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This study revisits the Great Canadian Grain Logistics Crisis of 2013-14 to explore the competitiveness of the country's grain exports. An approach to comprehending the dilemmas of the international grain supply chain and trade, and national logistics policy in an era of multinational corporations, draws upon the literature on global value chain analysis. This analysis identifies both the grain industry's global and local dimensions. An important literature on the 'politics’ of the supply chain is also called into play to discuss who controls what aspects. This task of interpreting the various steps in Canada's grain logistics chain recognizes the key economic actors - producers, grain companies, railway companies, port terminal operators and export buyers - and political struggles between them as they each seek to maximize their self-interest. Policy implications for streamlining logistics operations are drawn from identifying where changes in the supply chain arrangements have gained or lost opportunities in export markets, particularly in the Asia-Pacific region.

In North America, delegated practice “medical direction” models are often used as a proxy for clinical quality and safety in paramedic services. Other developed countries favor a combination of professional regulatory boards and clinical governance frameworks that feature paramedics taking lead clinician roles. The purpose of this paper is to bring together the evidence for medical direction and clinical governance in paramedic services through the prism of paramedic self-regulation.

This narrative synthesis critically examines the long-established North American Emergency Medical Services medical direction model and makes some comparisons with the UK inspired clinical governance approaches that are used to monitor and manage the quality and safety in several other Anglo-American paramedic services. The databases searched were CINAHL and Medline, with Google Scholar used to capture further publications.

Synthesis of the peer-reviewed literature found little high quality evidence supporting the effectiveness of medical direction. The literature on clinical governance within paramedic services described a systems approach with shared responsibility for quality and safety. Contemporary paramedic clinical leadership papers in developed countries focus on paramedic professionalization and the self-regulation of paramedics.

The lack of strong evidence supporting medical direction of the paramedic profession in developed countries challenges the North American model of paramedics practicing as a companion profession to medicine under delegated practice model. This model is inconsistent with the international vision of paramedicine as an autonomous, self-regulated health profession.

The purpose of this paper is to gain consensus regarding the clinical priorities and tasks required in supporting communication needs in those living with semantic dementia and their families, by specialist speech and language therapists (SLTs), working in clinical practice within dementia care settings in the UK.

A nominal group technique was used, followed by further exploration and refinement of issues using a modified Delphi technique with a group of six SLTs who specialised in dementia care and who had experience of working with individuals with semantic dementia and their families.

The findings in the study demonstrate a broader scope of practice than is evident within the research literature with this client group. Therapists identified a range of psychosocial issues for both the person with semantic dementia and their family, in particular finding ways to support activity and participation in conversation and explore barriers and facilitators within the communication environment.

This represents the first study to explore everyday practice in this rarer dementia and the information gathered here will be of use to a variety of health and social care professions interested in supporting those with semantic dementia and their families.

This paper aims to explore how the Celtic Tiger economic boom and Great Recession influenced drug and alcohol use in one Irish city.

Semi-structured interviews were conducted with 48 people, living in Cork City, who had previously used drugs and/or alcohol problematically. All participants had engaged with services for their problematic use and had at least one year of abstinence at time of interview.

Some participants reported that their drug and/or alcohol consumption increased during the economic boom; others, who were already in (self-defined) active addiction, reported how full employment lessened some of the harms of their problematic use. For others, problematic use struck once the economy entered a downturn and, heavy drink and drug use became a means of soothing the strains of economic recession.

The paper provides two key contributions. Methodologically, it demonstrates how large-scale national quantitative data can mask local idiosyncratic tendencies, suggesting the need for mixed-method approaches for understanding drug market trends. The paper also provides insights into the impact of global and local economic conditions on drug and alcohol consumption in Ireland.

In the early to mid-twentieth century, psychiatrist-led occupational therapy departments emerged in Irish psychiatric hospitals. This marked a transition towards establishing rehabilitative services in institutional settings. This paper aims to examine the development of occupational therapy in Grangegorman Mental Hospital and its auxiliary hospital, Portrane Mental Hospital from 1934-1954.

Historical documentary research methods were used to analyse primary source data from Grangegorman Committee Minutes, Inspector of Mental Hospital Reports, Boroughs of Mental Hospitals, Department of Foreign Affairs documents and newspaper archives. The archival data was analysed using both a chronological and thematic approach.

