Nested Case Study Research Articles

Assessing Consumer Perception of Effective Health Service Delivery: A Study of The Perspectives of Users of Diocesan Health Services in Sunyani

Background: The standard of the healthcare provided predicts a population's health. The purpose of this study is to comprehend how consumers perceive the effective management and provision of health services at the Diocesan Health Services in Sunyani, Ghana. Materials and Methods: The study used a mixed methodology in which both quantitative and qualitative data were utilized. Semi-structured interviews and a questionnaire were used to collect the data. The nested case study design approach was used for this investigation. The study was carried out in a few chosen facilities of Diocesan Health Services Sunyani. The sample included 331 people from the facilities. Respondents’ data were subjected to descriptive and inferential data analysis. Results: The findings revealed focused primary healthcare delivery, good management and leadership, community engagement, and integration of traditional and complementary medicine into the national health systems as quality healthcare. Conclusion: Users view increased accessibility, acceptability, availability, and good service outcomes as quality health service planning and delivery.

A conflict of visions: Ideas shaping wildlife trade policy toward African megafauna

Abstract Among factors that threaten wild populations of African megafauna, wildlife trade has gained prominence as a global policy issue, with concerted international campaigns aiming to influence the trade of species such as elephants, rhinos and lions. Trade policy is strongly contested, confounding attempts to develop coherent approaches across jurisdictions and through international mechanisms such as the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES). This undermines conservation efforts. Understanding the drivers of such conflict may help to address this problem. Scholars of political science increasingly recognise the power of ideas as drivers within policy processes. Guided by this literature, we developed an analytical framework and conducted a thematic analysis to examine the ideas driving wildlife trade policy conflict. Our nested case study approach examined debates over trade policy toward African elephants, rhinos and lions at two levels: the international policy arena of CITES and within a single country, South Africa. Informed by earlier literature, we tracked the evolution of international trade policy debates over a 4‐year period (2016–2019) and analysed submissions to a national policy review process in South Africa that took place during 2020. During the study period, state and non‐state actors contributed to vigorous trade policy debates within seven key thematic issues across the case study species. Arguments were driven by both cognitive ideas, which specify cause‐and‐effect relationships, and normative ideas, which are values‐based and especially salient elements of anti‐trade stances. Fusing these cognitive and normative ideational elements, we identified three distinct overarching narratives relating to wildlife trade policy. These three narratives align with broader environmental policy and political narratives and elucidate inherent tensions within the CITES arena. They also reveal differing ethical interpretations and perceptions of risk and precaution. Policy implications. Wildlife trade policy conflict is driven at least in part by competing ideological visions, which may be entrenched by the CITES Appendix listing system. The structural role of CITES in perpetuating this polarisation—and the consequences thereof—warrants further research. Read the free Plain Language Summary for this article on the Journal blog.

The opportunities and challenges of politically designed co-creation platforms

Contemporary governments face dwindling resources and populations who feel disconnected from political systems. In response, both governments and scholars increasingly explore more participative governance approaches. Such efforts have coalesced around ‘co-creation’, a way of governing through collaboration between public and private actors, often including citizens. Increasingly, scholars emphasise ‘co-creation platforms’: devices that use reconfigurable structures and resources to facilitate multiple instances of co-creation. By creating platforms, advocates claim, governments can facilitate widespread co-creation without unfeasible costs. Some even encourage governments to adopt platform-creation as their way of governing – so-called ‘generative governance’. Yet, with governments being time- and cash-poor, they cannot participate in every such co-creation initiative themselves. To realise the promise of generative governance, platforms must enable governments to facilitate co-creation initiatives at arm’s length. While, however, research suggests that governments can be successful platform-users, we know little about how successfully they can forge platforms to encourage co-creation among others. Consequently, we conducted a nested case study of the creation and use of one novel platform: London Borough of Culture. Theorised through literatures on platforms, and co-creation’s drivers and inhibitors, our findings affirm that platforms can facilitate co-creation. However, they also uncover how platforms fashioned by politically-led organisations become entangled in political dynamics that inhibit co-creation. Two contributions follow: first, platforms made by politically-led bodies enable, but simultaneously constrain, others’ co-creation; second, drivers and inhibitors of co-creation can be strategically shaped by interventions (for example, platforms) to maximise the chances of that co-creation succeeding.

