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Cardiovascular diseases are the leading cause of death worldwide. In Italy, acute myocardial infarction (AMI) is a major cause of hospitalization and healthcare costs. AMI is a myocardial necrosis event caused by an unstable ischemic syndrome. The Italian government has defined an indicator called “AMI: 30-day mortality” to assess the quality of the overall care pathway of the heart attacked patient. In order to guarantee high standards, all hospitals had to implement techniques to increase the quality of care pathway. The aim of the paper is to identify the root cause and understand the mortality rate for AMI and redesign the patient management process in order to improve it.

A Lean Six Sigma (LSS) approach was used in this study to analyze the patient flow in order to reduce 30-days mortality rate from AMI registered by Complex Operative Unit (COU) of Cardiology of an Italian hospital. Value stream mapping (VSM) and Ishikawa diagrams were implemented as tools of analysis.

Process improvement using LSS methodology made it possible to reduce the overall times from 115 minutes to 75 minutes, with a reduction of 35%. In addition, the corrective actions such as the activation of a post-discharge outpatient clinic and telephone contacts allowed the 30-day mortality rate to be lowered from 16% before the project to 8% after the project. In this way, the limit value set by the Italian government was reached.

The limitation of the study is that it is single-centered and was applied to a facility with a limited number of cases.

The LSS approach has brought significant benefits to the process of managing patients with AMI. Corrective actions such as the activation of an effective shared protocol or telephone interview with checklist can become the gold standard in reducing mortality. The limitation of the study is that it is single-centered and was applied to a facility with a limited number of cases.

LSS, applied for the first time to the management of cardiovascular diseases in Italy, is a methodology which has proved to be strategic for the improvement of healthcare process. The simple solutions implemented could serve as a guide for other hospitals to pursue the national AMI mortality target.

Background: Evidence from a range of major public health incidents shows that neighbour-based action can have a critical role in emergency response, assistance and recovery. However, there is little research to date on neighbour-based action during the 2020 coronavirus pandemic. This article reports on a survey of people engaged in supporting their neighbours in weeks three and four of the UK COVID-19 lockdown.

Methods: Members of area-based and community of interest COVID-19 support groups in the Bristol conurbation were invited to complete an online survey. Of 1,255 people who clicked on the survey link, 862 responded; of these, 539 responses were eligible for analysis.

Results: Respondents reported providing a wide range of support that went beyond health information, food and medical prescription assistance, to include raising morale through humour, creativity and acts of kindness and solidarity. A substantial proportion felt that they had become more involved in neighbourhood life following the lockdown and had an interest in becoming more involved in future. Neighbour support spanned all adult age groups, including older people categorised as being at-risk to the virus. With respect to most measures, there were no differences in the characteristics of support between respondents in areas of higher and lower deprivation. However, respondents from more deprived areas were more likely to state that they were involved in supporting certain vulnerable groups.

Conclusions: As with previous research on major social upheavals, our findings suggest that responses to the viral pandemic and associated social restrictions may increase existing social and health inequalities, and further research should explore this issue in more depth.

The purpose of this quantitative research was to determine if there are differences in scores on the Connor- Davidson Resilience Scale among undergraduate students involved in honors leadership programs at a four- year university. The study was an analysis of students’ reported resilience scores in relation to the number of leadership activities in which they participated to examine the potential impact of leadership practices on resilience levels of the students. Results of the dependent variables were the total resilience score, and the five factors of resilience: persistence and tenacity; emotional and cognitive control; adaptability and ability to bounce back; control; and spiritual influences. Independent variables were the number of leadership programs completed, age, gender, and class status. The level of significance used for the statistical test was .05. There was no significant difference in the total resilience scores among the three activity groups. However, a majority of students scored well above the national average score, and male students scored slightly higher than females. Additionally, females scored higher than the national average.

The purpose of this study was to explore how team members identify the social loafers on their teams and how they explain and manage social loafers’ behavior. The participants (n=49) in the study included members of student teams participating in a service project as a part of their coursework. We collected multiple sources of information: in-depth interviews, reflection journals, peer evaluations, and observations of team members interacting. Using attribution theory and status characteristics theory we describe how team members identify social loafer and explain the causes of their behavior. We also explore how those attributions affect team members’ interactions with the social loafers. The status of social loafers in the eyes of their teammates affects teammates’ willingness to accommodate or reject the social loafer. We identify strategies used by team members to manage the behavior of social loafers. We conclude with recommendations for practice and future research on social loafing.

This study offers implications for remote mentoring within school university partnerships based on a qualitative study focused on how three experienced mentor teachers within a long-standing Professional Development School (PDS) partnership adapted to remote mentoring during emergency remote teaching in the 2020–2021 school year.

Data was collected through interviews with three teachers and analyzed following qualitative methods to identify themes. Data is presented in case studies describing their remote mentoring practices.

Findings indicate that in the context of strong school–university partnerships, these mentor teachers were successful in adapting their mentoring of teacher candidates to a remote modality and that the benefits to collaborators within the partnership were like those documented in traditional, in-person mentorship. The challenges these teachers overcame include establishing relationships and providing adequate supervision.

