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Digital health technologies (DHTs) at the intersection of health, medical informatics, and business aim to enhance patient care through personalised digital approaches. Ensuring the efficacy and reliability of these innovations demands rigorous clinical validation. A PubMed literature review (January 2006 to July 2023) identified 1250 papers, highlighting growing academic interest. A focused narrative review (January 2018 to July 2023) delved into challenges, highlighting issues such as diverse regulatory landscapes, adoption issues in complex healthcare systems, and a plethora of evaluation frameworks lacking pragmatic guidance. Existing frameworks often omit crucial criteria, neglect empirical evidence, and clinical effectiveness is rarely included as a criterion for DHT quality. The paper underscores the urgency of addressing challenges in accreditation, adoption, business models, and integration to safeguard the quality, efficacy, and safety of DHTs. A pivotal illustration of collaborative efforts to address these challenges is exemplified by the Digital Health Validation Center, dedicated to generating clinical evidence of innovative healthcare technologies and facilitating seamless technology transfer. In conclusion, it is necessary to harmonise evaluation approaches and frameworks, improve regulatory clarity, and commit to collaboration to integrate rigorous clinical validation and empirical evidence throughout the DHT life cycle. [ABSTRACT FROM AUTHOR]

In recent years, the globe has faced a series of topics of growing concern, such as the COVID-19 pandemic, the international financial crisis, rising socio-economic inequalities, the negative outcomes of greenhouse gas emissions, which resulted in climate change, and many others. Organizations worldwide have confronted these new challenges of sustainable finance by incorporating environmental, social, and corporate governance (ESG) factors and digital transformation (DT) in their innovation business strategies. The healthcare sector represents a large share of the global economy (about 10% of global economic output), employs a large number of workers, and needs to rely more on an open innovation model where interested parties, especially patients, are going to have a say in their own well-being. Thus, it is imperative that healthcare providers be efficient, effective, resilient, and sustainable in the face of significant challenges and risks. At the same time, they must offer sustainable development goals and digital transformation to healthcare users through limited governmental resources. This study investigates the role, importance, and correlation of ESG factors and digital transformation to the sustainable finance of healthcare systems through an innovative model. The main purpose of the paper is to present the already implemented ESG and DT factors in the healthcare sector and to propose a mutual and combined implementation strategy based on common evaluation tools, methods, and actions. A set of proposed actions and strategies are presented for the sustainability and resilience of the healthcare sector. [ABSTRACT FROM AUTHOR]

Background: This systematic review contributes to the understanding of the characteristics of built food environments that may be associated with choices of alternative protein foods (APF). Using the built food environment typology proposed by Downs et al., we investigated various environmental structures (e.g., supermarkets, other retailers, farmers' markets, restaurants, schools, and online vendors) and the characteristics that may facilitate or hinder consumers' choices. For example, facilitators and barriers may refer to the physical characteristics of environmental structures, food presentation practices, the organizational strategies or policies operating in the setting, or the actions that retailers or consumers engage in while selling, serving, choosing, trying, or purchasing APF in these environmental structures. Methods: A systematic review (PROSPERO database preregistration; no. CRD42023388700) was conducted by searching 13 databases for peer-reviewed journals focusing on the fields of economics and business, agriculture, medical sciences, and social sciences. Data searches, coding, and quality evaluations were conducted by at least 2 researchers. A total of 31 papers (36 original studies) were included. The risk of bias was evaluated with the Joanna Briggs Institute quality evaluation tool, with 24 publications presenting low risk of bias. Results: The findings indicate that perceived and actual availability facilitate consumers' APF choices across a built food environment. Several barriers/facilitators were associated with APF choices in specific types of built food environments: the way food is presented in produce sections (supermarkets), consumer habits in terms of green and specialty shopping (grocery stores), and mismatches among retailer actions in regard to making APF available in one type of food environment structure (e-commerce) and consumers' preferences for APF being available in other food environment structures (supermarkets, grocery stores). The effect of a barrier/facilitator may depend on the APF type; for example, social norms regarding masculinity were a barrier affecting plant-based APF choices in restaurants, but these norms were not a barrier affecting the choice of insect-based APF in restaurants. Conclusions: Addressing barriers/facilitators identified in this review will help in developing environment-matching interventions that aim to make alternative proteins mainstream. Trial registration: PROSPERO database registration: #CRD42023388700. [ABSTRACT FROM AUTHOR]