A comparison of healthcare service for international students in United States and United Kingdom: A perspective of institutional complexity

As newcomers to the host country, international students face unique challenges when it comes to the healthcare service, such as the language barrier. The challenges lead to a low utilization rate of the healthcare service in the population of international student. This paper aims to find out the main reason behind the phenomenon and explore how to improve the health and welfare of the international students. A nested case study approach is used and the United States and the United Kingdom are the two countries for comparison. We found that benefiting from a simpler system, international students in the UK enjoy superior healthcare access compared to their counterparts in the US. It is recommended that UK and the US should prioritize comprehensive healthcare orientation programs, ensuring students are well-informed about accessing and navigating their respective systems.

Effective Leadership Types in Change Management in Sports Organizations

The aim of this study is to examine the types of effective leadership in change management in sports organizations. Qualitative research method was used in the study. The study design chosen in accordance with the purpose of the study is the nested case study model, which is one of the case study designs used to analyze and analyze one or more specific events in depth. The data of the study were collected by individual interview. The study group of the research consists of a total of 7 adult participants, employees of the sports federation. In-depth individual interviews were carried out with these participants and the data obtained were analyzed by content analysis method. When the findings of the study were examined, it was seen that five dimensions came to the fore: flexible, authoritative, insightful, situational, and meritocracy. The leadership type that emerged as a result of the study was seen to be "leadership type that includes flexible, authoritarian and understanding dimensions". It has emerged that there are two leadership types that contain these dimensions. These are autocratic and democratic leadership types. In other words, the participants who defended being authoritarian from autocratic leadership style emphasized the understanding and flexible features of democratic leadership type. When the answers given by the participants are examined in its entirety, it has been understood that the leadership types used during the change in sports federations are a leadership type that includes many leadership types rather than a single leadership type. Leadership type researchers have revealed many characteristics of leaders in their research on leaders. These characteristics are stated as behaviorist, situational, democratic, autocratic and liberal theories. In the study, when the codes made while determining the leadership type used in sports organizations were combined, it was seen that many leadership type theories emerged from the leadership type theories. Especially democratic and autocratic leadership institutions came to the fore. However, when looked at as a whole, it was seen that many features came to the fore. In the light of these findings, it was discovered that a leadership practice that differs according to the situation rather than a standard leadership type is required. This necessity brings success while experiencing change. As a result, these views of the participants brought the situational leadership type to the fore. According to the situational leadership theory, it is necessary to examine each situation according to its internal subjectivity. Afterwards, the participants argued that after revealing the subjectivity of the situation, it is necessary to apply the most appropriate leadership type.

Patriarchal Language Evaluation of Muslim Women’s Body, Sexuality, and Domestication Discourse on Indonesian Male Clerics Preaching

This nested case study (multiyear research critical discourse analysis—in this case, the first year) aims to provide support in the form of linguistic recommendations to the law reform, particularly on the issues of Muslim women's bodies, sexuality, and domestication based on the textual analysis of the patriarchal language used by different Islamic strands: Muhammadiyah's, Nahdlatul Ulama's and Salafi's clerics in their preaching in Indonesia. This is significant because such a study is relatively limited in Indonesian cases. However, it also shed light on how discrepant linguistic manners of these male clerics were deployed to voice their noblesse oblige about Muslim women's body, sexuality, and domestication as regulatory discourse. The data—six videos of the respective clerics' preaching—were taken from Youtube using purposeful stratified sampling. It is found that Muhammadiyah's cleric delineated this discourse based on the segregation of dubious religiously correct and incorrect propriety, whereas Nahdlatul Ulama's cleric, the apparent religious normality, and Salafi's cleric, the plausible religious propriety.

Rewarding academics: Experiences of the Tenure Track System in Pakistan

AbstractPakistan introduced the Tenure Track System (TTS) as a new performance‐based reform in public universities in 2005. The purpose of this study is to understand the experiences of higher education authorities, university leaders and tenure‐track faculty about the implementation of this reform. This is a qualitative interpretive study and utilised a nested case study design, focusing on two cases—Science Faculty and Social Sciences and Humanities Faculty in a large provincial university. It utilises three perspectives taken from organisation theory—instrumental, cultural and myth perspectives. The main results show instrumental problems of hierarchical authority and horizontal coordination, lack of expertise to implement, cultural compatibility problems through active resistance from some groups and active use of symbols to modify the impression of a challenging reform implementations. Summing up, this is a Western‐inspired reform that meet challenging conditions in Pakistan, making is rather less successful.

