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The cost of concrete ground‐supported floor slabs represents a significant proportion of the total capital cost of industrial projects. There are many structural design issues that impact on the concrete contractors’ method of construction. This is becoming more apparent with the use of new high‐technology levelling and trowelling equipment, which has significantly increased the pour and finishing rates, resulting in much faster slab construction times compared with the traditional methods of construction. Selection of both the design and the construction methods exerts a large influence on the initial cost. According to the results of the research reported in this paper, it may be possible to save between 2‐4 per cent of the building cost if high technology solutions are incorporated into the design and construction process. This paper investigates cost issues that impact on the design and construction of ground‐supported floors for industrial buildings.

A care pathway defines in detail the individual components of treatment for a group of patients. A well‐written pathway can lead to consistent care of the highest quality. There are both educational and audit advantages to the approach. The authors detail the means by which groups are selected and the care pathways written. An example of the benefits that can accrue comes from their experience at Ashford Hospital of running a pathway for patients having prostate surgery. The pathways are appreciated by patients, nurses, doctors and managers. Care is improved, costs contained and clinical governance enhanced.

Financial constraints, an increase in the demand for health-care from an ageing population, multiple comorbidities in both mental and physical health and delivering care closer to the community, are amongst the factors creating a need for innovation in the NHS. The purpose of this paper is to explore leader behaviours that promote innovation in a multidisciplinary musculoskeletal (MSK) service.

Qualitative semi-structured interviews were conducted to explore the experience and views of the multidisciplinary team (MDT) members on leadership and innovation. A total of 13 MDT members participated in the study.

Inter-professional collaboration and the absence of hierarchical behaviours are associated with a positive experience. Traditionally established hierarchy and inter-professional barriers for interaction were associated with challenging experience in MDT. There was an expression of fear of and vulnerability to being “taken over” or “eaten up” by other professions. Supportiveness, consulting behaviour, provision of time, vision and inspiring and risk-taking behaviours are associated with innovation. Target drove and monitoring behaviours or hierarchical expression of authority, directive or supervisory behaviours are negatively associated with innovation.

Day to day leader’s behaviours and interactions influences the work environment for innovation. Knowledge gained through Informal interaction, understanding each other’s professional strengths and weaknesses are implicit strengths of an MDT but when a member perceives their skills as less valuable to that of another member, they hold less power and influence. Therefore, a flat hierarchy provides a more effective structure for knowledge translation and maximising MDT productivity.

MSK services are complex adaptive systems with several pathways and interactions flowing between various specialities. For improving innovation and effective functioning of the MSK MDT, it is important to provide informal training for team leads on self-awareness of the behaviours associated with innovation.

Orthopaedics, rheumatology, pain management, specialist radiology and therapy services were brought under one umbrella to form Northwest Surrey integrated musculoskeletal (IMSK) services and introduced advance clinical practice, a multi-disciplinary team triage with a formalised straight to test (STT) process defined in 2018. Historically, prior to these services' integration, there were a primary and second care triage systems within individual specialities. The aim of this service evaluation is to assess the impact of a single IMSK multidisciplinary triage (MDT) system and the efficacy of STT from triage, which allows patients to be sent for diagnostics based on the cluster of symptoms and past medical history in order to achieve early identification of serious pathologies. This is a complex adaptive system with pathways spanning into the core areas of orthopaedics, rheumatology, therapies, pain management services, radiology and some less frequent specialities such as neurology, oncology, vascular and gynaecology. One of the objectives of this study was to identify how many referrals were triaged to consultants, Advance practice and therapies. In addition, the authors wanted to highlight the proportion of referrals that were sent straight to test from triage and the percentage of these that had sinister pathology identified. This information would then be compared against existing red flag literature to identify common themes. This study aims to discuss the aforementioned objectives.

Data were extracted retrospectively from a hospital database from January to December 2019 for all the adult musculoskeletal service referrals. The data collected were analysed on a Microsoft Excel sheet with information including date of triage, hospital number, ordering clinician, body part, type of diagnostic, indications for scanning, outcome for STT, serious pathology findings (named code 5 within our trust) and outcome of appointment.

A total of 47,039 referrals were received into the IMSK service. Of these referrals 19,967 were directly referred to therapies, with 27,072 referrals received into the IMSK service MDT process. Within triage, 718 patients were directed to STT to rule out serious pathology. A total of 28 patients (3.9%) had sinister pathology identified on their investigation. A total of 46% of patients were discharged from their first consultation following STT. Overall, 50% of the total number of referrals into the IMSK service was seen by advanced practitioners with 16% of patients directed to consultants with pre-consultation diagnostic work up.

This service evaluation highlights that STT allows early access to diagnostics, resulting in quicker access to identification of sinister pathology. A one stop MDT system has been shown to be effective in guiding the referral to the right place with increased referrals into allied health advance practice clinics and access to therapies directly. It has resulted in a reduction of unwarranted referrals to consultant care, duplication of investigations and identified patients on multiple pathways.

