Global Governance in the New Era: Concepts and Approaches

This book mainly introduces the concepts and approaches of global governance from the viewpoints of Chinese and Russian scholars and is divided into four parts. The first one deals with the concept of a new type of global governance, namely "Globalization 2.0". The second one is dedicated to institutions and multilateralism, including the importance and effectiveness of international institutions. The third part focuses on the important countries and regions in the new era, as well as such issues as the current global status quo, processes in Eurasia, the prospects of the U.S.-China-Russia trilateral relationship. The last part analyzes the future development of global governance and possible solutions of how it might be improved. Climate change, digital era, cyber security, financial and economic regimes, COVID-19 are all involved in this part. In short, this book is a profound and cutting-edge research on global governance. © China Social Sciences Press 2023.

A Qualitative Analysis of Physician, Staff, and Patient Perspectives During the Discharge Process for Vascular Patients

Objectives: Evidence demonstrates that when hospitals focus on the discharge process patient safety improves and overall costs decline. Hospital discharge requires care coordination of multiple disciplines, often leading to fragmented care, and adverse outcomes after discharge include emergency department visits and hospital readmissions. The Re-Engineered Discharge (RED) process was developed as an evidence-based strategy to improve the hospital discharge. We evaluated perspectives and priorities of physicians, health care workers, and patients involved in the vascular discharge process using RED as a framework. Method(s): A single-center qualitative analysis using a semi-structured focus groups and an interview guide based on the RED process. Focus groups were Zoom platform recorded, transcribed into text files, independently coded, and analyzed with Dedoose qualitative software using a directed content analysis approach. Thematic concepts were created, and comparisons between groups were analyzed by coding frequency. Researchers independently thematically coded each transcript;prior to analysis, all redundancy of codes was resolved;and all team members agreed on text categorization and coding frequency. Result(s): Eight focus groups with 38 participants were performed. Participants included: physicians (n = 13), nursing and ancillary staff (n = 19), and patients/caregivers (n = 6). Transcript analyses revealed facilitators and barriers to discharge. Overarching themes identified from the qualitative analysis frequencies are displayed by stakeholder role (Fig 1). Themes identified with the greatest coding frequencies included helpfulness of discharge instructions, patient health literacy, patient medical complexity, poor interdisciplinary team communication, time constraints during discharge, technology literacy of patients, barriers to obtaining medications for patients, barriers to organizing outpatient services for health care workers, barriers for patients to obtain help after discharge, and the impact of COVID-19. Conclusion(s): These findings identify the need to strengthen efforts to overcome stakeholder barriers to improve patient safety at the interface of the hospital to create a well-organized discharge. Physicians were most concerned with low patient health literacy, patient understanding of discharge instructions, organizing outpatient services, and overall patient medical complexity hindering a smooth discharge. Health care staff identified time constraints, obtaining medications and, and inter-team communication as their greatest obstacles to an organized discharge. Patients found the complexity and amount of discharge instructions, the impact of COVID-19 on support systems, and technology utilization after discharge most challenging. Modifications to address individual stakeholder barriers within the discharge process are needed to develop a national standardized discharge specific for vascular surgery patients to improve patient safety and satisfaction. [Formula presented]Copyright © 2023

Conclusion

This concluding chapter highlights the efforts put into reducing tax crimes. It starts with the socio-economic impact of the COVID-19 pandemic on budget deficits and optimisation of tax collection and reducing the tax gap. The Anti-Money Laundering (AML) framework and anti-tax fraud framework in the EU laid the foundation for future legislation and policy to counter tax crimes across Europe. Case studies, focus groups, and workshops found that interagency and international cooperation in fighting tax crimes fronted significant constraints, such as data exchange, joint investigations, collaborative asset confiscations, and sanctions. The chapter then discusses the findings from the PROTAX project to expound its point on legal regimes being made across Europe. It suggests that developing a holistic tax enforcement eco-system is needed instead of just tinkering with legal provisions. © U Turksen, D Vozza, R Kreissl, and F Rasmouki 2023.

