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With aging, the risk of requiring emergency care increases. Elderly patients who need Emergency Medical Services (EMS) are often vulnerable and dependent, especially when their decision-making ability is reduced, which may intensify the risk of important ethical values being violated. Studies about paramedics’ views on elderly people’s self-determination within EMS settings are scarce. The aim of this study was to explore the attitudes and perceptions of paramedics in a US context regarding self-determination in elderly patients who need emergency care provided by EMS.

The study had an exploratory design, and data were collected using a Delphi technique. A panel of experts consisting of US paramedics was recruited to answer a questionnaire sent out in three rounds. The questionnaire comprised 108 items, derived from a Swedish study on the same topic, rated with a five-point Likert scale ranging from agree to disagree with a predetermined consensus level of 70%.

In total 21 experts agreed to participate, 15 completed all three rounds, leaving a total response rate of 71%. Finally, 87 out of 108 items reached consensus, of which 60 were “agree” and 27 were “disagree.”

The paramedic–patient relationship is a core in assessing and handling ethical challenges within an advanced practice influenced by the paramedics’ educational level and/or the patient’s physical/mental status. Within a “find it fix it” modus operandi, there is a need to increase paramedics’ competence in understanding and handling advanced ethical challenges in relation to ethical values such as autonomy and self-determination in elderly patients.

This paper aims to present a case of project‐based management development with a group of younger researchers in a medical faculty in a university.

The case is based on documentation and recollections in which the first author was involved as a learning coach. The paper is a way to share a process of conversation between the authors and to highlight some critical issues through the elaboration of three perspectives: a macro perspective where the situation in the medical faculty is related to developments in the organizational field; a description from the consultant's point of view; and a human resource perspective in which the style of intervention is linked to the contingencies facing the organization at this point in time.

In retrospect the program was found to create opportunities for identity‐work and sensemaking involving the participants' individual roles as well as their representations of how the medical faculty was organized. While normal human resource management (HRM) may be seen as a kind of regular maintenance of an organization, it is suggested that the style of management development (as part of an overall HRM strategy) described here is better understood as a form of organizational identity work.

Distinguishing between different styles of HRM and relating them to contingencies in terms of threats to organizational identity contributes to a more nuanced discussion of the practical challenges, possibilities and risks related to different styles. There is a need for both large‐scale studies of the prevalence of new practices and in‐depth ethnographies of interventions like the one described in this paper, especially in situations where there are perceived threats to identity.

This chapter unpacks ‘design thinking’ as it relates to educational design, and highlights how developments in the field of Learning Design may be of assistance to educators. Design is defined as a creative, scientific, and complex process, underpinned by several design thinking qualities. Teaching, it is argued, should be positioned as a design science, based on its nature, practice, and intentions. Learning to design is characterized as a challenging pursuit that is supported through practice, refection, examples, and expert guidance. Based on the literature, the pursuit of designing for learning is explained as a process involving the creation of accessible and aligned designs that cater to students in order to achieve desired learning outcomes. Educational design models by Laurillard, Siemens, and Conole are contrasted and evaluated in order to critically reflect on the general utility of such models. The field of Learning Design is introduced as a discipline area that aims to help educators develop and share great teaching ideas. Six approaches that support the description and sharing of learning designs are briefly described (technical standards, pattern descriptions, visualizations, visualization tools, pedagogical planners, and the Learning Activity Management System) so as to illustrate how the Learning Design field has evolved and how educators can capitalize upon it. Directions forward are recommended, which center around reflection, collaboration, and a design orientation.

This paper seeks to explore critical factors that may obstruct or advance integration efforts initiated by the clinical management following a hospital merger. The aim is to increase the understanding of why clinical integration succeeds or fails.

The authors compare two cases of clinical integration efforts following the Karolinska University Hospital merger in Sweden. Each case represents two merged clinical departments of the same specialty from each hospital site. In total, 53 interviews were conducted with individuals representing various staff categories and documents were collected to check data consistency.

The study identifies three critical factors that seem to be instrumental for the process and outcome of integration efforts and these are clinical management's interpretation of the mandate; design of the management constellation; and approach to integration. Obstructive factors are: a sole focus on the formal assignment from the top; individual leadership; and the use of a classic, planned, top‐down management approach. Supportive factors are: paying attention to multiple stakeholders; shared leadership; and the use of an emergent, bottom‐up management approach within planned boundaries. These findings are basically consistent with the literature's prescriptions for managing professional organisations.

Managers need to understand that public healthcare organisations are based on competing institutional logics that need to be handled in a balanced way if clinical integration is to be achieved – especially the tension between managerialism and professionalism.

By focusing on the merger consequences for clinical units, this paper addresses an important gap in the healthcare merger literature.

This paper seeks to investigate the role of leadership styles in the implementation of evidence‐based treatment methods (EBP) for drug abuse and criminal behaviour.

The paper employs a triangulation approach through mail questionnaires to 112 treatment personnel (49 per cent response rate), interviews with 65 employees and managers, observations and feedback workshops.

Responses from treatment personnel involved in the implementation of EBP indicated that their views on their immediate superior's leadership behaviour was significantly related to the perceptions of organisational innovative climate, job satisfaction and work output. Problems with workload, lack of collegial and managerial support and a low priority given to the programmes and treatment integrity were the most common barriers to implementation of the programmes. Effective managers were providing space, time and opportunity for the staff to perform their treatment‐related tasks and to be creative during the implementation process. This functional space had to be continually protected, both vertically from demands from higher levels of the organisation and horizontally from non‐helpful colleagues.

