Search Results (4,954)

Sustainable environmental performance (SEP) among small and medium-sized enterprises (SMEs) has attracted researchers and practitioners’ attention. The achievement of sustainable environmental performance has been largely dependent on the prevailing external ecosystem conditions. Yet in emerging economies such as Ghana, there is limited research and evidence on the extent to which external ecosystem resources influence sustainable environmental performance. This study aims to investigate how external entrepreneurial ecosystem resources including policy, access to finance, market availability, institutional support, human capital and culture influence the sustainable environmental performance (SEP) of small and medium-sized enterprises (SMEs) using sample data from Ghana. A total of 386 SME manufacturing and service firms were sampled to participate. Structural equation modeling (PLS-SEM) tested a multi-theory framework grounded in the Resource-based View (RBV), Resource Dependency Theory (RDT) and Stakeholder Theory. The results indicate that policy, finance, institutional support, and markets exert significant positive effects on SMEs’ SEP. Culture and human capital were found to have a weaker contribution to SMEs’ SEP. The novelty of this study lies in empirically demonstrating the primacy of ecosystem structural levers over softer ecosystem factors in driving SME sustainable environmental performance, thereby offering a new explanatory hierarchy of ecosystem drivers for sustainability in developing economies. We advance the RBV, RDT and the Stakeholder Theory by showing that external ecosystem resources act as critical environmental enablers for SMEs in developing economies. The findings offer globally relevant policy insights for advancing SDGs 12 (Responsible Consumption and Production) and 13 (Climate Action) through targeted ecosystem interventions. Full article

Background: Mental health needs are rising globally, while workforce shortages constrain access to timely care. Israel launched formal training for Psychiatric–Mental Health Nurse Practitioners (PMHNPs) in 2023 as part of broader efforts to strengthen the public mental health system. This narrative review provides a focused synthesis of international and Israeli literature on PMHNP roles, models of practice, outcomes, and implementation considerations relevant to the Israeli context. Methods: We conducted a narrative, non-systematic literature review of international and Israeli literature on Psychiatric–Mental Health Nurse Practitioners (PMHNPs). Searches were conducted in PubMed/MEDLINE, CINAHL, PsycINFO, and Scopus (January 2000–December 2024), alongside targeted policy and regulatory documents. Eligible sources addressed NP/PMHNP roles, scope of practice, clinical and service outcomes, implementation processes, workforce implications, or policy considerations in high-income health systems. Findings were synthesized thematically. Results: Across the reviewed literature, particularly in primary care and community-based settings, PMHNP/NP-delivered care was generally associated with comparable outcomes on selected quality and safety indicators, alongside improved accessibility, continuity, and high patient satisfaction. Successful implementation depended on regulatory clarity, organizational readiness, interprofessional collaboration, and the development of a clear professional identity. In Israel, the role is emerging within a cautious regulatory framework and may face early barriers related to role ambiguity, variable organizational support, and limited stakeholder awareness. Conclusions: PMHNP implementation may offer an important strategy for strengthening mental health service capacity in Israel. However, the extent of its contribution will depend on regulatory clarity, organizational support, implementation quality, and future empirical evaluation in the Israeli context. Full article

Historical small towns (HSTs) embody irreplaceable cultural heritage and territorial identity, facing depopulation, economic marginalization, and infrastructure decay. Improving their liveability and attractiveness is essential to reverse these trends and boost sustainable development. In this context, HSTs are potential drivers of circular and sustainable socio-technical systems, where the circular economy (CE) offers a framework for local sustainability. However, HSTs lack adequate sustainable CE implementation tools. This study, the culmination of the H-SMA-CE project, develops a Decision Support System (DSS) to assist local policymakers in planning CE transitions in Italian HSTs. The DSS integrates three building blocks: context analysis (metabolic flows, stakeholder networks), an intervention library with cost–benefit data, and a composite Municipal Circular Economy Index (MCEI). The tool enables users to assess baseline circularity, simulate scenarios, and identify optimal investment portfolios through multi-objective optimization. This approach allows for the simultaneous evaluation of the benefits of each sustainability aspect, i.e., environmental, economic and social. Tested on the municipality of Taurasi (Italy), an HST with a wine-based economy, the results show that balanced intervention strategies yield greater circularity improvements than single-objective approaches. The paper contributes to the discourse on digital tools for sustainability transitions, offering a replicable model for evidence-based CE governance in heritage-rich territorial contexts. Full article

