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The authors developed and validated an algorithm using health administrative data to identify patients who are attached or uncertainly attached to a primary care provider (PCP) using patient responses to a survey conducted in Ontario, Canada.

The authors conducted a validation study using as a reference standard respondents to a community-based survey who indicated they did or did not have a PCP. The authors developed and tested health administrative algorithms against this reference standard. The authors calculated the sensitivity, specificity positive predictive value (PPV) and negative predictive value (NPV) on the final patient attachment algorithm. The authors then applied the attachment algorithm to the 2017 Ontario population.

The patient attachment algorithm had an excellent sensitivity (90.5%) and PPV (96.8%), though modest specificity (46.1%) and a low NPV (21.3%). This means that the algorithm assigned survey respondents as being attached to a PCP and when in fact they said they had a PCP, yet a significant proportion of those found to be uncertainly attached had indicated they did have a PCP. In 2017, most people in Ontario, Canada (85.4%) were attached to a PCP but 14.6% were uncertainly attached.

Administrative data for nurse practitioner's encounters and other interprofessional care providers are not currently available. The authors also cannot separately identify primary care visits conducted in walk in clinics using our health administrative data. Finally, the definition of hospital-based healthcare use did not include outpatient specialty care.

Uncertain attachment to a primary health care provider is a recurrent problem that results in inequitable access in health services delivery. Providing annual reports on uncertainly attached patients can help evaluate primary care system changes developed to improve access. This algorithm can be used by health care planners and policy makers to examine the geographic variability and time trends of the uncertainly attached population to inform the development of programs to improve primary care access.

As primary care is an essential component of a person's medical home, identifying regions or high need populations that have higher levels of uncertainly attached patients will help target programs to support their primary care access and needs. Furthermore, this approach will be useful in future research to determine the health impacts of uncertain attachment to primary care, especially in view of a growing body of the literature highlighting the importance of primary care continuity.

This patient attachment algorithm is the first to use existing health administrative data validated with responses from a patient survey. Using patient surveys alone to assess attachment levels is expensive and time consuming to complete. They can also be subject to poor response rates and recall bias. Utilizing existing health administrative data provides more accurate, timely estimates of patient attachment for everyone in the population.

Economics, business management

The case study is relevant for MBA, Master's and under graduate (economics, international and business economics) students.

Biocon is one of the top 20 companies from India in the Forbes list of “Best under a Billion” companies. It has emerged from being an enzyme-producing firm to a biotech powerhouse under the guidance of Ms Kiran M. Shaw. It is an innovative company with a varied scientific skill base and progressive manufacturing facilities for developing and commercializing biopharmaceuticals. This study attempts to explore the international foray of Biocon using the eclectic OLI framework. Entrepreneurship, need for integrated business model, innovation, quality control, etc. constituted the ownership (O) factors, important for Biocon to earn the more than compensating advantage in the overseas market. The locational factors were less important in case of Biocon as the global expansion was driven by a motive of either market seeking or cashing in on the cost advantage of its operations. The dominant mode of entry has been the joint ventures. The overseas patterns exhibited by Biocon can be captured fully by the O-L-I framework.

To understand the economic theory of OLI and the ownership, locational and internalisation advantages, link the OLI framework with the international foray of Biocon, Biocon's internationalization journey, major overseas deals signed and the economic rationale behind the deals.

Teaching notes are available for educators only. Please contact your library to gain login details or e-mail support@emeraldinsight.com to request teaching notes.

The main purpose of this study is to investigate Ishikawa’s statement that “95% of problems in processes can be accomplished using the 7 Quality Control (QC) tools” and explore its validity within the health-care sector. The study will analyze the usage of the 7 QC tools in the health-care service sector and the benefits, challenges and critical success factors (CSFs) for the application of the 7 QC tools in this sector.

In order to evaluate Ishikawa’s statement and how valid his statement is for the health-care sector, an online survey instrument was developed, and data collection was performed utilizing a stratified random sampling strategy. The main strata/clusters were formed by health-care professionals working in all aspects of health-care organizations and functions. A total of 168 participants from European health-care facilities responded to the survey.

