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The first three years of operation of the West Kendall Baptist Hospital (WKBH) in Miami, Florida provided a “poster child” for efficient and cost effective healthcare delivery to the West Kendall community that it served. The hospital leadership and management team exemplified a quality-oriented staff that moved as a cohesive and dedicated organization. WKBH exceeded every budget prediction and showed a profit in year 3, well before expected. Then came the winds of regulatory change. With the passage of the Affordable Care Act (ACA) and the attendant imposition of new reimbursement metrics, the picture at WKBH changed almost overnight. By the first quarter of 2016, WKBH started to lose money in excess of budget predictions despite its increased patient admissions, careful financial planning, expense reductions, quality service, and excellence in patient care delivery. A serious financial crisis was looming with little relief in sight. The hospital management team began to search for solutions.

The research methodology includes collecting quantitative data: original financial statements and financial data from WKBH, as well as qualitative data: interviews of hospital administrators and historical information.

Graduate capstone course in a finance course; masters in health administration; and/or the MBA program.

While it is clear that the ACA was designed with all good intentions, it has created substantial and perhaps, unanticipated financial burdens for caregivers. These issues are not only faced by WKBH. Most hospitals could relate to one or more of the four questions examined as part of this learning process. Graduate MBA students worked with the hospital to identify, define, focus, and resolve difficult quantitative and qualitative issues faced by the hospital as a result of major changes in the regulatory environment with the passage of the ACA. This case focuses upon the current reimbursement environment that has only recently emerged as a result of the implementation of the ACA.

The purpose of this paper is to explore the needs of people with cancer in advanced stages and to analyze factors that influence them.

A concurrent mixed-method design was used. Descriptive design was conducted in Ubon Ratchathani Province, Thailand. Data were collected from a convenience sample of patients with advanced cancer of any tissue or organ. Questionnaires were completed by 110 patients aged 60 years and above (response rate 110/130=84.6 percent). In-depth interviews were conducted with a total of eight patients. Content analysis of semi-structured interviews of a sub-sample was subsequently performed to better understand the real needs of patients with advanced stages of cancer at home setting.

The majority (77.5 percent) reported a preference to spend their final days at home. The four most common palliative care needs were more information about disease and medical treatment (98.2 percent), more treatment for pain (97.3 percent), health education for family caregivers (95.5 percent) and health volunteers visit at home (95.5 percent). Content analysis of the qualitative data suggested that patient needs health care providers to deliver open communication, pain management and provide psychosocial supports.

The result showed that patients-related variables are associated with the palliative care needs in patients with advanced stages of cancer. Communication skills and pain management are the key components to support the need for palliative care at home and to benefit the quality of life in terminally ill patients.

The following is an annotated list of materials dealing with orientation to library facilities and services, instruction in the use of information resources, and research and computer skills related to retrieving, using, and evaluating information. This review, the sixteenth to be published in Reference Services Review, includes items in English published in 1989. A few are not annotated because the compiler could not obtain copies of them for this review.

Co-teaching is a prevalent and productive coaching activity that coaches can leverage when working with teachers to support teaching and learning. However, there is insufficient research detailing how coaches can and should implement this coaching activity with teachers. Hence, the purpose of this qualitative interview study is to better understand the challenges that make co-teaching coaching cycles difficult for coaches to enact with in-service teachers, as well as the supports that can enhance the co-teaching experience for all involved parties.

Fourteen semi-structured interviews were completed with one instructional coach and three elementary teachers in one school district in the USA. A combination of emergent as well as literature-driven codes was used to code the data.

Overall, the participants pointed to six barriers they encountered when engaging in episodes of co-teaching, which spanned the broad categories of management and logistics, pedagogical dilemmas, and teacher learning. Furthermore, participants identified seven supports, spanning the broad categories of coach preparation, contextual factors, and management and logistics, that enabled them to productively engage in co-teaching.

Although coaches may frequently engage teachers in coaching cycles involving co-teaching, there is a lack of research-based guidance for coaches about how to engage teachers most productively in co-teaching episodes. The findings from this study, which shed light on the challenges and support of co-teaching from one coach and three teachers, will enable coaches to more effectively co-teach with teachers as a form of high-quality professional development.

There are calls for greater regulation of online content related to self-harm and suicide, particularly that which is user-generated. However, the online space is a source of support and advice, including an important sharing of experiences. This study aims to explore what it is about such online content, and how people interact with it, that may confer harm or offer benefit.

