Search Results (939)

Background: The emergence of artificial intelligence (AI) has triggered a global transformation, with the healthcare sector experiencing significant disruption and innovation. In current public health practice, AI is being deployed to power various aspects of public functions, including the assessment and monitoring of health, surveillance and disease control, health promotion and education, policy development and planning, health protection and regulation, prevention services, workforce development, community engagement and partnerships, emergency preparedness and response, and evaluation and research. Nevertheless, its use in leadership and management, such as in change management, process development and integration, problem solving, and decision-making, is still evolving. Aim: This study proposes the adoption of the Public Health AI Framework to ensure that inclusive data are used in AI development, the right policies are deployed, and appropriate partnerships are developed, with human-relevant resources trained to maximize AI potential. Implications: AI holds immense potential to reshape public health by enabling personalized interventions, democratizing access to actionable data, supporting rapid and effective crisis response, advancing equity in health outcomes, promoting ethical and participatory public health practices, and strengthening environmental health and climate resilience. Achieving this goal will require a deliberate and proactive leadership vision, where public health leaders move beyond passive adoption to collaborate with AI specialists to co-create, co-design, co-develop, and co-deploy tools and resources tailored to the unique needs of public health practice. Call to action: Public health professionals can co-innovate in shaping AI evolution to ensure equitable, ethical, and value-based public health. Full article

The digitalisation of education has introduced new possibilities for inclusive teaching practices, particularly in supporting students with special educational needs (SEN). While digital tools have demonstrated potential to enhance learning outcomes and engagement for these students, the role of school leadership in fostering teachers’ digital competence remains underexplored. The aim of the study is to investigate the association between school leadership, as rated by teachers, and teachers’ self-reported digital competence in supporting students with SEN. To this end, cross-sectional data from 285 Swedish teachers enrolled in special education training programmes have been used. The data were collected through the SELFIE survey, a European Commission tool designed to assess schools’ digital capacity. A stepwise linear regression analysis was conducted to examine the association between perceived school leadership and teachers’ self-reported digital competence in supporting students with SEN, controlling for teacher collaboration, infrastructure and equipment, and demographic variables. The results show a consistent and significant positive relationship between school leadership and teachers’ digital competence, even when other factors are accounted for. Teacher collaboration also contributed positively, though to a lesser extent, while infrastructure and equipment and demographic variables showed no significant effect. The study contributes knowledge by showing that teachers’ digital competence development depends not only on individual efforts but also on organisational factors, such as supportive school leadership, highlighting the importance of recognising school leadership as vital alongside digital resources in schools. Given the cross-sectional design, the findings should be interpreted cautiously and not as evidence of causal relationships. These findings suggest that school leadership is important in enabling teachers to use digital technologies to support students with SEN, highlighting practical and policy implications for strengthening school leadership in developing teachers’ digital competence in supporting students with SEN. Full article

This study examines the performance implications of CEO duality from a configurational governance perspective, with particular attention given to its relevance within an ESG-oriented framework. While prior research on CEO duality has produced inconsistent findings, much of the literature relies on variable-centered approaches that overlook the systemic and context-dependent nature of governance mechanisms. Drawing on agency theory, stewardship theory, and resource dependence theory, we analyze 59 publicly listed South Korean firms between 2018 and 2022 using fuzzy-set qualitative comparative analysis (fsQCA). Five governance-related conditions—CEO duality, ownership concentration, CEO tenure, institutional ownership, and environmental dynamism—are calibrated into fuzzy sets to identify causal configurations associated with high firm performance, defined as membership in the top 30% of return on assets (ROA). The results reveal six equifinal pathways to high performance, two of which exhibit particularly strong consistency and coverage. These dominant configurations show that CEO duality contributes positively to performance when embedded in either strong internal governance alignment or robust external monitoring under dynamic conditions. By demonstrating that the effectiveness of CEO duality is contingent upon its governance configuration, this study challenges one-size-fits-all prescriptions and contributes to the ESG literature by highlighting the conditional role of leadership structure in sustainable value creation. Full article

