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This study aims to investigate the notion of secondary vulnerability among transformative service providers, particularly frontline healthcare professionals (HCP), during the provision of end-of-life care. It seeks to understand how stressors and coping mechanisms influence vulnerability and subsequently impact service outcomes for patients and frontline employees.

The research framework, based on the Transactional Model of Stress and Coping, was used to explore secondary vulnerability among frontline healthcare providers. A qualitative, interpretive approach was employed involving semi-structured interviews for data collection. The interview transcripts were analysed using a two-stage process, starting with inductive analysis and followed by deductive analysis.

Secondary vulnerability is conceptualized along with its implications, shedding light on the role of stress and coping mechanisms in responding to vulnerable situations. It identifies the interplay between situational and personal factors that influence service outcomes for both HCPs and patients.

By recognizing stressors and coping strategies, organizations can implement support programs to enhance HCP well-being and improve care quality for patients experiencing vulnerability. Training programs can equip HCPs with effective coping mechanisms to mitigate the impact of secondary vulnerability on service outcomes.

This research contributes to the literature by addressing a gap in understanding regarding secondary vulnerability among transformative service providers. By integrating theories from various fields, including consumer vulnerability, transformative service mediation, healthcare services, and stress and coping mechanisms, it offers a novel perspective on the dynamics of vulnerability in end-of-life care in a healthcare setting.

Integrated care (IC) improves patient outcomes, patient and provider experiences and healthcare costs. Still, education and interprofessional experiential training in IC is limited. There is a lack of studies examining current practices, perceptions and barriers to implementing IC training. Specifically, no studies to date assess training and practice across multiple health professions and roles (student/faculty/clinicians) within an academic medical institution or university, a gap this study sought to address.

This cross-sectional study examined current clinical and training practices, attitudes about IC and barriers to IC practice, learning and training through a survey distributed to faculty, clinicians and students (n = 220) in nine departments of health professions within a large academic health system.

The majority of respondents reported that activities promoting IC occur often, including consultation with other professions in patient care settings, incorporation of IC concepts into teachings and interprofessional learning opportunities. Respondents endorsed willingness to practice IC, high perceived benefits of IC on patient outcomes and cultural benefits of IC. The most strongly endorsed barriers were related to resources and organizational culture. Knowledge barriers were not strongly endorsed.

In the most comprehensive study of attitudes toward IC to date, clinicians, students and faculty alike endorsed favorable attitudes about IC, supporting the acceptability of incorporating IC education and training into curricula. IC is seen as enhancing experiences, competence and professional marketability of providers-in-training, indicating it is a desired focus of future practice for many healthcare providers.

This study aims to identify the determinants of housing affordability in an effort to inform policy.

The authors use econometric analysis to determine variables that impact housing affordability in the USA.

The authors find that affordability depends on a number of demographic factors as well as physical characteristics of properties, including average age of homeowner, family size and average dwelling square footage. The authors also find that vacancy rates, increase in house price and median family income also have a significant impact on housing affordability. Additionally, the authors find that households with high-cost burdens are more vulnerable to mortgage rates and property taxes than those with moderate-cost burdens. As a result, changes in economic or policy variables tend to have a disproportionate impact on high-cost-burdened households, and they are more vulnerable to economic and policy shocks.

To date, the literature has not done a systematic investigation of housing affordability using detailed census data.