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The objectives of the current interim report are to measure the extent of the access to care problem, identify and compare the types of patient- and system-based barriers experienced by Vietnam veterans at risk for suicide when seeking care for physical, psychiatric, and substance abuse conditions, analyze patient-perceived quality of care for individuals who obtained access to care, and identify how the care-seeking experience effected future care seeking. This study is based on a longitudinal sample of 494 Vietnam veterans discharged from military service in September 1971 and subsequently identified as at risk for suicide (306 low risk; 188 high risk). Seventy-one percent (350) of 494 participants completed an extensive qualitative and quantitative interview covering, among other topics, physical conditions, psychiatric conditions, substance use, barriers to care, facilitators of care, and quality of care. Barriers, satisfaction, and effect of the experience were compared by type of condition and suicidal risk category using χ2 analysis and Fisher's as appropriate. The analysis is based on 257 interviews (73 percent) with qualitative data transcribed thus far. Results: Of the 195 patients with self-reported health conditions, 76 (39.0 percent) and 45 (23.1 percent) expressed system-based barriers to care, respectively. The group at higher risk of suicide was significantly more likely (p<0.01) to report patient-based barriers to care and system-based barriers to care (p<0.05), and more likely (p<0.05) to experience negative effects of the care-seeking experience. Both self-perceived and system-based barriers to care pose obstacles for patients at high risk of suicide. Targeted interventions are required to reach out to these patients to address needs for care currently unmet by the health care system and to reduce negative effects of the health care experience.

The main purpose of this paper is to identify the reasons for the stagnant behaviour of seaports contributing towards Sustainable Development Goals (SDGs).

Global seaport sustainability practices that correspond with SDGs were identified through an extensive literature review. In total, five focus interviews were carried out with port managers in Sri Lanka to identify the existing knowledge about seaport sustainability, and the reasons for disparities between the global standards and country-level port sustainability practices. Data collected from a questionnaire survey of 55 seaport terminal managers in Sri Lanka were analysed using exploratory factor analysis (EFA) and thematic analysis.

Deficient collaborative policies, structural and managerial constraints, market constraints and the absence of a well-established SDG-driven global port framework were identified as significant barriers for seaports to contribute towards SDGs.

Identifying barriers in implementing sustainable practices in ports help the responsible authorities tackle them. Hence, seaports in return and the wider society benefit from the spillover effects of port operations aligning to SDGs.

This paper provides port organizations insights on the barriers needing to be addressed in their operational and management systems to best incorporate practices aligning to SDGs in seaports.

The shift in policy discourse towards individualism is affecting service provision and access, which has become increasingly conditioned on individual agency and the “deservingness” of the recipient. Gendered and intersectional experiences of homelessness and excluded populations less likely to be living on the streets remain overlooked and unaddressed. This study thus aims to uncover what drives “invisibility” in services for women experiencing multiple disadvantage and the gendered constraints the women are facing when exiting and navigating multiple disadvantage.

The paper draws on in-depth interviews with women who face severe and multiple disadvantage and their support staff. Data is also gathered through survey data and observations with a wide range of frontline service providers, as well as support notes and numerical progress data recorded by one of the service providers.

Contradicting the common assumption that people act as rational actors in their interaction with services, the author found that women’s decisions to (dis)engage may be blinded by forces of multiple disadvantage and mistrust. These are often developed as a result of systemic and gendered constraints that limit women’s capabilities and exercise of choice. Barriers in service access often amplified the personal barriers they were facing and reinforced women’s decisions to not engage with services.

The author hopes that this paper sheds light on the particular set of barriers women with multiple disadvantage face, which will be vital to reach women who face severe disadvantage and provide more effective policies, care and support.

This study gives voice to a particular hidden population: women with multiple disadvantage. It contributes to existing frameworks on agency and choice by understanding gendered barriers behind service engagement and how services themselves may be contributing to women’s invisibility.

The purpose of this paper is to contribute an Australian perspective to the debate on health system integration by identifying some key Australian challenges to integration, policy responses to enhance integration and potential insights from these for international policy makers, researchers and practitioners.