Implementing an Empowerment Framework: The Significance for Children’s Play Environments and Reflective Practice

This paper examines implementing a unique way of observing children’s play through an empowerment framework; considering children’s choices, decisions, and interactions through an empowerment lens. The study considers the different ways children are empowered through their play environments using participation, voice, and ownership as three guiding themes and the challenges of recording children’s empowerment for practitioners. Five nested case studies in two different UK-based childcare environments form the basis of the research. Thematic analysis scrutinised the data that were generated from observations of children’s play, interviews with practitioners and a focus group with both settings. A phenomenological theoretical framing allowed a layered picture of empowerment to emerge. Practitioners made subjective yet informed judgements about children’s empowerment in their observations, drawing on knowledge and understanding of children’s personalities. Empowering experiences were recorded under prompt questions focusing on the way in which and the influences of how children were experiencing empowering moments. Observing through an empowerment framework has changed practice and the way practitioners think about the opportunities provided for children in their play environment. The main challenges for practitioners relate to anxiety around moving away from outcome-based observations and time limitations on producing meaningful narratives around children’s empowerment.

Association Between DPP-4 Inhibitors and Events of Colorectal and Liver Cancers in Patients With Diabetes Receiving Second-Line Agents: A Nested Case-Control Study.

ObjectivePlasma dipeptidyl peptidase-4 (DPP4) levels were significantly lower in patients with colorectal and liver cancers, and animal studies also showed DPP4 inhibitors (DPP4is) have procarcinogenic effects in colorectal cancer. Until now, whether DPP4is therapy affects the progression of liver cancer and colorectal cancer in patients with T2DM has not been well investigated. We investigated the association between cumulative defined daily dose (cDDD) of DPP4is exposure and risks of liver and colorectal cancers in patients with type 2 diabetes.Materials and MethodsWe identified 268,520 patients with diabetes receiving DPP4is as second-line agents between March 1, 2009, and December 31, 2013, from Taiwan’s National Health Insurance Research Database, Taiwan Cancer Registry, and National Death Registry of Taiwan. The amount of DPP4is were divided into three groups (low, medium, and high) based on the interquartile range of the cDDD of the DPP4is.ResultsThe data showed that the low cDDD of DPP-4is was associated with a reducing risk of colorectal cancer [adjusted odds ratio (OR), 0.49; 95% CI, 0.32–0.75; P=0.001]. However, the high cDDD of DPP-4is was associated with an increasing risk of colorectal cancer (adjusted OR, 1.86; 95% CI, 1.32–2.61; P<0.001). No association between DPP4is use and liver cancer risk was observed.ConclusionsThis nested case study revealed a J-shaped association between the cDDD of DPP-4is and colorectal cancer risk, but not liver cancer risk. Therefore, the effects of long-term DPP4is use on colorectal cancer risk warrant further study.

Impact of 'Enhanced' Intermediate Care Integrating Acute, Primary and Community Care and the Voluntary Sector in Torbay and South Devon, UK.

Introduction:Intermediate care (IC) was redesigned to manage more complex, older patients in the community, avoid admissions and facilitate earlier hospital discharge. The service was ‘enhanced’ by employing GPs, pharmacists and the voluntary sector to be part of a daily interdisciplinary team meeting, working alongside social workers and community staff (the traditional model).Methods:A controlled before-and-after study, using mixed methods and a nested case study. Enhanced IC in one locality (Coastal) is compared with four other localities where IC was not enhanced until the following year (controls), using system-wide performance data (N = 4,048) together with ad hoc data collected on referral-type, staff inputs and patient experience (N = 72).Results:Coastal showed statistically significant increase in EIC referrals to 11.6% (95%CI: 10.8%–12.4%), with a growing proportion from GPs (2.9%, 95%CI: 2.5%–3.3%); more people being cared for at home (10.5%, 95%CI: 9.8%–11.2%), shorter episode lengths (9.0 days, CI 95%: 7.6–10.4 days) and lower bed-day rates in ≥70 year-olds (0.17, 95%CI: 0.179–0.161). The nested case study showed medical, pharmacist and voluntary sector input into cases, a more holistic, coordinated service focused on patient priorities and reduced acute hospital admissions (5.5%).Discussion and conclusion:Enhancing IC through greater acute, primary care and voluntary sector integration can lead to more complex, older patients being managed in the community, with modest impacts on service efficiency, system activity, and notional costs off-set by perceived benefits.

