Search Results (1,182)

Rural maternity care in the United States faces an unprecedented crisis. As of 2022, more than half of rural hospitals lacked obstetric services, leaving many rural communities without local maternity care. This descriptive case study documents the implementation of maternity services at a 25-bed rural critical access hospital in North Carolina. We reviewed and coded data derived from the following sources from 2020–2025: institutional planning documents, clinical protocols, standard workflows, operational procedures, administrative records, meeting minutes, presentations and summaries, and published commentaries, manuscripts and articles related to the new maternity unit. We identified six critical domains for sustainability: (1) hospital and community engagement, (2) stable multidisciplinary staffing models, (3) emergency preparedness, (4) anesthesia service delivery, (5) financial sustainability, and (6) risk-appropriate scope of care. Successful implementation required integrated approaches across organizational dimensions facilitated by committed institutional leadership; community advocacy; innovative staffing models with family physicians, certified nurse-midwives, and certified registered nurse anesthetists; competency-based emergency training; Medicaid-based financial sustainability; and explicit risk stratification with clear interfacility communication protocols. Workforce sustainability emerged as the most significant ongoing challenge. Rural maternity service sustainability requires multifaceted, evidence-based approaches integrating workforce development, organizational infrastructure, financial mechanisms, and clear scope definitions. This case study demonstrates a model of perinatal regionalized and risk-appropriate care with replicable strategies that can inform efforts to address maternal health equity and strengthen rural health care systems. Full article

This study examines the capacities required for sustainability-oriented, BIM-enabled construction digitalization in developing countries and proposes context-sensitive strategies for fragmented, SME-dominated construction sectors. By improving information coordination, reducing rework, supporting lifecycle information management, and widening SME participation, BIM capacity building is positioned as a pathway toward more resource-efficient and socially inclusive construction. A mixed-methods design was adopted. First, semi-structured interviews with nine BIM experts from Sri Lanka, India, and Malaysia were analyzed using a hybrid inductive–deductive thematic analysis to identify internal firm-level and external ecosystem-level capacity strategies. These findings were validated through a modified two-round Delphi study involving 39 practitioners and academics from Sri Lanka, India, Malaysia, Thailand, Nepal, and Pakistan. Capacities and strategies were prioritized using the median and interquartile range, while strategy–capacity relationships were evaluated using percentage agreement and median linkage strength. The study identified 19 capacities and 25 strategies across internal and external dimensions. Internal strategies such as training, leadership support, role clarity, knowledge sharing, and BIM-enabled platforms were important and feasible through shared and flexible delivery mechanisms. External capacities, including standards, education, legal frameworks, procurement support, and incentives, were essential but less feasible without institutional coordination. Twenty strategy–capacity linkages achieved expert consensus, forming a practical roadmap that connects construction digitalization with the sustainable development goals of productivity, waste reduction, lifecycle value, and inclusive digital transformation in developing-country construction markets. Full article

Predicting queue waiting time for batch job schedulers in high-performance computing (HPC) systems is a critical research topic aimed at maximizing resource utilization efficiency and enhancing user experience. However, existing prediction approaches heavily rely on static job characteristics provided by users at submission time, exhibiting clear limitations in capturing the dynamic congestion state of the scheduling system. To address these limitations, a log-based feature engineering approach designed to significantly improve queue waiting time prediction accuracy is proposed in this study. Specifically, feature redundancy is eliminated through comparative analysis, and temporal features capturing periodic job submission patterns are generated. Furthermore, global and local (queue-level) waiting and running states at job submission time are reconstructed exclusively from historical job logs, thereby representing dynamic queue congestion in a fine-grained manner. The effectiveness of the proposed framework was validated using a large-scale job log dataset collected from the Theta supercomputer at the Argonne Leadership Computing Facility (ALCF) between 2017 and 2023, where queue waiting time was discretized into nine distinct intervals and formulated as a multi-class classification problem. Finally, an ablation study was conducted to quantitatively evaluate the performance contribution of each engineered feature group, and comparative experiments were carried out across multiple machine learning models, including Naïve Bayes, k-nearest neighbors (KNN), Random Forest, and XGBoost. Among the compared models, Random Forest achieved the best overall performance, with an accuracy of 88.89%, a balanced accuracy of 57.65%, a macro-averaged precision of 67.95%, and a macro-averaged F1-score of 61.71%. Compared with the baseline feature set, the proposed feature engineering strategy improved accuracy, balanced accuracy, and macro F1-score by 3.85, 7.28, and 9.82 percentage points, respectively, and the proposed RF model obtained a balanced accuracy 18 percentage points higher than the best-performing model reported in a comparable reference study on the same dataset, a cross-study difference not directly attributable to the proposed feature engineering alone. Full article

