Search Results (93)

This study synthesizes the rapidly expanding evidence on how digital technologies reshape international trade, with a particular focus on small and medium-sized enterprises (SMEs). Guided by two research questions—(RQ1) How do digital tools influence the volume and composition of cross-border trade? and (RQ2) How do these effects vary by countries’ development level and firm size?—we conducted a PRISMA-compliant systematic literature review covering 2010–2024. Searches across eight major databases yielded 1857 records; after duplicate removal, title/abstract screening, full-text assessment, and Mixed Methods Appraisal Tool (MMAT 2018) quality checks, 86 peer-reviewed English-language studies were retained. Findings reveal three dominant technology clusters: (1) e-commerce platforms and cloud services, (2) IoT-enabled supply chain solutions, and (3) emerging AI analytics. E-commerce and cloud adoption consistently raise export intensity—doubling it for digitally mature SMEs—while AI applications are the fastest-growing research strand, particularly in East Asia and Northern Europe. However, benefits are uneven: firms in low-infrastructure settings face higher fixed digital costs, and cybersecurity and regulatory fragmentation remain pervasive obstacles. By integrating trade economics with development and SME internationalization studies, this review offers the first holistic framework that links national digital infrastructure and policy support to firm-level export performance. It shows that the trade-enhancing effects of digitalization are contingent on robust broadband penetration, affordable cloud access, and harmonized data-governance regimes. Policymakers should, therefore, prioritize inclusive digital-readiness programs, while business leaders should invest in complementary capabilities—data analytics, cyber-risk management, and cross-border e-logistics—to fully capture digital trade gains. This balanced perspective advances theory and practice on building resilient, equitable digital trade ecosystems. Full article

The UI GreenMetric World University Ranking has become a widely adopted instrument for benchmarking institutional sustainability performance; nevertheless, empirically grounded evidence from universities in diverse regional contexts remains scarce. This study undertakes a rigorous appraisal of the extent to which Mahasarakham University (MSU) has institutionalized the United Nations Sustainable Development Goals (SDGs) within its pedagogical offerings, research portfolio, community outreach, and governance arrangements during the 2021–2024 strategic cycle. Employing a mixed-methods design and guided by the 2024 UI GreenMetric Education and Research indicators, this investigation analyzed institutional datasets pertaining to curriculum provision, ring-fenced research funding, 574 peer-reviewed sustainability publications, student-led community initiatives, and supporting governance mechanisms; the analysis was interpreted through a Plan–Do–Check–Act management lens. The number of sustainability-oriented academic programs expanded from 49 to 58. Student participation in community service activities strongly recovered following the COVID-19 pandemic, and MSU’s GreenMetric score increased from 7575 to 8475, thereby elevating the institution to the 100th position globally. These gains were facilitated by strategic SDG-aligned investment, cross-sector collaboration, and the consolidation of international partnerships anchored in Thailand’s Isaan region. The MSU case provides a transferable model for universities—particularly those operating in resource-constrained contexts—endeavoring to align institutional development with the SDGs and internationally recognized quality benchmarks. The findings substantiate the capacity of transformative education and applied research to engender enduring societal and environmental benefits. Full article

Background: Although improving the patient experience with care is being framed as part of value-based care, the economic and provider well-being impact of interventions for improving the patient experience has not been established. We aimed to synthesize the contemporary (2015–2024) empirical literature on the economic (e.g., costs, revenue) and other value-based impacts (e.g., provider well-being) of patient-experience improvement interventions. Methods: Systematic review using six databases of scientific literature (PubMed, EconLit, CINAHL, PsycINFO, DOAJ, and Scopus) supplemented by journal-specific and snowball searches following a registered study protocol (PROSPERO: CRD42022358337). Two independent reviewers performed eligibility decisions and quality appraisals of the study methods and economic assessments, when applicable; the latter was conducted using the Joanna Briggs Institute’s checklist for economic evaluations. Results: Out of 1317 unique references, nine were included. Four studies assessed the effectiveness of patient experience improvement interventions (e.g., provider communication training, discharge or transitional support) coupled with economic evaluations; these found statistically significant positive outcomes for both patient experience and economic dimensions—including reduced costs, improved revenue, or additional costs offset by increased revenue. Three additional studies on provider communication training also found statistically significant positive impacts on provider well-being (i.e., reduced burnout) and patient experience improvements. Conclusion: These findings shed light on the overall synergistic value of and business case for investments into developing patient experience improvement programs or activities. However, there is room for strengthening this body of knowledge in scope, volume, and method quality, including the need to study the impact on patient experience, provider well-being, health outcomes, and costs (i.e., the quadruple aim) in tandem. Full article