Learning Regulatory Lessons in Times of a Crisis

The bio/pharma sector is an industry that has probably been most affected by the pandemic, not only is there an expectation for bio/pharma companies to step up and develop appropriate treatments quickly, resulting in regulatory flexibility and unprecedented collaborations, but there have also been concerns around supply chain security. Agencies have prioritized protocol consultations, shortened the timelines for clinical trial application review and approvals, and there is some focus on implementing fast-track and priority review processes for the evaluation of marketing authorization applications. Marton (Arriello): Authorities that have more experience in evaluation of data adapted quickly, while other authorities, such as those in the Commonwealth of Independent States area, stopped all activities for a period of time or adapted along the way. Gross (ProductLife): There is already some cooperation between the US and Europe, especially in the regulatory development process and in the evaluation process, so it's possible the current situation could reinforce those efforts and lead to some further joint assessments for clinical trial protocols and marketing authorization reviews.

Lead the African way!

PurposeCountries in Africa have undergone an unprecedented transformation that has shaped the continent as they move ahead from the clutches of colonialism. The evolution of leadership and how organisations function optimally has given rise to the review of leadership approaches and practices, revolutionising its position in the global markets. With the recent spate of global suffering from the pandemic, the formal and traditional work structures are becoming transient. At the same time, the economic consequences of the Russo-Ukrainian crisis have catastrophic effects globally.Design/methodology/approachThe research was conducted via a systematic review of scientific sources from various academic websites. Eligibility criteria were defined with the agreement of pertinent themes and concepts.FindingsBy evaluating and analysing characteristics and success indicators from the blend of leadership competencies ascertained from Afrocentric principles in response to African associated problems, Africa can cement its leadership concepts without following the global north principles. These philosophies are resilient enough to contend with a range of VUCA (volatility, uncertainty, complexity and ambiguity) complexities, including the impact of the recent global pandemic of immeasurable proportions and the prospect of war as the Russo-Ukrainian conflict intensifies.Originality/valueWithin the African environment, there is a greater focus on the human element in shared values, holistic well-being, cooperation and experience. The global community band together to deal with these complexities. This is a typical example of global connectedness with positive and negative connotations.

Renewing the Object of Work as a Trigger for Inter-Organizational Learning

Purpose: The study refers to a health-care organization engaged in adopting "home health care" as a new object of activity. This study aims to explore how the reconfiguration of the object influences the transformative perspective, affecting not just a service but a broader approach and meaning behind patient care. It also investigates the main contradictions at play and the levers to support inter-organizational learning while facing the new challenges and change processes. Design/methodology/approach: The work is based on a qualitative and ethnographic methodology directed to examine cultural, practical and socio-material aspects. The activity theory is assumed as a powerful approach to understand collective learning and distributed agency processes. Findings: The renewal of the new object of work is analyzed as a trigger for shifts in representations, cultural processes and collective support implemented by the organization. Three agentic trajectories -- technical, dialogical and collaborative agency -- were cultivated by the management to deliver home health care through joint exercises of coordination and control, dialogical spaces and collaborative process. Research limitations/implications: The data collection was disrupted by the pandemic. A follow-up study would be beneficial to inquire how the learning processes shifted or were influenced by the contextual changes. Practical implications: This contribution provides a practical framework for health-care organizations aiming to navigate and explore the physiological tensions and contradictions emerging when the object of work is changed. Originality/value: The paper develops the field of intra- and inter-organizational learning by presenting an intertwined and structural connection between these processes and the renewing of the object of work. It advises that processes of transformation must be handled with attention to the critical and collective dynamics that accompany sustainable and situated changes.

MONEY AND GOODWILL, BUT WHAT HAPPENS NOW ON COVID THERAPIES?

The international pledging conference that the European Union hosted in May has surpassed its target of $8 billion, in cooperation with the United Nations, the World Health Organization (WHO), the International Labour Organization, the G20, the G7, the International Monetary Fund, and the World Bank. Many nations have rallied round the beleaguered World Health Organization (WHO) after Donald Trump announced he would withdraw U.S. funding for it. [...]the EU announced a coronavirus recovery plan in late May with a budget close to $2 trillion-which included a new €10 billion health program and additional projected spending on medicines to combat COVID-19.