The role of contextual factors on participation in the life area of work and employment after rehabilitation: A qualitative study on the views of persons with chronic pain.

BACKGROUND:A deeper understanding of how contextual factors affect the ability to participate in the life area of work and employment despite chronic musculoskeletal pain is needed as a basis for interprofessional rehabilitation programs.OBJECTIVE:To investigate which contextual factors influence rehabilitation program clients’ ability to participate in the life area of work and employment, and how they do this.METHODS:Nested case study using a realist evaluation framework of interprofessional interventions. Qualitative content analysis of problem-centered interviews to identify influential context-mechanism-outcome configurations.RESULTS:We identified several important context-mechanism-outcome configurations. In the pre-interventional phase, socioeconomic and environmental factors affected two mechanisms, “exhaustion” and “discrimination”. In the intra-interventional phase, the social skills of health professionals and opportunities for discussion with peers affected the ability of program participants to engage with program content. In the post-intervention phase, volitional competences of the social system affected the sustainable application of program content in everyday life.CONCLUSION:The identified context-mechanism-outcome configurations shows that the ability to participate in the life area of work is interdependent with the ability to participate in other areas of life. In practice and research, assessment and treatment should be carried out based on this understanding.

Food Security and Climate Change: Differences in Impacts and Adaptation Strategies for Rural Communities in the Global South and North

This research highlights the mismatch between food security and climate adaptation literature and practice in the Global North and South by focusing on nested case studies in rural India and the United States during the COVID-19 pandemic. The United States is one of the wealthiest countries in the world, but also has one of the largest wealth gaps. Comparatively, India has one of the largest populations of food insecure people. To demonstrate how adaptive food security approaches to climate change will differ, we first review the unique climate, agricultural, demographic, and socio-economic features; and then compare challenges and solutions to food security posed by the COVID-19 pandemic. While both countries rely on rural, low-income farmworkers to produce food, the COVID-19 pandemic has highlighted how agricultural and food security policies differ in their influence on both food insecurity and global hunger alike. Emphasis on agricultural production in developing regions where a majority of individuals living in rural areas are smallholder subsistence farmers will benefit the majority of the population in terms of both poverty alleviation and food production. In the Global North, an emphasis on food access and availability is necessary because rural food insecure populations are often disconnected from food production.

Social Sustainability in Micro and Small Enterprise Supply Chains: Empirical Insights from the Clothing Industry

This paper argues that micro and small enterprises (MSEs) can address social supply chain sustainability using social capital elements. Through a nested case study at José Avelino fashion center, results show the prominence of internal social sustainability performance and strong elements related to a friendly and familiar connection among members of the MSE’s supply chain, but their relationships remain transactional. It was established that while structural and cognitive capital exists, relational capital is limited due to a lack of trust and commitment between suppliers. This paper demonstrates how social issues can be addressed to support the pathway to a balanced response to sustainability in MSE supply chains.

Anthropogenic sediment traps and network dislocation in a lowland UK river

AbstractFarm ponds, reservoirs and in‐stream weirs exist in most lowland UK river catchments and often dominate natural features such as lakes, wetlands, floodplains and debris dams. Artificial structures have served multiple purposes, including provision of power for historic flour milling and iron ore crushing and provision of water for medieval fishponds, canals, crop irrigation and potable supply. Although unintentional, they can significantly affect longitudinal connectivity, including sediment delivery pathways, through river catchments.We report results from three spatially nested case studies that were undertaken in the Rother catchment, ranging in scale from small farm ponds of a few square metres in area, to larger in‐stream weirs and reservoirs (locally called ponds). Reservoirs typically trap sediment, decreasing sediment availability downstream, while inducing valley sediment accumulation upstream. We focus on the quantity and particle size characteristics of sediment trapped behind these structures compared to catchment soils and to sediments that are transported through, and deposited in, ‘natural’ gravel‐bed reaches.At all scales our results demonstrate that sediment trapping and release are particle size specific. Fine to coarse sands (125 μm to 2 mm diameter) and coarser sediments are retained behind structures at all scales, while silts and clays (&lt;63 μm diameter) and organic matter are generally depleted in the stored sediment. Even though 75% of the surveyed reservoirs have very low estimated trap efficiencies (&lt;5%), they slowly fill over time with sediment.An important management question relates to the likely benefits of impoundment, structure or sediment removal, and whether fine (here defined as &lt;63 μm) or coarser (&gt;63 μm) sediment is a priority for management.