Background: Degree apprenticeships (DA) help employees gain new knowledge and skills by allowing them to study towards a university degree while working full time. For these programmes to be effective, the learning design should be adapted to the needs of these students, who are goal oriented (i.e. they want to gain only knowledge that can be applied within their workplace), have limited time for studying, and usually have not attended formal education for some time. As these programmes are relatively new, there is limited research on how these students can be supported to achieve the programmes' learning goals by using information and communication technologies. Objectives: This paper aims to understand whether a learning design that combines game‐based learning with online flipped classrooms can engage DA students in their learning and help them develop their reflective skills. Methods: Two focus groups were conducted with DA students that study at a UK Business School towards gaining the Chartered Manager status. The focus groups recordings have been analysed using reflexive thematic analysis. Results and Conclusions: The three main themes, "change can be helpful and challenging at the same time", "the ideal game", and "the effect of others", show that DA students find game‐based learning and online flipped classrooms useful, with the right support. Simulation games can be more fulfilling to DA students than quiz games, even if they take more of their out‐of‐class time. In addition, instructors are advised to work more closely with diverse teams to enable students share their work experiences and learn from each other. Lay Description: What is already known about this topic?: Online flipped classrooms offer flexibility in learning, but instructors need to find solutions to challenges, like students' limited e‐learning readiness and lack of motivation.Game‐based learning has been found to facilitate learning in general, but there is a need to identify the specific circumstances (i.e. settings, gaming elements) under which it is effective.Degree apprenticeship students need more support with their learning compared to traditional university students, as they face additional challenges in terms of family life‐work balance and connecting their learning to their working experience. What this paper adds?: Game‐based learning can be useful to degree apprenticeship students providing that focuses on the application of knowledge and provides feedback.Despite facing challenges related to maintaining work‐study‐life balance, degree apprenticeship students are willing to complete the flipped classroom's out‐of‐class activities, if they see a clear benefit from doing so.Online group activities can be challenging for degree apprenticeship students, if they are not able to form teams with other learners that work for the same organisation. The implications of study findings for practitioners: Avoid quiz‐like games and select the ones that use real‐life scenarios for degree apprenticeship students to help them link their learning to their practice.Formative feedback should be provided by both the instructor and the game to motivate degree apprenticeship students to spend the additional time to complete the out‐of‐class activities.Students should be reminded frequently of the purpose of any new learning elements (e.g. learning analytics) as they may not have the time to explore them on their own.When forming student teams based on students' workplace is not possible, spend more time in each breakout room to facilitate the online group discussion and help students bring their different working experiences together. [ABSTRACT FROM AUTHOR]

Background: Game‐based learning can frame problem‐solving as a sense‐making experience with domain‐specific tasks for school students. However, multiple challenges arise when trying to support learners in such a complex, problem‐oriented learning environment. Objectives and Methods: With an architecture‐themed mathematics learning game, we conducted two mixed‐method studies to explore the impact and design of game‐based mathematical experience on the math problem‐solving performance of middle school students. Results and Conclusions: The study findings suggested a positive impact of game‐based math experience on math problem‐solving for middle school students. Problematization‐oriented game‐based math tasks with structuring features enhanced students' reasoning with problems and channelled it to doing mathematics. Takeaways: The current research findings support the initiative to frame learning as a sense‐making experience with domain‐specific tasks and inform the design of game‐based mathematical experience and learning support. Lay Description: What is already known about this topic: Realistic mathematical practices frame learning as a sense‐making experience.Challenges arise when involving learners in realistic mathematical experiences driven by domain‐specific tasks. What this paper adds: Game‐based simulation of math tasks framed learning as sense‐making experience.Game‐based math experiencing promoted math contextual problem‐solving performance.Structuring features enhanced problematized experiencing with math tasks. Implications for practice and/or policy: Teachers can integrate and facilitate game‐based math experiencing in class.Efforts should be made to make game‐based math tasks meaningful for students. [ABSTRACT FROM AUTHOR]