The main finding of this study is that 62% of respondents were trained in the 7 QC tools. Only 3% of participants in the health-care sector perceived that the seven tools of QC can solve above 90% of quality problems as originally claimed by Dr Ishikawa. Another relevant finding presented in this paper is that Histograms, Cause and Effect diagrams and check sheets are the most used tools in the health-care sector. The least used tools are Stratification and Scatter diagrams. This paper also revealed that the 7 QC tools proposed by Dr Ishikawa were most used in hospital wards and in administration functions. This work also presents a list of CSFs required for the proper application of the 7 QC tools in healthcare.

This research was carried out in European health-care facilities – and there is an opportunity to expand the study across global health-care facilities. There is also an opportunity to study the use of the tools and their impact on hospital performance using the Action Research methodology in a health-care organization.

To the best of the authors’ knowledge, this is the very first research within the health-care sector that focused on investigating the usage of all the 7 basic tools and challenging Dr Ishikawa’s statement: “95% of problems in processes can be accomplished using the 7 Quality Control (QC) tools” from his book “What is Quality Control?” The results of this study represent an important first step toward a full understanding of the applicability of these tools in the health-care sector.

Identifying the health-related needs in transgender (TG) people can help to formulate strategies for providing appropriate and accessible health services and promoting health and social justice, as well as human rights in these populations. This systematic review aims to determine health-related needs, problems and barriers, as well as ways to solve them in TG people from the viewpoint of TG individuals and health policymakers.

All international electronic databases such as PubMed (Medline), Embase, CINAHL, Scopus, Web of Sciences, Cochrane, PsycInfo and Google Scholar (Gray Literature) were searched from December 1990 to December 2019. After the search, the articles were screened based on their title, abstract and full text. The quality of articles was assessed using the Strengthening the reporting of observational studies in epidemiology (STROBE), Consolidated Standards of Reporting Trials (CONSORT) and Standards for Reporting Qualitative Research (SRQR) checklists. The search strategy, data extraction and quality evaluation of articles were independently performed by two researchers.

The general health-related needs identified in TG individuals from the viewpoint of themselves included access to legal hormone therapy, psychological and psychiatric counseling, privacy, health and hygiene needs, equality and freedom of expression. General health-related needs in TG individuals from the viewpoint of health policymakers included screening tests to detect sexually transmitted diseases, especially HIV, cancers and other diseases, as well as training service providers (physicians, nurses, health workers, etc.).

One of the limitations of this study was nonreporting of health-related needs in initial articles by different TG groups because these groups have had different needs and different barriers to accessing health-care services. In this study, health-related needs and barriers to satisfy them were categorized from the viewpoint of TG populations and health policymakers around the world, which may influence future decisions to provide services to TG populations. The results of this systematic review can help to develop different strategies by considering all TGs from individual, family and social aspects to better provide services for this group. However, given the dynamics and changes in the existing communities and the limited studies on gender minorities in developing countries, further research is required to comprehensively address the subject.

The findings can be used as an incentive to improve existing conditions and to address problems and shortcomings. The results of this systematic review formulate strategies for providing appropriate and accessible health services and better lives for TGs, planning for more effective participation of these individuals in local communities, improving their physical problems and mental health through counseling, as well as promoting health and social justice, and human rights for these populations.

The purpose of this paper is to ask how we can think about critical reflection as a pedagogical practice given the “confessional turn”. By the “confessional turn” the author refers to the idea that “subjective, autobiographical and confessional modes of expression” have expanded exponentially across a wide range of social spheres, including education, the legal system, the media and the workplace. Examining these developments, this paper asks what these debates on critical reflection and confession mean for pedagogical practice.

The main approach is a review of key debates in the literature on critical reflection and also in the wider social sciences.

The discussion compares different debates. Thus it shows that for critics, the turn to the “first person” technologies is narcissistic, psychologistic and de‐politicising. On this view, critical reflective practice might be understood as an individualistic and individualising pedagogy in spite of its claims to be critical. The paper discusses how in contrast, others see this move to talk about the subjective and the self as an extension of the feminist project of the personal is political – i.e. that personal stories, feelings and issues have social and political roots and consequences. For them, reflection can be critical, leading to political consciousness‐raising, i.e. a new awareness about social, political and personal processes. It finishes by examining the view that the idea of reflexivity might help us out of the conflict between these debates.

