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1 – 10 of 60Steven Wyatt, Robin Miller, Peter Spilsbury and Mohammed Amin Mohammed
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…
Abstract
Purpose
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.
Design/methodology/approach
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.
Findings
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.
Research limitations/implications
PCTs were abolished in 2011 and replaced by clinical commissioning groups in 2013, but the functions remain.
Practical implications
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.
Originality/value
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.
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Robin Miller, Catherine Weir and Steve Gulati
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.
Abstract
Purpose
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.
Design/methodology/approach
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.
Findings
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.
Practical implications
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.
Originality/value
This paper combines research evidence and international practice experience to guide future programmes to transform primary care.
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Alfred Austin Farrell, James Ashton, Witness Mapanga, Maureen Joffe, Nombulelo Chitha, Mags Beksinska, Wezile Chitha, Ashraf Coovadia, Clare L. Cutland, Robin L. Drennan, Kathleen Kahn, Lizette L. Koekemoer, Lisa K. Micklesfield, Jacqui Miot, Julian Naidoo, Maria Papathanasopoulos, Warrick Sive, Jenni Smit, Stephen M. Tollman, Martin G. Veller, Lisa J. Ware, Jeffrey Wing and Shane A. Norris
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…
Abstract
Purpose
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.
Design/methodology/approach
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.
Findings
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.
Research limitations/implications
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.
Practical implications
Skills-deficient LMIC universities should extensively and directly support their entrepreneurial academics to overcome their contextual deficiencies and challenging environment.
Originality/value
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.
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Robin Ayers Frkal and Michael S. Lewis
This study explores the work practices of managers who increased working from home during the pandemic to determine what, if any, impact there was on the conditions for vertical…
Abstract
Purpose
This study explores the work practices of managers who increased working from home during the pandemic to determine what, if any, impact there was on the conditions for vertical leadership development.
Design/methodology/approach
The project utilized a survey approach. Each of the participants completed an anonymous online questionnaire using Google Forms. The questionnaire included four sections. The first section included informed consent and required participants to agree before completing the questionnaire. Participants provided general demographic information in the second section, including gender, age, race, job title, company size, average project team size and industry. The third section asked if there had been any change in their work location following the pandemic. The last section asked participants about their work practices.
Findings
This study demonstrates that managers continued to be engaged in vertical leadership development activities while working from home. It also suggests that managers faced challenges working from home following the COVID-19 pandemic, which were prime vertical leadership development opportunities.
Originality/value
To capitalize on these opportunities, organizations can more intentionally support the development of their remote staff.
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Omran Alomran, Robin Qiu and Hui Yang
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…
Abstract
Purpose
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.
Design/methodology/approach
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.
Findings
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.
Originality/value
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.
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Amer Jazairy, Timo Pohjosenperä, Jaakko Sassali, Jari Juga and Robin von Haartman
This research examines what motivates professional truck drivers to engage in eco-driving by linking their self-reports with objective driving scores.
Abstract
Purpose
This research examines what motivates professional truck drivers to engage in eco-driving by linking their self-reports with objective driving scores.
Design/methodology/approach
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.
Findings
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.
Research limitations/implications
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.
Practical implications
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.
Originality/value
This is one of the first studies to give a voice to professional truck drivers about their daily eco-driving practice.
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Amer Jazairy, Robin von Haartman and Maria Björklund
The green logistics literature remains undecided on how collaboration between shippers (i.e. logistics buyers) and logistics service providers (LSPs) may facilitate green…
Abstract
Purpose
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.
Design/methodology/approach
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.
Findings
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.
Research limitations/implications
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.
Practical implications
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.
Originality/value
This is one of the first large-scale studies to systematically reveal in what way collaboration can facilitate the different types of GLPs.
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Prateek Kalia, Robin Kaushal, Meenu Singla and Jai Parkash
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…
Abstract
Purpose
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.
Design/methodology/approach
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.
Findings
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.
Originality/value
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.
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The purpose of this paper is to provide leadership studies educators with a resource to examine the work of a leader who displays characteristics of servant leadership. The lesson…
Abstract
The purpose of this paper is to provide leadership studies educators with a resource to examine the work of a leader who displays characteristics of servant leadership. The lesson allows students to study a modern servant leader by examining their work on a specific issue and how their efforts resulted in significant change in an area of human rights. Using a YouTube video for this lesson makes this a teaching tool that can be implemented in face-to-face class meetings or online learning environments.