The resilience factors of the agri-food supply chain: An integrative review of the literature in the context of the COVID-19 pandemic

Purpose: During the COVID-19 global pandemic, a very significant change has occurred in the demand for basic goods, resulting from the change in the consumer needs of the population in light of a large-scale health and economic crisis. This has revealed the true importance that the agri-food supply chains (ASC) have in the design of business strategies, especially at exceptional times, when the logistics process must be robust enough to continue to ensure the supply of products. In this context, the article presents a qualitative review of the academic literature, with the aim of extracting those factors that have the greatest influence on the degree of resilience of the ASC.Design/methodology: The methodology used is the integrative review of scientific publications, with a closer focus on those specialized in the supply chain, in order to perform a critical analysis and demonstrate theory based on the existing evidence. Both the document search and the content analysis abide by rigorous, explicit criteria.Findings: The bibliographic analysis reveals that there are at least three business strategies that can be considered critical factors in the degree of resilience of the ASCs. These three strategies are: a customer-oriented business awareness;distribution models based on proximity;and cooperative practices among the factors that make up the value chains.Originality/value: In such an important historical moment as the Coronavirus pandemic, it is very appropriate to look back in order to analyze all the scientific literature that could help us to better understand the current situation. It is even more important to do so in those areas of knowledge that do not yet have a consolidated academic trajectory, such as in the case of the resilience of supply chains.

COVID-19 Stresses EMA Resources

EMA has pleaded with the European Commission (EC) for more funds to finance the costs of its increased duties (2). "The GMP standards will be applied to the manufacture of sterile vials for the vaccines as per standard requirements, regardless of location," said a spokesman for the Medicines and Healthcare products Regulatory Agency (MHRA) of the UK, where a COVID-19 vaccine being jointly developed by AstraZeneca and Oxford University is considered likely to be among the first to gain authorization for mass distribution. Manufacturers of vaccines and their containers could be subject to two waves of standards-checking inspections- one for GMP and the other for pharmacovigilance. Because the latter will be the most extensive covering, for example, requiring surveillance quality systems in all the operations of a business, a manufacturer that is considered to be compliant with pharmacovigilance standards is unlikely to be breaching GMP rules. Other priorities include the work of key working parties and groups, drawing up of certain guidelines, the fight against anti-microbial resistance (AMR), co-operation with health technology assessment (HTA) bodies, innovation (especially in emerging therapies), clinical data publication, and international co-operation.

Narrative Encounters of Pedagogic Partnership, and the Development of Collegial Capital in Higher Education

Purpose: The study explores the relational encounters of five higher education tutors and programme leaders, working in collaboration across contrasting institutions--one, a modern, civic university in the Global North, and the other, a parastatal institution in the Global South. The purpose of the study is to deepen the understanding of evolving collegiality within a transnational partnership, stimulated by the COVID-19 pandemic related shift to online teaching and learning. Design/methodology/approach: The inquiry is informed conceptually by the concept of narrative encounter as a site of learning, with inductive, meta-analysis undertaken across our individual reflective narratives. Findings: The narratives reveal three emergent themes--shared purpose, shared responsibility -- through focus, routinised dialogue and concreteness;collective and individual risk-taking -- through negotiated decision-making;and trust in self and in peers -- through reciprocity, caring, duality and building on stable practices. Research limitations/implications: The data from which this paper is developed and its related central thesis of collegial capital are limited and partial. However, when agility within higher education partnerships is at a premium, this paper is a useful touchstone for further reflection. Originality/value: The paper seeks to further the concept of collegiality and collegial capital, a dialogical affordance which enabled the partnership to build on previous collaborative successes.