The wave of digital transformation has driven profound changes in construction mode. As the core driving force for the sustainable development of digital construction, organizational capabilities have gradually attracted widespread attention from both the academic community and practitioners. This study comprehensively analyzes the structural dimensions and influencing factors of construction project organizations’ capabilities in digital construction mode. Further, employing an analytical approach based on dynamic Bayesian networks, the organizational capability model is constructed to explore the key dimensions, influencing factors, and influence paths of organizational capabilities from a dynamic perspective. The results show that innovation capabilities serve as the pivotal drivers for advancing organizational capabilities, with a probability reaching 88.40%. In the short term, simultaneously enhancing innovation capabilities and leadership capabilities has the best effect on improving organizational capabilities, with a probability of up to 94.89%. However, from a long-term perspective, the probability distribution of various combined strategies is similar to that of the single-dimensional strategies. Consistency in core values stands as the key influencing factor, while the two influence chains symbolizing “technical hard power” and “organizational soft power” constitute the core paths for enhancing organizational capabilities. The research findings contribute to clarifying the priority order and core factors of organizational capability development in the digital construction mode, thereby providing a quantitative decision-making basis for optimizing resource allocation in construction project organizations. Full article

The top management team (TMT) plays a key role in shaping corporate strategy. However, how and when TMT faultlines influence corporate digital transformation remains unclear. Drawing on the categorization–elaboration model, this study examines the nonlinear relationship between TMT faultlines and corporate digital transformation and the moderating role of board governance. Using panel data from Chinese A-share-listed manufacturing firms, the results suggest an inverted U-shaped relationship between TMT faultlines and corporate digital transformation. Board monitoring and board networking are associated with a steeper inverted U-shaped curve, whereas board advising is associated with a flatter curve. Heterogeneity analysis shows that the inverted U-shaped relationship is mainly observed in non-state-owned enterprises, younger firms, and firms with high ownership concentration. These findings extend research on faultlines, strategic leadership, and corporate governance and offer practical implications for configuring TMTs and designing board governance mechanisms to support corporate digital transformation. Full article

The green transformation of enterprises is facing major challenges. However, how individual, organizational, and institutional factors jointly shape enterprise green development behavior remains insufficiently understood. This study constructs a three-dimensional analytical framework covering individual, organizational, and institutional levels. Using expert surveys and data from 129 listed building materials companies from 2014 to 2023, the fuzzy-DEMATEL and fuzzy-set qualitative comparative analysis (fsQCA) methods are used to identify key factors and explore multiple paths to achieve green development behavior (GDB). This study found that: (1) executives’ green cognition, technological innovation capability, government penalties, media attention, green consumer demand, and market competitiveness are key factors; (2) no single factor is a necessary condition; (3) four equivalent driving configurations are identified: public opinion and market adaptation, executive leadership and market dynamics, external pressure and innovation synergy, and policy constraints and market breakthroughs; and (4) technological innovation capability and market competitiveness exhibit potential functional substitutability across different configurations. This study identifies key factors shaping enterprise strategies, reducing uncertainty in green initiatives and improving sustainable development decisions. The findings reveal nonlinear and synergistic mechanisms of GDB, challenging traditional linear approaches and offering a new framework for complex decision-making. Full article

