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This paper aims to report on research undertaken in an National Health Service (NHS) emergency department in the north of England, UK, to identify which patients, with which clinical conditions are returning to the emergency department with an unscheduled return visit (URV) within seven days. This paper analyses the data in relation to the newly introduced Integrated Care Boards (ICBs). The continued upward increase in demand for emergency care services requires a new type of “upstreamist”, health system leader from the emergency department, who can report on URV data to influence the development of integrated care services to reduce further demand on the emergency department.

Patients were identified through the emergency department symphony data base and included patients with at least one return visit to emergency department (ED) within seven days. A sample of 1,000 index visits between 1 January 2019–31 October 2019 was chosen by simple random sampling technique through Excel. Out of 1,000, only 761 entries had complete data in all variables. A statistical analysis was undertaken using Poisson regression using NCSS statistical software. A review of the literature on integrated health care and its relationship with health systems leadership was undertaken to conceptualise a new type of “upstreamist” system leadership to advance the integration of health care.

Out of all 83 variables regressed with statistical analysis, only 12 variables were statistically significant on multi-variable regression. The most statistically important factor were patients presenting with gynaecological disorders, whose relative rate ratio (RR) for early-URV was 43% holding the other variables constant. Eye problems were also statistically highly significant (RR = 41%) however, clinically both accounted for just 1% and 2% of the URV, respectively. The URV data combined with “upstreamist” system leadership from the ED is required as a critical mechanism to identify gaps and inform a rationale for integrated care models to lessen further demand on emergency services in the ED.

At a time of significant pressure for emergency departments, there needs to be a move towards more collaborative health system leadership with support from statistical analyses of the URV rate, which will continue to provide critical information to influence the development of integrated health and care services. This study identifies areas for further research, particularly for mixed methods studies to ascertain why patients with specific complaints return to the emergency department and if alternative pathways could be developed. The success of the Esther model in Sweden gives hope that patient-centred service development could create meaningful integrated health and care services.

This research was a large-scale quantitative study drawing upon data from one hospital in the UK to identify risk factors for URV. This quality metric can generate important data to inform the development of integrated health and care services. Further research is required to review URV data for the whole of the NHS and with the new Integrated Health and Care Boards, there is a new impetus to push for this metric to provide robust data to prioritise the need to develop integrated services where there are gaps.

To the best of the authors’ knowledge, this is the first large-scale study of its kind to generate whole hospital data on risk factors for URVs to the emergency department. The URV is an important global quality metric and will continue to generate important data on those patients with specific complaints who return back to the emergency department. This is a critical time for the NHS and at the same time an important opportunity to develop “Esther” patient-centred approaches in the design of integrated health and care services.

I'm not sure why you would want to do this, but I saw a neat way to create a file of zero length (whatever that might mean, metaphysically). You use a command like: REM >ZERO.NUL

IN JULY, 1990, Michigan State University released the latest version of the MicroMARC:amc archives and manuscripts cataloging software, version 2.11. [Earlier versions were discussed in OCLC Micro 3(3):14–16 and 4(3):14–17.] Enhancements to the system that further increase its flexibility include the ability to import and export records in any of the MARC formats. This means records in the books, serials, visual materials, music, machine readable, etc., formats can now be loaded onto the MicroMARC:amc system. Once on the system, the user has the same ability to search and create reports with these records as with the records in the Archives and Manuscript Control Format.

The purpose of this paper is to analyze and compare the subject change for both citing and cited literature on digital libraries based on bibliometric techniques.

Library and Information Science Abstracts (LISA) was used to retrieve data of journal articles in digital libraries from 1960 to 2002. By employing the thesaurus search function, three descriptors for subject search, namely electronic library concept, digital libraries and virtual library concept, as suggested by LISA, were used to retrieve all relevant literature on digital libraries.

Most of the citing core journals on digital libraries are devoted to the subject of the application of computer and information technology to library implication, while the cited literature on digital libraries distributes mainly into four types of journals, namely, digital library orientation, general library and information science, new development in librarianship, and library technology. Digital libraries, electronic media and world wide web (WWW) are the three subject terms in common most for both citing and cited core journal literature. They also constitute the core subject for digital library literature. The change of highly used subject terms, such as WWW, internet, library technology, network, university or academic library, from cited to citing literature suggests that these subjects are becoming the main stream of researches in digital libraries.

Most subject terms of this study for both citing and cited literature in digital libraries could be categorized into the technical issues. However, other related issues dealing with copyright, charging and authenticity; social issues; quality of preservation and availability; use and user study; economic issues; education and promotion have not been popular research areas yet by 2002. Further studies are needed.

The present work is unique in its study of the subject and the results obtained provide significant insights into the evolution of digital libraries by identifying the core journals and examining their characteristics, as well as subject changes between citing and cited literature on digital libraries.

This study aims to contribute knowledge about different professional identities represented among HR practitioners from Weber's “ideal types” framework.

The paper is based on semi-structured interviews with 34 Swedish HR practitioners working in large public and private organisations.

The findings reveal that HR practitioners' identity is perceived as indistinct, unclear and shattered, which leaves lots of room for interpreting HR identity. Based on a thematic content analysis, three different ideal-type identities are presented, each representing the characteristic traits of an HR identity type. These are the Defender who always supports the managers, the Disturber who questions the managers in favour of the employees and the Driver who focuses on the economic expansion of the organisation.

One of the potential constraints of this study is the authors’ reliance on interview data. This finding implies that future research can employ mixed methods or observational techniques to bridge the gap between narrated responsibilities and real-time actions. The data source, predominantly from larger organisations, presents another limitation. This raises a significant research implication: there is a need to study identity formation among HR practitioners in smaller organisations. The theoretical framework this study contributes can aid in comprehending HR practitioners' identities and their corresponding actions. Continued research might explore the significance of these ideal-type identities.

