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The hospital industry is again experiencing a wave of consolidation as formerly independent hospitals are acquired by multihospital systems. The effects of these consolidations on operating costs and care quality have been researched extensively. However, in addition to these benefits, many hospitals also hope that joining a multihospital system will improve their access to capital. Improved access to capital could be a particularly important benefit for independent, not-for-profit (NFP) hospitals because these hospitals face capital constraints since they lack access to publicly issued equity. Despite being an often-cited benefit of system membership, access to capital has received little attention from researchers. We draw on financial theory to identify several mechanisms through which system membership might improve access to capital for acquired NFP hospitals. We develop and test hypotheses using data from an earlier period of hospital consolidation during which hospitals were even more financially constrained than they are at present. Using propensity score matched control hospitals, we examine changes in leverage that occurred after independent hospitals joined multihospital systems. We find evidence that system membership allows under-leveraged hospitals to increase their debt holdings, suggesting that system membership may help NFP hospitals attain an optimal capital structure.

Multidimensional fit (MDF) has been coined as “elusive” and relevant to an individual’s social identity and self-concept, unfolding over time as individuals assess their fit relative to Person-Organization, Person-Vocation, Person-Job, and Person-Team Fit. In this chapter, the literature as it relates to the refugee employment journey, MDF, and HRM practices that facilitate or inhibit MDF is reviewed. Furthermore, in this study, the process-oriented view of the refuge path highlights the complexity of their experience, noting an array of antecedents as they relate to country, host country and individual differences, interventions through NGOs, refugee resettlement agencies, and organizations, as well as the less explored entrepreneurial path. These diverse paths and the process of finding fit, and the obstacles refugees face, are viewed through the lens of shocks and reassessment of MDF throughout their journey. Finally, the study’s outcomes illustrate individual wellbeing factors, organizational level benefits, as well as community level benefits to MDF.

The global call to ‘leave-no-one behind’ cannot be achieved without tacking the intractable social issues faced by the most excluded people. There is increasing interest in using visual methodologies for participatory research in contexts of marginalisation, because they offer the potential to generate knowledge from people’s lived experience, which can reveal subjective, emotional, and contextual aspects missed by other methods; alongside the means for action through showing outputs to external audiences. The challenge is that the perspectives of those in highly inequitable and unaccountable contexts are – by definition – rarely articulated and often neglected. The author thus begins by assuming that there are unavoidable tensions in using visual methods; between perpetuating marginalisation by inaction, which is ethically questionable; and the necessary risks in bringing unheard views to public attention. Many experienced practitioners have called for a situated approach to visual methods ethics (Clark, Prosser, & Wiles, 2010; Gubrium, Hill, & Flicker 2014; Shaw, 2016). What is less clear is what this means for those wanting to apply this practically. In this chapter, the author addresses this gap through the exemplar of participatory video with marginalised groups. Drawing on cases from Kenya, India, Egypt, and South Africa, the author contributes a range of tried-and-tested strategies for navigating the biggest concerns such as informing consent; and the tensions between respecting autonomy and building inclusion, and between anonymity and supporting participant’s expressive agency. Through this, the author provides a resource for researchers, including prompts for critical reflection about how to generate solutions to visual ethical dilemmas in context.

This study is a queer autoethnography which deconstructs assumptions about a queer musical perspective and the associated heteronormative power and privilege. Using the lens of a Heideggerian interpretive phenomenology, it examines the request for and subsequent actualising or unfolding of musical compositions that respond to works of art. The request, being for a ‘queer compositional response’ to artworks occurred as personal; it touched my experience of being occurring as a kind of existential threat. As such, the personal is clearly political, positioning the experience of the request for queer compositions as a cultural experience which I am examining as socially unjust, or discriminatory. Furthermore, examining the intersectionalities of oppressive heteronormative and sexist attitudes and actions as queer in the world is an authentic mode of being in Heidegger's analytic of Dasein.

