Functional Specialty Research Articles

Dynamics of metabolism and regulation of epigenetics during cardiomyocytes maturation.

Maturation is the last step of heart growth that prepares the organ over the lifetime of the mammal for powerful, effective, and sustained pumping. Structural, gene expression, physiological, and functional specialties of cardiomyocytes describe this mechanism as the heart transits from fetus to adult phases. The main cornerstones of maturation of cardiomyocytes are reviewed and primary regulatory mechanisms are summarized to facilitate and organize these cellular activities. During embryonic development, cardiomyocytes proliferate rigorously but leave the cell cycle permanently immediately after the parturition of the child and experience terminal differentiation. The activation of a host of genes specific for the mature heart is correlated with the exit from the cell cycle. Even when exposed to mitogenic stimuli, the bulk of mature cardiomyocytes do not re-join the cell cycle. The reason for this permanent exit from the cell cycle is shown to be linked with stable switching off of the genes of the cell cycle directly involved in the G2/M transition phase and cytokinesis development. Researchers also trying to explain the molecular mechanism involved in stable inhibition of the gene and described structural changes (epigenetic and chromatin) in this mechanism. Substantial developments in the future with advances in the scientific platforms used for cardiomyocyte maturation research will broaden our understanding of this mechanism and result in better maturation of cardiomyocyte-derived pluripotent stem cells and effective treatment approaches for cardiovascular diseases.

Fabrication and Characterization of Femtosecond Laser Inscribed Long-Period Fiber Grating in Few-Mode Fiber

We experimentally investigated the fabrication and characterization of long-period fiber grating in few-mode fiber (FMF-LPFGs) by using the femtosecond laser direct writing technique. Thanks to the high flexibility and repeatability of this technique, stable FMF-LPFGs fabrication technology has been developed. In addition, the properties of FMF-LPFGs have also been characterized. The coupling of LP <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">01</sub> - LP <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">11</sub> and LP <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">01</sub> - cladding mode LP <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">13</sub> were investigated by both the transmission spectrum and the mode patterns. The temperature, strain and twist sensitivities of the resonance dips were calibrated by experiments, and the sensitivity difference between the dips was explained. By using their disparate responses to external temperature and strain, a cross coefficient matrix was established and dual-parameter discrimination determination is realized. This work provides a thoroughly theoretical and experimental investigation on the fabrication and characterization of FMF-LPFGs based on femtosecond laser direct writing technique. It is believed that the flexible and efficient LPFGs fabrication technique will benefit a lot in the future for developing various functional specialty optical fiber devices and sensors.

A Process Study of the Development of Capabilities for Replication in an Evolving Franchise Chain

The purpose of this paper is to extend insight about processes and routines needed for franchise replication and makes an important contribution to understanding ways through which dynamic capabilities are created. Based on a grounds-up study, this paper utilizes a storyline approach (Miles &amp; Huberman, 1994) to present interview data obtained from interviews with elite informants (IEIs) of the host company and its archival data. Evolution of capabilities, both substantive and dynamic, are captured in the findings section. Of the seventeen interviews, seven subjects were location heads and ten corporate executives. Interviews with corporate executives included questions pertaining to their functional specialty as well. Finally, implications for future research and practice are discussed.

Effect of physical parameters and temperature on the piezo-electric jetting behaviour of UV-curable photochromic inks

Although resource-efficient processes like inkjet printing have a large potential to foster the development of smart and functional textiles, one bottleneck still is the development of functional inks. To make inkjet printing and UV curing given production techniques for smart and functional specialty products, e.g. photochromic textiles, deepened knowledge about the development, rheological behavior and jetting behavior of functional ink is needed. This paper focuses on the formulation and performance of UV-responsive and UV-curable inkjet inks, which are based on photochromic dyes and their application to produce UV-responsive textiles. Two commercial photochromic dyes—Reversacol Ruby Red (RR) and Sea Green (SG), which represent dyes of the naphthopyran and spirooxazine class, respectively, have been used to develop the inks. The photochromic inks are characterized according to their physical–chemical and rheological properties in respect to temperature. The influence of temperature on the drop formation of the inks in an industrial print head is analyzed using a high-speed camera, which reveals important information regarding challenges in ink jettability. It was found that the dye structure and type used in the ink can influence the jetting behavior of photochromic UV-curable ink. More pronounced temperature sensitivity of dyes can increase the temperature-related effects of drop formation as was observed for SG ink. The printability of the RR and SG inks is framed and underpinned by theoretical calculations of the Z number. Discrepancies are observed and discussed between existing theory of ink jettability and visual evaluation of the photochromic ink.

The Quest for the Historical Jesus as an Experiment in Theological Method: A Lonerganian Perspective

Bernard Lonergan developed his theological method as a response to the need to integrate historical studies into theological method. While his method is derived from his transcendental method, this paper argues that the last three centuries of the quest for the historical Jesus provide a test case against which to test Lonergan’s method. While critical historical method corresponds (more or less) to Lonergan’s first three functional specialties (research, interpretation, and history), the dynamics of the quest itself point to the need for dialectics and foundations while raising the question of doctrine. In this way the quest provides some empirical verification for Lonergan’s method.