Compressed air leakages represent a major source of energy waste and financial loss in industrial facilities. However, accurately detecting and quantifying these leaks remains challenging due to the wide variation in the accuracy, cost, usability, and practical applicability of available methods. This paper presents a structured review and evaluation of leakage localization and quantification methods for compressed air systems (CASs), categorized into hardware-, software-, and non-technical-based approaches. Based on expert interviews and a comprehensive literature review, a set of evaluation criteria was defined and applied within a multi-criteria decision analysis (MCDA) framework. The Analytic Hierarchy Process (AHP) was used to derive criteria weights, while the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) was employed to rank the alternatives separately for localization and quantification tasks. To enhance practical relevance, five expert interviews were conducted with industrial stakeholders from diverse professional backgrounds, including maintenance engineers and energy managers. A questionnaire was also distributed to assess the methods. The results provide illustrative insights into the relative suitability of different methods. Within the scope of this exploratory study, from a practical industrial perspective, the compressor duty cycle method and non-intrusive load monitoring (NILM) appear to be promising approaches to leakage quantification, while ultrasonic detection is preferred for localization. Notably, discrepancies between questionnaire-based rankings and expert interview insights highlight the limitations of purely survey-driven evaluations. The proposed framework supports industrial decision-makers in selecting leakage detection and quantification methods by balancing technical performance, implementation effort, and operational constraints, thereby contributing to reduced energy losses and improved system efficiency. Full article

As complex system engineering involving multiple stakeholders, multi-objective collaboration, and multi-spatiotemporal scales, the components, logical structure, and functional mechanisms of production equipment operation management and control (PEOMC) can be generalized through functional modelling to support dynamic analysis and intelligent decision-making of PEOMC in the industrial internet environment. To address the diversity of scenarios and objectives of PEOMC, a hierarchical construction method for the functional model of PEOMC based on IDEF0 is proposed. By analysing relevant international standards, such as ISO 55010, ISO/IEC 62264, and OSA-CBM, the generic functional modules for the first and second layers of the functional model are identified and defined. On the basis of semi-supervised machine learning, topic clustering is used to extract the components, functional mechanisms, and logical relationships of production equipment operation management and control from approximately 200 standard texts and to construct a reference resource pool for the third-layer functional module. On this basis, an interface matching and recursive traversal algorithm for functional modules is designed, and a composition and orchestration strategy of functional modules for specific scenarios is provided to support the flexible construction of diversified and personalized PEOMC scenarios. The proposed construction and application method was validated through an engineering case study in an aero-engine transmission unit manufacturing workshop: the average process capability index of the enterprise’s production equipment steadily increased from 1.28 to approximately 1.60, the mean time to repair (MTTR) of production equipment failures significantly decreased from 8 h to 3 h, and the average overall equipment effectiveness (OEE) increased from 56.43% to a stable 68.57%, demonstrating its effectiveness and practicality. Full article