This study aims to identify and map the factors that can influence sustainable organizational performance. This study aims to identify the factors that directly and indirectly influence sustainable organizational performance. This study also categorizes its findings based on research themes, theories employed, and the organizational sectors under examination, thereby providing a comprehensive, up-to-date, and structured overview as a foundation for theoretical development and strategic guidance for organizations seeking to enhance their sustainable performance. This study employs the systematic literature review (SLR) method following the PRISMA guidelines. The Scopus database was used to search for articles. The study analyzed 44 selected articles based on predetermined criteria. The results suggest that sustainable organizational performance can be influenced by several key factors, including knowledge, innovation, leadership, organizational learning, human resource management, organizational culture, technology, and market orientation. This study also reveals the theories used in research related to sustainable organizational performance. The Resource-Based View emerged as the most dominant theory, followed by Dynamic Capabilities, Social Exchange, and Knowledge-Based View. Several mediating and moderating variables were identified as playing a significant role in strengthening or weakening the relationship between factors, although some findings yielded inconsistent results. These findings underscore the need for further research to clarify the role of these factors in supporting sustainable organizational performance. Full article

The research examines organisational leadership styles in the transition to the circular water economy using explanatory quantitative methods, combining semantic normalisation of structured survey responses and latent class analysis. One hundred and fifty organisations from the water sector in Lima, Trujillo, and Cajamarca participated and received a previously validated 30-item Likert-type questionnaire (α = 0.97). The nine analytical domains were developed resources, leadership, culture, technological capabilities, rivalry, suppliers, regulatory framework/support, implementation, and results to discover different organisational configurations. The ideal model identified eight latent classes that are grouped into four organisational archetypes: established leaders, aspirants with regulatory deficits, environment-focused with medium execution, and structural laggards. The findings reveal that circular implementation and results depend more on the articulation between organisational culture, strategic leadership, and regulatory framework than on the availability of technical or financial resources. In addition, great interorganizational heterogeneity was found, which challenged homogeneous public policies and requires differentiated strategies according to the level of circularity in which each organisation finds itself. The research provides empirical evidence to operationalise water transition indicators within the framework of SDG 6 and SDG 12, developing a robust taxonomy to track institutional progress toward water sustainability. Full article

Background/Objective: Hand hygiene is a cornerstone of infection prevention; however, compliance is inconsistent in intensive care units (ICUs), particularly in resource-constrained settings. This study evaluated whether a low-cost, multimodal quality improvement intervention could improve process-level hand hygiene compliance using routine, episode-based audits embedded in the ICU practice. Methods: We conducted a single-cycle Plan-Do-Study-Act quality improvement project in a 12-bed mixed medical–surgical ICU in Pakistan (December 2023–January 2024). Hand hygiene performance was assessed using the unit’s routine weekly episode-based audit protocol, aligned with the WHO Five Moments framework. A targeted multimodal intervention comprising education, point-of-care visual reminders, audit feedback, and leadership engagement was implemented between the pre- and post-intervention phases (four weeks each). Non-applicable moments were scored as “compliant by default” according to the institutional protocol. A sensitivity analysis was performed excluding these moments to calculate pure adherence. Compliance proportions were summarized using exact 95% Clopper–Pearson confidence intervals without inferential testing. Results: A total of 942 audit episodes (471 per phase) generated 4710 moment-level assessments were generated. Composite hand hygiene compliance increased from 63.1% pre-intervention to 82.0% post-intervention [absolute increase: 18.9 percentage points (pp)]. Sensitivity analysis excluding non-applicable moments demonstrated pure adherence improvement from 54.2% to 82.5% (+28.3 pp), confirming a genuine behavioral change rather than a measurement artifact. Compliance improved across all five WHO moments, with the largest gains in awareness-dependent moments targeted by the intervention: before touching the patient (+27.0 pp) and after touching patient surroundings (+40.0 pp). Week-by-week compliance remained stable within both phases, without immediate post-intervention decay. Conclusions: A pragmatic, low-cost multimodal intervention embedded in routine ICU workflows was associated with substantial short-term improvements in hand hygiene compliance over a four-week observation period, particularly for awareness-dependent behaviors. Episode-based audit systems can support directional process monitoring in resource-limited critical care settings without the need for electronic surveillance. However, its long-term sustainability beyond one month and generalizability to other settings remain unknown. Sensitivity analyses are essential when using “compliant by default” scoring to distinguish adherence patterns from measurement artifacts. Full article

