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The aim of this paper is to enhance the effectiveness of pharmacovigilance programs that provide information about medical products to benefit consumers, aid health care professional’s decision-making and improve community health. This research sought to determine whether distinct segments of consumers can be identified for prescription drug safety social marketing and communication activities and if these segments would respond differently to information about prescription drug products.

Theories of risk information-seeking behavior were used to develop questions for respondents in an online survey panel. Latent class analyses identified clusters that were similar in their ability to accurately interpret risks and benefits, preferred sources of health information, medication use and other related factors. Multinomial logistic regression models identified demographic and psychographic differences across the segments. Logistic and linear regression models were then used to compare each segment’s responses to a specific drug safety information product.

The 1,244 respondents were clustered into four segments: not engaged (12 per cent), low-involvement users (29 per cent), careful users (50 per cent) and social information seekers (9 per cent). These segments were distinguished by perceived seeking control, self-appraisal of skill, information insufficiency, self-efficacy, information competency and health literacy. Sources of health information and health-seeking behaviors were also different across the four segments. Significant differences were found among the segments in their comprehension and perceived utility of the content and their intentions to take relevant actions.

From an array of potential behavioral influences, adults can be segmented by risk information-seeking constructs and related behaviors. These segments respond differently to drug safety information. Use of the personas developed in this work can help pharmacovigilance programs around the world develop more relevant and tailored social marketing products, services and content.

A social marketing approach using empirically tested theoretical constructs can be useful for drug safety or pharmacovigilance programs. The results were used to create personas that quickly convey relevant information to drug safety program managers and staff.

Higher education (HE) systems in Europe have been identified as an essential element for promoting economic competitiveness since the Bologna Declaration in 1999. The aim of the Bologna Process was to expand access to educational opportunities, fostering participation in post-compulsory education by creating the European Higher Education Area (EHEA). Inequalities in training because of geographic, ethnic or social origin, and inequalities in job opportunities, salaries, and incomes are critical dimensions of social development in HE. The development of policies, including those concerning education, that extend access to opportunities is essential to prevent such exclusion becoming permanent. The Access4All project aims to promote the educational and social inclusion of underrepresented groups as well as of non-traditional learners.

In this chapter, the project’s main results are reviewed, with: (1) a brief overview of inclusion policies and practices in European HE; (2) an operational definition of “good practice” and criteria for selecting examples of good practice for inclusion in HE; (3) a self-assessment tool enabling the characterization of institutional capacity for innovation and of inclusion policies and practices; and (4) a model for promoting strategic planning, focusing on inclusion in HE.

Reciprocal abuse inside care practices remain under-studied due to their invisibility and further research is required. The purpose of this paper is to explore different levels of conflicts inside organisations.

The paper is based on a self-administered questionnaire filled out by care workers (n = 150), in 16 Portuguese care homes.

Results indicated that, overall, 54.7% of care workers had observed abuse, in their daily practice, in the preceding 12 months: 48.7% psychological; 36.0% neglectful care practices; 14.0% physical and 3.3% financial abuse. The figures decreased significantly as regards abuse committed themselves, with 16.7% of those admitting to having committed at least one of these behaviours. The highest figures were also recorded for psychological abuse (13.3%) and neglect (6.7%). However, there is a statistically significant relationship between abuse committed by care workers and abuse committed by residents. Overall, 52.0% of care workers reported having been the target of at least one such behaviour by residents.

This paper has its limitations as the sample consisted of only 16 nursing homes (12 not-for-profit and 4 for-profit nursing homes). The fact that only 4 of the 16 LTC homes were for-profit is a potential limitation both in general and in particular because research has shown that lower quality of care and elder abuse and neglect are more common in for-profit nursing homes at least in Portugal. The results were also based on self-reported measures.

A reactive behaviour, the risk of retaliation, after a complaint, the difficulty in dealing with dementia and the residents' aggressive behaviour, an absence of a training and support policy in an environment where difficult working conditions prevail, are factors enhancing a reciprocal process of abuse. The analysis followed by a discussion of potential implications to prevent institutional elder abuse and neglect, based on communication and social recognition, including better working conditions and training, and a cooperative work environment.

Conflict is much more than reducing an interpersonal relationship problem between residents and staff (care workers, professional staff, managers) and extending to the whole organisation. Therefore, there are still uncertainties on how organisations, staff and residents interact between themselves, and affect care practises.

Reciprocal abuse in nursing homes is an important area of research and this paper enabled a discussion of potential implications concerning the quality of care, which required the identification of levels of conflict, in an organisational system, including interactions, the context where care is provided, difficult working conditions, lack of training and levels of support. All these factors are important when considering elder abuse and neglect and this calls for special attention by policymakers and researchers.

This study aims to propose a method for measuring lean supply chain management (LSCM) maturity based on the main lean practices and existing waste of a supply chain.

A three-stage approach was developed. First, a thorough literature review was performed to raise concepts and previous findings on maturity models (MMs) and LSCM. This review’s outcomes were then validated by experts in the field using the fuzzy Delphi method (FDM). Subsequently, the proposed model was illustrated and assessed based on a multi-case study.

All companies attained high outcomes in the elimination of the waste pillar. The pillars of logistics management, continuous improvement and information technology management also stood out in the three organizations’ results. The company with the lowest maturity level operates in a make-to-order production policy, which may harm the lean supply in its supply chain.

The proposed model can reveal external opportunities and threats and internal strengths and weaknesses in supply chains (SCs). It is also capable of providing a clear roadmap for SC improvement in companies.

To the best of the authors’ knowledge, no study to date has proposed a MM in the LSCM context using FDM and considering the crucial relationship between lean practices and wastes.