The model presented provides a new way of understanding HR practitioners' complex and shattered professional identity and the various stakeholders that direct different expectations towards them. This knowledge can be used both in HR education and in HR work as a basis for discussing the social work environment of HR practitioners and negotiating their work and identity.

The study contributes knowledge of the professional identities of HR managers, an under-researched area, especially when it comes to empirical research about the HR practitioners' own experiences of their everyday work and view of the HR profession.

Using participatory action research, this paper explains how the Service Employees International Union and community groups collaborated to organize home care workers in Oregon. The tactics used include policy borrowing and tinkering, a ballot initiative, coalition building, lobbying, and legislative politics. This approach to organizing low-wage human service providers has important implications for other unions. Home care workers are similar to many other human service providers because the funding stream for their jobs is public. In essence, they are quasi-public sector employees. The tactics employed by the SEIU may serve as a “handle” for organizing other human service workers, who are employed by nongovernmental organizations, but are paid through federal, state, and local government funds.

This study aims to explore the individual lived crucible experiences of women leaders in higher education (HE) and business as the catalyst to investigate organisational inequality regimes that prevent women leaders from fully participating, contributing and flourishing at work. Drawing upon Bolman and Deal’s four-frame theoretical organisational model, this study analyses women’s lived crucible leadership experiences to better understand the organising processes and practices that render intersectionality invisible that reinforce and perpetuate inequality regimes.

A collaborative autoethnographic research method was selected for data collection. The research team members each selected one significant crucible moment from their professional career and used the Gibb’s six-part reflective cycle to document their narrative and reflect on their leadership experience. A reflexive thematic analysis was used based on Braun and Clarke’s six phases.

The study features the importance of creating a climate in organisations that acknowledges the need for greater equity, diversity and inclusion (EDI) to support women leaders. Four global themes emerged from the analysis of the leadership narratives: organisation, power dynamics, emotional distress and perseverance and intersectionality. These themes illuminate a greater understanding of organisational life for women and confirm the presence of inequality regimes of gender and race.

This is the first study to explore the impact of women leaders’ crucible experiences through the lens of the Bolman and Deal’s model that highlights the need to consider an EDI lens as the fifth frame.

This study aims to examine whether peer victimization predicted disordered eating behaviors during emerging adulthood, and if this relationship was mediated by perceived stress.

Participants included undergraduate females from a diverse university in the Southwestern USA who reported on their experiences of peer victimization, perceived stress and eating behaviors.

Mediation analysis revealed that perceived stress partially mediated the association between peer victimization and perceived stress. Peer victimization significantly predicted eating behaviors even after controlling for perceived stress. An exploratory analysis of the EAT-26 subscales was also conducted.

The present study adds to the literature on peer victimization, eating behaviors and stress by allowing researchers to understand the complexity of these relationships within an emerging adulthood population. The present results can assist individuals working with this population in interventions to prevent instances of victimization, reduce stress and provide psychoeducation for eating disorders.

The present study adds to the literature on peer victimization, eating behaviors and stress by allowing researchers to understand the complexity of these relationships within a college population.

Given the substantial resources of the United States, the failure of the American federal response to coronavirus disease 2019 (COVID-19) has been both tragic and avoidable. The authors frame this response as an artifact of power-addiction among administration officials and examine the US federal response to the COVID-19 pandemic through the lens of maladaptive denial by government officials, including President Trump.

The authors use qualitative research methods for this study by analyzing key events, public statements by administration officials from multiple credible media reports and US federal government websites. The authors analyzed these data using Weidner and Purohit's (2009) model describing maladaptive denial in organizations and power-addiction among leaders.

The authors' analysis identifies maladaptive denial – and the concomitant power-addiction – as significantly contributing to the Trump administration's failed response to COVID-19. Maladaptive denial and power-addiction characterized Trump as a candidate and for the three years of his presidency preceding the COVID-19 crisis. Whatever normative “guardrails” or checks and balances existed in the American system to restrict the administration's behavior before the crisis were ill-equipped to significantly prevent or alter the failed federal response to the pandemic.

The article applies the model of maladaptive denial in organizations (Weidner and Purohit, 2009) to the public sector, and explores the lengths to which power-addicted leaders and regimes can violate the public's trust in institutions in a crisis, even in the US, a liberal democracy characterized by freedom of political expression. While organizations and change initiatives may fail for a variety of reasons, this case revealed the extent to which maladaptive denial can permeate a government – or any organization – and its response to a crisis.

The current review aims to focus on how risk and protective factors for self-harm in secure mental health hospitals are captured in the literature.

Fifty-seven articles were included in a systematic review, drawn from an initial 1,119 articles, post duplicate removal. Databases included Psycinfo, Psycarticles, Psycnet, Web of Science and EBSCO host. A thematic analysis was used, which included a meta-ethnographic approach for considering qualitative papers.

There was a clear focus on risk factors, with eight identified (in order of occurrence): raised emotional reactivity and poor emotion regulation; poor mental health; traumatic experiences; personality disorder diagnosis and associated traits; increased use of outward aggression – dual harm; constraints of a secure environment and lack of control; previous self-harm and suicide attempts; and hopelessness. Protective factors featured less, resulting in only three themes emerging (in order of occurrence): positive social support and communication; positive coping skills; and hope/positive outlook.

This includes a proposal to move focus away from “risk” factors, to incorporate “needs”, in terms of individual and environmental factors. There is also a need for more attention to focus on developing high quality research in this area.

The research captures an area where a synthesis of research has not been comprehensively undertaken, particularly with regards to capturing protective as well as risk factors.