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Early access to senior decision makers and investigations has improved outcomes for many conditions. A surgical clinical decisions unit (CDU) was created to allow rapid assessment and investigation by on-call senior surgical team members to facilitate decision making and, if appropriate, discharge within a set time frame (less than four hours). The purpose of this paper is to compare outcomes for unscheduled general surgery admissions to the hospital before and after commissioning this unit.

Prospectively collected hospital episode statistics data were compared for all general surgical admissions for one year prior to (July 2010-June 2011) and two years after (July 2011-June 2013) the introduction of the CDU. Statistical analysis using the Mann Whitney U-test was performed.

More patients were discharged within 24 hours (12 per cent vs 20 per cent, p < 0.001) and total hospital stay decreased (4.6 days vs 3.2 days, p < 0.001) following introduction of CDU. Admission via A & E (273 vs 212, p < 0.01) was also decreased. Overall there was a 25.3 per cent reduction in emergency surgical admissions. No difference was noted in 30-day readmission rates (47 vs 49, p=0.29).

The introduction of a CDU in has increased early discharge rates and facilitated safe early discharge, reducing overall hospital stay for unscheduled general surgical admissions. This has decreased fixed bed costs and improved patient flow by decreasing surgical care episodes routed through the emergency department (ED). In all, 30-day readmission rates have not been influenced by shorter hospital stay. Service redesign involving early senior decision making and patient investigation increases efficiency and patient satisfaction within unscheduled general surgical care. Not original but significant in that the model has not been widely implemented and this is a useful addition to the literature.

Purpose – This chapter considers the consequences on liberty in relationship to the development of the international problem-solving court movement.

Design/methodology/approach – The research, which relies principally on ethnographic fieldwork in six different common law countries (England, Ireland, Scotland, Australia, Canada, and the United States), explores the development of local problem-solving courts in each jurisdiction. These include drug courts, community courts, domestic violence courts, and mental health courts. The ethnographic fieldwork was supplemented with data from various other sources, including government reports, parliamentary debates, evaluations of individual court programs, publications issued by various advocacy groups, media accounts, public statements and articles by problem-solving court judges, and analyses of specialty courts in law reviews and other academic journals.

Findings – The research reveal that the five countries outside of the United States demonstrate greater concern with protecting the dignity of the court, due process, and individual rights – or what the Australians refer to as open and natural justice.

Originality/value – It is the first large-scale comparative study of problem-solving courts in the common law countries where the movement is most advanced.

The journey to find the right vehicle for delivering learning disability services is set in the context of foundation trust and social enterprise options being introduced into the wider NHS. The Ridgeway Partnership shares the challenges it is facing as an integrated service that is caught in the middle of these options.

This paper aims to consider whether ethical persuasion can be part of public relations practice.

The paper contends that the critical issue for practitioners is not whether they engage in persuasion, but whether they do so ethically. Accordingly, a definition of ethical persuasion is derived by examining unethical propaganda. The paper then considers what standard might be used to assess the ethics of persuasion. The notion of “the public interest” – ubiquitously linked to ethical practice in public relations – is considered but found to be too elusive to guide the practice individual practitioners. Other more assessable standards are identified, as is a guiding approach to ethics. The approach to ethics adopted in this paper is rule utilitarianism. The methodology of this paper is deductive and derivative analysis, argument and synthesis, drawn from a broad body of literature.

Persuasion can be ethical, and a definition of ethical persuasion is proffered. The public interest is not a standard that individual practitioners can determine, decide, know, or apply to assess the ethics of their practice. Ethical persuasion can, however, be assessed using other standards, discussed in the paper. Consequently, a set of criteria and standards to practicing ethical persuasion is developed.

The paper does not extend into a discussion of practical persuasive techniques. Therefore, an extension of this examination could consider a thorough assessment of the ethics of practical persuasive communication techniques.

Directly relevant to the daily work of public relations practitioners, communicators, adertisers and marketers, who are interested in acting ethically. The paper provide a basis for a guide to assessing the ethics of persuasive practice.