The paper poses a number of questions in relation to critical reflection that can be taken up by practitioners in the field.

The paper brings new literature to bear on the practice of critical reflection and raises important questions relevant to academics and practitioners.

Continuity of care and access to primary care have been identified as important contributors to improved health outcomes and reduced reincarceration among people who are justice-involved. While the disproportionate burden of health concerns among incarcerated populations is well documented, less is known about their health service utilization, limiting the potential for effective improvements to current policy and practice. This study aims to examine health status and health care utilization among men recently released from a superjail in a large metropolitan area to better understand patterns of use, risk factors and facilitators.

Participants included adult men (n = 106) matched to a general population group (n = 530) in Ontario, Canada, linked to medical records (88.5% linkage) to examine baseline health status and health utilization three-months post-release. The authors compared differences between the groups in baseline health conditions and estimated the risk of emergency department, primary care, inpatient hospitalization and specialist ambulatory care visits.

Superjail participants had a significantly higher prevalence of respiratory conditions, mental illness, substance use and injuries. Substance use was a significant risk factor for all types of visits and emergency department visits were over three times higher among superjail participants.

This empirical case is illustrative of an emerging phenomenon in some regions of the world where emergency departments serve as de facto “walk-in clinics” for those with criminal justice involvement. Strategic approaches to health services are required to meet the complex social and health needs and disparities in access to care experienced by men released from custody.

This study aims to reveal the association between task conflict and job satisfaction with the mediating role of incivility and the moderating role of self-esteem. In addition, the data collected from the UK and Turkey were analyzed separately, and the aim was to contribute to the literature in this field by analyzing the research model in a cultural context.

This research focuses on the relationship between managers and subordinates in organizations. In this study, a survey method was applied to 708 subordinates, both UK and Turkish citizens, working in nine different industries. The obtained data were first analyzed in combination; then, the data of both countries were analyzed separately, and the effect of cultural differences on the research model was investigated.>

According to the results obtained, the relationship between task conflict and job satisfaction is negative, and subordinates’ perceptions of incivility play a mediating role in this relationship. In addition, subordinates’ self-esteem level has a moderating role in the effect of task conflict on job satisfaction through incivility. However, there is no evidence of an effect of culture on this model.

This study contributes to the literature by presenting new evidence on the antecedents of job satisfaction. In addition, it is one of the pioneering studies that provides evidence of the impact of the perceptions and personal characteristics of disputants in a task conflict on task conflict outcomes. Furthermore, this study contributes to the limited cross-cultural studies in the conflict and job satisfaction literature.

One of the organization's main goals is to maintain their customers' loyalty, as this can give them a competitive advantage. Therefore, this study is intended to look into the impact of library service quality using LibQUAL + TM dimensions (library service effect, personal control and library as a place), library image and trust on users’ loyalty with the mediating effect of perceived service value and satisfaction.

Data for hypotheses testing were gathered from Minhaj University Lahore (MUL), a private sector university's staff, administration and students, using a survey questionnaire. About 500 questionnaires were randomly distributed, and 407 were utilized as the final sample for analysis. Structural equation modelling (SEM), using SmartPLS 4 and SPSS 25, were used to analyze the empirical data.

First, research reveals that library image, users’ trust, library service effect and personal control significantly influence user satisfaction. Second, the library as a place and personal control are not a significant indicator of perceived service value. Third, perceived service value and satisfaction have a direct positive relationship with users' loyalty. Fourth, trust and library service effect is indirectly related to loyalty via perceived service value. Fifth, satisfaction does not mediate the relationship between library as a place and loyalty.

Customer satisfaction must be guaranteed by library administration if it hopes to win users’ loyalty. In light of the fact that a variety of factors can affect customer satisfaction, their perception and loyalty, library management should enhance not just the quality of library services along with other factors such as library image and users’ trust.

The study examined the independent impact of library image and users’ trust on satisfaction, perceived service value and users’ loyalty, which, within the framework of the library, has never been addressed in literature.