Emilia Vann Yaroson

Effective management of buyer–supplier relationships in supply chains significantly impacts the success and efficiency of stakeholders. However, the pharmaceutical supply chain's (PSC) unique characteristics may indicate that power dynamics are shaped by other factors, including the regulatory framework, digitalisation, culture, sustainability, and resilience capabilities. Exploring buyer–supplier power dynamics in PSCs is crucial for understanding how the pharmaceutical industry operates, decision-making processes, and how different stakeholders influence each other. In this chapter, we explore how these factors trigger power imbalances in PSC buyer–supplier relationships.

Background: Digital health twins (DHTs) have been evolving with their diverse applications in medicine, particularly in care settings for older adults, in response to the increasing demands of older adults. Despite its numerous benefits, the optimal implementation of DHTs has faced several challenges, particularly in terms of ethics and quality of care. Given the continuous rise in the need for such care and the evident potential for DHTs to meet these needs, this review seeks to identify and address the gaps in research knowledge to enhance DHT implementation. Objective: The review aims to compile and synthesize the best available evidence regarding the issues associated with quality of care, the ethical implications of DHTs, and the strategies undertaken to overcome those challenges in care settings for older adults. Methods: The review followed the Joanna Briggs Institute (JBI) methodology as a guide. The published studies were searched through CINAHL, MEDLINE, JBI, and Web of Science. The unpublished studies were searched through Mednar, Trove, OCLC WorldCat, and Dissertations and Theses. Studies published in English from 2016 were considered. This review included studies of older individuals (aged 60 years and older) undergoing care delivery associated with DHTs and respective care providers. The concept involved the application of technology, and the context included studies based on care settings for older adults. A broad scope of evidence, including quantitative, qualitative, text, and opinion studies, was considered. In addition, 2 independent reviewers screened the titles and abstracts and reviewed the full text. Results: The results will be presented in a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram. A total of 2 draft charting tables were developed and presented. A summary of the characteristics of the included studies was then described in terms of location, study sites, timing, participants, and outcomes measured or phenomena of interest. A result-based convergent (integrated) synthesis design was used to identify 5 key challenges. Those challenges included (1) data security and privacy concerns, (2) equity and accessibility of health care, (3) effectiveness concerning context, timing, and location, (4) ethical implications regarding autonomy, consent, and overdiagnosis, and (5) the impact of DHTs on health care workflows and provider workload. Conclusions: The studies reviewed reveal several critical characteristics regarding the implementation of DHT technologies and their associated ethical considerations, particularly in terms of safety, equity, timing, location, participant characteristics, and workflow impact. The implications of these challenges emphasize the necessity for more practical ethical guidelines and policy frameworks to mitigate the potential risks associated with DHT application in older care. Further research should be conducted to examine other dimensions of the quality of care, such as access, timeliness, acceptability, and appropriateness.

BACKGROUND Quality improvement (QI) interventions are designed to resolve the recurring challenges of care for older individuals, such as working conditions for staff, roles of older individuals in their care and their families, and relevant stakeholders. Therefore, there is a need to map the impacts of QI interventions in older care settings and further improve health and social care systems OBJECTIVE This review aims to compile and synthesise the best available evidence regarding the care of older individuals and the effectiveness of policy and practice QI interventions in older care. It also aims to understand QI intervention-related experiences and perspectives of stakeholders, care providers, older individuals, and their families. METHODS The mixed-methods review will follow the standard methodology used by the Joanna Briggs Institute. The published studies will be searched through CINAHL, MEDLINE, PsycInfo, and Web of Science, and the unpublished studies through Mednar, Trove, OCLC WorldCat, and Dissertations and Theses. This review included both qualitative and quantitative analyses of older individuals undergoing older care and any health and care professionals involved in this care delivery; a broad range of QI interventions, including assistive technologies, effects of training and education, safety programs, and medical devices; the experiences and perspectives of staff and patients; the context of older care setting; and a broad range of outcomes, including patient safety. The standard procedure for reporting, i.e., PRISMA guidelines, will be followed. RESULTS The results were presented in a PRISMA flow diagram and two draft charting tables in tabular and descriptive formats. A summary of the characteristics of the included studies was then described in terms of location, study sites, timing, participants, and types of interventions. Eight kinds of QI interventions were identified: training (use of technology), education, communication, technology implementation, person-centred care, health and well-being promotion, systematic support, and competence development. The integrated synthesis yielded a range of outcomes and phenomena of interest, including staff self-efficacy, competence and skill enhancement, technology adoption, and user experience, communication and collaboration, co-designing with end users, person-centred care, health and well-being, transitional care and discharge planning, barriers to QI implementation, safety and risk reduction, peer support, and social connection, and promoting active ageing. CONCLUSIONS This comprehensive review provided insights into some QI interventions and their impact, outlined a range of outcomes and phenomena of interest for older care, and benefited both the practical usefulness of care service activities and society. Educational interventions designed for staff and older adults exemplified a promising outlook on enhancing clinical competence and promoting health literacy through various initiatives. Areas promoting health and well-being, targeting physical, mental, and social well-being, have proven to improve quality of life. INTERNATIONAL REGISTERED REPORT RR2-10.2196/56346

