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The purpose of this paper is to explain how different emergency services adopt and adapt the same hospital-wide lean-inspired intervention and how this is reflected in hospital process performance data.

A multiple case study based on a realistic evaluation approach to identify mechanisms for how lean impacts process performance and services’ capability to learn and continually improve. Four years of process performance data were collected from seven emergency services at a Swedish University Hospital: ear, nose and throat (ENT) (two), pediatrics (two), gynecology, internal medicine, and surgery. Performance patterns were linked with qualitative data collected through realist interviews.

The complexity of the care process influenced how improvement in access to care was achieved. For less complex care processes (ENT and gynecology), large and sustained improvement was mainly the result of a better match between capacity and demand. For medicine, surgery, and pediatrics, which exhibit greater care process complexity, sustainable, or continual improvement were constrained because the changes implemented were insufficient in addressing the higher degree of complexity.

The variation in process performance and sustainability of results indicate that lean efforts should be carefully adapted to the complexity of the care process and to the educational commitment of healthcare organizations. Ultimately, the ability to adapt lean to a particular context of application depends on the development of routines that effectively support learning from daily practices.

Reflecting on the contingencies and felicitous moments of life and career, a senior scholar celebrates the intellectual community and friends that inspired and sustained his efforts.

The indigenous and sustainable knowledge possessed by the tribal people and communities plays an extremely important role in the conservation of the climate. As per the United Nations Sustainable Development Goals (UN SDGs), tribal communities play an important role in preserving traditional knowledge, culture, food practices and textiles. The remains of the Indus Valley civilisation highlight the importance of the culture and religion. Animism and the worship of nature to achieve success in routines and tasks have been practised by these tribes for centuries. India is a mosaic of more than 705 different colourful tribes, and each of these tribes has their own identity that differentiates it from the other tribes. With increasing ecological complexities, the knowledge owned by the tribes is extremely useful in the preservation of the climate. This chapter seeks to explore the various hues and colours that constitute the mosaic of Indian tribal culture.

THE question of the advisability of exercising a censorship over literature has been much before the public of late, and probably many librarians have realised how closely the disputed question affects their own profession.

Healthcare policymakers and managers struggle to engage private physicians, who tend to view themselves as independent of the system, in new models of primary care. The purpose of this paper is to examine this issue through a social identity lens.

Through in-depth interviews with 33 decision-makers and 31 fee-for-service family physicians, supplemented by document review and participant observation, the authors studied a Canadian province’s early efforts to engage physicians in primary care renewal initiatives.

Recognizing that the existing physician–system relationship was generally distant, decision-makers invested effort in relationship-building. However, decision-makers’ rhetoric, as well as the design of their flagship initiative, evinced an attempt to proceed directly from interpersonal relationship-building to the establishment of formal intergroup partnership, with no intervening phase of supporting physicians’ group identity and empowering them to assume equal partnership. The invitation to partnership did not resonate with most physicians: many viewed it as an inauthentic offer from an out-group (“bureaucrats”) with discordant values; others interpreted partnership as a mere transactional exchange. Such perceptions posed barriers to physician participation in renewal activities.

The pursuit of a premature degree of intergroup closeness can be counterproductive, heightening physician resistance.

This study revealed that even a relatively subtle misalignment between a particular social identity management strategy and its intergroup context can have highly problematic ramifications. Findings advance the literature on social identity management and may facilitate the development of more effective engagement strategies.

This study aims to analyze a backchannel account on news of the coronavirus at the beginning of the pandemic, with information not disseminated in official media due to the social alarm it might cause and the negative image of government management. Specifically, it examines acceptance and dissemination of this type of content in a period of lack of information, while reflecting on what would constitute proper management of this type of channel.

First, based on a literature review, this study classifies possible explanatory variables of online content dissemination into content richness and psychological content. Second, this study performs sentiment analysis of the Twitter backchannel account @COVID_19NEWS and use Qualitative Comparative Analysis to find causal configurations of variables that obtained a high rate of retweets.

The results reveal predominance of one combination of three factors in backchannel information diffusion: emotional, identifying and video content. Other interesting combinations of factors were shown to be attractive enough to contribute to success of the tweets.

Knowledge of the main configurations that attract information dissemination in backchannel accounts is useful for public management of a health crisis such as the Covid-19 outbreak. Rather than suppressing these channels, the authors discuss different solutions.

