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Nurse leaders are challenged by ethical issues in today’s complex health-care settings. The purpose of this study was to describe and analyze key elements of moral distress identified by nurse leaders from health-care systems in the USA, Germany, Austria and Switzerland. The aim was to develop an understanding of distressing ethical issues nurse leaders face in the USA and three German-speaking European countries.

This descriptive cross-sectional study surveyed a convenience sample of nurse leaders in the USA, Germany, Austria and Switzerland. The voluntary, anonymous survey also included qualitative questions and was distributed using the Qualtrics® platform. A thematic analysis of the qualitative data in each country was carried out and a comparative analysis identified similarities and differences between the groups of nurse leaders comparing the US data to that from three German-speaking European countries.

The survey was completed by 316 nurse leaders: Germany, Austria, and Switzerland (n = 225) and the USA (n = 91). Similar themes identified as causing all nurse leaders moral distress included a lack of individual and organizational integrity, hierarchical and interprofessional issues, lack of nursing professionalism, patient care/patient safety concerns, finances negatively impacting care and issues around social justice. Within these six themes, there were also differences between the USA and the three German-speaking European countries.

Understanding the experiences associated with distressing ethical situations can allow nurse leaders and organizations to focus on solutions and develop resilience to reduce moral distress in the USA and three German-speaking European countries.

This study aims to summarize studies that compared the performance of health-care institutions led by leaders with medical background versus those with no medical background.

A systematic search was conducted on three databases: PubMed, Ovid Medline and Google Scholar to identify relevant peer-reviewed studies using the keywords “performance,” “impact,” “physician,” “medical,” “doctor,” “leader,” “healthcare institutions” and “hospital.” Only quantitative studies that compared the performance of health-care institutions led by leaders with medical background versus non-medical background were included. Articles were screened and assessed for eligibility before the relevant data were extracted to summarize, appraise and make a narrative account of the findings.

A total of eight studies were included, four were based in the USA, two in the UK and one from Germany and one from the Arab World. Half of the studies (n = 4) reported overall better health-care institutional performance in terms of hospital quality ranking such as clinical effectiveness and patient safety under leaders with medical background, whereas one study showed poorer performance. The remaining studies reported mixed results among the different performance indicators, especially financial performance.

While medical background leaders may have an edge in clinical competence to manage health-care institutions, it will be beneficial to equip them with essential management skills to optimize leadership competence and enhance organizational performance.

The exclusive inclusion of quantitative empirical studies that compared health-care institutional performance medical and non-medical leaders provides a clearer link between the relationship between health-care institutional performance and the leaders’ background.

This study aims to describe the perceptions of some participants from a community mental health center in the Department of Chocó, Colombia.

A case study with a qualitative approach was carried out in 2023. Focus groups were conducted with mental health leaders and members of a community mental health center. The data were analyzed using a thematic analysis.

Two categories emerged: characterize the Community Mental Health Center of Chocó and Reaffirm human rights. In the first category, the community center is described as a place of recovery that mobilizes social services and works to increase agency capacity. In the second category, the human rights were assumed as part of community services, not only to eliminate coercive practices but also to support the increase of autonomy.

The limitations of this study are the analysis of strategies from the perspective of global politics, without delving into the structure of community actions themselves, which are not necessarily based on global recommendations.

Despite the design and development of public policies the study of their implementation still poses several challenges. The strategies carried out by regions that follow evidence-based practices and participation routes are not officially recognized as good practices in mental health and, therefore, independently supported to be sustained.

A community mental health center is described that manages to be implement and deliver a service despite not being able to be financed by current national regulations. This indicates, apart from a need, the capacity of the regions to build their solutions beyond regulations.

Our aim in this study is to investigate the relative importance of the economic policy uncertainty and of the geopolitical risk on U.S. REITs (Real Estate Investment Trusts) returns with a special focus on the different real estate sectors.

We use an augmented Fama-French (1993)’s asset pricing model, including economic policy uncertainty indices (EPU), introduced by Baker et al. (2016), and geopolitical risk indices (GPR) recently developed by Caldara and Iacoviello (2022), to price the potential risk factors for U.S. Nareit indices returns. To obtain robust economic results, we correct for the problems of errors-in-variables in linear asset pricing models; we advocate the use of higher moments estimators as instruments in a generalized method of moments (GMM) framework.

Our results report that economic policy uncertainty (EPU), and geopolitical risk (GPR) are priced for the different Nareit sectors for the last three decades. The GPR index stands as a relevant risk factor. The coefficient estimates are low compared to Fama-French risk factors. They are higher for Shopping Centers, Retail and Region Malls and lower for Health Care and Lodging/Resorts. EPU indices are also priced and less statistically significant. Health Care sector, followed by Shopping Centers and Retail are the most policy-sensitive sectors.