Human-artificial intelligence collaboration (CAIT) presents considerable opportunities for optimising supply chain outcomes. Nonetheless, it poses numerous ethical, technological, and organisational obstacles that could impede its efficacy. This study contends that responsible AI (RAI) systems can function as a conduit between CAIT and supply chain outcomes to tackle these challenges. Accordingly, we leveraged the resource-based view (RBV) and socio-technical system (STS) theoretical lenses to analyse the mediating role of RAI in the relationship between CAIT and two supply chain outcomes (supply chain wellbeing (SCWB) and sustainable business performance (SBP)). The suggested model was evaluated using PLS-SEM on survey data from 301 supply chain managers in the UK. Our analysed data revealed a statistically insignificant relationship between CAIT and supply chain outcomes (SCWB and SBP). However, the mediating role of RAI was confirmed. The findings suggest that CAIT is merely a component of a supply chain's capacity to produce intrinsic resources, rather than a universal solution. To harness the dividends of human-AI collaboration involves designing boundaries, aligning CAIT to supply chain goals and integrating ethical and transparent strategies. Our findings contribute to the discourse on AI use in supply chain literature by showing that CAIT can influence supply chain outcomes by bridging ethical, operational and technological gaps while fostering trust and efficiency.

Background: Quality improvement (QI) interventions are designed to resolve the recurring challenges of care for older individuals, such as working conditions for staff, roles of older individuals in their own care and their families, and relevant stakeholders. Therefore, there is a need to map the impacts of QI interventions in older adult care settings and further improve health and social care systems associated with older adults. Objective: This review aims to compile and synthesize the best available evidence regarding the effectiveness of policy and practice QI interventions in older adult care. The secondary aim is to understand the care of older individuals and QI intervention-related experiences and perspectives of stakeholders, care providers, older individuals, and their families. Methods: The mixed methods review will follow the standard methodology used by Joanna Briggs Institute. The published studies will be searched through CINAHL, MEDLINE, PsycINFO, ASSIA, and Web of Science, and the unpublished studies through Mednar, Trove, OCLC WorldCat, and Dissertations and Theses. This review included both qualitative and quantitative analyses of patients undergoing older adult care and any health and care professionals involved in the care delivery for older adults; a broad range of QI interventions, including assistive technologies, effects of training and education, improved reporting, safety programs, and medical devices; the experiences and perspectives of staff and patients; the context of older adult care setting; and a broad range of outcomes, including patient safety. The standard procedure for reporting, that is, PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, will be followed. Results: A result-based convergent synthesis design will be used in which both quantitative and qualitative studies will be analyzed separately, and the results of both syntheses will be then integrated during a final (convergent) synthesis. The integration will compare the findings of quantitative and qualitative evidence using tables in light of the results of both syntheses. Conclusions: This comprehensive review is expected to reflect on the insights into some QI interventions and their impact, outline some common challenges of quality for older adult care, and benefit both the practical usefulness of care service activities and the society at large. International Registered Report Identifier (IRRID): PRR1-10.2196/56346

Background: Digital health twins (DHTs) have been evolving with their diverse applications in medicine, specifically in older care settings, with the increasing demands of older adults. DHTs have already contributed to improving the quality of dementia and trauma care, cardiac treatment, and health care services for older individuals. Despite its many benefits, the optimum implementation of DHTs has faced several challenges associated with ethical issues, quality of care, management and leadership, and design considerations in older care settings. Since the need for such care is continuously rising and there is evident potential for DHTs to meet those needs, this review aims to map key concepts to address the gaps in the research knowledge to improve DHT implementation. Objective: The review aims to compile and synthesize the best available evidence regarding the problems encountered by older adults and care providers associated with the application of DHTs. The synthesis will collate the evidence of the issues associated with quality of care, the ethical implications of DHTs, and the strategies undertaken to overcome those challenges in older care settings. Methods: The review will follow the Joanna Briggs Institute (JBI) methodology. The published studies will be searched through CINAHL, MEDLINE, JBI, and Web of Science, and the unpublished studies through Mednar, Trove, OCLC WorldCat, and Dissertations and Theses. Studies published in English from 2002 will be considered. This review will include studies of older individuals (aged 65 years or older) undergoing care delivery associated with DHTs and their respective care providers. The concept will include the application of the technology, and the context will involve studies based on the older care setting. A broad scope of evidence, including quantitative, qualitative, text and opinion studies, will be considered. A total of 2 independent reviewers will screen the titles and abstracts and then review the full text. Data will be extracted from the included studies using a data extraction tool developed for this study. Results: The results will be presented in a PRISMA-ScR (Preferred Reporting Items for Systematic Review and Meta-Analysis extension for Scoping Reviews) flow diagram. A draft charting table will be developed as a data extraction tool. The results will be presented as a “map” of the data in a logical, diagrammatic, or tabular form in a descriptive format. Conclusions: The evidence synthesis is expected to uncover the shreds of evidence required to address the ethical and care quality-related challenges associated with applying DHTs. A synthesis of various strategies used to overcome identified challenges will provide more prospects for adopting them elsewhere and create a resource allocation model for older individuals. International Registered Report Identifier (IRRID): DERR1-10.2196/51153

