154 research outputs found
Continuity and tension in the definition, perception and enactment of first-line management role in healthcare
Book Review: Daniel Defoe and the Bank of England: The Dark Arts of Projectors
No abstract available
A better place
Mark Gatenby considers what it means for business schools – and universities more generally – to embrace Utopian ways of thinking
The restructuring of public sector work: a critical realist account of workplace change in UK local government
Teamworking: history, development and function: a case study in Welsh local government
Teamworking has been a fashionable management idea in the redesign of work for over half a century. After being observed in UK manufacturing environments in 1950s, the concept has developed and spread widely across industries and international contexts. Today, surveys suggest that management practitioners across all sectors are enthusiastically adopting teamworking initiatives. However, empirical research has not kept pace with the diffusion of team ideas in different contexts. There has been relatively little attention to the concept in service industries and particularly in public services. This study takes up the challenge of exploring team ideas in new contexts, conducting a case study within the UK local Government. An ethnographic approach is adopted to enable the collection and analysis of detailed descriptive data. Central concerns include the way in which teamworking is used as a vehicle for organisational change and how employees experience management attempts to implement teamworking. The study findings suggest that there is as much interest in the idea of teamworking in local Government as in traditional team contexts. In the case study, teamworking was used as part of a wide ranging strategy of organisational transformation. More specifically, it was used by senior management as a way to legitimise strategic change and provide a soft veneer to a more demanding performance regime. The ambitious variety of new team initiatives led to considerable implementation problems and resistance from workers. Particular levels of management were seen to be trapped between the old approach and the new team discourse. The study presents a warning for the advocates of teamworking in appreciating senior management motivations for introducing change and considering the unappealing detail when implementing and maintaining teamworking systems
Intentional paediatric poisoning presentations to emergency departments during the COVID-19 pandemic
Objective: To characterise paediatric poisoning presentations to EDs and determine if the advent of the COVID-19 pandemic was associated with increased intentional paediatric poisoning presentations. Methods: We performed a retrospective analysis of paediatric poisoning presentations to three EDs (two regional and one metropolitan). Simple and multiple logistic regression analysis were performed to determine the association between COVID-19 and intentional poisoning events. In addition, we calculated the frequency with which patients reported various psychosocial risk factors as being an implicating factor in engaging in an intentional poisoning event. Results: A total of 860 poisoning events met inclusion criteria during the study period (January 2018–October 2021), with 501 being intentional, and 359 unintentional. There was an increased proportion of intentional poisoning presentations during the COVID-19 pandemic (261 intentional and 218 unintentional in the pre-COVID-19 period vs 241 intentional and 140 unintentional during the COVID-19 period). In addition, we found a statistically significant association between intentional poisoning presentations and an initial COVID-19 lockdown (adjusted odds ratio 26.32, P < 0.05). ‘The COVID-19 lockdown’ or ‘COVID-19’ was reported to be implicating factor for psychological stress in patients who presented with intentional poisonings during the COVID-19 pandemic. Conclusions: Intentional paediatric poisoning presentations increased during the COVID-19 pandemic in our study population. These results may support an emerging body of evidence that the psychological strain of COVID-19 disproportionately impacts adolescent females. © 2023 The Authors. Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine
Characterisation and outcomes of patients referred to a regional cancer of unknown primary team: a 10-year analysis
BACKGROUND: In the United Kingdom, national guidance published in 2010 recommended the establishment of specialist teams to improve clinical pathways for patients presenting with malignancies of undefined primary origin (MUO) and cancer of unknown primary (CUP). This study sought to define outcomes of patients referred to a regional MUO/CUP service. METHODS: Data were collected prospectively on all patients (n = 1225) referred to a regional CUP team over a 10-year period. Patient demographics, clinical, pathological and outcome data were recorded and analysed. RESULTS: Confirmed CUP (cCUP) was diagnosed in 25% of patients. A primary metastatic cancer was identified in 36%, 5% were diagnosed with provisional CUP (pCUP), 27% retained the diagnosis of MUO and in 8% a non-cancer diagnosis was made. Median survival was low in all patients with a final malignant diagnosis: primary identified 9.0 months, cCUP 4.0 months, pCUP 1.5 months and MUO 1.5 months. CONCLUSIONS: Patients presenting with MUO have poor outcomes irrespective of the final diagnosis. These patients need a patient-centred, streamlined, rapid diagnostic pathway. There are clear benefits to primary and secondary care teams having access to a dedicated, multidisciplinary MUO/CUP service, with clinical nurse specialists supporting the patients, to help facilitate this pathway and ensure early oncology review
Limiting motorboat noise on coral reefs boosts fish reproductive success
Anthropogenic noise impacts are pervasive across taxa, ecosystems and the world. Here, we experimentally test the hypothesis that protecting vulnerable habitats from noise pollution can improve animal reproductive success. Using a season-long field manipulation with an established model system on the Great Barrier Reef, we demonstrate that limiting motorboat activity on reefs leads to the survival of more fish offspring compared to reefs experiencing busy motorboat traffic. A complementary laboratory experiment isolated the importance of noise and, in combination with the field study, showed that the enhanced reproductive success on protected reefs is likely due to improvements in parental care and offspring length. Our results suggest noise mitigation could have benefits that carry through to the population-level by increasing adult reproductive output and offspring growth, thus helping to protect coral reefs from human impacts and presenting a valuable opportunity for enhancing ecosystem resilience
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