FINANCIAL SECURITIES FOR TOUR OPERATORS IN CASE OF INSOLVENCY RESULTING FROM THE DIRECTIVE 2015/2302 OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL WHICH ARE IN FORCE IN POLAND

The insolvency of travel agencies is dealt with in a special way by the EU legislator. European Union law introduces legal solutions for the benefit of consumers insofar as the relevant services are not performed by organizers as a consequence of its insolvency. The current 2015/2302 Directive provides much more comprehensive protection than 90/314/EWG Directive for travelers in the event of insolvency of a tour operator. However, in the past, in the practical functioning of travel agencies, it has repeatedly turned out that the Polish legislation has not been able to guarantee full protection provided for in EU law. This situation has changed. In Poland, since August 1, 2018 the system of security and financial guarantees in the event of insolvency of organizers and traders facilitating linked travel arrangements consists of two pillars. If Pillar I funds are exhausted, the costs of actions taken by the Marshal of the Province related to the repatriation of the customers of an insolvent tour operator will be covered from Pillar II, which is created from contributions to the Tourist Guarantee Fund. Due to the COVID pandemic, another form of security was introduced in Poland from January 1,2021 - Tourist Assistance Fund. The fund is designed to support tourism entrepreneurs in the event of extraordinary circumstances. The aim of the paper is to present the legal regulations in force in Poland in the field of financial security of tour operators in the event of their insolvency and to analyze whether these solutions sufficiently protect the interests of travelers. Conclusions included in the paper justify the statement that the extension of the security system by Pillar II make the full protection possible. The two-pillar solution should be sufficient in case of insolvency of a travel agency and that it fully implements the EU recommendations.

Research and Technology Development Achievements During the COVID-19 Pandemic—An Overview

At the beginning of 2020, the World Health Organization (WHO) started a coordinated global effort to counterattack the potential exponential spread of the SARS-Cov2 virus, responsible for the coronavirus disease, officially named COVID-19. This comprehensive initiative included a research roadmap published in March 2020, including nine dimensions, from epidemiological research to diagnostic tools and vaccine development. With an unprecedented case, the areas of study related to the pandemic received funds and strong attention from different research communities (universities, government, industry, etc.), resulting in an exponential increase in the number of publications and results achieved in such a small window of time. Outstanding research cooperation projects were implemented during the outbreak, and innovative technologies were developed and improved significantly. Clinical and laboratory processes were improved, while managerial personnel were supported by a countless number of models and computational tools for the decision-making process. This chapter aims to introduce an overview of this favorable scenario and highlight a necessary discussion about ethical issues in research related to the COVID-19 and the challenge of low-quality research, focusing only on the publication of techniques and approaches with limited scientific evidence or even practical application. A legacy of lessons learned from this unique period of human history should influence and guide the scientific and industrial communities for the future. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

The impact of digital supply chain capabilities on enterprise sustainable competitive performance: an ambidextrous view

PurposeThe construction of digital supply chains to integrate internal and external resources is becoming an important path for manufacturing enterprises to gain competitiveness. However, at present, research on the internal mechanisms of digital supply chain capabilities (DSCC) and enterprise sustainable competitive performance (ESCP) has not been sufficiently studied. Based on contextual ambidexterity theory, this study investigates whether DSCC could enable the realization of supply chain ambidexterity and further explains the mediating role of supply chain ambidexterity on DSCC and ESCP, and the boundary conditions of supply chain governance on supply chain ambidexterity and ESCP.Design/methodology/approachWith a survey data set of 232 Chinese manufacturing enterprises from different industries, the study empirically tests a moderated mediating model and conducts hierarchical linear modeling and bootstrap to test the study's hypotheses.FindingsThe results demonstrate that: (1) DSCC positively enhance ESCP;(2) supply chain ambidexterity, which can be regarded as a synergic ability of supply chain alignment and adaptability, partially mediates the positive relationship between DSCC and ESCP;and (3) supply chain governance such as incentive governance positively moderates the association between supply chain ambidexterity and ESCP, but there is no evidence that relational governance moderates their relationship.Originality/valueThis paper proposes a new interpretive perspective to understand digital supply chains. More importantly, it reveals the importance of DSCC in contributing toward supply chain ambidexterity and ESCP, and demonstrates the differential regulating action of incentive and relational governance on the association between supply chain ambidexterity and ESCP, with implications for both academics and practitioners.