Purpose: Since the 1960s, federal and state governments and private-sector companies have used supplier diversity initiatives to ensure their supply chains include businesses owned by traditionally economically disadvantaged or underrepresented groups. Originally concentrated on racial and ethnic minority groups, programs have expanded to include businesses owned by women, veterans, LGBTQ+ individuals, and, in some cases, people with disabilities. This study investigates the extent to which disability is included in supplier diversity initiatives of Fortune 500 companies. Methods: This paper uses a novel data set created by the authors with information on supplier diversity initiatives and Disability, Equity, and Inclusion (DEI) statements in Fortune 500 companies extracted from public sources. This information is combined with data from Compustat, a corporate financial database published by Standard and Poor's and additional variables from other sources. Results: 75% of the Fortune 500 companies have supplier diversity programs that express a commitment to diversity yet only 49% of those with such programs include disability-owned businesses (38% of all Fortune 500 companies). Among the largest 100 companies, 89% had supplier diversity programs that included disability, almost 6 times the rate Ball et al. reported in 2005. This study finds disability inclusion varies significantly by company size, industry, and whether the company is a government contractor. Conclusion: Despite the growth in disability inclusion, the absence of disability as a diversity category in regulations mandating supplier diversity initiatives for government contractors impacts disability inclusion. If we want to align our supplier diversity programs with the Americans with Disabilities Act, the first step is to address the issue in the Small Business Administration and federal contracting requirements. [ABSTRACT FROM AUTHOR]

Mobile health (mHealth) screening tools for autism are gaining in prevalence, and have benefits such as video content and direct resources linkage. However, it is unclear whether such tools will ameliorate autism inequities or will help only those already advantaged in autism care. To investigate this issue, we conducted semi-structured qualitative interviews with 18 primary care and Early Intervention/Early Childhood Special Education providers in six US states. Providers were given hypothetical scenarios in which a family presents to care with results from one of 9 mHealth autism screening tools. Providers discussed their clinical approach and assessed the tool's fit with their patient/client population. Each transcript was audio-recorded, transcribed, and coded; a phenomenological approach was used to develop key themes. 4 themes and 18 subthemes emerged. These included Clinical and business factors (e.g. scope of practice concerns and clinical efficiency), Validity and trustworthiness (e.g. familiarity, data privacy/security), Family interaction quality (e.g. supporting family advocacy, provision of information, affecting family anxiety, and emotional support), and Accessibility (e.g. English proficiency/language issues, cultural inclusivity, and literacy/educational level). Providers suggested modifications to enhance equity, such as portraying diverse families, reducing the reading level of text, and making tools shorter to better fit clinical context. Families may find information about autism online, and health care and education providers may use online tools to screen for autism. However, we do not know if online autism screening tools are easily used by families and providers. We interviewed primary care and educational providers, asking them to review results from online tools that screen for autism. Providers had concerns about how usable and accessible these tools are for diverse families and suggested changes to make tools easier to use. [ABSTRACT FROM AUTHOR]

Universities play a crucial role in scientific research by promoting innovation, advancing knowledge, and nurturing future scientific experts and performers. The activities conducted within universities cover a wide spectrum, but strategies prioritize key elements. Crafting these strategies is particularly complex in this field, requiring the involvement of a large number of stakeholders, among which academic and research staff stand out in importance. The paper presents the perceptions of academic staff at the "Grigore T. Popa" University of Medicine and Pharmacy in Iași (UMF Iași) regarding the main axes of university strategy development. Essential aspects are addressed, such as the weighting of academic activities, funding procedures, and incentives provided to encourage and support scientific research activities, the objectives of scientific research strategy, and how research activities are integrated into the university's strategy.

he development of transdisciplinary projects, crucial in the context of the complex challenges facing society. The organization of scientific research must prioritize the human factor and involve establishing the departments involved in university scientific research and the connections between them. This paper presents the perceptions of academic staff at a medical university regarding the organization and implementation of research within the university and the sources of research funding. The results highlight a clear orientation towards interdisciplinary research, albeit conducted within the organization itself, and a weak prioritization of fundamental research. Additionally, funding through international grants is seen as less accessible than national funding, despite the medical field being considered a priority in the funding programs. The research findings are relevant for decision-makers in the field of research funding at both the national and organizational levels.

