Sustainable marketing and strategy

The theme of this Special Issue (SI) is Sustainable Marketing and Strategy, as in the literature, we have seen growing evidence of how sustainability efforts are increasingly bringing significant benefits to enterprises. This effect has been further witnessed following the outbreak of the COVID-19 pandemic, whereby we have seen an even more conscious consumer appear. The benefits include increased brand awareness, as those firms that stand out tend to catch attention by being keen to help and not hurt the environment as well as local communities. Consumers are thus opting for more environmentally and community-friendly firms, which is thus a means to achieving greater competitiveness. That the sustainability theme may be seen simply as a marketing tactic has also been debated. It surely makes strategic and marketing sense to be nice to the community, above what is required by law. Doing so in sincere and planned efforts will reap better returns in the age of the informed consumer. Greenwashing must be avoided at all costs, as firms will be punished for not being authentic in their social responsibility efforts. The articles published in this SI discuss how companies are managing the issues related to a new era whereby sustainability is a major goal for academics and practitioners alike.info:eu-repo/semantics/publishedVersio

Effectiveness of the Portugal 2020 Programme: A study from the citizens’ perspective

The European Structural and Investment Funds (ESIF) are the main instrument of the European Union (EU) Cohesion Policy to promote convergence, economic growth and reduce imbalances between EU members. The objectives of the 2014–2020 programming period follow the agenda of the Europe 2020 Strategy to promote smart, sustainable and inclusive growth of EU members. Since before joining the EU, in 1986, until the end of the Portugal 2020 Partnership Agreement (PT2020), Portugal will have received more than EUR 130 billion. Have the subsidies that Portugal has received been well applied? Our study fills a gap in the literature by portraying citizens’ perceptions about the effectiveness of EU funds for the development of the country and its regions. The study is quantitative in nature, and a non-probabilistic sample of 1119 participants answered our survey. A high proportion (76%) of the respondents considered that EU funds contributed to the development of the region where they live, although a significant percentage of the respondents (more than half) considered that there may be corruption in Portugal. The Portuguese also mentioned the existence of practices such as favouritism and lobbying regarding the approval of projects. Our findings are supported by the literature, which refers to “lost opportunities” in the inefficient application of ESIF, while recognising that EU funds have played a significant role in Portugal’s development over the last three decades.info:eu-repo/semantics/publishedVersio

Tourism towards sustainability and innovation: A systematic literature review

In this paper, we analyze the progress of tourism towards sustainability and innovation through a systematic literature review summarizing the last five years of research strictly focused on innovation and sustainability applied to tourism. This research comprises a range of theories, practices, methods, and results pursuing innovation and sustainability across different levels, stages, and drivers, and in many tourism contexts. Wide, in-depth, and structured analysis, evaluation, and examination (using the PRISMA and VOSviewer tools) of a final sample of 50 scholarly papers from 27 journals, published between 2017 and the first quarter of 2021, were undertaken. Current publications emphasize qualitative, quantitative, and mixed research methods, as well as statistical and econometric methods, such as descriptive statistics, factor analysis, and structural equation modeling. This study categorizes the four major topics identified, sustainability, innovation, sustainable development, and sustainable tourism, which comprised the contextual dimensions and relevant stages of the subject areas examined. This systematic literature review highlights advances and the significantly increasing overall number of papers over recent years. Currently, sustainability is in a more advanced state compared to innovation. The outcomes highlight that the indicators of sustainability and innovation still need further analysis within the tourism context. However, more concrete process indicators are needed for continuous improvement of the front-end of innovation and sustainable tourism. The results help in better understanding the sustainability and innovation process as applied to tourism. In particular, this study explores further direct linkages between sustainability and innovation and tourism, discussing and providing new future directions aligned with the closing remarks as well as a strategic agenda for future action post-COVID-19.info:eu-repo/semantics/publishedVersio

Weaknesses in motivation and in establishing a meritocratic system: A portrait of the Portuguese public administration