The purpose of this paper is to analyse how Lean office planning and implementation take place in a Brazilian regulatory agency and to investigate the adjustments needed for its implementation.

A longitudinal case study was conducted. Interview was the main source of evidence. Between September and October 2012, data about the planning phase were collected; between April and May 2015, Lean office implementation was investigated. Altogether, five employees of the agency were interviewed.

The agency assumed its mission as value for the user, establishing control process, evaluating and improving processes to achieve perfection and recognising its weakness in a continuous improvement culture. Planning and implementation of Lean office in the regulatory agency followed the main recommendations in the literature. However, adjustments were necessary in accordance with the particularities of the public institution.

Owing to the nature of this study, no generalisation was possible. Moreover, interviews with managers were about both Lean planning, which has taken place in the past, and Lean implementing, which is still running; thus, some information may be abstruse.

It was possible to list the main adjustments needed for planning and implementing the Lean office in the public agency and some are applicable for other public administration bodies.

Lean office studies are mainly related to private organizations, but this paper demonstrates that their fundamentals are preserved in public service, and thus it proved that Lean thinking may be applied to the public administration. It also raised a series of questions for future studies.

Since the development of the COVID-19 vaccinations, questions surrounding race have been prominent in the literature on vaccine uptake. Early in the vaccine rollout, public health officials were concerned with the relatively lower rates of uptake among certain racial/ethnic minority groups. We suggest that this may also be patterned by racial/ethnic residential segregation, which previous work has demonstrated to be an important factor for both health and access to health care.

In this study, we examine county-level vaccination rates, racial/ethnic composition, and residential segregation across the U.S. We compile data from several sources, including the American Community Survey (ACS) and Centers for Disease Control (CDC) measured at the county level.

We find that just looking at the associations between racial/ethnic composition and vaccination rates, both percent Black and percent White are significant and negative, meaning that higher percentages of these groups in a county are associated with lower vaccination rates, whereas the opposite is the case for percent Latino. When we factor in segregation, as measured by the index of dissimilarity, the patterns change somewhat. Dissimilarity itself was not significant in the models across all groups, but when interacted with race/ethnic composition, it moderates the association. For both percent Black and percent White, the interaction with the Black-White dissimilarity index is significant and negative, meaning that it deepens the negative association between composition and the vaccination rate.

The analysis is only limited to county-level measures of racial/ethnic composition and vaccination rates, so we are unable to see at the individual-level who is getting vaccinated.

We find that segregation moderates the association between racial/ethnic composition and vaccination rates, suggesting that local race relations in a county helps contextualize the compositional effects of race/ethnicity.

The chapter introduces the reader to select language of human sexuality and the definitions and characteristics of some key terms related to lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ+), identifies different theoretical perspectives of human sexuality and sexual orientation, and discusses select LGBTQ+ theories and concepts in a historical context that library and information science (LIS) professionals should consider while performing their roles related to information creation–organization–management–dissemination–research processes. It helps better understand the scope of what is LGBTQ+ information and traces its interdisciplinary connections to reflect on its place within the LIS professions. The chapter discusses these implications with the expectation of the LIS professional to take concrete actions in changing the conditions that lack fairness, equality/equity, justice, and/or human rights for LGBTQ+ people via the use of information. Important considerations in this regard include the need for an integrative interdisciplinary LGBTQ+ information model, growth of a diversified LGBTQ+ knowledge base and experiences, holistic LGBTQ+ information representations, LGBTQ+ activism, and participatory engagement and inclusion of LGBTQ+ users.

Primary mental health workers have been based in West Lothian schools since 2003 to act as links between the community and hospital‐based services. The research programme this paper describes aimed to examine how this model worked and its impact for children and their families.

This paper reports on interviews with secondary school staff, the link workers and comparative post‐holders. The research study was qualitative and the research question was “What is the perceived impact of Mental Health Link Workers in West Lothian schools?”.

The paper finds that Primary mental health workers felt that their main contribution was building capacity in the community to support children with mental health problems, and identified four strands to this: space, relationships, skills and containment. Two described direct access for children and their families as the main gain. Secondary school staff considered that the greatest impact was for children at the onset of mental illness, and their own knowledge and skills.

Primary mental health work in the community is fairly new in Scotland. This study suggested that it speeded up and improved access to services for children in need of mental health assessments and services. It was based on temporary contracts and short‐term funding. Sustainability within schools may only take place when the work becomes well resourced.

The paper is a detailed look at the views of Primary Mental Health Workers based in schools and school staff.

In the OECD countries, hospitals face increased financial restrictions and competition. Process orientation is an essential means of remaining competitive. A wide range of theories and concepts relating to clinical process management already exists. When it comes to practical implementation, however, a comprehensive approach for the target‐oriented and consistent introduction of clinical process management throughout an entire hospital is missing. The purpose of this paper is to document the case of a German hospital that has realised a project of this kind and demonstrate the impacts on cooperation and on operational efficiency, which is understood as the degree to which a hospital is capable of steadily realising short lengths of stay.

The case shows the approach to implementing theories and concepts for managing clinical processes in practice as a consistent management system in the day‐to‐day use of process management and its impacts.

The effect of using clinical processes shown in the case is an additional net profit of several million euros a year – without a reduction in quality.

While the impacts of clinical pathways on hospitals are not country‐specific, the reasons are nonetheless subject to the political and economic conditions. Therefore, some findings are only valid for hospitals in German‐speaking countries. However, major effects (e.g. reduction in the length of stay) may exist everywhere.

The paper shows how process orientation in a medium‐sized hospital can be systematically implemented.