Paramedic Board Certification: The International Board of Specialty Certification Turns 20

The International Board of Specialty Certification (IBSC) has been offering specialty certification for 20 years. Originally formed as the Board for Critical Care Transport Paramedic Certification (BCCTPC), the first official examination at the Air Medical Transport Conference (AMTC) in October of 2000. Paramedic specialty certification flourished because of the vision and tireless commitment of a small group of paramedic champions. Some of that group from 20 years ago included David O. Bump, John R. Clark, Dr. John Cole, Dr. Robert Donovan, Chris Giller, Lisa Gilmore, Jonathan Gryniuk; Bob Hesse, TJ Kennedy, Brian Schaeffer, and Jackie Stocking. Without their tenacity, paramedic specialty certification would not be celebrating this milestone.The IBSC is a functional specialty board with a mission to support paramedicine specialties anywhere in the world. The Certified Flight Paramedic (FP-C®), Certified Critical Care Paramedic (CCP-C®) Certified Tactical Paramedic (TP-C®), Certified Tactical Responder (TR-C®) and Certified Community Paramedic (CP-C®) examinations are well established and have become a recognized standard for clinical competency by medical providers in the United States, Europe, South Africa and the Middle East. Founded in 2000, the IBSC is a not-for-profit professional certification organization responsible for the administration and development of specialty certification exams for critical care professionals. The mission of the IBSC is to improve quality of care in all aspects of specialty EMS care across a wide variety of settings by providing a portfolio of certification exams that are an objective, fair, and honest validation of specialty knowledge to paramedics and other allied health providers are called upon to perform critical care transport. Exams are developed that are responsive to the needs of the paramedic community. Currently, there are nearly 10,000 board certified providers in one of the five specialty designations.

Whistleblowing behaviours and anti-corruption approaches in public administration in Kenya

This article demonstrates that whistleblowing often receives little attention in public administration due to ambivalence regarding administrative roles held by public administrators, the fluid scalar chain and horizontal linkages, and competitive and intricate public, organisational and private interests. Drawing on comparative analysis to elucidate the broader scope of anti-corruption reforms and whistleblowing in public administration, the article explores the influence of the administrative culture on the relationship between whistleblowing behaviours and implementation of anti-corruption reforms in public administration in Kenya. It illustrates how bureaucratic oversight mechanisms such as internal auditing procedures and ethical guidelines tend to underperform where administrative environments largely feature autocratic bureaucratic authority, parochial management styles and centralised decision-making processes. Despite the functional specialty of public institutions, these cultural composites potentially elicit administrative behaviours that generally make whistleblowing anti-organisational, anti-social and an outright illegality in public administration. The absence of whistleblowing legislation or weak whistleblowing laws exacerbate these conditions. Whistleblowing becomes even more complex at the local-state level as social networks and working groups tend to be strengthened by the collectivist associational culture in public administration. Consequently, non-performance of anti-corruption reforms were found to stem from the collective chastisement of whistleblowing practices in public organisations in Kenya. Furthermore, institutional deficits typical in local-state administration seemingly made it riskier for potential whistleblowers to come forth, mainly attendant to loose and inconsistent legislation on corruption. Therefore, to enhance whistleblowing, there is a need to insulate potential whistleblowers from legal retaliation, including cultural retaliations that come in forms of emotional and professional ‘attacks’.

Basic approach to strategic planning of investment activities of business entities in agricultural sector

Purpose. The aim of the article is to highlight the basic approach to strategic planning of investment activity of business entities in agricultural sector and its main components. Methodology of research. The main research methods in the article are analysis and synthesis methods. Using the analysis method, the components of the basic approach to strategic planning of investment activity are analysed. Using the synthesis method, significant elements of the studied basic approach are determined. Findings. The article discusses the basic concepts used in the process of strategic planning of investment activity of business entities in agricultural sector, in particular: “investment”, “investment activity”, “planning”, “strategic planning” and “strategic planning of investment activity”. The specialities of planning and strategic planning of investment activity in the business entities in agricultural sector are described. Peculiarities of planning and strategic planning of investment activity in economic entities of the agricultural sector are described. Originality. The author defines the main components of the basic approach to strategic planning of investment activities of business entities in agricultural sector: functional specialities, industry differences, principles, criteria, structural elements, sources of investment, stages. The attention of agricultural entities is emphasized on the importance of flexible application of the basic approach in the process of strategic planning of investment activity, taking into account the specialization of their economic activity, the level of material and technical support, the actual and potential ratio of investment sources, the influence of environmental factors and specific development goals. Practical value. The results of the study can be used in the process of preparing strategies and strategic plans for investment activities by agricultural entities. Key words: investments, investment activity, planning, strategic planning, investment activity strategies.