In their “2023–2024 Top Ten Issues Affecting Real Estate” “political unrest and global economic health” is ranked 1 issue by the Counselors of Real Estate. Our results report that economic policy uncertainty and geopolitical risk are priced for the different Nareit sectors. They suggest implications for investors, insurers, bankers, policymakers and other stakeholders. The geopolitical risk index (GPR) stands as a relevant and significant risk factor for REITs returns.

Based on parsimonious robust asset pricing models, the results shed a new light on the relative importance of geopolitical risk and economic policy uncertainty in the real estate sector, with a special focus on the different U.S. REITs sectors. They suggest possible implications for investors, insurers, bankers, policymakers and other stakeholders in a context marked by higher uncertainty shocks and geopolitical risks.

This chapter pays tribute to Andrew Jones' research in health programme evaluation, health-risky behaviour and income-related health inequalities by reviewing policy-relevant empirical studies in these domains using Italian data. In the first section, We discuss the impact of reimbursement systems on healthcare behaviour, particularly the transition from incurred-cost-based to prospective systems in hospitals. We explore incentive-driven practices like up-coding and cream skimming, while also considering the potential advantages of primary care incentives and the mixed outcomes associated with cost-sharing schemes. The second section delves into health-risk behaviours in Italy, encompassing substance use, preventive healthcare and responses to health information. The last section presents some evidence on socioeconomic status (SES)-related health disparities and discusses the necessity of accounting for these factors in the Italian National Health Service (NHS)'s resource allocation formula in line with British NHS experience.

Although the quality of health-care infrastructure and equipment influences patient’s overall health-care experience, health-care infrastructure and equipment are not always managed and maintained with the attention required. This is due mainly to the complexity of health-care infrastructure and equipment and shortage of maintenance budget. This study aims to determine if patient’s satisfaction of core health-care business is mediated by the quality of health-care infrastructure and equipment.

This cross-sectional study comprises 622 adult patients at the Physician OPD and Polyclinic of Komfo Anokye Teaching hospital, Tamale Teaching hospital and Cape Coast Teaching hospital in Ghana. Structural equation model Smart PLS was used to analyse the data.

The study results showed that the quality of health-care infrastructure and equipment has a positive significant influence (mediation) on the relationship between health-care delivery and patient’s satisfaction as well as the relationship between adequacy of health-care resources and patient’s satisfaction. However, it was shown not to have a positive significant influence (mediation) on the relationship between quality of health-care personnel and patients’ satisfaction as well as health-care administrative process and patient’s satisfaction.

First, the study findings are centred on cross-sectional data, which capture the opinion of the patients at a specific time period instead of over a period of time. Consequently, in future, though difficult to achieve, a longitudinal study can be piloted to provide more insight. Second, the data was collected from only one country (Ghana); thus, the ability to generalise the results may be a challenge.

The implication of this study is that there is the need to prudently maintain hospital infrastructure and equipment in good working condition as it has a positive effect on patients’ satisfaction of their overall health-care experience.

Most studies have concentrated on patient’s health-care experience. This study extends the knowledge of patient’s health-care experience by determining the mediating role of quality of health-care infrastructure and equipment on the relationship between patient’s satisfaction and core health-care business. There are limited studies of such nature in Ghana. Therefore, this study will provide invaluable empirical data for the health-care sector of a developing African country.

The purpose of this study is to delve into the intricate terrain of assimilating sustainability practices into digital accounting and finance, centring on the transformative dynamics introduced by artificial intelligence (AI)-enabled FinTech. The primary objective is to scrutinize critical lacunae in existing literature, exploring how organizations can meticulously construct comprehensive sustainability frameworks. Simultaneously, the study investigates the protracted repercussions of AI-enabled FinTech on the enduring sustainability paradigms.

Executing a systematic literature review, the research engaged in the meticulous identification and assessment of a voluminous pool of 1,158 articles. Using a judicious two-phase strategy, the scrutiny distilled a mere 64 pertinent articles, subjecting them to rigorous evaluation encompassing methodologies, contributions and overall quality. The Fuzzy Delphi method was used to elicit expert opinions and facilitate consensus-building, leveraging fuzzy logic to accommodate uncertainties in the data.