When using traditional approaches, such as pharmacokinetics and pharmacodynamics, the entire cellular or molecular response to drugs in the body cannot be fully ascertained or established. The oral medication process involves pharmacokinetics, followed by oral microbiomics and then gut microbiomics and pharmacodynamics. Recently, there has been increasing interest in the role of genetics (pharmacogenetics and pharmacogenomics) in both humans and microbiomes, as well as omics alterations (e.g., epigenetic, transcriptomic, proteomic, and metabolomic alterations as a consequence of drug exposure), which can help to ascertain the cellular responses to medications. Both the efficacy and toxicity of a drug are influenced by these factors. To assess these at an individual level, an integrative Personalized Medicine Model may be needed to help with medication management. Two example application cases for SSRIs and statins demonstrate the clinical usefulness of such a model, which can guide clinicians during drug selection and dosing to reduce reliance on trial-and-error, thus potentially improving patient outcomes and safety. Integrating this framework into practical clinical workflows requires the capture, analysis, and translation of multi-omics data in order to realize decision support protocols and actionable drug recommendations. This review also discusses IT requirements and different stakeholder roles. Although the proposed model can guide the treatment of diseases at the individual patient level, further research is still needed before it can be implemented as part of drug development research, clinical care, and healthcare delivery systems. Full article

The Ghanaian economy faces significant challenges in providing robust policy support and cohesive ecosystem structures that enable small- and medium-sized enterprises (SMEs) operating in the country to effectively convert entrepreneurial marketing activities into sustainable social outcomes. The research examines the effect of entrepreneurial marketing on sustainable social performance of SMEs using entrepreneurial ecosystem policy as the mediating variable. The Resource Dependency Theory, Resource-Based View and the Stakeholder Theory were utilized, and the study was designed a cross-sectional survey. The data collected were based on 386 SME owners and managers of different sectors in Ghana. Structural equation modeling with SmartPLS 3 was used to test the proposed relationships. The results indicate that entrepreneurial marketing has a significant positive impact on sustainable social performance. In addition to that, ecosystem policy has a strong and positive impact on sustainable social performance. The mediating effect of ecosystem policy in the relationship between entrepreneurial marketing and sustainable social was found to be positive. The research has limitations in that it was cross-sectional and specific to Ghana, which might limit its generalizability. Longitudinal and cross-country designs may be used in future studies to include the dynamic effects of policy interventions. Hypothetically, the research moves towards the mediating role of the ecosystem policy in the relationship between marketing and sustainability. In practice, the study findings highlight the necessity to use combined policy frameworks that empower SMEs to enhance their marketing strengths and social investments to meet Sustainable Development Goals (SDGs) 8, 9, and 12. The research finds that enabling policies of entrepreneurial ecosystems are needed to convert the marketing efforts by SMEs into a sustainable social value. Full article

Empty Container Management (ECM) represents a cost-intensive and environmentally impactful component of global container logistics, with its effects most visibly manifested in inland transport systems. Despite extensive academic attention, research on ECM remains fragmented across optimisation, coordination, sustainability, and technology-oriented approaches, often addressing isolated processes or decision problems. As a result, persistent costs, inefficiencies, and emissions continue to characterise inland container logistics. This study applies PRISMA guidelines to systematically review the ECM literature. The analysis focuses on three aspects: the structural causes of container imbalances, the operational activities generating costs and emissions, and the stakeholders influencing ECM decisions. The findings show that empty container imbalances do not arise from a single source. Instead, they result from the interaction of global trade asymmetries, demand uncertainty, fragmented inland operations, and diverse regulatory and institutional environments. The answers to the research questions reveal three fundamental research gaps in the existing literature. First, optimising locally does not always improve the entire system, as it might simply shift costs to other parts of the empty container management (ECM) system. Second, technological solutions cannot operate effectively without appropriate governance mechanisms and data-sharing arrangements. Third, the actors responsible for setting rules and controlling equipment availability often do not bear the full consequences of empty container movements. This review provides a structured foundation for developing integrative decision-support approaches capable of addressing inland ECM under real-world structural constraints. Full article