Based on Conservation of Resources (COR) theory and a socio-technical systems perspective, this study examines how technology-enacted abusive supervision (TAS) influences employees’ counterproductive work behavior (CWB) in digitalized organizational contexts. Conceptualizing TAS as a system-embedded form of digitally mediated control, we argue that technology-amplified supervisory power constitutes a persistent resource threat that reshapes employees’ behavioral regulation strategies. Using three-wave time-lagged survey data from 428 employees working in digital-intensive enterprises in China, we develop and test a moderated mediation model. The results indicate that TAS is positively associated with CWB, with defensive silence serving as a critical mediating mechanism. Although defensive silence may temporarily reduce interpersonal risk, it disrupts feedback and resource replenishment processes, leading to cumulative resource depletion and a higher likelihood of counterproductive behavior over time. Moreover, power distance significantly moderates this indirect effect, such that the mediating role of defensive silence is stronger among employees with higher-power-distance orientations. By integrating leadership research, COR theory, cultural value orientations, and a socio-technical systems perspective, this study advances our understanding of covert resistance and behavioral risk in technology-driven work systems and offers important implications for digital governance and sustainable organizational performance. Full article

This study addresses the critical problem of barriers hindering Green Supply Chain Management (GSCM) adoption in Egypt’s petrochemical sector, a major economic driver that produces approximately 4.5 million tons annually but generates significant GHG emissions and hazardous waste. The objective is to identify, rank, and analyze the hierarchical relationships among internal and external barriers using a mixed-methods approach. This study focuses on the full petrochemical supply chain in Egypt, encompassing upstream (raw material sourcing), midstream (manufacturing/refining processes), and downstream (distribution, waste management, reverse logistics), with an emphasis on emission/waste reduction practices. Data were collected via a structured questionnaire from 400 employees in Egyptian petrochemical firms and analyzed using Interpretive Structural Modeling (ISM). The findings showed that internal impediments, such as a lack of corporate leadership and support (IB1), a critical shortage of resources (IB6), and the absence of green initiatives (IB5), serve as driving forces that exert a cascading influence over the external barriers, which include insufficient government support (EB1), a lack of markets for recycled materials (EB5), and human resources or expertise shortages (EB7). The study contributes to the existing literature on GSCM by incorporating international trends and specifically addressing Egyptian issues, including weak policies, difficult supply chains, high energy-intensive operations, and costly operations. The study suggests that sending clear messages from the top and providing financial incentives can help push the obstacles aside and guide the industry down the path of environmentally responsible operations. Full article

Generative Artificial Intelligence (GenAI) is rapidly reshaping public-sector operations, yet its adoption in developing countries remains poorly understood. Existing research focuses largely on traditional AI in developed contexts, leaving unanswered questions about how GenAI interacts with institutional, organizational, and governance constraints in resource-limited settings. This study examines the organizational factors shaping GenAI adoption in Vietnamese local government using 25 semi-structured interviews analyzed through the Technology–Organization–Environment (TOE) framework. Findings reveal three central dynamics: (1) the emergence of informal, voluntary, and bottom-up experimentation with GenAI among civil servants; (2) significant institutional capacity constraints—including absent strategies, limited budgets, weak integration, and inadequate training—that prevent formal adoption; and (3) an “AI accountability vacuum” characterized by data security concerns, regulatory ambiguity, and unclear responsibility for AI-generated errors. Together, these factors create a state of governance paralysis in which GenAI is simultaneously encouraged and discouraged. The study contributes to theory by extending the TOE framework with an environment-specific construct—the AI accountability vacuum—and by reframing resistance as a rational response to structural gaps rather than technophobia. Practical implications highlight the need for capacity-building, regulatory guidance, accountable governance structures, and leadership-driven institutional support to enable safe and effective GenAI adoption in developing-country public sectors. Full article

