significantly contribute toward commitment and trust, respectively, in male users as compared to females. Empathy was found important for postpaid users for trust-building, whereas trust was found to be more important for prepaid users to stay loyal to the service provider.

This article contributes toward understanding the role of SQ, trust and commitment to CL moderated by marital status, gender and connection type in an integrated model concerning telecom service.

The purpose of this paper is to examine bank performance using the different performance measures, namely, return on assets, return on equity and bank margins (MAR).

Unbalanced panel data were constructed to test the related hypotheses and provide evidence on the relationship between ownership types, banking models and performance indicators adopting the random effects techniques.

The findings of the paper substantiate that the banking models are significant performance indicators. However, the results are contingent on the GDP growth of the country. Moreover, the evidence indicates that the impact of ownership types is inconclusive in all measures of performance. However, the GDP is significant when it interacts with the types of ownership, particularly for foreign and government banks, although the evidence is mixed and unfavourable for government banks.

The results of the study provide insights for bankers and policymakers to enhancement Yemen’s banking sector.

This study is considered as the first attempt in examining the role of banking model and ownership type and their link to banking model.

Mainstream pornography is popular, freely accessible, and infused with themes of male dominance, aggression, and female subservience. Through depicting sex in these ways, mainstream pornography has the potential to influence the further development of harmful sexual scripts that condone or endorse violence against women and girls. These concerns warrant the adoption of a harms-based perspective in critical examinations of pornography's influence on sexual experiences. This chapter reports on findings from interviews with 24 heterosexual emerging adults living in Aotearoa/New Zealand about how pornography has impacted their lives. Despite a shared awareness among participants of mainstream pornography's misogynistic tendencies, and the potential for harm from those displays, men's and women's experiences were profoundly gendered. Men's reported experiences were often associated with concerns about their own sexual behaviors, performances, and/or abilities. Conversely, women's experiences were often shaped by how pornography had affected the way that men related to them sexually. Their experiences included instances of sexual coercion and assault which were not reported by the men. These findings signal the need for a gendered lens, situated within a broader harms-based perspective, in examinations of pornography's influence.