The real estate sector is increasingly recognizing facility management (FM) as a key driver of asset value. Among emerging technologies, Building Information Modeling (BIM) and Building Management Systems (BMSs) stand out for their potential to enhance FM efficiency by integrating design data with building operations across the entire lifecycle, from construction to maintenance, performance monitoring, and renovation. While their technical applications have been widely studied, the financial impact of these tools on FM remains underexplored. This paper addresses that gap by estimating the economic value generated by implementing BIM and BMS in real estate facility management. Based on thirteen semi-structured interviews with professionals from the Italian real estate sector, we identified and quantified cost-saving factors and challenges related to digital adoption. These cost efficiencies, when recurring and quantifiable, can improve net operating income (NOI), thereby supporting higher asset valuations under income-based real estate appraisal methods. The results show that integrating BIM and BMS in facility management may generate average annual cost savings of 5.81% relative to asset value, with coordination improvements alone accounting for up to 3.28% per year. Based on a 30-year simulation, these savings correspond to a positive Net Present Value (NPV), supporting the financial viability of digital FM adoption in real estate. This study offers empirical evidence to support investment decisions in digital FM technologies and contributes to bridging the gap between innovation and financial evaluation in the real estate sector. Full article

Capital budgeting, particularly sophisticated decisions, is key to the financial performance and risk management of firms, yet academic studies have documented their relationship inconsistently. This study employs the fundamentals of resource-based view (RBV) and agency theories to investigate the impact of sophisticated capital budgeting decisions on financial performance and risk management of the firms of two different sizes, classified as small and medium enterprises (SMEs) and multinational corporations (MNCs). The empirical data of 590 Indonesian firms from between 2014 and 2023 were obtained and analyzed through the Generalized Method of Moments (GMM) technique. The results show that the usage of sophisticated capital budgeting decisions in investment appraisals of classified firms significantly improves their financial performance. Further analyses confirm that although sophisticated capital budgeting decisions are robust in resolving solvency issues, they appear less effective in reducing liquidity risks. The findings also elucidate that sampled firms may realize the financial benefits of sophisticated risk management. The mediation results highlighted that risk management has a significant and positive effect on the relationship between sophisticated capital budgeting decisions and financial performance. The present study contributes to corporate finance by validating the relevance of SCBDs in strategic financial planning and stable investments in firms of different sizes. Full article

Background: Heat stress in agricultural work is a significant health risk, especially due to dehydration as a result of exposure to heat, physical exertion, and inadequate hydration practices. This problem becomes even more critical when working outdoors, where extreme conditions can intensify the effects. Objective: The main objective of the present study was to determine the existing interventions to prevent or mitigate dehydration among agricultural workers exposed to heat stress during their workday outdoors, in both real and simulated contexts. Methods: A systematic review was performed in accordance to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search strategy combined MeSH terms and an open search in six scientific databases. Relevant studies were selected and data from the interventions were extracted, following the guidelines from the Joanna Briggs Institute (JBI) for systematic reviews. The studies were assessed with the Mixed Methods Appraisal Tool (MMAT) and the GRADE assessment framework. Results: Nine studies were included, which focused on interventions such as education programs, cooling devices, and hydration strategies. The results showed that adequate access to water, rest in the shade, the use of cooling bandanas, and hydration backpacks, were effective in reducing dehydration and heat stress among agricultural workers exposed to high temperatures. Conclusions: An integrated approach combining education, hydration, and workplace improvements is essential to prevent dehydration and heat stress among agricultural workers. While body cooling is promising, further research and investments in infrastructure are needed to ensure access to safe drinking water, shaded rest areas, cooling technologies, educational initiatives, and health monitoring systems. Full article