Drawing on the systems theory concept of entropy, the authors contend that there exist factors that contribute to system fragmentation. Whilst policy responses to these challenges are contextual, there are generalisable features worth exploring internationally.

The authors suggest that recognition of inherent system-based barriers is an important initial stage in moving towards integration. Whilst process and people factors are important contributors to integration, the political will to move in this direction is a necessary dynamic to energise the system through appropriate funding, incentives and governance structures.

The paper provides a fresh Australian perspective to the international discourse on barriers and opportunities to enhance health system integration.

To provide practitioners of information management with an overview and framework to explore the various controversies associated with the methods of traditional methods of voting with electronically enhanced voting via the internet (I‐voting). The current paper is centered on the assumption that I‐voting is the next logical step in applying online information‐gathering and retrieval technologies to the field of e‐government.

A review of the applied literature on electronically enhanced voting methods with potentials associated with internet voting, as well as from practical experience, resulted in a basic model for discussion of the emergent nature of I‐voting.

I‐voting would reduce the cost for staffing polling stations, and also the funds needed to pay for voting machines. I‐voting could also reduce the number of errors made by both the voters and the electoral administrators, and allow for easier adoption of uniform standards in the ballot format, since it could be transmitted via the internet from a central election agency to all local and regional polling places. Bridging the digital divide and internet security issues may be the most important barriers that must be overcome if I‐voting becomes a viable option in the USA.

It may be years, if ever, before a truly secure, relatively risk‐free internet service, such as I‐voting, is developed. However, despite the controversies associated with election fraud, the numerous current voting systems that are in place suffer from the same problems associated with online informational exchanges; but, for the most part, nations still conduct their businesses and the political systems are still relatively stable.

Owing to recent voting débâcles in the USA, the public is demanding a more reliable and secure method of voting. Currently, many nations are moving more toward electronically enhanced voting methods with the long‐term goal being internet voting. Unfortunately, there are heated debates about the pros and cons of handing over the right to vote, using a system that is prone to security risks from outside sources.

In the short term, there should be increased interest in establishing national and international standards for testing and certification of electronic and I‐voting systems and their IT‐infrastructure. It is a basic premise of the present study that voting online increases voter participation, which can only be viewed in a positive light.

This study aims to describe and understand performance measurement system (PMS) change in an emerging economy bank.

Using institutional theory as a theoretical lens, the study uses Kasurinen's accounting change model to explain management accounting change as a product of motivators, catalysts and facilitators. The model also focuses on how confusers, frustrators and delayers inhibit PMS change and the role of leaders in the change process. Data were gathered from multiple sources including relevant internal and external documents covering a ten‐year period (1997‐2007), and semi‐structured interviews with managers from different hierarchical levels.

The bank's PMS experienced two significant changes from 1997 to 2007. While uncertain economic conditions, increasing competition, and pressures to improve performance and enhance accountability motivated changes in the bank's performance measurement system, the major catalysts of change were the financial losses experienced, major regulatory changes, and the appointment of a new board of directors and president. The change leader played an important role in overcoming resistance to change and in ensuring adequate technical support and training was provided to facilitate the change.

Bank managers must be aware of the influence of institutional factors on PMSs. In particular, they need to be aware of the factors that can necessitate change (motivators), initiate change (catalysts) and the prevailing conditions required to support change (facilitators) in order to maintain the utility of PMSs.

The paper provides a more detailed insight into the impact of institutional factors on changes in PMSs in the context of an emerging economy, which will assist practitioners in addressing issues concerning PMSs changes in similar contexts.