Game Analysis of Oil Trade among Major Countries: Taking China, Russia, India and Saudi Arabia as Examples

A new pattern of oil trade has emerged under the influence of geopolitics and the COVID-19 pandemic. To explore China's oil security in these changed times, this study takes the new pattern of global oil trade as the background and adopts the oil trade models of Russia, India, Saudi Arabia, and China itself. Since Saudi Arabia's oil trade with China and India has been safe and stable for long, this study uses evolutionary game theory to make a quantitative analysis of the energy competition between China and India and the energy cooperation between China and Russia. The research results reveal the following: 1) The continued increase in India's Russian oil imports will pose a threat to China's oil security. When India's oil imports from Russia reach 16.5%, it will change the oil trade structure of the four countries and become a crucial threat to China and 2) Russia's willingness to export has a direct impact on the results. As Russia's willingness to export declines, it will affect the results and pose a threat to China's oil security. This study is of great significance as it provides meaningful insights to ensure China's oil security in the post pandemic era with key changes in the world's oil trade pattern. © 2023 Science Press. All rights reserved.

Regulatory and broadband industry responses to COVID-19: Cases of Uganda, Peru, and the Caribbean

The COVID-19 pandemic was particularly challenging for developing countries because of pre-existing poverty and severe inequality. Governments tended to set public safety as a primary goal, but it could not be their singular goal. Broadband was an important feature of any policy solution. Business lockdowns, school closures, and social distancing led to an unprecedented acceleration in the demand for broadband. But the government restrictions on social and economic interactions made it difficult to maintain and expand broadband networks. Governments might have let markets work out this challenge of escalating demand and increasing costs of supply, but few did. Governments quickly grew to believe that it would need cooperative relationships among multiple government agencies and private businesses to answer what appeared to be a broadband shortage. Regulatory controls over broadband providers were quickly suspended in favour of developing common goals and coordinated efforts. These approaches proved effective, although citizens continued to suffer from the pandemic. © 2023 the authors.

Cross-cultural collaboration through virtual teaming in higher education

Scholars from three universities in three different parts of the world - North America, Africa, and Eurasia - across different cultures, disciplines, and contexts, collaborated with the objective of advancing transversal skills and intercultural competences through immersing their students in international virtual teamwork. Students and lecturers represented the Appalachian State University (United States of America), University of the Free State (South Africa), and Novgorod State University (Russia). In this article, we share our lessons learned from the challenges we faced in the hopes of deepening understanding in higher education concerning what can be accomplished through remote learning across continents and cultures. This work allowed us to be ahead of the collapse of traditional teaching on campuses caused by the COVID-19 pandemic, as we had prior experience of online pedagogies reaching across international borders, cultures, time zones, and languages. Even during hard lockdown, when travelling abroad was impossible, our students experienced internationalised curricula, interacted with international scholars and staff, and were able to continue with the programme as planned. We began this work more than five years prior to the pandemic;therefore, these efforts led to successfully switching to online learning in other courses. We began with engaging staff members as well as students in ongoing, project-based collaboration across cultures from these institutions. This required the use of synchronous and asynchronous digital platforms, which would enable staff members and students to work collaboratively for six to eight weeks to create realistic projects. Staff members began to compile the collaborative co-creating courses that would be taught together, thus combining and adapting various pedagogical approaches. We then shared the responsibility for co-facilitating each course, despite different philosophies of teaching and learning. The result was a balanced blend of pedagogies, allowing students to collaborate successfully with students from the other universities. Students overcame a number of challenges: (a) cultural differences;(b) infrastructure for technology platforms;(c) time zones;(d) languages;(e) age and generational differences;(f) unfamiliarity with various pedagogies;(g) interaction with other cultures and settings;and (h) stereotypes fuelled by popular media. We share our journey and the strategies that addressed these challenges, including the use of technology and results from this continued collaboration.

