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The aim of this paper is to explain how University Hospitals of Leicester's Nuclear Medicine service managers needed to reduce waiting times to comply with internal clinical requirements and with external local primary care trust (PCT) and national Department of Health targets.

The team undertook a comprehensive service review to identify problem areas and potential improvements, including: process mapping; data gathering (activity and demand, equipment and staff availability/utilisation); external practice reviews, searching evidence bases; and financial implications. This case study describes how an inter‐disciplinary team redesigned the service and used new working methods to reduce waiting times. Their aim was to discuss a service's practical elements and show how innovation leading to sustainable change can be implemented effectively.

The review highlighted service delivery bottlenecks for myocardial perfusion imaging, which were linked to medical staff shortages, staff use and equipment between hospital sites, and a silo approach to referrals rather than a coordinated organisation‐wide approach.

Introducing enhanced roles allowed nurses, radiographers and technologists to undertake work previously performed by medical staff thus removing a key service bottleneck. Modifications to service delivery and a cultural change in nuclear medicine resulted in a service that was more efficient, flexible and able to cope with increased demand.

These changes meant that minimum waiting‐time targets were achieved, in particular waiting for myocardial perfusion imaging (reduced from 42 weeks in 2005 to two weeks by 2009). Changes allowed service managers to maintain short waiting times in the current, challenging healthcare climate.

Although leadership and organizational scholars have suggested that the virtue of wisdom may promote outstanding leadership behavior, this proposition has rarely been empirically tested. The purpose of this paper is to investigate the relationships between transformational leadership, narcissism, and five dimensions of wisdom as conceptualized by the well-established Berlin wisdom paradigm. General mental ability and emotional intelligence were considered relevant control variables.

Interview, test, and questionnaire data were obtained from 77 employees of a high school and from two or three colleagues of each employee. Data were analyzed using hierarchical regression analyses.

After controlling for general mental ability and emotional intelligence, narcissism and the wisdom dimension relativism of values and life priorities were negatively related to transformational leadership, and the wisdom dimension recognition and management of uncertainty was positively related to transformational leadership. The other three wisdom dimensions, rich factual knowledge about life, rich procedural knowledge about life, and lifespan contextualism, were not significantly related to transformational leadership.

Limitations to be addressed in future studies include the cross-sectional design and the relatively small and specialized sample.

Tentative implications for leadership training and development are outlined.

This multi-method and multi-source study represents the first empirical investigation that examines links between well-established wisdom and leadership constructs in the work context.

In many countries, both the number of older people in need of care and the number of employed caregivers of elderly relatives will increase over the next decades. The purpose of this paper is to examine the extent to which perceived organizational, supervisor, and coworker support for eldercare reduce employed caregivers’ strain and weaken the relationship between eldercare demands and strain.

Survey data were collected from 100 employed caregivers from one organization.

Results showed that eldercare demands were positively related to strain, and perceived organizational eldercare support (POES) was negatively related to strain. In addition, high POES weakened the relationship between eldercare demands and strain.

The cross-sectional design and use of self-report scales constitute limitations of the study.

POES is a resource for employed caregivers, especially when their eldercare demands are high.

This research highlights the relative importance of different forms of perceived support for reducing employed caregivers’ strain and weakening the relationship between eldercare demands and strain.

Institutional structures of professional career paths often support breadwinner–homemaker families, with a stay at home wife available full time to support the professional (and children), so the professional can devote complete energy and time to developing a career. This research examines how two partners in the same narrowly structured, fast track occupational culture such as those occurring for dual military officer couples shape how women and men negotiate decision making and life events. Data from interviews with 23 dual U.S. Navy officer couples build upon Becker and Moen’s (1999) scaling back notions. With both spouses in these careers, placing limits on work is extremely difficult due to fast track cultures that demand higher status choices and structures that formally do not reliably consider collocations. Trading off occurs, but with distress due to the unique demands on two partners in the fast track culture, which means career death for some. Two partners in fast track careers may not yet have given up on two careers as many peers may have, but they lose a great deal, including time together and their desired number of children. But they ultimately posit individual choice rather than focusing on structural change. The pressured family life resulting is likely similar to that for partners in other narrowly structured, fast track cultures such as in law firms and academia.

Communications regarding this column should be addressed to Mrs. Cheney, Peabody Library School, Nashville, Tenn. 37203. Mrs. Cheney does not sell the books listed here. They are available through normal trade sources. Mrs. Cheney, being a member of the editorial board of Pierian Press, will not review Pierian Press reference books in this column. Descriptions of Pierian Press reference books will be included elsewhere in this publication.

Current issues of Publishers' Weekly are reporting serious shortages of paper, binders board, cloth, and other essential book manufacturing materials. Let us assure you these shortages are very real and quite severe.

Health apps offer a potential approach to support healthier food behaviours but a lack of sufficient engagement may limit effectiveness. This study aims to use a user engagement theoretical lens to examine the factors that influence app engagement over time and may prompt disengagement.

A phenomenological exploration of the lived experience was used. Women from a lower socioeconomic background (based on the occupation and employment status of the household’s primary income earner) were randomly assigned to use one of two apps for a minimum of eight weeks. Multiple data collection methods, including accompanied shops, researcher observations, interviews, participant reflective accounts and questionnaires, were used at different time-points to examine engagement. Theoretical thematic analysis was conducted to explore the engagement experience and relevant social, personal and environmental influences.

Healthy food involvement appears to drive app engagement. Changes in situational involvement may contribute to fluctuation in engagement intensity over time as the saliency of personal goals change. Negatively valenced engagement dimensions may contribute to the overall expression of engagement. A lack of congruency with personal goals or an imbalance between perceived personal investment and value was expressed as the primary reasons for disengagement.

Situational involvement may act as a trigger of different engagement phases. There is a need to better distinguish between enduring and situational involvement in engagement research.

Individual characteristics may shape engagement and propensity for disengagement, which highlights the practical importance of incorporating tailored features into app design.

Findings broaden the current conceptualisation of engagement within the digital space and prompt a reconsideration of the role of situational involvement and negatively valenced dimensions throughout the engagement process.

The purpose of this study is to explore the support needs surrounding intimate relationships and sexuality of autistic adults accessing funded social care in England.

Semi-structured interviews with 15 autistic adults who were accessing funded social care examined their support needs surrounding intimate relationships and sexuality, with subsequent data analysis using reflexive thematic analysis.

Four themes were generated: Help at hand, but not too close for comfort, No “cookie-cutter rules”: personalised, inclusive approaches, Playing it safe, not leaving it too late, and Autism-informed education and support.

The authors produced an online learning module for social care staff in England on best practice in supporting autistic adults without learning disabilities with relationships and sexuality.

To the best of the authors' knowledge, there has been no other UK-based research published to date on the social care support needs of autistic adults without learning disabilities surrounding relationships, gender and sexuality.