The review navigates the convoluted impact of AI across diverse sectors, accentuating its transformative imprint on realms such as health care, finance and transportation. Specifically, in the financial domain, the discerning eye of AI-enabled FinTech optimizes investment portfolios, augments risk assessment, propels financial inclusion and streamlines the intricate landscape of sustainability reporting. The study meticulously pinpoints research gaps encompassing investment optimization, risk management, financial inclusion, sustainability reporting and ethical considerations within the intricate milieu of AI-enabled FinTech. This research contributes to the existing body of knowledge by synthesizing intricate thematic strands, discerning overarching trends and spotlighting critical voids in the synthesis of sustainability practices and AI-enabled FinTech. The findings resonate with far-reaching implications, emphasizing the exigency of comprehensive investigations into the longitudinal sustainability ramifications instigated by AI-enabled FinTech.

The study underscores the imperative of crafting robust ethical frameworks for the equitable and transparent deployment of AI solutions within the intricate landscape of FinTech. Moreover, this research stands poised to shape organizational strategies, inform regulatory frameworks and guide investment decisions, thereby catalyzing the cultivation of conscientious and sustainable financial practices.

Several disciplines and thousands of studies have used, developed and supported technology adoption theories to guide industry and support innovation. However, within the past decade, a paradigm shift referred to as the fourth industrial revolution (4IR) has resulted in new considerations affecting how models are used to guide emerging technology integration into business strategy. The purpose of this study is to determine which technology adoption model, or models are primarily used when assessing smart technologies in the 4IR construct. It is not to investigate the rigour of existing models or their theoretical underpinnings, as this has been proven.

To achieve this, a systematic literature review based on the preferred reporting items for systematic reviews and meta-analysis methodology is used. From 3,007 publications, 125 papers between 2015 and 2021 were deemed relevant for thematic analysis.

From the literature, five perspectives were extracted. As with other information and communication technology studies, the analysis confirms that the technology acceptance model remains the predominantly used model. However, 105 of the 125 models extended their theoretical underpinnings, indicating a lack of maturity. Furthermore, the countries of study and authors’ expertise are predominantly clustered in the European and Asian regions, despite the study noting expansion into 16 different subject areas, far beyond the smaller manufacturing scope of Industry 4.0.

This study contributes theoretically by providing a baseline to develop a generalisable 4IR model grounded on existing acceptance trends identified. Practically, these insights demonstrate the current trends for strategists and policymakers to understand technology adoption within the 4IR to direct efforts that support innovation development, an increasingly crucial factor for survival in the digital age. Future research can investigate the additional constructs that were impactful while considering the level of research they were applied to.

This paper aims to propose a framework for marketing to the sandwich generation (SG) shopper, an influential and growing demographic in the marketplace.

This paper draws from research in business, sociology, health care and industry sources that have studied the SG. It proposes a marketing framework to create value for SG shoppers and their families, in multiple ways.

SG members seek to meet at least four major kinds of needs across their intergenerational families: financial management, social support, health care and wellness. Businesses can help them more efficiently bridge those needs by including certain enablers in their offerings: human resource benefits to manage health and associated costs, resource allocation tools to manage financial and social support needs across different lifespans, time management tools to integrate social support needs with wellness outcomes and technology/services that help meet health and wellness needs across the family.

Managers can attract SG members and their families to their offerings by keeping in mind three rules of thumb: help them recover their most scarce resource: time; capitalize on age-friendly adjustments in the marketplace; and innovate with universal design in mind.

To the author’s knowledge, this is the first application of existing knowledge on the SG to a marketing framework that addresses key SG customer concerns.

The purpose of this paper that will address in this paper are: how to implement and test a reliable Block-chain-based energy system for the EU energy payments and logistic? What are the main results, impacts and implications of a Block-chain-based energy system for the EU energy payments and logistic?

The main aim of this study is to propose a Block-chain-based method to offer a secure, reliable and transparent method for energy logistic and payments for European Energy Transactions. To accomplish that aim, the research method of the study follows the design science research approach of smart contracts in the EU Energy logistic and payments. This research approach mainly consists of five sequential steps which are (1) problem and motivation identification, (2) solution objectives definition, (3) design and development and (4) demonstration and evaluation.

Results of data model demonstrate that the Block-chain-based energy system here can be used for any EU energy payments and logistics. Based on the data results of the model that mentioned above enhance the security and the integrity of the energy payments and logistic by using cryptographic techniques and consensus mechanisms to prevent and detect any tampering or falsification of the data on the Block-chain.

This paper represents a genuine piece of research that contributes to the field by providing new insights and understanding. The findings presented are the result of rigorous analysis and have not been previously published or submitted elsewhere for consideration.