Should China Expand Its Medical Education Scale? Evidence From Comparative Research

Purpose This study compares doctor staffing level and the scale of medical education in China with those of other countries and proposes policy recommendations for future adjustments to the scale of China's medical education. Design/Approach/Methods This study employs a literature review and descriptive analysis. Findings China had 1.98 medical doctors per 1,000 people in 2018, ranking 85th out of the 193 member-states of the World Health Organization (WHO). In 2017, China had 1.99 practicing doctors per 1,000 people, only ranking above Turkey (1.88) in Organisation for Economic Co-operation and Development (OECD) countries. China had only 10.28 medical graduates per 100,000 people—placing in the bottom third of OECD countries. China's provision of 1.4 medical schools per 10 million people was also significantly lower than the global average (3.9). However, the average number of students enrolled in medical schools (509) in China was significantly higher than the global average (160). Originality/Value Although the scale of admission in undergraduate medical education must be expanded in China, this needs to be achieved while controlling the average number of medical students per school and reducing enrollment in low-quality medical schools. Furthermore, it is necessary to establish new medical schools while improving the operating level of existing ones.

Transformation of an independent sector treatment centre to a regional trauma centre during COVID pandemic

ContextOn the 11th March 2020, the WHO declared SARS-CoV-2 (COVID) outbreak a global pandemic. Healthcare facilities in the UK faced an unprecedented challenge of managing the outbreak, whilst maintaining basic healthcare services such as cancer and trauma. The NHS and independent sector partnership allowed a safe work stream, a relationship that continues now to support the elective recovery coming out of the pandemic.Issue/ChallengeReorganisation of healthcare provision led to the transformation of Practice Plus Group (PPG) hospital, Ilford to a green site for Barking Havering and Redbridge NHS University Trust (BHRUT) trauma service from 30/03/2020 to 10/06/2020. PPG Hospital had to rise to the challenge mobilising quickly from an elective service to a trauma unit serving a local population of over 1 million. The hospital transformed over one weekend, mobilising staff and equipment to deliver a trauma service. Their service went on to exemplify gold standard treatment of the very sick. The unit responded, adapted and developed outpatient clinics, plaster room, trauma ward and theatres to manage COVID-negative trauma cases that BHRUT received.Assessment of issue and analysis of its causesClinical staff had to upskill to take on the very sick (ASA 4) who may require end organ support, to carry out trauma surgery and procedures that were never performed before at the unit. Surgeons and surgical trainees from the trust became part of the multidisciplinary collaboration whilst the senior leaders developed a strong relationship to ensure good governance throughout the period. All of PPG staff had to get involved in ward care. Staff were trained with regards to personal protective equipment (PPE), Aerosol generating procedures (AGPs), pressure area care and applying traction to realign bones as some of the examples. The staff involved came from the following groups: theatre staff, outpatient staff, the anaesthetic consultants, ward staff, endoscopy, pharmacy, physio, housekeeping, infection control and portering.ImpactConsultant anaesthetists had a steep learning curve to both update their trauma knowledge and sharpen their skills. The guidelines of fracture hips were reviewed. The weekly teaching meetings’ topics were all about anaesthesia for emergency surgery, trauma and COVID. Anaesthetic work rota modified to provide a suitable recovery time following long days in theatres. The necessity of rest periods improves immunity.InterventionThere were some logistic hurdles, including the lack of availability of a suitable meeting facility that can accommodate a large number of attendees. There was a need to have a combined meeting with the BHRUT team in the red zone. On the first day, the meeting was carried out on the ‘ZOOM’ platform on smart phones. Within a couple of days. The trauma meeting was held in the capacious theatre reception, using a wall-mounted big screen for audio-visual display. This allowed better communication with all clinical teams including orthopaedic surgery, anaesthesia, nursing and coordinators.Involvement of stakeholders, such as patients, carers or family members:The PPG team implemented the pillars of clinical governance to improve the quality of care. The virtual monthly morbidity meeting included clinicians from all disciplines. A brief update of previous monthly data was reviewed. An initial internal audit showed that the average anaesthetic start time was 09:39. 19 lists (out of 23, 83%) started even after 09:15. The identified causes for this delay included late sending time, and the patient not being ready at the ward due to longer pre-operative checks and staff shortage. A ‘Golden Patient' was not always identified. A collaborative multi-disciplinary approach aimed to streamline the admission processes to ensure availability of both the surgical team and the patient to ensure a prompt theatre start. A repeat audit confirmed that the average anaesthetic start time has become 09:03. Only four out of 24 lists had an anaesthetic start time of 09:15 or later (17%). Th t is an Improvement of 69%.Key MessagesAs COVID created so much pressure on BHRUT, we quickly formed a positive can do working relationship both clinically and managerially to set up the Trauma service in just a few days. The 30 day mortality rate of patients with fracture neck of femur was less than the national average. This positive approach has enabled us to continue working together to help ease pressure off the lengthy patient waiting lists in Orthopaedics and General Surgery.Lessons learntPPG was proud to receive many compliments from patients and BHR staff. A patient wrote ‘I am so humbled and impressed by the amazing team-work and skill of the staff here that I want to congratulate you on what is an outstanding success amongst all the many stories coming out of the corona pandemic. Watching the way in which staff from so many different departments and skills bases are coming to this ward and learning nursing techniques with humility and patience as well as bonding in an upbeat, joyful team is something I will always remember. A surgical trainee mentioned The Independent Sector Treatment Centre (ISTC) team has been absolutely excellent so far. They have made us feel welcome and have worked hard to optimize the service'. This COVID cooperation paved the way for the ongoing cooperation between BHR and PPG, Ilford.Measurement of improvementThe outcome data shows that the service was able to successfully manage fractured neck of femur with better outcomes against national KPI. During the period from 30/03/20 to 10/06/2020, 85 patients had surgery for an emergency fracture neck of femur (Table 1). At PPG, the 30 days mortality rate was 3.5%. The national mortality rate for patients with fracture neck of Femur was 6.1%.75 patients with fracture neck of femur had surgical fixation within 36 hours.Strategy for improvementCollaborative cooperation between NHS and PPG led to set up of new pathways, governance and processes that enable patients to be transferred directly to us as well as creating capacity for BHRUT surgeons to operate in our hospital, supported by our theatre and ward teams.