The authors undertook a systematic review of the published evidence, using customised searches up to February 2021 in seven databases. The authors included empirical research on the internet or online use and self-harm or suicide content that had been indexed since 2015. The authors undertook a theoretically driven narrative synthesis.

From 4,493 unique records, 87 met our inclusion criteria. The literature is rapidly expanding and not all the evidence is high quality, with very few longitudinal or intervention studies so little evidence to understand possible causal links. Very little content online is classifiable as explicitly harmful or definitively helpful, with responses varying by the individual and immediate context. The authors present a framework that seeks to represent the interplay in online use between the person, the medium, the content and the outcome.

This review highlights that content should not be considered separately to the person accessing it, so online safety means thinking about all users. Blanket removal or unthinking regulation may be more harmful than helpful. A focus on safe browsing is important and tools that limit time and diversify content would support this.

In this article, the authors, a university elementary social studies methods faculty member and a district social studies supervisor, discuss the creation of sustained professional development (PD) for elementary teachers on integrated social studies instruction.

The authors detail the development of a PD sequence that included two 45-minute whole-group PD sessions and two days of individual and small-group school-day coaching for each school in the district. The ultimate goal of this PD was to provide the classroom teachers with the pedagogical content knowledge to meaningfully integrate social studies and English language arts (ELA) in their classrooms.

The collaboration between the university faculty member and the district administrator allowed for the development of meaningful, sustained PD for the classroom teachers.

This work has implications related to the development of PD to integrate social studies and ELA for university faculty working with teachers in school-based settings and for school administrators seeking to provide more PD for their teachers.

Since environmental factors have influenced Generation Y shoppers (those born after 1977) to make them different from older groups, this study examines the decision making of Adult Female Generation Y consumers using Sproles and Kendall’s (1986) Consumer Styles Inventory (CSI). The study uses the CSI as a basis for segmenting Generation Y consumers in to five meaningful and distinct decision‐making groups, namely: “recreational quality seekers”, “recreational discount seekers”, “trend setting loyals”, “shopping and fashion uninterested” and “confused time/money conserving”. Implications for retailers and marketing practitioners targeting Generation Y consumers are discussed.

International educational research has shown that high quality coaching, mentoring, and induction for beginning teachers can enhance development and retention of highly effective teachers and, ultimately, increase student success. In Canada, like many jurisdictions, teacher induction programs have grown in popularity as a means to support beginning teachers, yet programs vary greatly in terms of delivery and effectiveness. This chapter presents the findings from a qualitative case study that examined one bespoke teacher induction program in the Western Québec School Board (WQSB). Specifically, it reports on the experience of mentor–coaches (MC) who are part of the school district’s Mentoring and Coaching Fellowship (MCF). In the district, mentoring and coaching are viewed as distinct, yet interconnected components of an effective induction program. In the WQSB, teaching fellows and MCs learn together in a social and situated context (Lave & Wenger, 1991) as they focus on four key elements: the practice of teaching, navigating school and district culture, what it means to be a teacher, and the formation of a teaching identity. Research has shown effective coaching and mentoring programs not only enhance teaching and learning, but also they offer powerful benefits to veteran teachers. With mentoring and coaching practice highly diverse and inconsistent depending on the quality of the relationship and the context, it is clear that effective selection, support and professional learning and development for MCs is essential. This chapter examines the strengths and challenges of the school district’s Mentor–Coach Professional Learning Network (MC PLN) from the perspective of network members. Data collected from questionnaires, focus groups and semi-structured interviews were abductively analyzed with and against Brown and Poortman’s (2018) five supporting conditions for effective PLNs. Study findings indicated that the MC PLN offers valuable professional learning and development for participants and is a critical feature in a powerful induction program that also focuses on “growing the top.” However, challenges also emerged that highlight the need for the district to ensure ongoing attention to the PLN’s structure and processes in order to sustain MC motivation, engagement, and commitment.

This chapter investigates resistance initiated by trans athletes and their allies and evaluates developments in policies and practices at the international, national and local levels of sport. The limitations of liberal approaches to trans inclusion are identified, and examples of radical, transformative approaches grounded in intersectional feminism are presented, together with an analysis of the crucial roles of solidarity work provided by allies and accomplices. The potential offered by boxing as a route to empowerment for trans and nonbinary participants is examined. An overview of recent media coverage of trans athletes suggests that global resistance is having an important impact on mainstream journalism. Finally, this chapter outlines how a successful campaign challenging a trans-exclusive Sport Canada's 2022 opinion survey and a recent report by Canadian Centre for Ethics in Sport provide further evidence of effective resistance to trans exclusion in sport.