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The purpose of this paper is to provide a practical framework that health care organizations could use to decrease preventable healthcare-acquired harms.

An existing theory of how hospitals succeeded in reducing rates of central line-associated bloodstream infections was refined, drawing from the literature and experiences in facilitating improvement efforts in thousands of hospitals in and outside the USA.

The following common interventions were implemented by hospitals able to reduce and sustain low infection rates. Hospital and intensive care unit (ICU) leaders demonstrated and vocalized their commitment to the goal of zero preventable harm. Also, leaders created an enabling infrastructure in the way of a coordinating team to support the improvement work to prevent infections. The team of hospital quality improvement and infection prevention staff provided project management, analytics, improvement science support, and expertise on evidence-based infection prevention practices. A third intervention assembled Comprehensive Unit-based Safety Program teams in ICUs to foster local ownership of the improvement work. The coordinating team also linked unit-based safety teams in and across hospital organizations to form clinical communities to share information and disseminate effective solutions.

This framework is a feasible approach to drive local efforts to reduce bloodstream infections and other preventable healthcare-acquired harms.

Implementing this framework could decrease the significant morbidity, mortality, and costs associated with preventable harms.

THE high standards of examination and qualifications for membership set by the Institute of Incorporated Work Study Technologists can be seen in the new Prospectus just issued by the Institute.

This paper aims to contribute to the literature on value creation by examining value within the visual arts market and arguing for a broader, socio-culturally informed view of value creation.

The authors develop an original conceptual framework to model the value co-creation process through which art is legitimised. An illustrative case study of artist Damien Hirst demonstrates the application of this framework.

The findings illustrate how value is co-constructed in the visual arts market, demonstrating a need to understand social relationships as value is dispersed, situational and in-flux.

The authors problematise the view that value emerges as a result of operant resources “producing effects” through working on operand resources. Rather, adopting the socio-cultural approach, the authors demonstrate how value emerges and is co-constructed, negotiated and circulated. The authors establish the need to reconceptualise value as created collaboratively with other actors within industry sectors. The locus of control is, therefore, dispersed. Moreover, power dynamics at play mean that “consumers” are not homogenous; some are more important than others in the valuation process.

This more distributed notion of value blurs boundaries between product and service, producer and consumer, offering a more unified perspective on value co-creation, which can be used in strategic decision-making.

This paper illustrates that value co-creation must be understood in relation to understanding patterns of hierarchy that influence this process.

MORE than thirty national bodies, previously comparative strangers, have been brought into closer contact during the year. They have now collectively organised a National Productivity Year Conference to be held at Eastbourne in the closing days of November. It would be wrong to regard this as a finale; to apply to it the closing words of Vanity Fair: ‘Come, children, let us shut up the box and the puppets, for our play is played out.’

Sex has increasingly been constructed as a problem for men with learning disabilities. Research has focused on their vulnerability to abuse and their capacity to exploit. There are also the additional fears of their sexual activity leading to HIV infection or pregnancy. Notions of sexual rights and sexual pleasure are lost in such a discourse. This paper looks in detail at the actual experience of sex for men with learning disabilities, based on qualitative interviews. It paints a very uncomfortable picture, leading to the title question: is sex a good thing for men with learning disabilities?

To examine bad credit experiences in the context of identity to understand the entanglement between bad credit and the deformation of identity.

A qualitative method using depth interviews and hermeneutical analysis.

Bad credit is a major life event and plays a critical role in identity. By restricting or eliminating identity construction and maintenance through consumption, identities are deformed. Consumer identities are deformed as they are consumed by the identity deformation process as normal patterns of consumption that have built and supported their identities are disrupted and demolished. Bad credit is overwhelmingly consumptive of consumers – it consumes their time, energy, patience, lifestyle, relationships, social connections, and perhaps most importantly, it consumes their identity as it deforms who they are.

Researchers need to examine more closely not just the creation and maintenance of identity, but also how identity is deformed and deconstructed through consumption experiences that can no longer be enjoyed.

Government agencies may want to reexamine policies toward the granting of credit to reduce the incidence of loading up consumers with credit they are not able to pay for. The deformation of identity may result in anti-social behavior, although our study does not address this directly.

This study is different from previous work in several ways. We focus on identity deformation due to bad credit. By analyzing a crisis response that transcends the specific impetus of bad credit, we extend identity theory by developing an insight into “identities-in-crisis.” We also provide a theoretical framework and explore how consumers’ identities are deformed and renegotiated.

Aim of the present monograph is the economic analysis of the role of MNEs regarding globalisation and digital economy and in parallel there is a reference and examination of some legal aspects concerning MNEs, cyberspace and e‐commerce as the means of expression of the digital economy. The whole effort of the author is focused on the examination of various aspects of MNEs and their impact upon globalisation and vice versa and how and if we are moving towards a global digital economy.

John Andrews Fitch spent a year studying labor conditions in the steel industry around Pittsburgh during 1907 and 1908. The results of his research became The Steel Workers, one of six volumes in the Pittsburgh Survey, a groundbreaking 1910 analysis of conditions faced by working people in a modern industrial city. Introducing his discussion of common employment practices in the steel industry, Fitch declared, “A repressive regime…has served since the destruction of unionism, to keep the employers in the saddle.” He traced the origins of management’s arbitrary power to the Homestead lockout of 1892, when Carnegie Steel destroyed the last stronghold of organized labor in the mills of western Pennsylvania. During his stay in Pittsburgh, Fitch saw the results of fifteen years of management domination. “The steel worker,” he wrote, “sees on every side evidence of an irresistible power, baffling and intangible. It fixes the conditions of his employment; it tells him what wages he may expect to receive and where and when he must work. If he protests, he is either ignored or rebuked. If he talks it over with his fellow workmen, he is likely to be discharged” (Fitch, 1989, pp. 206, 232–233).

The public’s awareness of noise and vibration forms a significant barrier to further development of railways. This chapter begins with a short introduction to the main fundamental aspects of acoustics, including decibels, frequency analysis, the propagation of sound with distance and common measurement quantities. The main sources of railway noise are discussed, including rolling noise, impact noise, curve squeal and aerodynamic noise. Simple calculation procedures are described that can be used to assess the impact of railway noise and to compare it with legal limits. The final section is devoted to ground vibration, which is a related form of environmental disturbance.

The vibration of the rails is a significant source of railway rolling noise, often forming the dominant component of noise in the important frequency region between 400 and 2000 Hz. The purpose of the paper is to investigate the influence of the ground profile and the presence of the train body on the sound radiation from the rail.

Two-dimensional boundary element calculations are used, in which the rail vibration is the source. The ground profile and various different shapes of train body are introduced in the model, and results are observed in terms of sound power and sound pressure. Comparisons are also made with vibro-acoustic measurements performed with and without a train present.

The sound radiated by the rail in the absence of the train body is strongly attenuated by shielding due to the ballast shoulder. When the train body is present, the sound from the vertical rail motion is reflected back down toward the track where it is partly absorbed by the ballast. Nevertheless, the sound pressure at the trackside is increased by typically 0–5 dB. For the lateral vibration of the rail, the effects are much smaller. Once the sound power is known, the sound pressure with the train present can be approximated reasonably well with simple line source directivities.

Numerical models used to predict the sound radiation from railway rails have generally neglected the influence of the ground profile and reflections from the underside of the train body on the sound power and directivity of the rail. These effects are studied in a systematic way including comparisons with measurements.