Introduction: Nursing informatics aims to improve patient care through rapid access to patient data, systematic assessment, a reduction in clinical errors, evidence-based practice, cost-effectiveness, and improved patient outcomes and safety. Background: Despite being the largest workforce in healthcare, nurses are not being adequately prepared to use nursing informatics, and this has been attributed to poor digital literacy, limited professional development, and a lack of undergraduate informatics education. Objectives: This scoping review aims to review contemporary published literature on the benefits, barriers, and enablers for embedding nursing informatics into undergraduate nursing education with a focus on the Australian healthcare context. Methods: A scoping review was conducted using the PRISMA-ScR checklist and the JBI Manual for evidence synthesis in adherence with an a priori scoping review protocol. A comprehensive search of JBI, Cochrane, CINAHL, Ovid, ProQuest, PubMed, and Scopus databases was performed. Two reviewers independently screened the results via Covidence, with discrepancies resolved via a third reviewer. Results: Two searches were conducted for this scoping review. In the first search, a total of 3227 articles were identified through database searches, with an additional 76 articles identified through bibliographic and grey literature searches. Following duplicate removal and screening, 46 articles met the inclusion criteria. In the second search, a total of 1555 articles were identified, and after duplicate removal and screening, 16 articles met the inclusion criteria. Duplicate removal during the second search round included those articles identified in the first search. The combined searches resulted in a total of 62 sources for this review. Conclusions: Despite the early adoption of nursing informatics in Australia in the 1980s, barriers remain to effective nursing informatics engagement and proficiency, including a lack of understanding of nursing informatics, limited infrastructure and resources, inadequate digital literacy of students and faculty, and the evolving nature of nursing informatics. Definitions of nursing informatics and associated fields, development of university faculty competency, access to digital health technologies, competency standards, digital literacy of the student cohort, faculty digital proficiency, and leadership from professional nursing bodies are all viewed as integral foundations for the development of student competency in nursing informatics. Full article

Digital transformation poses significant challenges to employee well-being, particularly in public administration, where hierarchical structures, increasing digitalization pressures, and high mental health-related absenteeism underscore the need to understand individual and job demands and resources. This study explores these aspects from the perspectives of employees and supervisors in public administration. Between September 2023 and February 2024, semi-structured interviews were conducted with eight employees and eleven supervisors from public administration organizations in Northern Germany and analyzed using deductive–inductive qualitative content analysis based on the Job Demands-Resources model. Identified individual resources included technical affinity, error tolerance, and willingness to learn, while key job resources involved early and transparent communication, attentive leadership, technical support, and counseling services, with most job resources linked to leadership behavior and work organization. Reported job demands comprised insufficient participation, inadequate planning, and lengthy procedures, whereas personal demands included fears and concerns about upcoming changes and negative attitudes toward transformation. The variation in perceived demands and resources highlights the individuality of the employees’ experiences. The findings provide initial insights into factors influencing psychological well-being at work during digital transformation, emphasizing the importance of participatory communication, employee involvement, leadership awareness of stressors, and competence development. Future research should employ longitudinal and interventional designs to improve causal understanding and generalizability. Full article

As an important industrial organizational form in the era of the digital economy, digital industry agglomeration exerts a profound impact on urban ecological resilience. Using panel data of 281 prefecture-level cities in China from 2011 to 2021, this study measures the level of digital industry agglomeration by means of the location entropy method, and constructs an urban ecological resilience evaluation system based on the “Pressure-State-Response (PSR)” model. It systematically examines the impact effects and action mechanisms of digital industry agglomeration on urban ecological resilience. The results show that: (1) The spatio-temporal evolution of the two presents a gradient pattern of “eastern leadership and central-western catch-up”, and their spatial correlation deepens over time, with the synergy maturity in the eastern region being significantly higher than that in the central and western regions. (2) Digital industry agglomeration significantly promotes the improvement in urban ecological resilience, and this conclusion remains valid after endogeneity treatment and robustness tests. (3) The promotional effect is more prominent in central cities, coastal cities, and key environmental protection cities, whose advantages stem from digital infrastructure and innovation endowments, industrial synergy and an open environment, and the adaptability of green technologies under strict environmental regulations, respectively. (4) Digital industry agglomeration empowers ecological resilience by driving green innovation and improving the efficiency of land resource allocation, while the construction of digital infrastructure plays a positive regulatory role. Full article