The results offer rich insights into the experiences of mentor teachers when conditions necessitate a change in instructional modality and create implications for innovation in mentorship of teacher candidates, particularly in remote mentorship settings.

School–university partnerships should be maintained during emergencies because of the benefits to all partners, most notably to prek-5 students. We recommend that articulated agreements be revisited and modified to address potential future emergencies. The value of establishing and maintaining strong PDS partnerships should not be undervalued during times of emergency.

Teacher preparation programs can sustain the important work of educating teachers through challenges such as the COVID-19 pandemic most effectively when they work in partnership with prek-12 schools. Use of technology in innovative ways, such as remote mentoring, can support teacher preparation when in-person clinical experiences are limited.

This study offers initial data on remote mentoring, an innovative mentoring approach which has, to this point, been the subject of limited empirical investigation. Additionally, as remote educational opportunities for prek-5 learners increase, teacher preparation programs may choose to utilize remote mentoring in PDS programming, making this data of particular value.

When discussing the term “technology-facilitated violence” (TFV) it is often asked: “Is it actually violence?” While international human rights standards, such as the United Nations' Convention on the Elimination of All Forms of Discrimination against Women (United Nations General Assembly, 1979), have long recognized emotional and psychological abuse as forms of violence, including many forms of technology-facilitated abuse (United Nations, 2018), law makers and the general public continue to grapple with the question of whether certain harmful technology-facilitated behaviors are actually forms of violence. This chapter explores this question in two parts. First, it reviews three theoretical concepts of violence and examines how these concepts apply to technology-facilitated behaviors. In doing so, this chapter aims to demonstrate how some harmful technology-facilitated behaviors fit under the greater conceptual umbrella of violence. Second, it examines two recent cases, one from the British Columbia Court of Appeal (BCCA) in Canada and a Romanian case from the European Court of Human Rights (ECtHR), that received attention for their legal determinations on whether to define harmful technology-facilitated behaviors as forms of violence or not. This chapter concludes with observations on why we should conceptualize certain technology-facilitated behaviors as forms of violence.

The purpose of this study is to empirically test how problem-solving lean practices, along with leaders as learning facilitators in an action learning approach, can be transferred from a production context to a knowledge work context for the purpose of becoming a learning organization while enhancing performance. This is important to study because many organizations struggle to enhance efficiency in the short term while still trying to be long-term learning oriented (i.e. learning organization development).

The authors draw on theory on learning interventions to show how lean practices for problem-solving can foster learning and help an organization to become adaptive. This study’s subject is a non-production department of 100 employees at the LEGO corporation. The authors applied survey results from a natural experiment lasting 18 months between a pre-measurement survey and a post-measurement survey. The results were compared to a control department of 50 employees who were not exposed to the lean practices intervention. The authors’ focus was on the individual level as individuals have different perceptions of lean practices, performance, and learning.

Using repeated-measures tests, difference-in-difference regressions analyses, and structural equation models, the authors find that a package of contemporary lean practices for problem-solving, along with leaders who function as learning facilitators, significantly improved learning organization dimensions while also enhancing efficiency and quality and that learning organizations positively mediate the relationship between the lean intervention and quality-related performance, while efficiency is directly affected by the lean interventions. Data from LEGO's key performance indicators (KPIs), benefit trackers, on-site observations and more than 40 interviews with managers provided results that were consistent with the survey data. A detailed description of the lean practices implemented is provided to inspire future implementations in non-operations environments and to assist educators.

The authors contribute to the learning literature by showing that a learning-to-learn approach to lean management can serve as an active and deliberate intervention in helping an organization becoming a learning organization as perceived by the individual organizational members. The authors also add to the lean literature by showing how a learning approach to lean, as used by LEGO, can positively affect short-term efficiency and quality and create a foundation for a longer-term competitive advantage (i.e. a learning organization) in a non-production context. By contrast, most of the lean literature streams treat efficiency separately from a learning organization and mainly examine lean in a production context.

The extant literature shows three research streams on lean, learning, and performance. The authors built on these streams by trying to emphasize both learning and efficiency. Prior research has not empirically tested whether and how the application of problem-solving lean practices combined with leaders as learning facilitators helps to create a comprehensive learning organization while enhancing performance in a non-production context.

Sociologists have long thought of the integration of people in communities – social integration – and hierarchical social systems – systemic integration – as contradictory goals. What strategies allow organizations to reconcile social and systemic integration? We examine this question through 40 in-depth, longitudinal interviews with leaders of nonprofit organizations that engage in the dual pursuit of social and systemic integration. Two processes reveal how the internal structure of organizations often mirrors the ways in which organizations are embedded in their local environments. When organizations engage in loose demographic coupling, relegating those who “match” the community to the work of social integration, they produce internal inequalities and justify them by claiming community building as sacred work. When engaging in community anchoring, organizations challenge internal and external inequalities simultaneously, but this process comes with costs. Our findings contribute to a constructivist understanding of community, the mechanisms by which organizations produce inequalities, and a place-based conception of organizations as embedded in community.