Covid-19: It's too soon to lift lockdown

While we count the terrible toll of covid-19 (doi:10.1136/bmj.m1835) and continue asking hard questions of our governments (doi:10.1136/bmj.m2052), clinicians and patients are embracing new ways of doing things: virtual wards are helping to keep covid patients out of hospital (doi:10.1136/bmj.m2119), mental health services are experimenting with phone triage and virtual appointments (doi:10.1136/bmj.m2106), and doctors are supporting each other through their uniquely shared covid experience (doi:10.1136/bmj.m1499). [...]in other news the NHS has launched a race and health observatory, after The BMJ's call for action to end racial inequalities (doi:10.1136/bmj.m2191). The world is facing a scale of challenge not seen since the second world war. [...]rather than identify and empower local leadership (https://blogs.bmj.com/bmj/2020/05/27/chris-ham-test-and-trace-strategy-must-value-local-leadership-to-be-a-success), the government seems set to continue its centralised bungling and magical thinking (https://blogs.bmj.com/bmj/2020/05/28/public-trust-and-the-publics-health-two-sides-of-the-same-coin).

Core social motives explain responses to collective action issues

Managing collective action issues such as pandemics and climate change requires major social and behavioral change. Dominant approaches to addressing these issues center around information provision and financial incentives to shift behavior, yet, these approaches are rarely effective without integrating insights from psychological research on motivation. By accurately characterizing human motives, social scientists can identify when and why individuals engage, and facilitate behavior change and public engagement. Here, we use the core social motives model to sort social psychological theories into five fundamental social motives: to Belong, Understand, Control, self-Enhance, and Trust. We explain how each motive can improve or worsen collective action issues, and how this framework can be further developed towards a comprehensive social psychological perspective to collective action issues. (PsycInfo Database Record (c) 2023 APA, all rights reserved)