Background/Objectives: Telemedicine has emerged as a transformative solution to healthcare access challenges in Sub-Saharan Africa, where many populations remain underserved. This systematic review focuses on the adoption, implementation, and technological prospects of telemedicine in South Africa, Kenya, and Nigeria, three countries leading the region in healthcare innovations. Methods: A systematic search of PubMed, Scopus, and Web of Science, guided by PRISMA protocols, identified 567 studies published between 2014 and 2024, of which 53 met the inclusion criteria with a focus on telemedicine adoption, implementation, and technological prospects in the selected countries. A structured critical appraisal was used to assess potential biases in the included studies’ design, selection criteria, and reporting, while findings were thematically analysed to provide actionable and comparative insights. Results: The findings reveal that South Africa has the highest adoption rate, focusing on specialist teleconsultations, chronic disease management, and mental health services. Kenya demonstrates strong mHealth integration and advanced mobile applications, particularly in maternal health, HIV care, and sexual and reproductive health. While facing infrastructural and regulatory constraints, Nigeria is advancing innovations for remote diagnosis and teleconsultation. Conclusions: By synthesising evidence from peer-reviewed literature, the review identifies adoption trends, enabling factors, and opportunities for scaling telemedicine in these contexts. Despite these advancements, challenges persist, including regulatory gaps, digital literacy limitations, and infrastructure constraints. Addressing these barriers requires targeted investments in broadband expansion, policy harmonisation, and healthcare workforce training to optimise telemedicine’s impact and ensure its sustainability as a healthcare delivery model in Sub-Saharan Africa. Full article

Introduction: Nursing faces numerous challenges amidst broader socio-political transitions in many countries. Despite efforts to establish formal nursing education and legislative frameworks, the profession’s status remains relatively low within some healthcare systems. This study aims to examine the factors influencing nursing professionalism and provide insights into strategies for its enhancement. Aim: The study seeks to summarize the existing literature on nursing professionalism, assess methodological quality, and derive recommendations for future research. Through a systematic review, the study explores various factors shaping nursing professionalism, including communication skills, resilience, education, and cultural perceptions. Methods: A systematic search was conducted across multiple electronic databases from 2014 to 2024 to identify relevant studies on nursing professionalism. The search strategy encompassed elements of professionalism, nursing, and exclusion criteria. Selected studies underwent methodological quality assessment using the Critical Appraisal Skills Programme Qualitative Checklist. Results: The review identified 421 records, yielding 72 eligible studies after screening and eliminating duplicates. Fourteen studies met the inclusion criteria, revealing a complex framework of factors influencing nursing professionalism. The key determinants include communication skills, resilience, education, and cultural perceptions. Studies emphasized the importance of effective communication, resilience in crisis management, quality education, and understanding psychological and cultural influences on professionalism. Conclusions: Nursing professionalism is influenced by multifaceted factors, including communication skills, resilience, education, and cultural perceptions. Recognizing these factors is vital for promoting high-quality nursing practice and ensuring patient safety. Addressing these elements can inform targeted interventions to enhance nursing professionalism and support nurses in delivering optimal healthcare. This study underscores the importance of investing in nursing education, fostering resilience, and considering cultural nuances to cultivate a culture of excellence and professionalism within healthcare systems. Full article

Forward-looking metrics of uncertainty based on options-implied information should be highly predictive of equity market returns in accordance with asset pricing theory. Empirically, however, the ability of the VIX, for example, to predict returns is statistically weak. In contrast to other studies that typically analyze a short time-series of option prices, I make use of a ‘VIX-type’ but a text-based measure of uncertainty starting in 1890, which is constructed using the titles and abstracts of front-page articles of the Wall Street Journal. I hypothesize that uncertainty timing might increase Sharpe ratios because changes in uncertainty are not necessarily correlated with changes in equity risk and, therefore, not offset by proportional changes in expected returns. Using a major US equity portfolio, I propose a dynamic trading strategy and show that lagged news-based uncertainty explains future excess returns on the market portfolio at the short horizon. While policy- and war-related concerns mainly drive these predictability results, stock market-related news has no predictive power. A managed equity portfolio that takes more risk when news-based uncertainty is high generates an annualized equity risk-adjusted alpha of 5.33% with an appraisal ratio of 0.46. Managing news-based uncertainty contrasts with conventional investment knowledge because the strategy takes relatively less risks in recessions, which rules out typical risk-based explanations. Interestingly, I find that the uncertainty around governmental policy is lower and, by taking less risk, it performs better during periods when the Republicans control the senate. I conclude that my text-based measure is a plausible proxy for investor policy uncertainty and performs better in terms of predictability compared to other options-based measures. Full article