BACKGROUND Quality improvement (QI) interventions are designed to resolve the recurring challenges of care for older individuals, such as working conditions for staff, roles of older individuals in their own care and their families, and relevant stakeholders. Therefore, there is a need to map the impacts of QI interventions in older adult care settings and further improve health and social care systems associated with older adults. OBJECTIVE This review aims to compile and synthesize the best available evidence regarding the effectiveness of policy and practice QI interventions in older adult care. The secondary aim is to understand the care of older individuals and QI intervention-related experiences and perspectives of stakeholders, care providers, older individuals, and their families. METHODS The mixed methods review will follow the standard methodology used by Joanna Briggs Institute. The published studies will be searched through CINAHL, MEDLINE, PsycINFO, ASSIA, and Web of Science, and the unpublished studies through Mednar, Trove, OCLC WorldCat, and Dissertations and Theses. This review included both qualitative and quantitative analyses of patients undergoing older adult care and any health and care professionals involved in the care delivery for older adults; a broad range of QI interventions, including assistive technologies, effects of training and education, improved reporting, safety programs, and medical devices; the experiences and perspectives of staff and patients; the context of older adult care setting; and a broad range of outcomes, including patient safety. The standard procedure for reporting, that is, PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, will be followed. RESULTS A result-based convergent synthesis design will be used in which both quantitative and qualitative studies will be analyzed separately, and the results of both syntheses will be then integrated during a final (convergent) synthesis. The integration will compare the findings of quantitative and qualitative evidence using tables in light of the results of both syntheses. CONCLUSIONS This comprehensive review is expected to reflect on the insights into some QI interventions and their impact, outline some common challenges of quality for older adult care, and benefit both the practical usefulness of care service activities and the society at large. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/56346

BACKGROUND Digital health twins (DHTs) have been evolving with their diverse applications in medicine, specifically in older care settings, with the increasing demands of older adults. DHTs have already contributed to improving the quality of dementia and trauma care, cardiac treatment, and health care services for older individuals. Despite its many benefits, the optimum implementation of DHTs has faced several challenges associated with ethical issues, quality of care, management and leadership, and design considerations in older care settings. Since the need for such care is continuously rising and there is evident potential for DHTs to meet those needs, this review aims to map key concepts to address the gaps in the research knowledge to improve DHT implementation. OBJECTIVE The review aims to compile and synthesize the best available evidence regarding the problems encountered by older adults and care providers associated with the application of DHTs. The synthesis will collate the evidence of the issues associated with quality of care, the ethical implications of DHTs, and the strategies undertaken to overcome those challenges in older care settings. METHODS The review will follow the Joanna Briggs Institute (JBI) methodology. The published studies will be searched through CINAHL, MEDLINE, JBI, and Web of Science, and the unpublished studies through Mednar, Trove, OCLC WorldCat, and Dissertations and Theses. Studies published in English from 2002 will be considered. This review will include studies of older individuals (aged 65 years or older) undergoing care delivery associated with DHTs and their respective care providers. The concept will include the application of the technology, and the context will involve studies based on the older care setting. A broad scope of evidence, including quantitative, qualitative, text and opinion studies, will be considered. A total of 2 independent reviewers will screen the titles and abstracts and then review the full text. Data will be extracted from the included studies using a data extraction tool developed for this study. RESULTS The results will be presented in a PRISMA-ScR (Preferred Reporting Items for Systematic Review and Meta-Analysis extension for Scoping Reviews) flow diagram. A draft charting table will be developed as a data extraction tool. The results will be presented as a “map” of the data in a logical, diagrammatic, or tabular form in a descriptive format. CONCLUSIONS The evidence synthesis is expected to uncover the shreds of evidence required to address the ethical and care quality-related challenges associated with applying DHTs. A synthesis of various strategies used to overcome identified challenges will provide more prospects for adopting them elsewhere and create a resource allocation model for older individuals. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/51153