This chapter assessed internal and external environmental factors that affect variations in rural hospital profitability with a focus on the impact of the Patient Protection and Affordable Care Act regulations that resulted in the expansion of Medicaid eligibility, as well as four Medicare programs that target rural hospitals. A cross section of 2,114 rural US hospitals operating during 2015 was used. The primary source of data was Medicare Hospital Cost Reports. Ordinary least squares regression with correction for serial correlation, using total margin and operating margin as dependent variables, was employed to ascertain the association between profitability and its correlates.

The mean values for operating margin and total margin were −0.0652 and 0.0259, respectively. Hospital profitability was positively associated with location in a Medicaid expansion state, classification by Medicare as a Critical Access Hospital or Rural Referral Center (total margin only), hospital size, system membership, and occupancy rate. Profitability was negatively associated with average length of stay, government ownership, Medicare and Medicaid share of admissions, teaching status, and unemployment rate.

This chapter found that the Medicaid expansions provided modest help for the financial condition of rural hospitals. However, the estimates for the four targeted Medicare Programs (i.e., Critical Access Hospital, Medicare Dependent, Sole Community Critical Access Hospital, and Rural Referral Center) were either small or not significant (p > 0.10). Therefore, these specially targeted federal programs may have failed to achieve their goals of preserving the financial viability of rural hospitals. This chapter concludes with implications for practice.

The Bureau of Economics in the Federal Trade Commission has a three-part role in the Agency and the strength of its functions changed over time depending on the preferences and ideology of the FTC’s leaders, developments in the field of economics, and the tenor of the times. The over-riding current role is to provide well considered, unbiased economic advice regarding antitrust and consumer protection law enforcement cases to the legal staff and the Commission. The second role, which long ago was primary, is to provide reports on investigations of various industries to the public and public officials. This role was more recently called research or “policy R&D”. A third role is to advocate for competition and markets both domestically and internationally. As a practical matter, the provision of economic advice to the FTC and to the legal staff has required that the economists wear “two hats,” helping the legal staff investigate cases and provide evidence to support law enforcement cases while also providing advice to the legal bureaus and to the Commission on which cases to pursue (thus providing “a second set of eyes” to evaluate cases). There is sometimes a tension in those functions because building a case is not the same as evaluating a case. Economists and the Bureau of Economics have provided such services to the FTC for over 100 years proving that a sub-organization can survive while playing roles that sometimes conflict. Such a life is not, however, always easy or fun.

This chapter reviews qualitative research on parenting children with disabilities published over the last 50 years to explore whether shifts in academic discourse and changes in professional training have affected research on parenting and/or the experiences of parents who are the subject of such research.

An extensive literature search was conducted, and 78 peer-reviewed, qualitative studies on the experience of parenting a child with a disability were included in the sample. Themes were extracted from the reviewed literature and compared across decades.

The findings of the present review suggest that some aspects of the parenting experience have changed very little. In particular, parents continue to experience negative reactions such as stress and anomie, especially early in their children’s lives, and socially imposed barriers such as unhelpful professionals, and a lack of needed services continue to create problems and inspire an entrepreneurial response. In addition, stigmatizing encounters with others continue to be a common occurrence. In contrast to earlier decades, studies conducted in more recent years have begun to use the social model of disability as an analytic frame and also increasingly report that parents are questioning and challenging the concept of “normal” itself.

Additional improvements are needed in professional education and services to reduce the negative reactions experienced by parents of children with disabilities.

The findings of this meta-analysis can serve as a guide to future research on parenting children with disabilities.

Values have long guided special education services and supports for students with extensive support needs; over the past four decades, those values have been backed by research evidence demonstrating the critical nature of values related to inclusive education, self-determination, and seeking strengths and assets. In this chapter, we investigate these values and their supporting research, documenting strengths and needs in extant research. We emphasize the need to continue to embrace and maintain these values while pursuing research that addresses research gaps while centering the priorities, perspectives, and preferences of people with extensive support needs.