This study aims to explore women school administrators’ experiences of sustainable leadership by examining how they define sustainable leadership, the leadership practices they adopt, the challenges they encounter, the resilience strategies they employ, and their perspectives on the future of educational management. The study was conducted using a qualitative case study design. The participants consisted of 23 women school administrators working in the provinces of Manisa and Hakkâri, Türkiye. Data were collected through semi-structured interviews and analyzed using content analysis. The findings revealed that women school administrators primarily perceived sustainable leadership as a future-oriented leadership approach that emphasizes building a strong organizational culture, continuously improving the quality of education, and adopting a human-centered management philosophy. Sustainable leadership practices were found to revolve around collaboration, stakeholder participation, supporting teachers’ professional development, the effective use of school resources, empathy, and inclusive leadership. However, participants also reported significant challenges in implementing sustainable leadership, including traditional gender roles, work–life balance difficulties, limited access to leadership positions, and the perceived preference for male leadership. To overcome these challenges, participants emphasized continuous professional development, collaboration, strong communication networks, fair decision-making, emotional regulation, and maintaining work–life balance as key resilience strategies. Furthermore, they envisioned the future of educational management as being shaped by leadership approaches that are inclusive, collaborative, empathetic, innovative, and adaptable to change. Full article

The objective of this study is to examine, through a narrative literature review and a qualitative cross-case comparison, how women’s cooperatives and cooperative-linked financial mechanisms contribute to women’s financial inclusion and economic empowerment under different institutional and socioeconomic conditions. The study synthesizes evidence from successful initiatives, including the Self-Employed Women’s Association (SEWA) in India, digital savings cooperatives in Indonesia, and M-Pesa-enabled cooperative models in Kenya, women-oriented banking in Rwanda, Cooperative Home Care Associates in the United States, and women’s cooperatives in Türkiye. The findings indicate that cooperative systems enhance women’s access to financial services, strengthen financial and digital capabilities, support income generation, and foster leadership and economic participation. However, persistent barriers, including limited digital access, inadequate financial literacy, and restrictive socio-cultural norms, continue to constrain the effectiveness and scalability of these models. The study concludes that strengthening women’s cooperatives through targeted policy support, capacity-building initiatives, and digital financial inclusion strategies can significantly improve women’s economic empowerment while contributing to more inclusive financial systems and broader sustainable development objectives. Full article

Family firms are distinctive organisational forms in which ownership, governance, leadership, and strategic decision-making are closely intertwined. Although prior research has examined leadership, succession, governance, and strategy in family firms, the literature remains fragmented regarding how leadership styles are associated with both strategic behaviour and strategic choices. This study addresses this gap by conducting a Systematic Literature Network Analysis of 59 studies on leadership and strategy in family firms. Combining systematic review procedures with bibliographic network analysis, this paper maps the intellectual and thematic structure of the field and synthesises the evidence around five research questions. The findings show that the literature is theoretically rich but not yet fully consolidated, with socioemotional wealth, upper echelon theory, agency theory, stewardship theory, and the resource-based view serving as dominant lenses. Leadership appears to be connected with strategy mainly through affective, political, and cognitive mechanisms, while the procedural core of strategic decision-making, including participation, dissent, consensus formation, and formal planning, remains underdeveloped. This review also shows that leadership is more frequently studied in relation to identity-relevant strategies, such as sustainability, innovation, succession, digital transformation, and professionalisation, while scale-and-scope strategies remain less examined. This study contributes by proposing an integrative framework of five leadership-to-outcome pathways and by outlining a future research agenda for leadership, entrepreneurship, and strategic renewal in family firms. Full article