This study advances scholarship on backchannel communications in emergency situations, providing insights to understand and manage such channels.

Este estudio analiza una cuenta extraoficial sobre noticias del coronavirus al inicio de la pandemia, con información no difundida en los medios oficiales por su posible repercusión en la alarma social y la imagen negativa de la gestión gubernamental. Concretamente examina la aceptación y difusión de este contenido en un periodo de desinformación, así como reflexiona sobre la gestión de este tipo de canales.

En primer lugar, en base a la revisión de la literatura, clasificamos las variables explicativas según la riqueza de contenido y el contenido psicológico. En segundo lugar, sobre la cuenta extraoficial de @COVID_19NEWS en Twitter, realizamos análisis de sentimiento y utilizamos Análisis Comparativo Cualitativo (QCA) para encontrar configuraciones causales de variables que obtuvieron una alta tasa de retweets.

Los resultados revelan la importancia de una combinación de tres factores en la difusión de información del canal secundario: contenido emocional, identificativo y video. Otras combinaciones de factores también contribuyeron al éxito del tweet.

Estas configuraciones podrían ser útiles para la gestión pública ante una crisis sanitaria como la Covid-19, prestando atención a los factores cuya configuración atrae la difusión de información en las RRSS. En lugar de suprimir estos canales, se presentan soluciones para garantizar una colaboración eficaz.

Este estudio realiza una contribución académica a las comunicaciones extraoficiales en situaciones de emergencia, proporcionando información para comprender y gestionar este tipo de canales.

Covid-19, Coronavirus, Canal extraoficial, Twitter, Análisis cualitativo comparado

Trabajo de investigación

在新冠疫情初期, 由于可能引起社会恐慌和政府管理部门的负面形象, 官方媒体缺少相关的新闻报道。本文研究了在这种官方信息匮乏的危机时期, 非正式渠道（backchannel）对于新冠病毒内容的接受和传播情况, 本文同时反思了如何对这类非正式渠道进行正确的管理。

基于文献综述, 我们先将在线内容传播的可能解释变量分为内容丰富度和心理内容这两个方面。其次, 我们对推特上的非正式渠道账户@COVID_19NEWS发布的内容进行情感分析, 并使用定性比较分析法来寻找内容获得高转发率的原因。

结果显示, 对于非正式渠道信息的成功传播, 情绪化、具有辩认度和包含视频内容这三个要素的组合占主导地位。此外, 其他要素的组合也有来助于推文的成功传播和扩散。

了解非正式渠道吸引信息传播的主要原因, 将有利于应对健康危机（例如Covid-19爆发）和进行公共管理。文本讨论了不同的解决方案, 而不是简单地压制这些非正式渠道。

这项研究推进了危机背景下非正式渠道传播的学术研究, 为理解和管理这类非正式渠道提供了见解。

关键词 - Covid-19, 新冠病毒, 非正式渠道, 推特, 定性比较分析

What kinds of changes do mentoring programs initiate for children and their schools? According to a study by Public/Private Ventures which specializes in social policy, just under half of mentoring programs are based at a particular site (Herrera, 1999). Schools are the most common site recognized. Schools purchase the mentoring program examined in the study to follow. Adults work with children primarily on academic activities and they are paid to do so. The school pays half of the cost of the NSCC (National School and Community Corp) program and federal funds provide the remaining support. Herrera (1999, p. 11) has argued the most direct benefit of school-based programs is the mentor's integration into the school environment and the role of advocate that the mentor can play. Advocacy has been recognized as the critical task performed by mentors. As advocate, mentors develop a relationship with a child, which advances youth development and deters youth detrimental behavior (Herrera, 1999). This singular relationship, the advocate mentor and child, is challenged by research that follows. The advocate mentor recognizes a socialization model used in studying children that assumes the mentor as the active role taker shaping the child as passive recipient of mentoring. This model relies on an adult perspective, assuming the child to be an empty vessel serving as clay to be shaped (Waksler, 1994). Waksler (1994) has criticized this model, arguing that children must be taken seriously as a topic of study – not as objects of socialization. The interpretive model of childhood development by contrast is more useful for examining the data gathered in the following study. Rather than focus on the advocate mentor in relationship with a child, the interpretive model recognizes the child as actor and highlights the range of peer relationships sponsored through mentoring activities. This collective view as contrasted with the singular relationship assumes a different perspective on childhood development.