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Virtual care is any interaction between a patient and clinician or clinicians, occurring remotely using information technologies. Like many international services, United Kingdom (UK) ambulance services use paramedics and nurses to undertake telephone assessments of patients calling the 999 emergency service line. Using their clinical knowledge, experience, and, at times, computer decision support software, these clinicians assess patients from a range of clinical acuities to confirm the need for an emergency response or identify and support those patients who can be cared for with remote treatment advice and referral. The Covid-19 pandemic saw UK ambulance services change and adapt their operating models to meet social distancing requirements, increase clinical staff numbers and mitigate staff becoming unavailable for work due to self-isolation. One such strategy was moving clinicians from Emergency Operations Centres (EOCs) to working at home. Staff utilised digital phone systems, remote computer-aided dispatch modules, remote clinical decision support software and video platforms, which allowed close to full functionality compared to inside typical EOCs. There is a dearth of literature exploring the comparative practice of clinicians from home rather than from EOCs. Therefore, this study reports the findings of a qualitative analysis of these effects from the clinician's perspective. The authors hope that the findings from this study will inform the operating, education and leadership practices of those delivering such services.

A convenience sample of telephone nurses and paramedics from one UK ambulance service in which home working had been implemented were contacted. 15 clinicians with recent home working experience responded to the invite out of a possible 31 (48%). All participants had previously practised remote assessment from within an EOC. Semi-structured interviews took place via video conferencing software and were recorded, transcribed and thematically analysed. An inductive approach was taken to generating codes and both researchers separately reading the transcripts before re-reading them, assigning initial themes and determining frequency.

Four main themes were identified with further associated sub-themes: (1) performance, (2) support, (3) distractions and interruptions and (4) confidence in decision-making.

There are very few studies exploring the practice of remote clinicians in emergency EOCs. This study identified that home working clinicians felt their productivity had increased, making them more satisfied in their practice. However, there were mixed feelings over the level of support they perceived they now received, despite the mechanisms of support being largely the same. Supervisors found it especially challenging to provide support to practitioners; and employers might need to clarify the support mechanisms they provide to homeworkers. The elimination of distractions and interruptions was seen as a largely positive result of homeworking; however, these interruptions were not seen as inappropriate, thus, identifying a need for role clarity and task coordination rather than interruption elimination. Finally, clinicians felt that they become more confident when working from home, researching more, trusting themselves more and relying less on others to reach safe outcomes. However, there were missed opportunities to learn from listening to others' clinical practice.

This paper aims to explore how varsity football athletes and coaches negotiate meanings when faced with the unmet expectations of a new head coach brought into lead a turnaround process. It also aims to pay particular attention to the role of history in this meaning making process.

This paper draws on semi‐structured interviews with players and coaches at two points in time. To preserve the richness of their experiences and illuminate the historical aspects of change, it focuses on the stories of three players and one supporting coach.

Numerous symbols of change emerge that have multiple and contradictory meanings. The meanings around success and failure are renegotiated over time as individuals struggle with the unmet expectations of change. Moreover, individuals are unable to shed the failures of the past and move forward.

Change is a complex and messy process of managing multiple meanings. Understanding change entails more than a snapshot picture of an organization. New leaders have no control over the past, yet they need to be aware of how individuals experienced the past in order to increase the likelihood of success in the present.

Success and failure are experienced as an ongoing process as athletes and coaches experience, reflect on and interact with others. In illuminating the role of history in how change is experienced in the present, the paper demonstrates that the past can serve as both an immobilizing force, as well as a comparative point enabling individuals to rationalize their emotions.

Professor Harry G. Johnson, the economist, died on May 8 at the age of 53. His death rated a longish obituary in the New York Times, but went unremarked on the evening news shows. For Professor Johnson was not a public figure. He never deigned to wallow in the swamps of political economy. Rather, he was the quintessential economic scientist. Even his closest friends were hard put to discover his ideological bent, for Harry Johnson professed none. More than that, he escaped all the neat taxonomies: in manifold books and professional‐journal articles, he attacked Keynes where he felt the great Lord was wrong; he criticized the Neoclassicists for their myopia; and he remained distrustful of what he viewed as the overly simplistic analytics proffered by Milton Friedman, his senior colleague at the University of Chicago.