The complexities of Public Administration have gained the growing attention of scholars around the world, mainly due to the impacts of the reforms implemented under the doctrine of New Public Management (which aims to apply concepts and practices of private management in public management) on civil servants. The aim of this study is to find out how Portuguese citizens evaluate the Portuguese Public Administration under the aspects of bureaucracy, organisation of human resources, innovation, skills and attitudes of civil servants, its motivation and recognition; and to verify if there are differences of opinion between respondents working in public sector and respondents from other sectors. This study follows a quali-quantitative approach, and data were collected through an online survey in the period from June to December 2020. The survey was answered by 1119 citizens from all districts of Portugal. The main findings reveal a still high level of bureaucracy in the Portuguese Public Administration; weaknesses in the management of human resources, namely regarding the motivation and recognition of civil servants; and difficulties in the establishment of a meritocratic system of recruitment and performance evaluation of civil servants. Statistically significant evaluation differences (chi-square test and non-parametric Mann–Whitney U tests, involving five hypotheses) were found between the public sector and other sectors, except for the motivation variable.info:eu-repo/semantics/publishedVersio

The Potential of Big Data Research in HealthCare for Medical Doctors’ Learning

The main goal of this article is to identify the main dimensions of a model proposal for increasing the potential of big data research in Healthcare for medical doctors’ (MDs’) learning, which appears as a major issue in continuous medical education and learning. The paper employs a systematic literature review of main scientific databases (PubMed and Google Scholar), using the VOSviewer software tool, which enables the visualization of scientific landscapes. The analysis includes a co-authorship data analysis as well as the co-occurrence of terms and keywords. The results lead to the construction of the learning model proposed, which includes four health big data key areas for MDs’ learning: 1) data transformation is related to the learning that occurs through medical systems; 2) health intelligence includes the learning regarding health innovation based on predictions and forecasting processes; 3) data leveraging regards the learning about patient information; and 4) the learning process is related to clinical decision-making, focused on disease diagnosis and methods to improve treatments. Practical models gathered from the scientific databases can boost the learning process and revolutionise the medical industry, as they store the most recent knowledge and innovative research

Accessibility levels of Portuguese Enterprise websites: Equal opportunities for all?

Artigo revisto disponível online 18 Maio, 2011 (iFirst)Web accessibility is growing in importance as time goes by. Alongside this growth we find an increasing need for access to Web resources by those with some sort of disability. The Web is very important for spreading information and for promoting interaction between the various elements in society. Given this, it is essential that the Web presents itself as a totally accessible resource, so that it can help disabled citizens and their integration in society. This obligation should be even greater for enterprises as primarily the Web is used as a marketing and business platform. With this document we present indicators regarding the [lack of] accessibility levels of Portuguese websites. This article is divided into eight parts containing theoretical and background considerations leading up to two different studies which the research team undertook. In the first study (considering WCAG 1.0) we make a comparison between the 1,000 largest Portuguese enterprises (annual sales volume) and the 1,000 best Portuguese SMEs1 using a specialized software tool. In the second study a group of recommendations towards accessibility are made; these recommendations were achieved through a focus group interaction. We do also, however, present an insight into the WCAG 2.0 influence on existent accessibility levels

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Young university spin-off firms' internationalization: The influence of founding teams and networks

Commercialization of inventions urges university spin-off firms to develop networks abroad, particularly if they are active in a small national economy. While it is recognized that young spin-offs are vulnerable due to lack of various resources and capabilities, support in internationalization from the university is rare. We investigate university spin-offs' internationalization using a sample of 105 of such firms in Northwest European countries. In early years, 62 per cent employ international networks, enhanced by capabilities gained in PhD education, participation in market training and innovation experience at practical level, but also (and strongly) by diversity among partners in domestic networks. Subsequent growth leads to a stronger internationalization, mainly derived from early patterns of internationalization, but a good 30 per cent of the spin-offs tend to face problematic situations, namely a shrinking pattern or persistent lack of internationalization. The paper concludes with some challenges for improvement.</p

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

Background: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit