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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.

Artists operating under a studio model, such as Andy Warhol, have frequently been described as reducing their work to statements of authorship, indicated by the signature finally affixed to the work. By contrast, luxury goods manufacturers decry as inauthentic and counterfeit the handbags produced during off-shift hours using the same materials and craftsmanship as the authorized goods produced hours earlier. The distinction between authentic and inauthentic often turns on nothing more than a statement of authorship. Intellectual property law purports to value such statements of authenticity, but no statement has value unless it is accepted as valid by its audience, a determination that depends on shared notions of what authenticity means as well as a common understanding of what authenticity designates.

Purpose: Artists with disabilities use their bodies and minds to create art. Yet, the prevailing cultural narrative that art is “therapeutic” for people with disabilities shifts attention from their creative accomplishments to their disabilities. Some ally organizations attempt to challenge the narrative that art is merely therapy for people with disabilities. However, drawing on narratives of “helping” people with disabilities attracts funding. This chapter examines how organizations navigate empowering allies while still maintaining funding.

Methods/Approach: This chapter uses narrative analysis of material accessed through a nonprofit arts-based disability ally organization's website to address two research questions: 1. How do ally organizations both draw on and resist cultural narratives of disability in order to garner public support?; and 2. How do personal narratives of disabled artists associated with ally organizations support and/or resist organizational and cultural narratives about the connection between disability and art?

Findings: The organization uses narratives to address important and sometimes conflicting goals. Personal narratives from artists with disabilities that are available through the website tell a range of stories about art and disability. The organization draws on these heterogeneous stories to position itself as an ally. By including such personal narratives on its website, the organization challenges the cultural narrative that the art produced by disabled artists is merely therapeutic.

Implication/Value: Much of the work on allyship focuses on how individuals can be allies. Examining ways in which organizations frame themselves as allies can help us to more fully understand allyship on multiple levels of social life.

I begin with a dispute over a fox hunt, by which to understand the law of tangible property, then develop that metaphor for the major types of intellectual property. I start with domestic U.S. patent law for the sake of concreteness, and generalize to other jurisdictions and types of intellectual property. In the latter parts of the paper I discuss the international implications of intellectual property, including especially the effects of information spillovers. The last part of the paper describes the hazards in analogizing “trade” in intellectual property rights to trade in goods, and particularly in interpreting international patent data. These hazards motivate the search for a structural model specially adapted to the purpose of valuing international intellectual property rights and rules. The goal is to give economists a simple and integrated framework for analyzing intellectual property across time, jurisdiction and regime type, with an eye towards eventually developing other incentive systems that have the advantages of property (such as decentralized decision-making), but fewer of the disadvantages.