Background/Objectives: Chronic diseases place sustained pressure on primary care systems worldwide. While artificial intelligence (AI) shows promise for supporting chronic disease management in primary care, the factors influencing its adoption and implementation have not been comprehensively addressed within the specific context of primary care chronic disease management. The aim of the scoping review was to identify the key drivers that influence AI adoption in primary care settings for chronic disease management. Methods: This scoping review was conducted following the PRISMA ScR guidelines. A comprehensive search of seven databases was conducted between 14 April and 14 May 2025, with an updated search on 27 February 2026 using the same search strategy and eligibility criteria. Eligible studies examined the adoption or implementation of AI for chronic disease management in primary care and were published in English from 2010 to 2026. Data were charted using a standardised extraction tool and synthesised narratively. The protocol for this scoping review was registered with INPLASY. Results: Twenty-two studies were included, identifying five domains influencing AI adoption. Technical factors included data quality, interoperability, and algorithm transparency. Human factors related to clinician trust, workload, digital literacy, and preferences for hybrid human–AI care. Legal and ethical considerations centred on privacy, accountability, fairness, and independent validation. Organisational factors involved leadership, workflow integration, and resourcing, while geographical and cultural contexts shaped readiness, acceptability, and equity. Conclusions: AI adoption in chronic disease management within primary care is shaped by multi-level, context-dependent factors. The findings suggest that implementation may require coordinated strategies encompassing robust data governance and interoperability, clear regulatory frameworks, workforce capability development, workflow-aligned hybrid models with appropriate human oversight, and sustainable resourcing and reimbursement. Future research should extend beyond technical performance to evaluate acceptability, safety, workload, equity, and longer-term organisational impacts. Full article

This study examines social media communication in Kenya to assess how dryland pastoral concerns are represented in national climate policy dialogues. Approximately 80% of Kenya’s land area consists of drylands that support pastoral livelihoods, yet recurring droughts and increasingly variable rainfall threaten these social-ecological systems. Although Sustainable Development Goal 13 (Climate Action) emphasizes adaptation, progress is typically measured using national indicators that may overlook local priorities. We analyzed digital communications from pastoral nongovernmental organizations, civil society organizations, newspapers, and government agencies using an adaptation pathways framework to examine links among climate risks, governance, and decision-making. Five themes emerged: water security, rangeland degradation and mobility, climate communication, gender and social inclusion, and climate finance. Kenya has developed relatively strong national climate policies, but social media reveals a persistent implementation gap between national policy and local pastoral priorities. Pastoral communities consistently emphasize Indigenous and local knowledge, women’s leadership, community participation, and locally appropriate adaptation strategies. Social media provides a novel source of evidence for identifying these local priorities and informing more participatory, place-based climate adaptation. Full article

Digital transformation (DT) is a strategic priority for healthcare systems seeking to improve the quality of care, patient safety, and operational efficiency. In Saudi Arabia, DT is central to Vision 2030; however, evidence regarding its effects on healthcare quality and safety remains dispersed across technologies and healthcare settings. This narrative review aimed to examine the impact of digital transformation on healthcare quality and patient safety in Saudi Arabia and to identify the principal implementation facilitators, barriers, and policy implications. A structured narrative literature search was conducted for publications from January 2010 to March 2026 using PubMed/MEDLINE, Scopus, Web of Science, Google Scholar, the Saudi Digital Library, and relevant Saudi governmental and policy documents. In total, 64 peer-reviewed studies, reviews, reports, and policy documents addressing digital health initiatives and outcomes related to quality, safety, efficiency, or patient experience were included. Evidence was synthesized thematically, focusing on electronic health records, digital prescribing, online appointment systems, clinical and pharmacy automation, claims and financial analytics, telemedicine, governance, and workforce factors. The reviewed evidence indicates that Electronic Health Record (EHRs), computerized provider order entry, e-prescribing, barcode-supported medication systems, telemedicine, digital appointment platforms, and automated workflows can improve access to care, documentation, care coordination, medication safety, workflow efficiency, and patient experience. However, the benefits of DT are constrained by fragmented infrastructure, limited interoperability, workforce resistance, insufficient digital literacy, funding limitations, and unclear or fragmented governance and regulatory arrangements. In conclusion, digital transformation has substantial potential to enhance healthcare quality and patient safety in Saudi Arabia. Achieving these benefits requires context-sensitive implementation, interoperable systems, strong governance, sustained investment in infrastructure and workforce capacity, and effective leadership and change-management strategies aligned with Vision 2030. Full article