Despite pressure to scale green building (GB) adoption in Indonesia, many government building projects underperform against their initial intended design, creating a compliance gap between the design and construction phases and reducing the GB rating and its potential benefits. This study investigated the barriers and drivers affecting the Indonesian government’s GB projects’ compliance using a systems thinking (ST) approach. A causal loop diagram (CLD) was constructed from stakeholder interviews and literature scoping, followed by semi-qualitative analysis, combining systems archetype identification, eigenvector centrality (EC), and influence mapping to propose potential leverage points as a basis for policy analysis of the current regulatory scenario. Key findings show that knowledge development, sustained stakeholder integration, project documentation readiness, and government support reinforce GB compliance, but are undermined by financial constraints. CLD analysis identified that the more sustainable factors, including regulation alignment, capacity building, and enhancing collaboration, should become a focus of interventions in the system, instead of focusing solely on the provision of funding. This study presents a novel exploration of the GB adoption problem in an Indonesian governmental context through a comprehensive and systems approach. Further research might require narrowing the system boundaries, broadening the literature and stakeholder validation, and performing quantitative modelling to test intervention scenarios to support rigorous decision-making processes. Full article

The construction sector is one of the primary areas that underpin a country’s economic development. However, this sector is characterized by various types of obstacles, including the participation of numerous stakeholders, strict schedules, limited resources, and the management of vast amounts of data throughout the project lifecycle. Building Information Modeling (BIM) has emerged as a promising technology for centralizing and managing construction data throughout the project lifecycle. However, having the ability to extract real-time, decision-oriented insights from BIM models remains a challenge for project stakeholders. To address this limitation, this research paper explores the integration of BIM with Business Intelligence (BI) to enhance control and management of construction projects throughout the development of a customized Power BI dashboard. The proposed framework of the paper utilizes BIM’s data-rich environment and Power BI’s advanced analytical and visualization capabilities to deliver real-time and interactive insights about project performance and progress. The customized dashboard enables stakeholders, especially project managers, to monitor key performance indicators of the project that are related to cost and schedule. It also supports progress tracking, early identification of inefficiencies, and data-driven decision-making. To demonstrate the practical application of the proposed framework, a case study was conducted. The results indicate that integrating BIM with BI helps in enhancing project control, improving transparency, and facilitating collaboration between stakeholders through a centralized cloud platform that can be easily accessed through desktop and mobile devices. Full article

In the digital economy era, digital marketing has become a key strategy for firms seeking competitive advantage. However, its reliance on data has heightened exposure to cybersecurity risks. While existing research highlights the importance of digital transformation, less is known about how cybersecurity governance influences firms’ digital marketing activities. Drawing on signalling theory and the resource-based view, this study uses panel data from Chinese A-share listed firms during 2012–2023 to examine the impact of cybersecurity governance on digital marketing and its underlying mechanisms. The results show that effective cybersecurity governance significantly enhances firms’ digital marketing engagement. Mechanism analyses identify three channels. First, by preventing data breaches and negative incidents, firms enhance corporate reputation. Second, by creating a secure operating environment, cybersecurity governance strengthens risk-taking capacity and encourages marketing innovation. Third, by improving information disclosure and stakeholder communication, it alleviates information asymmetry. Heterogeneity analyses indicate that the positive effect is more pronounced for non-state-owned enterprises, firms in eastern regions, and high-tech firms. This study fills a gap in the literature by linking cybersecurity governance path to digital marketing and contributes to research on its economic consequences. The findings also offer practical implications for strengthening internal governance to support external market activities. Full article

Background: Environmental, social, and governance (ESG) practices have evolved from regulatory requirements to strategic drivers of competitiveness and long-term value creation, particularly in road freight logistics, where environmental impacts, greenhouse gas emissions, labor relations, and stakeholder transparency are critical. Methods: This study identifies and systematizes ESG-related critical performance factors in road logistics by combining a systematic literature review with an analysis of sustainability reports from Brazilian road freight logistics companies. Academic findings and market practices were compared to support the development of an integrated ESG monitoring and assessment dashboard. Results: The findings reveal limited standardization in sustainability monitoring and control practices, with convergence observed around a restricted set of critical performance factors across companies. Conclusions: Based on these results, a unified theoretical dashboard integrating the three ESG dimensions into structured criteria and performance indicators is proposed. The model contributes to a more systematic assessment of ESG maturity and offers a theoretically grounded framework to support sustainability monitoring and managerial decision-making in road freight logistics. Full article

