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The paper tests if and to what extent lean management system adoption generates abnormal profitability, and how it accrues over time. Configurational approaches to lean management systems and “S-curve” effects in lean implementation are used to ground the paper's hypotheses and interpret its findings.

Using the emerging view of lean as enterprise-wide management systems, this quasi-experimental study uses a difference-in-differences approach to estimate the abnormal profitability (ROIC) attributable to lean management system adoption. The paper leverages a unique data set of lean adopters nested in a panel data set (19 years) of 2,088 industrial firms matched by industry and firm size. It applies a variety of regression methods (two-way fixed effect panel estimator, propensity score matching, instrumental variable two-stage-least squares) to estimate the size of the abnormal profitability attributable to lean management systems, addressing endogeneity issues related to non-random sampling, omitted variable bias and reverse causation. It also analyzes the cross-firm variability of such abnormal profitability and how it accrues over time.

For the average non-adopter in the sample (44.3 million euro revenues), lean adoption generates abnormal ROIC ranging from 1.4% to 3.9%. These results come into effect approximately three years after starting lean adoption and peak after eight years. While the average abnormal profitability attributable to lean adoption is sizable, it varies significantly across firms and over time. This significant variation is compatible with firms' diverse ability to understand the complex inner workings of lean systems, and to design and implement them so that they improve profitability.

The conceptualization of lean as enterprise-wide management system can be further refined to more effectively categorize the components of lean systems and investigate the nature of their relationships. Lean system adoption measurement can be fine-tuned to better capture cross-firm and longitudinal heterogeneity. Future work can explore other dependent variables of interest to different stakeholders including shareholders' value, employment and environmental and social sustainability.

The financial benefits of adopting lean can be reaped to the extent to which managers embrace lean as a philosophy and implement it pervasively in the organization. A firm can use the study's estimates as a basis for making calculations about the returns of investment in lean adoption. The paper also shows that “getting the lean system right” makes a significant difference in terms of abnormal profitability, which is twice as large for the best lean adopters..

Compared with the promises of many lean proponents and supporters, the paper provides a more realistic view of what to expect from lean adoption in terms of profitability. Adopting lean as a comprehensive, enterprise-wide management system is not a universal panacea, but a complex endeavor, characterized by multiple complex decisions that require considerable capabilities, coordinated efforts and consistency of action.

Differently from extant research, this study does not study the correlation between the adoption of lean operation practices and financial performance but focuses on the abnormal profitability generated by the adoption of lean as a pervasive, enterprise-wide management system. Its research design allows to identify the differential profitability attributable to lean adoption and documents that it accrues non-linearly.

Most UK ambulance services undertake remote assessments of 999 calls with nurses and paramedics to manage demand and reduce inappropriate hospital admissions. However, little is known about the differences in the types of cases managed by the two professions comparatively, their clinical outcomes, and the quality and safety they offer.

The retrospective descriptive study analysed data collected at Welsh Ambulance Services University NHS Trust (WAST) from prioritisation, triage, and audit tools between the 17th May 2022 to 8th November 2022. A total of 21,076 cases and 728 audits were included for review.

There was little difference in the type and frequency of the presenting complaints assessed, and clinical outcomes reached in percentage terms. Whilst paramedics had more highly compliant call audits and fewer non-compliant call audits, there was, again, little difference in percentage terms between the two, indicating positive levels of safety across the two professional groups.

There continues to be a substantial difference between UK paramedics to those in the Middle East, the United States, and some African nations, which may limit the applicability of findings. This study also looked at a six-month window from only one UK service using one type of prioritisation and triage tool. Future research could explore longer periods from multiple services using various tools. It is important to note that this study did not link outcome data with primary, secondary or tertiary care settings. Thus, it is impossible to determine if the level of care aligned closely with the final diagnosis.

The practical implications of this work include better workforce planning for agencies who have perhaps only employed one type of clinician or a reaffirmation to those who have employed both. The authors suggest that the training and education of both sets of clinicians could remain general in nature, with no overt requirement for specificity based on professional registration alone. Commissioners and stakeholders in the wider health economy should consider ensuring equitable access to alternative pathways for patients assessed by both nurses and paramedics.

It has been posited that UK nurses and paramedics are, by virtue of their consistency in education, skill set, licensure, and general experience, both able to achieve safe and effective remote outcomes in 999 settings. This study provides evidence to support that hypothesis. These results say more about the two professions' ability to work together rather than just the professions themselves. The multidisciplinary team approach is well-established in acute care settings, and is broadly considered to improve communication, coordination decision making, adherence to up-to-date treatment recommendations, and be positive for shared learning and development for younger colleagues.