Background: The evolution of eHealth development has shifted from standalone tools to comprehensive digital health environments, fostering data exchange among diverse stakeholders and systems. Nevertheless, existing research and implementation frameworks have primarily emphasized technological and organizational aspects of eHealth implementation, overlooking the intricate legal, ethical, and financial considerations. It is essential to discover what legal, ethical, financial, and technological challenges should be considered to ensure successful and sustainable implementation of eHealth. Objective: This review aims to provide insights into barriers and facilitators of legal, ethical, financial, and technological aspects for successful implementation of complex eHealth technologies, which impacts multiple levels and multiple stakeholders. Methods: A scoping review was conducted by querying PubMed, Scopus, Web of Science, and ACM Digital Library (2018-2023) for studies describing the implementation process of eHealth technologies that facilitate data exchange. Studies solely reporting clinical outcomes or conducted outside Europe were excluded. Two independent reviewers selected the studies. A conceptual framework was constructed through axial and inductive coding, extracting data from literature on legal, ethical, financial, and technological aspects of eHealth implementation. This framework guided systematic extraction and interpretation. Results: The search resulted in 7.308 studies that were screened for eligibility, of which 35 (0.48%) were included. Legal barriers revolve around data confidentiality and security, necessitating clear regulatory guidelines. Ethical barriers span consent, responsibility, liability, and validation complexities, necessitating robust frameworks. Financial barriers stem from inadequate funding, requiring (commercial) partnerships and business models. Technological issues include interoperability, integration, and malfunctioning, necessitating strategies for enhancing data reliability, improving accessibility, and aligning eHealth technology with existing systems for smoother integration. Conclusions: This research highlights the multifaceted nature of eHealth implementation, encompassing legal, ethical, financial, and technological considerations. Collaborative stakeholder engagement is paramount for effective decision-making and aligns with the transition from standalone eHealth tools to integrated digital health environments. Identifying suitable stakeholders and recognizing their stakes and values enriches implementation strategies with expertise and guidance across all aspects. Future research should explore the timing of these considerations and practical solutions for regulatory compliance, funding, navigation of responsibility and liability, and business models for reimbursement strategies. [ABSTRACT FROM AUTHOR]

Leaders of small and medium-sized enterprises (SMEs) are often confronted with specific burdens, which frequently result in increased levels of stress. Leadership behaviour, in turn, has a significant impact on employees' health and performance. Using the Population, Intervention, Comparison, Outcome (PICO) method, we conducted a systematic literature search covering publications from 2002 to 2023 using PubMed, PsycInfo and Business Source Premier on stress-reducing and well-being-improving interventions for SME leaders. The Effective Public Health Practice Project (EPHPP) Quality Assessment Tool was used to assess the methodological quality and risk of bias of the included studies regarding selection bias, study design, confounders, blinding, data collection, withdrawal and drop-out. Of the 3150 identified publications, 6 were included after screening. The studies varied in content (cognitive behavioural therapy [CBT]-based, psychoeducation, and mixed interventions) and approach (individual- and organisation-centred). Not all of the examined interventions provided significant outcomes. However, CBT-based and individualised approaches showed a positive trend in reducing SME leaders' psychosocial stress and improving their well-being. Despite the limited data, it can be concluded that such interventions are beneficial for leaders and their specific needs. Future research should focus on tailored approaches, derived from well-founded theories and integrative interventions addressing SME leaders. [ABSTRACT FROM AUTHOR]