The main key event emerged in 1935 when four Grangegorman nursing staff were sent to Cardiff Mental Hospital to undergo a six month training course in occupational therapy. The following themes emerged – “establishing occupational therapy in Grangegorman and Portrane”; “the role of short-course trained nursing staff in providing occupational therapy services” and “therapeutic rationales vs hospital management rationales”.

This study throws light on the early practitioners of occupational therapy in Grangegorman and highlights the complexities of occupational therapy’s role origins in mid-twentieth century Ireland. In line with contemporaneous psychiatric hospitals, the occupational therapy activities promoted in Grangegorman were mainly handicraft or productivity based. The absence of patients’ voices means there are limitations to determining the therapeutic nature of this early occupational therapy service.

This study aims to investigate the factors that influence South African customers to potentially switch from one bank to another. Instead of using established models and survey techniques, the research measured social media sentiment to measure threats to switch.

The research involved a 12-month analysis of social media sentiment, specifically customer threats to switch banks (churn). These threats were then analysed for co-occurring themes to provide data on the reasons customers were making these threats. The study used over 1.7 million social media posts and focused on all five major South African retail banks (essentially the entire sector).

This study concluded that seven factors are most significant in understanding the underlying causes of churn. These are turnaround time, accusations of unethical behaviour, billing or payments, telephonic interactions, branches or stores, fraud or scams and unresponsiveness.

This study is unique in its measurement of unsolicited social media sentiment as opposed to most churn-related research that uses survey- or customer-data-based methods. In addition, this study observed the sentiment of customers from all major retail banks across 12 months. To date, no studies on retail bank churn theory have provided such an extensive perspective. The findings contribute to Susan Keaveney’s churn theory and provide a new measurement of switching threat through social media sentiment analysis.

This paper aims to reinforce the arguments for applying the social support concept in social marketing.

This paper aims to conceptually outline the potential positive contribution of social support for social marketing practice as a tool to induce behavior change.

This paper focuses on the philosophical principle of social exchange, highlights the consumer-centered perspective of social marketing, which implies the natural evaluation of the social networks of influence and support and presents social support as a mechanism to induce long-term behavior change.

No empirical (qualitative or quantitative) investigations were used to test the application of the concept in practical interventions.

This paper provides significant insights for intervention developers that can be used to program and theoretically justify future social marketing interventions applying the social support concept.

Empirical research concluded for a positive relation between social support and human health and well-being. Thus, increasing the use of the concept in social marketing can serve to attain these social goals.

The concept of social support has gained considerable interest in the areas of behavioral medicine and health psychology. Despite such interest, it is still not clear how it can be approached in social marketing as there is a lack of conceptual literature discussing social support from a social marketing perspective, the number of social marketing interventions operationalizing the concept is limited and, till date, no research has focused in comprehensively establishing a theoretical rationale to operationalize the concept in social marketing.

This research aimed to conceptualize organizations as open and purposeful systems to study how organizational culture (OC) influences firms' Innovative Performance (IP). The authors proposed goal setting and internal integration/external adaptation paradox as central to explaining OC's mediating and suppressing effects on IP.

The authors collected data from 372 Costa Rican organizations and analyzed them with structural equations. This research used the Denison Model instead of the usual typology-based approaches.

The mission had a direct and high impact on IP. The mediated effect via adaptability was also elevated, as well as the suppressor effect through consistency. There was no effect on IP of involvement. According to these results, the Open and Rational Systems Framework emerge as the main theoretical explanatory concepts.

Disaggregating the OC through a performance-oriented dimensional model makes it possible to study the dynamics between the elements that compound it and facilitate integrating these findings with other research streams.

The purpose of this paper is to describe and analyse two approaches to paramedic service clinical governance and quality management from the perspective of two groups of paramedics and paramedic managers working in North America.

A case study approach was utilised to describe and analyse paramedic service medical direction in North America and contrast this with the professional self-governance and clinical governance systems operating in other high-income countries. Researchers interviewed participants at two remote North American sites, then completed transcription and thematic analysis.

Participants identified three themes: first, resourcing, regulatory frameworks and fragmentation; second, independent practice facilitators and barriers; and third, paramedic roles and professionalisation. Those trained outside North America tended to identify self-regulation and clinical governance as the preferred approach to quality management. Few participants had considered paramedicine becoming a self-regulating health profession.

In North America, the “medical direction” model is the dominant approach employed to ensure optimal patient outcomes in paramedic service delivery. In contrast, other comparable countries employ paramedic self-regulatory systems combined with clinical governance to achieve the same ends. This is one of two studies to examine medical direction from the perspective of paramedics and paramedic managers.