We examine the entry mode choice for Canadian firms entering the United States (U.S.). Entry options are categorized into three competing modes: mergers and acquisitions; joint ventures; and subsidiaries. The unit of analysis is the foreign direct investment (FDI) transaction between a Canadian firm and an American counterpart during the period from January 1980 through December 1989. Using canonical discriminant analysis, we develop a set of variables that characterize the entry mode choice. We find transaction specific information available to senior management provides important information regarding the entry mode choice. The importance of mergers and acquisitions is particularly apparent over this sample period. Empirical evidence strongly supports our measures of resource commitment, dissemination risk, and liquidity position as important measures determining mode of entry. Joint ventures display meaningful differences related to these measures in contrast to both mergers and acquisitions, and subsidiary investments.

This paper discusses the American debate over price controls and economic stabilization after World War II, when the transition from a war economy to a peace economy was characterized by bottlenecks in the productive system and shortages of food and other basic consumer goods, directly affecting the living standard of the population, the public opinion, and political discourse. Specifically, we will focus on the economist Franco Modigliani and his proposal for a “Plan to meet the problem of rising meat and other food prices without bureaucratic controls.” The plan prepared by Modigliani in October 1947 was based on a system of taxes and subsidies to foster a proper distribution of disposable income and warrant a minimum meat consumption for each individual without encroaching market mechanisms and consumers’ freedom. We will discuss the contents of the plan and its further refinements, and the reactions it prompted from fellow economists, the public opinion, and the political world. Although the Plan was not eventually implemented, it was an important initiative for several reasons: first, it showed the increasing importance of fiscal policy among postwar government tools of intervention in the economic sphere; second, it showed a third way between direct government intervention and full-fledged laissez faire, in tune with the postwar political climate; third, it proposed a Keynesian macroeconomic approach to price and income stabilization, strongly based on econometric and microeconomic foundations. The Meat Plan was thus a fundamental step in Modigliani’s effort to build the “neoclassical synthesis” between Keynesian and Neoclassical economics, which would deeply influence his own career and the evolution of academic studies and government practices in the United States.

Following the naming of Fred MacFee, Jr as Vice‐President and Group Executive of General Electric's Aircraft Engine Group, several changes in staff assignments have been announced effective 1 April 1978.

IN order to be able to discriminate with certainty between butter and such margarine as is sold in England, it is necessary to carry out two or three elaborate and delicate chemical processes. But there has always been a craving by the public for some simple method of determining the genuineness of butter by means of which the necessary trouble could be dispensed with. It has been suggested that such easy detection would be possible if all margarine bought and sold in England were to be manufactured with some distinctive colouring added—light‐blue, for instance—or were to contain a small amount of phenolphthalein, so that the addition of a drop of a solution of caustic potash to a suspected sample would cause it to become pink if it were margarine, while nothing would occur if it were genuine butter. These methods, which have been put forward seriously, will be found on consideration to be unnecessary, and, indeed, absurd.