Background/Objectives: The use of scientific evidence for the diagnosis and treatment of mental disorders is crucial for achieving optimal clinical outcomes and providing high-quality care. This study investigates the knowledge, sources of evidence, and attitudes of Brazilian clinical psychologists regarding evidence-based practice in psychology (EBPP) and discusses barriers to its implementation. Methods: A total of 696 Brazilian clinical psychologists participated in an online questionnaire designed to assess their understanding of EBPP, their familiarity with scientific platforms/databases, and their professional development investments. Latent class analysis (LCA) was conducted, which can be used to identify subgroups of psychologists with similar patterns of professional and training characteristics. Results: The results indicate that while psychologists recognized the importance of EBPP for effective patient care, there was a significant gap in understanding its fundamental principles and concepts. Many participants reported the limited use of scientific databases, missing opportunities to access the latest research advancements. A lower percentage of psychologists consistently implemented EBPP in their clinical practice, highlighting a gap between knowledge and application. Four latent classes emerged from the LCA: I—experienced/established professional psychologist; II—academic psychologist; III—supervised traditional psychologist; and IV—young professional psychologist. Conclusions: This study emphasizes the need for better integration of EBPP into psychology curricula and continuing education programs. Enhancing clinical psychologists’ understanding and proficiency in EBPP can promote evidence-based decision-making and improve the quality of mental health care in Brazil. Efforts should be made to familiarize psychologists with reliable scientific databases, equip them with skills to critically appraise research, and foster a culture of lifelong learning and professional development. Additionally, it is essential to develop strategies tailored to the distinct profiles of professionals identified in this study, considering their training sources, reference usage, and knowledge of EBPP. Full article

The paper contains five parts—a theory about entrepreneurial choice under uncertainty, a formal econometric structure for a test, the test, an appraisal of the test, and a description of the data generating process. Here, an entrepreneur is an individual who manages a firm that produces one commodity with labor, an intermediate good, and capital. He pays dividends to shareholders, invests in bonds and capital, and has an n-period planning horizon. Conditioned on the values of current-period prices, the entrepreneur aims to maximize the expected value of a utility function that varies with the dividends he pays each period and with his firm’s balance sheet variables at the end of the planning horizon. The test comprises a family of trials of theorems that I derive from the axioms of the theory part of the formal econometric structure. In the test, the theorems are appraised for their empirical relevance in an empirical context, where each one of a random sample of four hundred entrepreneurs has chosen the first-period part of his optimal n-period expenditure plan. My formal econometric arguments demonstrate that the theorems pass all the trials. At the end, I show that my formal econometric results imply that the theory is empirically relevant. Full article

Innovation is a key driver of high-quality economic development. Building strong relationships between central and local financial authorities, with a clear division of powers and responsibilities and well-coordinated fiscal resources, is both practical and significant. Such collaboration enhances the government’s ability to support scientific and technological innovation, leading to improved outcomes. In this study, multiple mechanisms of fiscal decentralization and government innovation investment in regional innovation were explored based on Chinese-style fiscal decentralization, the theory of fiscal decentralization, and the innovation system. Provincial panel data from 2008 to 2021 were used to examine both the direct effect of fiscal decentralization and the mediating effect of government innovation investment on regional innovation. The results show that fiscal decentralization distorts the government’s fiscal expenditure behavior, significantly inhibiting regional innovation enhancement. The results of a mechanism analysis demonstrate that fiscal decentralization weakens the government’s support and guidance for scientific and technological innovation, but increasing innovation investment can offset this effect and enhance the regional innovation level. Overall, fiscal decentralization negatively affects regional innovation by inhibiting the government’s innovation investment. To address these challenges, the fiscal system requires deeper reform, adjusting the relationship between central and local governments. Additional measures should include improving the government’s performance appraisal system, guiding local authorities to adopt appropriate performance perspectives, increasing fiscal expenditure and the government’s role in scientific and technological innovation, and enhancing independent scientific and technological innovation. Full article