The correlational design used in this study does not permit conclusions about causality.

Implementation of evidence‐based treatment programmes in clinical settings should pay attention to the impact of leadership styles on the experiences of treatment staff (climate, job‐satisfaction, burnout) and programme outcome. These variables should also be considered in the evaluation of treatment effects. The process of implementation can be seen as a route for learning and innovation, and managers should pay attention to the facilitation of these processes.

The role of leadership in implementation concerns not only production and structure but also learning, creativity and persistency during the process. The triangulation approach in this study also sheds light on the limitations of questionnaires in capturing the dynamics of leadership in human service organisations.

This chapter aims to establish a positive vision for the technology-enhanced learning design field. It commences by summarizing the current state of technology-enhanced learning research, as established by the previous analysis, in order to clarify the foundations upon which the field can build. The future of learning technology is considered, in the first instance, by extrapolating trends in information and communication technologies throughout history. This process showcases how the most impactful technologies are those that bring information closer to us, support sharing, and offer more visceral learning experiences. The nature of learning technology trends occurring in recent Horizon Reports, for instance, gesture-based computing, augmented reality, Massive Open Online Courses, and table computing, are analyzed and explained in terms of Roger’s Diffusion of Innovation Theory and Gartner’s Hype Cycle. This leads to identifying teachers as the critical lynch pin in order for society to derive greatest educational benefit from the exponential advances in technology. Consequently, support for educators is argued as essential. Into the future the learning technology field will only optimize its progress if educators and researchers work together to understand design issues and possibilities. Directions forward for educators and researchers are proposed, emphasizing a research-driven, pedagogically focused, creative, and collaborative approach to technology-enhanced learning design.

This paper gives a review of the finite element techniques (FE) applied in the area of material processing. The latest trends in metal forming, non‐metal forming, powder metallurgy and composite material processing are briefly discussed. The range of applications of finite elements on these subjects is extremely wide and cannot be presented in a single paper; therefore the aim of the paper is to give FE researchers/users only an encyclopaedic view of the different possibilities that exist today in the various fields mentioned above. An appendix included at the end of the paper presents a bibliography on finite element applications in material processing for 1994‐1996, where 1,370 references are listed. This bibliography is an updating of the paper written by Brannberg and Mackerle which has been published in Engineering Computations, Vol. 11 No. 5, 1994, pp. 413‐55.

In response to increasing demands on improved environmental performance, companies need to develop their capabilities in assessing the environmental performance of their operations. Knowledge among practitioners as well as solid research results in this area is lacking. This paper aims to present a framework of dimensions, which are important to consider regarding environmental measurement in supply chain management. The paper also aims to present a practical example on how environmental performance measurements can be a success by applying these dimensions.

Literature regarding logistics management and performance measurement is coupled with theories regarding environmental logistics and green supply chain management. A framework is developed. A case study based on four actors in a reverse supply chain is used to illustrate the framework.

The paper outlines important aspects to consider in the design of environmental performance measurements in supply chain management and identifies shortcomings in existing research. The case presents successful examples of how environmental performance measurements can be applied across managerial levels as well as company borders in a supply chain.

The literature review shows shortcomings in the measuring tools applied today. The case provides examples of how these shortcomings can be addressed.

This paper addresses the intersection between environmental logistics and performance measurements. The case shows how environmental performance measurements can be applied over a single company's borders by including four different actors in the supply chain.

The purpose of this paper is to examine the aspects of internal and external transformation that take place in each company along the supply chain when a “sustainable packaging logistics” approach is implemented. Before this can be achieved, it is necessary to identify and characterise the principal cornerstones and stages associated with this implementation.

In the paper the combination of “case study” and “action research” techniques have been chosen. It has been analysed the implementation of “sustainable packaging logistics” in the supply chain of Mercadona (one of the largest retailers in Spain), paying special attention to the implementation and evolution in one of its main food suppliers.

To adopt a “Sustainable Packaging Logistics” approach allows for a proactive integration of the efficiency and sustainability in supply chains. The proposal to implement “sustainable packaging logistics”, based on four cornerstones and three stages of evolution is particularly significant, while contributing to improved competitiveness. This implementation constitutes an evolutionary process which is conditioned by how each area, department or company along the supply chain interpret and assess different packaging features over time.

The model is based on a single supply chain analysis.

This paper may be of interest both for researchers and professionals, because the model can aid companies in improving their global vision of product and packaging design in order to jointly increase sustainability and efficiency in the supply chain.

This study aims to develop a proprietary indicator to measure the digital presence of the institutions: the digital presence index.

This research delves into how nonprofit institutions, specifically business interest associations (BIAs), have developed their internet presence by applying essential digital marketing techniques. To this end, and using big data mining tools, this study analyzes the tracking by internet users of 102 BIAs, with their respective websites in 36 countries in Europe and the USA. In addition, the presence and activity of the institutions included in this study on social networks are considered.

This research serves as a basis for discussing the current gap between social reality and the digitalization of institutions. In this sense, conclusions are drawn on the importance of managerial profiles in decision-making on digitization and the necessary knowledge that, together with Web and social network managers, they must have to articulate the means and techniques that promote the internet presence of the organizations they manage.

Conclusions are drawn according to the geographical scope of the BIAs, and an argument is made about the difficulties of connection and loss of prominence of this type of institutions among their different target audiences, especially among the youngest and most digitized.