Most UK services use a mix of nurses and paramedics; however, little is known about the differences in the types of cases managed by the two professions comparatively, their clinical outcomes, and the quality and safety they each offer. The most recent studies of this nature were published in 2003 and 2004 and looked only at low-acuity 999 calls when remote assessment was not even an established role for UK paramedics. This study updates the literature, identifies areas for future research, and applies to the international setting for the most part.

This paper aims to provide a living tribute to the mental health activist and international trainer Peter Bullimore.

Peter provided a list of people to who he wanted to provide tributes. Jerome approached all these people. All agreed.

Several people from around the world attest to the influence that Peter’s teaching and personality have had on their clinical practice and on their lives.

The disappearance of an Open Mind has left a shortage of journals, which welcome the user perspective. Mental Health and Social Inclusion have always championed the voice of people with lived experience. These are selected tributes to one man’s work in the field of mental health.

These accounts provide insights into the work of a remarkable individual.

Students of the mental health professions are mainly exposed to work produced by their peers. The history of mental health is filled with the stories of professionals, not the people who have used services.

Historically accounts of psychiatry are written by mental health professionals. Service user or lived experience accounts are often written from the perspective of the person’s story of illness and recovery. There are comparatively few, which celebrate the additional achievements of specific individuals with lived experience.

The aim of this study was to determine the impact of oral communication in improving the marketing and financial management skills of sweet potato farmers.

The study used a quasi-experimental design with a pre- and post-test approach. The sample was 540 sweet potato farmers that were randomly assigned to training (n = 270) and no-training groups (n = 270) with analysis of covariance (ANCOVA) as the method of data analysis. While the training group received oral training sessions for three farming seasons beginning in 2019, 2020 and 2021, the no-training group did not receive any intervention.

Before the training sessions, all the sweet potato farmers scored low on marketing skills like advertising, sales promotion and sales forecasting. Both groups also scored low on financial management skills like budgeting, investments, saving and controlling expenditures. Their annual income level was also low and both groups did not significantly differ. However, after the training and during the follow-up evaluation, the participants in the training group reported a significant improvement in their marketing skills and financial management skills. There was also an improvement in their income level from $238 (N109,480) at baseline to $523 (N240,580) after the training and $782 (N359,720) after the follow-up evaluation. On the other hand, the no-training group reported a staggered fluctuation in their income of $241 (N110,860) at baseline, $371(N170,660) during post-training evaluation and $214 (N98,440) at follow-up assessment.

The first limitation is that the study examined only one crop. There is a need to pay attention to farmers of other crops for better understanding. Another limitation of the study is that the researchers examined only oral communication. There is a need to compare more than one training to understand which is more effective. Finally, the current study did not consider the moderating effect of other factors like the source of labour and expenses.

This study has shown that oral communication is an effective tool for promoting the acquisition of marketing and financial management skills and enhancing agribusiness.

All of us are born critical thinkers; some perfect this talent; others ignore it as useful in daily life. This chapter follows those who perfected this talent in order to learn from them the art and models of critical thinking in terms of its optimal inputs, processes, and outputs. According to great critical thinkers in business management, critical thinking questions – or should question – the obsessive generalizations, constraints, and “best” practices of the prevailing system of management, and try to replace them with more valid assumptions and more meaningful generalizations that uphold the dignity, uniqueness, and inalienable rights of the individual person and the community. After setting out some cases illustrating the lack of critical thinking, in Part I of this chapter, we introduce some representative management thinkers on critical thinking, and in Part II, we introduce eight models or practical approaches for critical thinking.

The main aim of this paper is to provide a living tribute of lived expert by experience and researcher Andrew Voyce.

Andrew provided the author with a list of names of people he might approach to write a tribute on his behalf.

The accounts describe the influence that Andrew has had both as an educator and as a trusted colleague for the people approached.

In many ways, the voices of people with mental health problems have been marginalised. Few mental health journals, with only some exceptions, encourage lived experience contributions.

The mental health agenda continues to be dominated by professional groups. The remarkable individuals who continually battle with serious mental illness are often lost in official discourses.

Despite the fact that the topic of mental health is now much more in the public domain, research tells us that the most effective anti-stigma strategy is contact with sufferers.

The archivist Dr Anna Sexton co-produced one of the few mental health archives that only featured people with lived experience. Andrew was one of the four people featured in it. This account “showcases” the work of this remarkable man.