This paper confronts both the question of whether practitioners can use the notion of the public interest to assess the ethics of practice, and also what constitutes ethical (and unethical) persuasion, and considers how persuation can be used ethically.

To examine whether or not exposing novice teachers in a graduate literacy education diversity course to particular texts and activities focused on economic diversity and lifestyle differences among students makes them more likely to positively respond to these lesser understood forms of diversity in their own teaching and if so, in what ways. The research design was qualitative and included written reflections from the teacher–participants at the beginning, middle, and end of the semester, and videotaping and transcribing activities and post-activity discussions. Ethnographic observations and notes were made by the primary investigator. The theoretical frameworks that were foundational to the study were critical literacy and teaching for social justice. The findings of this qualitative study indicate that exposing teachers to texts, discussions, and activities that educate them on economic diversity and lifestyle differences among students makes them more likely to positively respond to these forms of diversity in their own teaching. Specific examples of how participants did this are provided. This study contributes to the literature on diversity in literacy instruction by providing concrete, research-based suggestions for how both teacher educators and K-12 teachers can expand their definitions of student diversity to include economic disparities and lifestyle differences among students. It includes recommended texts and activities for both teacher educators and K-12 teachers to address less typical forms of diversity, with a focus on economic diversity and lifestyle differences.

This study aims to identify intra-organisational drivers that enhance the implementation of a purchasing social responsibility (PSR) approach and drivers that influence PSR throughout the phases of the process.

The conceptual framework presents PSR as a process, rather than merely a decision. It focuses on three dimensions (centralisation, specialisation and formalisation) to highlight the role and evolution of key drivers through a three-phase process (set-up, operating and sustaining). The empirical analysis is based on a single qualitative case study of Société Nationale des Chemins de Fer Français (SNCF), France’s state-owned railway company, which is particularly advanced in its PSR-related practices.

The intra-organisational drivers differ according to the phase of the PSR process. Transitions across the three phases entail organisational adaptation, which require the company to transform from a mechanistic to an organic structure.

This research contributes to a better understanding of the PSR implementation process through an in-depth study focused on intra-organisational drivers. Although relatively understudied, these drivers play important roles.

This study identifies operational, intra-organisational leverage actions that can benefit firms that aim to adopt or maintain a PSR approach. It also provides comprehensive guidance for activating these leverages throughout the PSR implementation process, and it helps firms identify their level of PSR.

This study proposes the first processual, organisational interpretation of PSR approaches.

The purpose of this paper is to contribute to emerging theory about the role of authenticity in social media use through discussion of a not‐for‐profit organisation's experiences of using social networking to communicate with potential stakeholders during a recruitment campaign.

The paper uses critical discourse analysis of semi‐structured interviews with organisational spokespersons to examine the use of social media by this not‐for‐profit organisation.

The organisation attempted to re‐position its identity to appear “authentic” to potential young stakeholders, and to use social media to build a dialogue that would attract new recruits to the industry. The paper discusses the challenges and opportunities experienced by the not‐for‐profit organisation in this recruitment campaign.

Organisations contemplating the use of social networking sites to engage new audiences can reflect on the problems encountered in the implementation of this campaign, and plan to avoid similar pitfalls.

The study presents original empirical data in relation to social networking by a not‐for‐profit organisation. It demonstrates the importance of audience perceptions of authenticity and raises important questions about organisational “control”, and the expectations of employees carrying out “authenticity work”.

Academic and popular literatures have addressed growing concerns about the ways we produce, harvest, distribute, and consume food; manage fisheries and inputs to agriculture; and deal with waste. Throughout the 20th century, a series of issue-specific frames emerged that explicitly addressed issues of social justice, the environment, and human health in the food system. During the mid-1990s that comprehensive master frames were established in attempts to bring disparate ideas and actions together into a more inclusive food movement. In this chapter, we explore the development of these collective action frames and turn to Canada as a case study to examine the key moments that have brought together diverse actors through collaborative networks to assert their place within a broader social movement. We argue that recognizing the increasing development of food networks and making these relationships visible opens new theoretical and practical possibilities for food system transformation.