This study was the first to examine two related constructs within the context of leadership. Stoicism is an ancient philosophy offering practical advice for a virtuous and eudaemonic life. As a method to examine one’s emotional experiences (Sellars, 2006), leaders such as Roman Emperor Marcus Aurelius and Teddy Roosevelt (Aurelius, ca. 160 A.D., 2002) practiced Stoicism, yet mentions of it within the field of leadership research have been scant. Leadership academics contrast desirable emotional intelligence behaviors with Stoicism (Grewal & Salovey, 2005; Mayer et al., 2008). Regardless, these two constructs are both concerned with effectively managing emotions, practicing self-awareness, high levels of motivation, and sensitivity to the expression of emotion in others (Goleman, 2005; Pigliucci, 2017; Salzgeber, 2019)

Undergraduate students in a leadership minor (_N_ = 445) at a public university completed the Emotional and Social Competency Inventory - University and the Liverpool Stoicism Scale. Analysis included a description of assessment results, an examination or the relationship between variables and differences in participant’s scores based on race, gender, and age. Stoicism and emotional self-awareness showed a moderate, statistically significant negative correlation (_r_ = - 0.391, _p_ = .05). A low, statistically significant negative relationship was reported between stoicism and the relationship management competency of teamwork (p = .003, r = -.018), and a low statistically significant positive relationship between self-management competencies, adaptability (p = .043, r = .189) and emotional self-control (p = .039, r = .192). Student’s Stoicism scores were significantly correlated with gender (_t_(113) = 2.479; _p_ = .015, _d_ = .564)

The research findings provided baseline statistics for continued exploration of Stoicism within the context of leadership. Future research that better aligns with the original doctrines of the philosophy is recommended, particularly in the interest of leadership development.

For many Indigenous nations globally, ethics is a conversation. The purpose of this paper is to share and mobilize knowledge to build relationships and capacities regarding the ethics review and approval of research with Indigenous peoples throughout Atlantic Canada. The authors share key principles that emerged for shifting practices that recognize Indigenous rights holders through ethical research review practice.

The NunatuKavut Inuit hosted and led a two-day gathering on March 2019 in Happy Valley-Goose Bay, Newfoundland and Labrador, to promote a regional dialogue on Indigenous Research Governance. It brought together Indigenous Nations within the Atlantic Region and invited guests from institutional ethics review boards and researchers in the region to address the principles-to-policy-to-practice gap as it relates to the research ethics review process. Called “Naalak”, an Inuktitut word that means “to listen and to pay close attention”, the gathering created a dynamic moment of respect and understanding of how to work better together and support one another in research with Indigenous peoples on Indigenous lands.

Through this process of dialogue and reflection, emergent principles and practices for “good” research ethics were collectively identified. Open dialogue between institutional ethics boards and Indigenous research review committees acknowledged past and current research practices from Indigenous peoples’ perspectives; supported and encouraged community-led research; articulated and exemplified Indigenous ownership and control of data; promoted and practiced ethical and responsible research with Indigenous peoples; and supported and emphasized rights based approaches within the current research regulatory system. Key principles emerged for shifting paradigms to honour Indigenous rights holders through ethical research practice, including: recognizing Indigenous peoples as rights holders with sovereignty over research; accepting collective responsibility for research in a “good” way; enlarging the sphere of ethical consideration to include the land; acknowledging that “The stories are ours” through Indigenous-led (or co-led) research; articulating relationships between Indigenous and Research Ethics Board (REB) approvals; addressing justice and proportionate review of Indigenous research; and, means of identifying the Indigenous governing authority for approving research.

Future steps (including further research) include pursuing collective responsibilities towards empowering Indigenous communities to build their own consensus around research with/in their people and their lands. This entails pursuing further understanding of how to move forward in recognition and respect for Indigenous peoples as rights holders, and disrupting mainstream dialogue around Indigenous peoples as “stakeholders” in research.

The first step in moving forward in a way that embraces Indigenous principles is to deeply embed the respect of Indigenous peoples as rights holders across and within REBs. This shift in perspective changes our collective responsibilities in equitable ways, reflecting and respecting differing impetus and resources between the two parties: “equity” does imply “equality”. Several examples of practical changes to REB procedures and considerations are detailed.

What the authors have discovered is that it is not just about academic or institutional REB decolonization: there are broad systematic issues at play. However, pursuing the collective responsibilities outlined in our paper should work towards empowering communities to build their own consensus around research with/in their people and their lands. Indigenous peoples are rights holders, and have governance over research, including the autonomy to make decisions about themselves, their future, and their past.

The value is in its guidance around how authentic partnerships can develop that promote equity with regard to community and researcher and community/researcher voice and power throughout the research lifecycle, including through research ethics reviews that respect Indigenous rights, world views and ways of knowing. It helps to show how both Indigenous and non-Indigenous institutions can collectively honour Indigenous rights holders through ethical research practice.