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This article explores theoretical assumptions regarding negative consequences of social capital in the empirical case of a failed cooperation project, and how these consequences are related to processes involving people, structures and environments.

The article is based on a case study of a cooperation project within municipal labor market services. The methodology followed a theorizing process, where data were collected through ethnographical methods and analyzed in relation to existing concepts from theories describing negative effects of social capital and shadow organizing.

The results highlight how the development of negative social capital in the project can be understood through three relational processes, namely the social dynamics of insulation, homogenization and escalating commitment. The authors conclude that the quality of social capital is conditional upon complex interactions within social structures. Moreover, the results highlight the importance of studying organizing practices outside explicit structures, in order to identify the development of non-canonical practices and their consequences.

Organizing cooperation projects that aim to bridge professional competencies or organizational boundaries have to be attentive toward informal organizing practices which if remaining unrecognized may grow and threaten the original intentions.

The study makes a theoretical contribution by combining a shadow organizing approach with literature on social capital. This combination proves especially useful for analyzing how organizational dynamics can influence the development of social capital into producing negative effects.

The initial policy of the countries that developed vaccines has been to lock the vaccine by patent. This has been due to the fact that domestic demand for vaccine was mounting. Since only a few countries could invest in it, manufacturing and export remained at the behest of those few resulting in deep inequity in the global rollout. Pandemics are global health crises. Hence, calls for the patent waiver for the COVID-19 vaccine are growing to access the vaccine. The vaccine and its production, marketing and distribution have been politicized driven by the hegemonic aspiration. Both manufacturing and import-dependent countries are racing to win the diplomatic battle: the former has to win to gain hegemony and the latter to get the vaccine. Hence, the vaccine distribution has been marked with deep discrimination, and as a result, the migrant community is less likely to get their vaccine on time. This article engages in the decades-long debate over intellectual property rights and patenting life-saving vaccines. We argue that exemption of COVID-19 vaccines from intellectual property rights would improve global access and equity.

The purpose of this paper is to update the core data set of self-neglect safeguarding adult reviews (SARs) and accompanying thematic analysis. The initial data set was published in this journal in 2015 and has since been updated annually. The complete data set is available from the author. The second purpose is to reflect on the narratives about adult safeguarding and self-neglect by focusing on the stories that are told and untold in the reviews.

Further published reviews are added to the core data set, drawn from the national SAR library and the websites of Safeguarding Adults Boards (SABs). Thematic analysis is updated using the domains used previously, direct work, the team around the person, organisational support and governance. SAR findings and recommendations are also critiqued using three further domains: knowledge production, explanation and aesthetics.

Familiar findings emerge from the thematic analysis and reinforce the evidence-base of good practice with individuals who self-neglect and for policies and procedures with which to support those practitioners working with such cases. SAR findings emphasise the knowledge domain, namely, what is actually found, rather than the explanatory domain that seeks to answer the question “why?” Findings and recommendations appear to assume that learning can be implemented within the existing architecture of services rather than challenging taken-for-granted assumptions about the context within which adult safeguarding is situated.

A national database of reviews completed by SABs has been established (www.nationalnetwork.org.uk), but this data set remains incomplete. Drawing together the findings from the reviews nonetheless reinforces what is known about the components of effective practice, and effective policy and organisational arrangements for practice. Although individual reviews might comment on good practice alongside shortfalls, there is little analysis that seeks to explain rather than just report findings.

Answering the question “why?” remains a significant challenge for SARs, where concerns about how agencies worked together prompted review but also where positive outcomes have been achieved. The findings confirm the relevance of the evidence-base for effective practice, but SARs are limited in their analysis of what enables and what obstructs the components of best practice. The challenge for SAR authors and for partners within SABs is to reflect on the stories that are told and those that remain untold or untellable. This is an exercise of power and of ethical and political decision-making.

The paper extends the thematic analysis of available reviews that focus on work with adults who self-neglect, further reinforcing the evidence base for practice. The paper analyses the degree to which SARs answer the question “why?” as opposed simply to answering the question “what?” It also explores the degree to which SARs appear to accept or challenge the context for adult safeguarding. The paper suggests that SABs and SAR authors should focus explicitly on what enables and what obstructs the realisation of best practice, and on the choices they make about the stories that are told.

Emergency care delivery is a process requiring input from various healthcare professionals within the hospital. To deliver efficient and effective emergency care, professionals must integrate rapidly at multiple interfaces, working across functional, spatial and professional boundaries. Yet, the interdisciplinary nature of emergency care presents a challenge to the optimization of patient flow, as specialization and functional differentiation restrict integration efforts. This study aims to question what boundaries exist at the level of professionals and explores how these boundaries may come to influence integration and operational performance.

To provide a more holistic understanding of the inherent challenges to integration at the level of professionals and in contexts where professionals play a key role in determining operational performance, the authors carried out an in-depth case study at a busy, Level 1 trauma center in The Netherlands. In total, 28 interviews were conducted over an 18-month period.

The authors reveal the existence of structural, relational and cultural barriers between (medical) professionals from different disciplines. The study findings demonstrate how relational and cultural boundaries between professionals interrupt flows and delay service processes.

This study highlights the importance of interpersonal and cultural dynamics for internal integration and operational performance in emergency care processes. The authors unveil how the presence of professional boundaries creates opportunity for conflict and delays at important interfaces within the emergency care process, and can ultimately accumulate, disrupting patient flow and increasing lead times.