Green buildings (GB) have emerged as an effective strategy for mitigating environ-mental degradation, reducing resource depletion, and combating climate change linked to rapid urbanization. Due to the accelerating pace of urban growth in Nigeria and the demand for increased infrastructure, there is a growing need to incorporate GB principles into sustainable urban planning. In this study, Nigerian GB Policy Frameworks (GBPFs) are reviewed and analysed in terms of their degree of integration into sustainable urban planning. A narrative literature review with systematic elements was conducted using secondary data, including policy documents and international GB standards from 2000 to 2026. The review focused on four primary Nigerian policy documents (the National Building Code (NBC), National Housing Policy (NHP), Energy Efficiency Building Code (EEBC) and the Green Building Council of Nigeria (GBCN) and provided a comparative analysis between the Nigerian GBPFs and the international frameworks—Leadership in Energy and Environmental Design (LEED), Building Research Establishment Environmental Assessment Methodology (BREEAM), Green Star SA, and Green Mark etc. The findings indicate progress in GB construction practices in Nigeria; however, the existing GB policies (GBPs) in Nigeria are largely fragmented, poorly enforced, and poorly integrated into urban planning processes. Institutional overlaps, lack of adequate financial resources, lack of technical capacity, lack of stakeholder engagement, and the absence of a nationally sanctioned GB rating system present ongoing barriers to implementation. The comparative analysis indicates that countries that have implemented stronger regulatory frameworks, greater financial incentives, and introduced compulsory certification systems achieve greater success in the integration of GB principles into urban development. The study advocates a legally binding national GB framework that would provide for improved institutional coordination, the provision of financial incentives, the establishment of climate-responsive standards, and robust monitoring mechanisms to support sustainable urban development in Nigeria. Full article

Gendered leadership theories suggest that women executives may adopt distinct crisis management approaches, yet evidence from private-sector small- and medium-sized enterprises (SMEs) remains limited. This study examines associations between women’s executive presence, crisis strategies, and firm outcomes during COVID-19. Using survey data from 207 SMEs across 12 sectors in Istanbul, Türkiye, we apply non-parametric tests and regression models controlling for firm age, size, and sector. Firms with women executives reported stronger cash-flow sustainability and cost management outcomes but no significant differences in revenue generation or overall performance. They also scored higher on a composite defensive strategy index, although measurable outcome differences were limited to the cost-related dimension. These findings suggest that the association between women’s executive presence and crisis outcomes is domain-specific rather than uniform across performance dimensions. Because the indicator captures executive presence rather than decision-making authority, these associations may also reflect organizational characteristics with which women’s executive presence coincides. Full article

In contemporary Information Technology (IT) enterprises, workforce role configuration decisions sit at the intersection of leadership strategy, corporate Artificial Intelligence (AI) transformation and sustainable operational governance. This study investigates how heterogeneous workforce role configurations affect Service Level Agreement (SLA) compliance in SLA-aware Business Process Model and Notation (BPMN) IT business processes, framing this as a people management and leadership decision problem with explicit Environmental, Social and Governance (ESG)-oriented trade-offs. A validated MATLAB Simulink simulation tool is employed to conduct structured scenario testing across combinations of human role configurations and AI maturity levels, measuring their impact on key Service Level Objectives (SLOs) and Key Performance Indicators (KPIs). To support leadership decision making, a Workforce Sustainability Index (WSI) is introduced that integrates SLA compliance with workforce cost and AI dependency risk, where AI dependency risk captures the social dimension of ESG by emphasizing workforce skill development, upskilling and reskilling pathways, human oversight and responsible AI adoption. The simulation results reveal that no universally optimal configuration exists; the best-performing workforce design depends on organizational context and leadership priorities, as captured through scenario-based weight configurations representing performance-driven, cost-driven, human-centric and balanced governance orientations. These findings provide IT leaders and organizational decision-makers with actionable, evidence-based guidance for sustainable workforce design in the context of corporate AI transformation, contributing to the broader discourse on people management, merit-based organizational performance, responsible AI governance and sustainable digital operations management. Full article