The shortage of grain, reflected by an increase in the rate of extraction in milling and then by the rationing of bread, has fully aroused the attention which it warrants. Avoidance of wastage, always important, now becomes imperative. In view of this, notes in connection with the occurrence of “rope” in bread which were recently made available to members of the baking industry by the Ministry of Food may be even more important than the warnings issued in previous years. The disease is associated with warm weather and develops most rapidly at about 100°F. The first of the symptoms is usually the development in the bread of a faint fruity odour, resembling that of an over‐ripe pineapple, which becomes more intense as the bread gets older. Discolouration and softening of the crumb next occurs, so that on attempting to cut the bread it tends to stick to the knife. When the crumb is pulled apart, fine gelatinous threads may be formed. Although an outbreak of “rope” is unpleasant, there is fortunately little or no evidence that such an occurrence is dangerous to health. The disease can of course occur in cakes and similar bakery products, but outbreaks are practically always confined to bread. The comparative immunity of cakes is probably due to a generally lower moisture content, which does not encourage development of the disease. Another possibility is that fruit, where present, may cause the development of a certain amount of acid, and acid conditions discourage the activity of the organism responsible for the trouble. “Rope” in bread is caused by the spore‐forming bacterium B. mesentericus. It has been suggested the disease is due to the decomposition of the starch by amylase, in which the organism is rich. There are several strains of this bacterium, which is of widespread occurrence—it is found, for example, in the soil. All kinds of flour, whether of high or of low extraction, and including those derived from cereals other than wheat, are possible carriers of the disease. However, carefully‐conducted experiments have shown that the “rope” spore content of the flour, unless particularly high, is of minor significance when outbreaks of “rope” occur. Far more important are the conditions under which the bread is made and under which it is treated after baking. It has been found that “rope” formation is more likely to develop in the dense crumb associated with under‐fermentation than in loaves in which the crumb is well‐developed. Use of sufficient yeast to cause the fermentation to be vigorous has also been found to be beneficial. The initial development of the organism appears to be at the expense of the soluble nitrogen compounds, sugars, etc., present in the bread. When these materials are exhausted, attack upon the protein of the loaf proceeds. A possibility is that prolonged fermentation causes a partial transformation of the gluten into nitrogenous substances which are more easily assimilated by the bacteria, whereas in a short, vigorous fermentation the formation of such substances may not occur to the same extent. Occurrences of the disease may be expected to be more severe with high extraction flours or whole‐meals, since higher extraction gives a medium which is better suited for the growth of the “rope”‐causing organism. All the members of the mesentericus group are characterised by the formation of spores which are extremely difficult to destroy by heating. For example, the spores can resist the temperature of boiling water for hours on end. Since the interior of a loaf probably does not exceed this temperature whilst in the oven, many of the spores will escape destruction. The spores will thus pass through the operation of baking and, if conditions are favourable, the development of the disease will start at or near the middle of the loaf. Since the damp, soggy crumb associated with an under‐baked loaf is conducive to the development of “rope,” thorough baking is a definite advantage. Owing to the fact that the “rope” organism requires warmth for its growth, rapid and thorough cooling of the bread in well‐ventilated cooling rooms is an important preventative factor. Spacing upon the racks should be such that the loaves do not touch, and the latter should not be packed whilst warm into delivery vans. Cleanliness is also of vital importance. Odd scraps of bread, dried dough, etc., may contain the spores of the organism and contact of the loaves with such material will lead to contamination which may bring to nought the preventative efforts made in other directions. Since the “rope” organism does not like acidity, addition to the bread dough of acidic substances is a useful deterrent. Acetic acid and acid calcium phosphate are particularly useful in this connection, since the requisite concentrations of these substances do not cause deterioration in bread quality. Bakeries with sackages below 100 per week may obtain without permit acetic acid solution of strength suitable for immediate addition. For larger users, the acid is supplied in a more concentrated form against a permit obtainable from the Directorate of Molasses and Industrial Alcohol, and is diluted before adding to the mixing. Though acetic acid or acid calcium phosphate may be used to suppress outbreaks or as preventatives during exceptional conditions, supplies of these agents are insufficient to enable them to be used continually as general preventatives during hot weather. For this purpose, the “acid dough” process of the British Arkady Co. Ltd., which requires no special materials, is recommended by the Ministry of Food. A small batch of “starter” dough is first prepared and is then incorporated into a larger mixing of “acid dough.” Portions of the latter are then added to the main mixing of bread dough, no alteration in the other constituents of the latter being required. Once the “acid dough” has been prepared, daily supplies may be kept up for months. A portion of the dough from the previous day is used as a starter for the new mixing, and from the second day onwards the “acid dough” becomes a fairly‐stabilised producer of acid.

Competitiveness is one of the most misunderstood concepts of the 1990s. It has drawn substantial attention from the government and business communities during the last 25 years. Morrisson et al. (1988) noted that between 1983 and 1987, the term competitiveness appeared more than 5700 times in the titles of newspapers and magazine articles. The growth of importance and interest can also be observed from the increase in the bibliographical entries in ABI/Inform database. From 1981 to 1986, the topic “international competitiveness” increased by about 26 listings per year (a total of 159 in 6 years) and the rate increased to 45 listings per year from 1987 to 1993. Academic interest in the area has also increased and as a result, new developments contemplating conceptualization and understanding of competitiveness are taking place. However, to no one's surprise, writers from different disciplines offer a variation in perspective when describing the concept, understanding, and postulation of competitiveness.