This study investigates the crucial role energy leaders play in driving strategic energy management (SEM) and accelerating cost savings within a manufacturing organization and consequently, the industrial sector. Whereas energy efficiency can be seen as an innovative business practice with irrefutable cost benefits, its effective implementation requires strategic leadership and a structured approach. This research analyzes data collected from 120 participants representing 71 companies attending the Energy Bootcamp events organized by the U.S. Department of Energy’s (DOE) Better Plants program. The collected data focused on the state of SEM implementation, the presence and responsibilities of energy leaders, and the formation and function of energy teams. The findings reveal a significant gap between the perceived importance of SEM and its actual adoption, highlighting the need for strong leadership to drive behavioral changes by championing energy efficiency initiatives. Results indicate that effective energy leaders possess a diverse skill set, including the ability to secure top management buy-in, foster a culture of energy consciousness, and collaborate across departments. This study emphasizes the importance of empowering energy leaders with clearly defined roles and responsibilities as well as the authority to build and lead cross-functional energy teams. Furthermore, integrating energy management into existing organizational structures and leveraging readily available resources are identified as key factors for successful implementation. This research underscores how dedicated leadership and effective SEM practices help achieve industrial energy efficiency goals, providing practical insights for organizations seeking to improve performance and contribute to a resilient future. Full article

To enhance PharmD student leadership and advocacy skills, combat the paucity of trained pre-health advisors for pharmacy admissions, augment community relationships, and increase pharmacy admissions volume, we designed, implemented, and assessed PAALS, a Pre-health Academic Advising and Leadership System. PAALS was grounded in Astin’s Theory of Student Involvement and evaluated using the RE-AIM implementation science framework. RE-AIM measured outcomes across Reach, Effectiveness, Adoption, Implementation, and Maintenance as indicators of PAALS’s scale, fidelity, sustainability, and institutional embedding. Analysis of PAALS using the RE-AIM framework demonstrated the following outcomes: (1) Reach: 42 P1-P3 PharmD students participated as mentors; external partnerships expanded from 2 to 8 regional high schools and community programs; and more than 25 mentored learners successfully matriculated into the PharmD program. (2) Effectiveness: students enacted sustained leadership, advocacy, and mentoring roles. (3) Adoption: voluntary uptake of mentoring and governance roles by PharmD students occurred with repeated engagement by external partner institutions. (4) Implementation: Core program components were delivered consistently using existing institutional resources. (5) Maintenance: PAALS remained operational across five academic years despite student turnover, with leadership succession and institutional embedding sustained across cohorts. Our findings demonstrate that student-led advising and advocacy ecosystems address critical gaps in pharmacy-specific pre-health advising models. Full article

The advent of generative AI (GenAI) and its growing use in education has sparked a renewed wave of school digital transformation. School principals are pivotal in advancing and shaping school digital transformation, yet little is known about how they understand and lead digital transformation in the age of GenAI, particularly within China’s complex educational system. This study employed Q methodology to identify the perceptions and leadership styles of Chinese K–12 school principals toward school digital transformation in the age of GenAI. An analysis of a 30-item Q set with a P sample of 23 principals revealed four leadership types: Cautious Observation–Technological Gatekeeping Leadership, Moderate Ambition–Culturally Transformative Leadership, Moderate Ambition–Emotionally Empowering Leadership, and High Aspiration–Strategy-Driven Leadership. Overall, principals’ stances on GenAI formed a continuum, ranging from cautious observation and skeptical optimism to active embrace. These perceptions and leadership styles were shaped by Confucian cultural values, a flexible central–local governance arrangement, and parents’ high expectations for students’ academic achievement. Furthermore, structural constraints in resource provision further heightened principals’ reliance on maintaining guanxi-based relationships. This study enhances the understanding of the diversity of principals’ leadership practices worldwide and offers actionable insights for governments and principals to more effectively advance AI-enabled school digital transformation. Full article