RETHINKING ADULT EDUCATION IN TURKEY: THE PROPOSAL OF AEP MODEL

In this study, it is aimed to examine adult education policies in Turkey based on the views of managers, teachers, qualified instructors and trainees and to present a conceptual model for a future-based adult education system. The study is a case study and has the single nested case study design. Adult education policies in Turkey, which is the single case of the study; is considered in the dimensions of policy and strategy, organizational structure and implementation. By using semi-structured interview technique in the study, data on the features of a future-based adult education system were collected from a total of 32 managers, teachers, qualified instructors and trainees who played a role in the adult education system in Turkey and were selected through stratified purposeful sampling. Content analysis, one of the qualitative data analysis methods, was used for the analysis of the data. In consequence of the study, certain findings related to the basic features of a future-based adult education system have been reached particularly in the dimensions of policy and strategy, organizational structure and implementation, educational qualifications, human capital education and sustainable development, organizational autonomy, access and participation, teaching methods and techniques and content. As a result of the study, it is suggested for the implementers that a restructuring process should be initiated towards a productive, employable, self-sufficient and sustainable economic structure in adult education. As for the researchers, quantitative and qualitative studies are also recommended in the dimensions of human capital education, sustainable development, global change and developments, and 21st century skills.&#x0D; &#x0D; &lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/edu_01/0895/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

Factors Influencing Fidelity to a Calorie Posting Policy in Public Hospitals: A Mixed Methods Study.

Background: Labelling menus with nutrition information has increasingly become an important obesity policy option. While much research to-date has focused on determining its effectiveness, few studies report the extent to which menu labelling is implemented as designed. The aim of this study was to explore factors influencing fidelity to a calorie posting policy in Irish acute public hospitals.Methods: A mixed methods sequential explanatory study design was employed, with a nested case study for the qualitative component. Quantitative data on implementation fidelity at hospitals were analysed first and informed case sampling in the follow-on qualitative phase. Maximum variation sampling was used to select four hospitals with high and low levels of implementation and variation in terms of geographic location, hospital size, complexity of care provided and hospital type. Data were collected using structured observations, unstructured non-participant observations and in-depth semi-structured interviews. The Consolidated Framework for Implementation Research guided qualitative data collection and analysis. Using framework analysis, factors influencing implementation were identified. A triangulation protocol was used to integrate fidelity findings from multiple sources. Data on influencing factors and fidelity were then combined using joint displays for within and cross-case analysis.Results: Quantitative fidelity data showed seven hospitals were categorised as low implementers and 28 hospitals were high implementers of the policy. Across the four hospitals selected as cases, qualitative analysis revealed factors influencing implementation and fidelity were multiple, and operated independently and in combination. Factors were related to the internal hospital environment (e.g., leadership support, access to knowledge and information, perceived importance of calorie posting implementation), external hospital environment (e.g., national policy, monitoring), features of the calorie posting policy (e.g., availability of supporting materials), and the implementation process (e.g., engaging relevant stakeholders). Integrated analysis of fidelity indicated a pattern of partial adherence to the calorie posting policy across the four hospitals. Across all hospitals, there was a consistent pattern of low adherence to calorie posting across all menu items on sale, low adherence to calorie information displayed per standard portion or per meal, low adherence to standardised recipes/portions, and inaccurate calorie information.Conclusion: Efforts to maximise fidelity require multi-level, multi-component strategies in order to reduce or mitigate barriers and to leverage facilitators. Future research should examine the relative importance of calorie posting determinants and the association between implementation strategies and shifts in fidelity to intervention core components.

Navigating conflicting logics: Early or late(r) retirement in the German teaching profession?