The possibility of carrying out the cultivation of numerous plant species in vertical farming highlights the need for policy makers to determine the cadastral value of the buildings in which these production activities are carried out. In this regard, estimates of buildings intended to host vertical farming are illustrated according to the procedure established by Italian cadastral legislation, which establishes that the fiscal value of buildings intended for vertical farming must be estimated through their market value. Appraisals is carried out using the direct capitalization method but follow two different approaches. One approach is based on the expertise of the appraiser, who acts by making assessments through subjective and arbitrary choices. The other approach is based on the use of best practices, as indicated by international evaluation standards that follow appropriate methodologies. Our comparison between the two approaches focuses on determining the capitalization rate, which determines the estimated value. The market value estimated using the procedures recognized by the valuation standards appears to be more valid methodologically and more reliable. This is demonstrated by applying yield capitalization to the same income cash flow in both formulations. Additionally, through the identification of the conversion cash flow, useful details on financial flow can be obtained and used to determine the value. The obtained results may be useful for public operators for the purposes of determining the value of assets for tax purposes. More generally, they are also useful from a methodological and application point of view in real estate valuation and support the development of tools for making efficient investment choices. Full article

Investigating the experience and improvement measures for China’s distinctive land supply participation in macro-control processes holds significance for full utilization of land policy. However, the spatial heterogeneity and its theoretical and comprehensive analysis of drivers are still poorly revealed. This paper uses spatial analysis methods and micro-scale big data on land transactions to depict the spatiotemporal heterogeneity of land supply, and analyses its driving mechanisms via an endogenous–exogenous factor framework and regression models. Land supply experienced fluctuating “growth–decline–growth” trends in 2001–2021, spatially showed a large cluster in the east, a small cluster in the center and scattering in the west, with the gravity center relocating southwest, and formed a multi-core, hierarchical, circular structure of high density in core cities, density in peripheral cities and sparseness in districts. Endogenously, total land resources and road accessibility facilitated land supply, while topographic relief and urban proximity showed inhibitory effects; land supply positively correlated with land finance dependence, officials’ appraisal pressure, local government competition and officials’ corruption but negatively related with fiscal tax revenues and fiscal transparency; construction land indicators directly determined land supply, while the intensity of use control restricted the conversion of arable land and weakened land supply. Exogenously, urbanization, industrialization, capital investment, technological innovation and marketization level promoted land supply, while the substitution of human capital reduced the demand for land; economic fluctuations showed non-significant relationships with land supply. Differentiated impacts of multiple factors on land supply pattern are emphasized and should be integrated into formulating land policy and optimizing land allocation. Full article

Assessing project profitability using Net Present Value (NPV), Internal Rate of Return (IRR), and Modified Internal Rate of Return (MIRR) is a common practice. However, these metrics often overlook key differences between new and existing projects, leading to potential data uncertainty and the failure to capture the complex interrelationships among influencing factors. This paper introduces data envelopment analysis (DEA) as a supplementary tool to identify the most efficient year within a project’s lifecycle, optimize inputs and outputs, and evaluate the factors most impacting the efficiency of decision-making units (DMUs). By optimizing these values, the paper reexamines NPV, IRR, and MIRR to allow for a comparison with the original assessment. If profitability improves, the project becomes more attractive, with the modified inputs and outputs serving as the new benchmark. A case study of a non-viable road project demonstrates this approach. While NPV, IRR, and MIRR showed improvement, the project remained unappealing under optimal conditions. Additionally, a simulated dataset, based on case study parameters, revealed enhanced profitability and new project viability when analyzed. With revised input and output values, the project’s appeal and viability were significantly improved. Full article