In the last few years there has been a great upsurge of interest in text‐based computer systems and a 60 per cent annual growth‐rate is predicted over the next few years as systems improve and the cost of storage decreases. Commercial database systems are expensive at the input stage and with more and more documents being originally produced in electronic form it is tempting to consider applications which can use these as a resource available for searching, selection, transmission and archiving. It is especially so where “total information” can be handled, with words, numbers and illustrations.

Yoga practice has become increasingly popular around the world for the benefits it can bring for physical and mental health. However, little research has been done regarding the use of yoga as a therapy for elderly people with mental health problems. This literature review will therefore attempt to answer the questions: what research has been done to look into the use of yoga as therapy for elderly people with a diagnosis of mental health problems, what does this research show and what future directions may this work take in the future.

The review describes four research studies that have been done looking at the use of yoga as an intervention in older people with diagnosed mental health problems and one upcoming larger study.

Therefore, it is shown that the research in this area is so far still in its infancy, but that yoga has potential to be a useful potential treatment for older people with mental health problems.

As with all research into treatments for mental health problems, involvement of patients and their carers will be vital to ensure that the direction of the research is one that will be valuable, and that the traditions of yoga that have been of so much benefit to so many can be used to help a group of people who are often vulnerable and who sometimes do not receive all the treatment that they deserve.

Bureaucracy, the structural form of the modern administrative state, is, by any credible theory of social development, endogenous to social and political transformation. Bureaucracy is not imposed, not exogenous. It is created by polities; it solves problems.

The purpose of this paper is to seek comment on a proposed new model for measuring and monitoring the sustainability of corporate governance.

The unprecedented combination of the scarcity of finance, low growth, and environmental pressures, together with new attitudes to employment, makes an extremely challenging environment that demands a more comprehensive concept of sustainability. It is redefined here to encompass the management of all resources, whether they be natural, human, environmental financial or social, and “Sustainable Governance^©” is a framework that creates and monitors a structure that husbands the way that all resources are managed for today and for a long term sustainable future. To meet the challenge of the changing world, a 12‐point management model is proposed, together with a comprehensive rating system employed to analyse progress and benchmark competitive performance.

Corporate governance cannot be left to chance in the business climate of the twenty‐first century. Public trust has been lost and boards will need to be seen to be in control not only of the present but also of the future. All resources will have to be treated as finite and accountability will be a byword in all corporations. To be sustainable, corporate governance must cover all aspects of corporate resources and activities and it must also be measured in a more formal and transparent manner. This article outlines a model that could be used for this purpose. It is taking measurement beyond the simplistic “scorecard” approach favoured in the past. It is a seed from which the authors expect to see a fertile growth and all comments are welcome to further the model and the process.

The choice facing organizations in the twenty‐first century is either to react to each set of pressures that come along as they arise, or to take a hard look at the economic, environmental and social context in which they operate, and create a framework that will give them the ability to manage in a long‐term sustainable structure.

This supersedes the scorecard approach for monitoring corporate governance. It is new and untried but the authors seek input and comments from readers.

Despite widespread interest in the gig economy, academic research on the topic has lagged behind. The present chapter applies organizational theory and research to compose a working model for understanding participation in the gig economy and how gig work may impact worker health and well-being. Drawing from past research this chapter defines the gig economy in all its diversity and advances a framework for understanding why individuals enter into gig economy. Next, the authors discuss how various characteristics of the gig economy and gig workers can be understood as both demands and resources that influence how gig work is likely to be experienced by the individual. To understand how these characteristics are likely to influence worker health and well-being, we draw from past research on alternative work arrangements and entrepreneurship, as well as the limited extant research on the gig economy. Finally, a research agenda is proposed to spur much needed research on the gig economy and its workers.

Purpose: During turbulent social and economic times, perceptions of job insecurity can be expected to increase. In this chapter, we outline a theoretical model that links perceptions of job insecurity to lower affective commitment and high work-related stress, resulting in employees' engaging in poor decision-making behavior. We argue further that employees who possess individual skills of being aware of emotions and managing emotions are less susceptible to such behavior. Study Design/Methodology/Approach: We tested our model in two studies. The first study was conducted using an online sample of 217 respondents. The second study used a split administration design conducted in a single organization and used a sample of 579 employees. Findings: Our data revealed that job insecurity is linked to negative decision-making behaviors and that better emotional awareness and management skills may reduce negative decision-making behaviors. Originality/Value: Our findings support the notion of threat rigidity theory where we found that job insecurity affects how individuals make decisions. Our analysis suggests that the individual's level of emotional skills can act as a form of behavioral control that can ameliorate the effects of job insecurity on decision-making behavior. Research Limitations: Both studies had a female gender bias in our sampling frames. There is a possibility of common method variance affecting the results of Study 1, and both studies involved the use of a self-report measure of emotional skills.