Drawing on the institutional logics perspective and life course theory, we explore conflicting logics related to retirement: early retirement versus late(r) retirement in line with extended working life policies. Using qualitative interview data collected in a multiple nested case study, we explore how secondary school teachers in a German School District conceptualise these conflicting logics in the context of factors at the micro-individual, meso-organisation and macro-policy level of analysis that enabled and/or constrained retirement transitions. We further explore teachers’ narratives to evaluate how they navigated these multi-level factors and whether they were able to control and/or plan retirement timing. Our findings indicate that conflicting logics were perceived similarly by the individuals in our study, but that they navigated these logics differently depending on existing experiences related to career proactivity and changes to professional identities. Using five narratives based on four extreme cases, we outline how individuals were able to use human agency when navigating factors that influenced their anticipated retirement transitions, but this was mostly seen as a strategic adaptation to their constraining external environment rather than rational choice.

Performing Categories through Material, Spatial and Verbal Practices: the case of “Historical Shops”

Categories make intelligible our world by classifying and labelling objects, actors and events around us. Sometimes categories are created by some promoters re-interpreting already existing entities to re-orientate meaning systems according to strategic goals. This phenomenon is particularly spread in urban and cultural contexts, where policy-makers often found labels to re-qualify, valorise or preserve specific areas of interest. Adopting a qualitative methodology and a multiple nested case study, I analyse the case of creation of the Historical Shops category in two Italian cities with the aim of understanding the conditions and the mechanisms through which a category takes life, is acknowledged and performed on a daily basis, and the ones that, instead, hinder this process. Findings show that the interaction of material, spatial and verbal practices enacted within categorical boundaries co-create an externally perceived experience of the category, which, in turn reinforce the categorical members’ identification with the category, hence sustaining category performance. The initial acts of category creation and actions of category promoters and intermediaries may support or undermine the whole process. The study contributes to categorization studies by providing a situated view on categorization where materiality, place, experience and categorical members’ identification have a fundamental role.

Cultivating a Queer Mindset: How One Elementary School Teacher is Rattling Common Sense

Background/Context A significant body of research on gender and sexual diversity in education has called on teachers to “move beyond inclusion” of LGBTQ+ voices in curriculum by queering their practice and “disrupting cis-heteronormativity.” Few studies have focused on the ways that disrupting cis-heteronormativity is challenging work for teachers to engage. Purpose/Objective/Research Question/Focus of Study In this case study, we focus on patterned moves that Laura, a first-grade teacher, made to disrupt cis-heteronormativity by supporting her students in cultivating what we call a “queer mindset”—a way of thinking, feeling, and doing that “rattles” her students’ common sense. Research Design The qualitative study reflects a nested case study design in which Laura represents an individual case within the broader case. Specifically, we use instrumental case study methodology. Conclusions/Recommendations To make good on the goal of disrupting cis-heteronormativity, we encourage educators to cultivate in their students ways of thinking, feeling, and doing that upend common sense and that challenge the status quo. We encourage educators to support their students in developing queer mindsets. This way, not only can educators support individual students, but they can also propel the kind of social transformation we want to see.

Managing micro and small enterprise supply chains: A multi-level approach to sustainability, resilience and regional development

Amidst the high number of frameworks associated with supply chain sustainability (SCS), proper consideration to the role and importance of micro and small enterprises (MSEs) has been missing in the literature. To address this research gap, this paper investigates the driving factors that support MSE supply chains to achieve sustainability. We employ institutional and complexity theories to broaden our understanding of the dynamics behind neglected supply chain structures, especially the ones predominantly formed by MSEs. An in-depth nested case study is carried out in a MSE supply chain in an emerging economy, where 33 supply chain players were involved in the data collection. Using a combination of deductive and inductive approaches to analyze the data, we find that to truly implement SCS, research and practice should consider not only the strategic, structural and process levels, but also the contextual level, which is critical dimension to SCS dynamics. Results show that MSE supply chains contribute significantly to regional socio-economic development due to their local roots and regional history. Also, findings demonstrate that MSE supply chains have enhanced resilience to crises (e.g., economic, political and other disruptions) because they are often focused on long-standing economic activities within the regional ecosystems. This paper contributes to theory by arguing that SCS is a much more complex phenomenon in practice than the current theory implies. Therefore, incorporating the diversity from reality and the peculiarities of MSE supply chains into the SCS debate helps the literature to get closer to the SCS practice.