A cross-sector systematic review and synthesis of knowledge on telemedicine interventions in chronic wound management-Implications from a system perspective.

Based on initially identified needs for further telemedicine (TM) and chronic wound management research, the objective of this article is twofold: to conduct a systematic review of existing knowledge on TM interventions in chronic wound management-including barriers and opportunities-across the specialist and primary care sectors, and to incorporate the review findings into a system framework that can be further developed and validated through empirical data. We conclude that there is a pressing need for broader and more comprehensive empirical explorations into quality improvement and integration of TM in chronic wound management, including using system frameworks that can capture cross-sector system perspectives and associated implications. Of practical consideration, we suggest that the design and execution of TM improvement interventions and associated research projects should be conducted in close cooperation with managers and practitioners knowledgeable about barriers and opportunities that can influence the implementation of important interventions within chronic wound management.

A holistic perspective on continuing care for substance use and dependence: Results and implications from an in-depth study of a Norwegian continuing care establishment.

This article explores, systematically and in depth, users' perceptions of participating in a Norwegian non-profit establishment that provides a continuing care programme for substance use and dependence. Identified results are linked to a holistic system perspective, where human, technology, and organisation (HTO), as well as external environment, are viewed as intertwined. At the establishment level, i.e., where the continuing care programme is delivered, we find that a clear holistic and user-oriented profile - comprising combined interventions including physical and social activities - can create a safe and stable environment that exerts a positive mental and physical influence on the user and thereby promotes abstinence from substances. However, our results suggest that the internal environment needs to connect more strongly with the external environment, such as a substance-free network, close family, and working life. At the establishment level, we conclude that there is a need to develop an explicit strategy and practice for collaborating with the external environment, built on systemisation and application of individual users' insights into the design of the current interventions. Further research should explore the presence and absence of interplays between elements of human, technology, and organisation and the external environment, and the associated consequences for intervention processes and users' health outcomes. Our holistic system model, empirically informed by data from a Norwegian context, can represent a starting point for such endeavours. The holistic system model also constitutes an original and novel contribution to research on continuing care interventions.

Exploring multiple working arrangements in Norwegian engineering, procurement, and construction industry from a middle manager and supervisor perspective: A sociotechnical system perspective.

With a scarcity of research on multiple working arrangements, the aim of the paper is to contribute empirical data from a Norwegian engineering, procurement, and construction enterprise that shed light on the challenges and benefits of a 14-21 working arrangement in itself and in relation to other working arrangements. We combine a sociotechnical system perspective with systematic content analysis using QSR NVivo, which reveals organizational complexity comprised of indirect, direct, positive, negative, and mutual interplays between various aspects of the enterprise, including processes and outcomes. We find that the 14-21 working arrangement, in combination with other factors of the work system, sets the premises for work processes and outcome factors that are both beneficial and challenging to individuals and the organization. We also find that work process factors, such as work and information flow as well as follow-up and facilitation, depend on the presence of, and dynamic coordination and communication among, individuals across the organization. This in turn requires a support network, work groups, and supervisors to be on the same working arrangement.