The role of Corporate Social Responsibility (CSR) in advancing economic, social, and environmental well-being has been increasingly acknowledged in the broader context of the United Nations Sustainable Development Goals. For instance, CSR in Saudi Arabia is increasingly framed as a mechanism to support Vision 2030—a national strategy aimed at transforming Saudi Arabia to a sustainable economy. However, evidence on how financial institutions disclose and prioritize CSR at the country level remains fragmented. This study examines the extent and patterns of CSR disclosure across the Saudi banking sector by analyzing publicly available documents, e.g., annual reports and ESG/CSR reports (n = 36) from 10 banks (4 Islamic and 6 commercial). Findings indicate that CSR disclosures were primarily clustered into four macro themes—society, economic contribution, internal stakeholders, and environment—with a strong thematic emphasis on philanthropic activities, financial donations, disability support, and financing for Small and Medium Enterprises (SMEs). Environmental initiatives were disclosed less frequently and were generally narrower in scope, focusing on resource efficiency, recycling, and selective green financing. In addition, a comparative analysis between Commercial and Islamic banks revealed that the latter focused on values-based CSR, while commercial ones emphasized governance-oriented CSR. Full article

This research examines the potential of Battlefield Tourism as a strategic tool for rural development, focusing on the cultural heritage of Extremadura, Spain. Given the specific nature of the regional tourism offer, this paper is presented as a case study to analyze how military historical resources can be integrated into sustainable tourism models. The study employs a mixed-methodology approach, combining a quantitative cross-sectional survey with complementary qualitative analysis of open-ended responses. A sample of 149 municipal managers was analyzed to evaluate their institutional perceptions of military cultural tourism and its potential integration into regional strategic initiatives. Results, supported by χ² tests and Cronbach’s α reliability analysis, suggest that the use of specific terminology associated with cultural heritage, rather than ‘war’ or ‘dark’ tourism, is perceived by local stakeholders as more socially and politically acceptable for rural development plans. Given the sample size and self-selection bias, these perception-based findings highlight the importance of terminological sensitivity for local leaders exploring new tourism offerings. The study concludes that, from an institutional standpoint, framing Battlefield Tourism through professional heritage protocols may facilitate its acceptance as a potential tool for economic diversification in inland destinations facing challenges of depopulation. Full article

Background: Polysubstance use, particularly the combination of opioids and stimulants, represents a growing public health concern due to its high risk of severe multisystem complications and mortality. Here, we present a case illustrating the lethal synergy of opioid–stimulant co-use. Methods: A 37-year-old male with chronic Hepatitis C and documented polysubstance use reported recent use of fentanyl, cocaine, methamphetamine, and cannabis. He presented with generalized weakness, left lower limb pain, tense edema, and anuria. Clinical assessment included monitoring of vital signs, physical examination, capillary blood gas analysis, extended laboratory panels (muscle and cardiac enzymes, electrolytes, and coagulation parameters), urinalysis, and Doppler imaging. Management over five days included intravenous hydration, diuretics, urinary alkalinization, electrolyte correction, anticoagulation, metabolic and vitamin therapy, hemodialysis, and comprehensive supportive care. Results: Laboratory evaluation revealed massive rhabdomyolysis (peak CK 161,050 U/L), severe hyperkalemia (K⁺ 8.4 mmol/L), metabolic acidosis, acute kidney injury with oligoanuria, and left-sided deep vein thrombosis. Despite intensive multidisciplinary interventions, the patient’s repeated refusal of ongoing treatment critically contributed to a fatal outcome. Conclusions: This case underscores the high mortality risk associated with opioid–stimulant co-use and the crucial impact of treatment refusal. Clinicians and public health stakeholders should recognize the rapid progression of multisystem dysfunction in polysubstance users and prioritize early, aggressive interventions combined with patient engagement strategies to mitigate fatal outcomes. Full article