The objective of this study is to investigate how country risk, different political actions from the government and bureaucratic behavior influence the activities in industry supply chains (SCs) in emerging markets. The main objective of this study is to investigate the influence of these external stakeholders’ elements to the demand-side and supply-side drivers and barriers for improving competitiveness of Ready-Made Garment (RMG) industry in the way of analyzing supply chain. Considering the phenomenon of recent change in the RMG business environment and the competitiveness issues this study uses the principles of stakeholder and resource dependence theory and aims to find out some factors which influence to make an efficient supply chain for improving competitiveness. The RMG industry of Bangladesh is the case application of this study. Following a positivist paradigm, this study adopts a two phase sequential mixed-method research design consisting of qualitative and quantitative approaches. A tentative research model is developed first based on extensive literature review. Qualitative field study is then carried out to fine tune the initial research model. Findings from the qualitative method are also used to develop measures and instruments for the next phase of quantitative method. A survey is carried out with sample of top and middle level executives of different garment companies of Dhaka city in Bangladesh and the collected quantitative data are analyzed by partial least square-based structural equation modeling. The findings support eight hypotheses. From the analysis the external stakeholders’ elements like bureaucratic behavior and country risk have significant influence to the barriers. From the internal stakeholders’ point of view the manufacturers’ and buyers’ drivers have significant influence on the competitiveness. Therefore, stakeholders need to take proper action to reduce the barriers and increase the drivers, as the drivers have positive influence to improve competitiveness.

This study has both theoretical and practical contributions. This study represents an important contribution to the theory by integrating two theoretical perceptions to identify factors of the RMG industry’s SC that affect the competitiveness of the RMG industry. This research study contributes to the understanding of both external and internal stakeholders of national and international perspectives in the RMG (textile and clothing) business. It combines the insights of stakeholder and resource dependence theories along with the concept of the SC in improving effectiveness. In a practical sense, this study certainly contributes to the Bangladeshi RMG industry. In accordance with the desire of the RMG manufacturers, the research has shown that some influential constructs of the RMG industry’s SC affect the competitiveness of the RMG industry. The outcome of the study is useful for various stakeholders of the Bangladeshi RMG industry sector ranging from the government to various private organizations. The applications of this study are extendable through further adaptation in other industries and various geographic contexts.

This study aims to improve the reliability of emergency safety barriers by using the subjective safety analysis based on evidential reasoning theory in order to develop on a framework for optimizing the reliability of emergency safety barriers.

The emergency event tree analysis is combined with an interval type-2 fuzzy-set and analytic hierarchy process (AHP) method. In order to the quantitative data is not available, this study based on interval type2 fuzzy set theory, trapezoidal fuzzy numbers describe the expert's imprecise uncertainty about the fuzzy failure probability of emergency safety barriers related to the liquefied petroleum gas storage prevent. Fuzzy fault tree analysis and fuzzy ordered weighted average aggregation are used to address uncertainties in emergency safety barrier reliability assessment. In addition, a critical analysis and some corrective actions are suggested to identify weak points in emergency safety barriers. Therefore, a framework decisions are proposed to optimize and improve safety barrier reliability. Decision-making in this framework uses evidential reasoning theory to identify corrective actions that can optimize reliability based on subjective safety analysis.

A real case study of a liquefied petroleum gas storage in Algeria is presented to demonstrate the effectiveness of the proposed methodology. The results show that the proposed methodology provides the possibility to evaluate the values of the fuzzy failure probability of emergency safety barriers. In addition, the fuzzy failure probabilities using the fuzzy type-2 AHP method are the most reliable and accurate. As a result, the improved fault tree analysis can estimate uncertain expert opinion weights, identify and evaluate failure probability values for critical basic event. Therefore, suggestions for corrective measures to reduce the failure probability of the fire-fighting system are provided. The obtained results show that of the ten proposed corrective actions, the corrective action “use of periodic maintenance tests” prioritizes reliability, optimization and improvement of safety procedures.

This study helps to determine the safest and most reliable corrective measures to improve the reliability of safety barriers. In addition, it also helps to protect people inside and outside the company from all kinds of major industrial accidents. Among the limitations of this study is that the cost of corrective actions is not taken into account.

Our contribution is to propose an integrated approach that uses interval type-2 fuzzy sets and AHP method and emergency event tree analysis to handle uncertainty in the failure probability assessment of emergency safety barriers. In addition, the integration of fault tree analysis and fuzzy ordered averaging aggregation helps to improve the reliability of the fire-fighting system and optimize the corrective actions that can improve the safety practices in liquefied petroleum gas storage tanks.