A Lonerganian-Bakhtinian novelization of inculturation

AbstractI wish to correlate Bernard Lonergan’s functional specialty Communications with Mikhail Bakhtin’s notion of novelistic discourse with the goal of teasing out how the Bakhtinian notion of discourse furthers on-going reflection on inculturation. Theology as a highly differentiated and specialized reflection on religion bears fruit in the final stage (Communications) of theological reflection. This fruit – inculturation – can be explained using different constructs. This paper privileges the Bakhtinian construct in that it addresses “the life and behavior of discourse in a contradictory and multi-languaged world” in ways that Lonergan’s differentiated and specialized reflection on theology accounts for multiplicity of cultural traditions in an ever-changing world church.

Spleen mediates a distinct hematopoietic progenitor response supporting tumor-promoting myelopoiesis.

Cancer progression is associated with alterations of intra- and extramedullary hematopoiesis to support a systemic tumor-promoting myeloid response. However, the functional specialty, mechanism, and clinical relevance of extramedullary hematopoiesis (EMH) remain unclear. Here, we showed that the heightened splenic myelopoiesis in tumor-bearing hosts was not only characterized by the accumulation of myeloid precursors, but also associated with profound functional alterations of splenic early hematopoietic stem/progenitor cells (HSPCs). With the distinct capability to produce and respond to granulocyte-macrophage CSF (GM-CSF), these splenic HSPCs were "primed" and committed to generating immunosuppressive myeloid cells. Mechanistically, the CCL2/CCR2 axis-dependent recruitment and the subsequent local education by the splenic stroma were critical for eliciting this splenic HSPC response. Selective abrogation of this splenic EMH was sufficient to synergistically enhance the therapeutic efficacy of immune checkpoint blockade. Clinically, patients with different types of solid tumors exhibited increased splenic HSPC levels associated with poor survival. These findings reveal a unique and important role of splenic hematopoiesis in tumor-associated myelopoiesis.

The Quest for the Historical Jesus after the Demise of Authenticity: Toward a Critical Realist Philosophy of History in Jesus Studies by Jonathan Bernier

Reviewed by: The Quest for the Historical Jesus after the Demise of Authenticity: Toward a Critical Realist Philosophy of History in Jesus Studies by Jonathan Bernier Llewellyn Howes Bernier, Jonathan. 2016. The Quest for the Historical Jesus after the Demise of Authenticity: Toward a Critical Realist Philosophy of History in Jesus Studies. The Library of New Testament Studies 540. London and New York: Bloomsbury T&T Clark. Hardback. ISBN 978-0567662866. Pp. 224. $39.95. The Third Quest for the historical Jesus entails perhaps most importantly the conviction that there was a great measure of continuity between Judaism, Jesus and the early church. On the one hand, scholars like Ben F. Meyer and E. P. Sanders are often credited for laying the groundwork that would eventually cement the current scholarly consensus of continuity between Jesus and first-century Judaism. On the other hand, James D. G. Dunn should in all likelihood be credited for being the first scholar to convince many others that there was significant continuity between the historical Jesus and the early church. These developments have brought the criterion of "double dissimilarity" into disrepute in recent years. The philosophical approach to historiography known as "critical realism" had a huge influence on Ben Meyer, and was also explicitly appropriated by James Dunn. These scholars are heavily indebted to experts in the philosophy of science, including especially the theologian, Bernard Lonergan. In the monograph reviewed here, the historiographical enterprise of the Third Quest for the historical Jesus is considered anew by reflecting on the contributions of "critical realism" in general and the work of Lonergan in particular. The book is divided into two sections: "The first will lay out the basic structure of Lonergan's critical realism as it relates most fully to the task of New Testament historiography while the second will undertake the work of historiography proper" (12). The first chapter introduces critical realism, which is best defined in contrast with both empiricism and idealism. A purely empirical approach supposes that our knowledge of reality is limited to our sensory perception, so that perceived reality is only real if it is devoid of subjective meaning. Conversely, a purely idealist approach maintains that our knowledge of reality always includes both sensory perception and subjective meaning, so that perceived reality is never real, but always ideal. Both perspectives believe that subjective meaning distorts reality. The empiricist combats this belief by striving for [End Page 497] complete objectivity, while the idealist combats the same belief by striving for complete subjectivity. By contrast, the critical realist accepts with the empiricist that reality can be known, but also accepts with the idealist that knowledge is always mediated and subjective. For the critical realist, the answer lies neither in circumventing mediation nor in denying the ability to possess accurate knowledge of reality, but in embracing mediation as a necessary part of gaining such accurate knowledge. "The question is never whether one is mediating reality but, rather, it is how one does so and how well" (22). According to this understanding, objectivity is not a neutral state and subjectivity is not in all cases an impediment to knowing. Rather, objectivity means to acknowledge one's own subjectivity while also adopting a stance that values actual truth and critical thinking over desired truth and wishful thinking. Such objectivity guards against subjective bias, which does indeed curtail and distort true knowledge. The word "critical" implies making judgments, so that the term "critical realism" implies making judgments about reality. For historians, this means making judgments not only about how well constructions of the past match the available data, but also about the extent to which these constructions are able to predict the data. When it comes to the broad category of theology, Lonergan identified a number of functional specialties, only four of which are relevant to historical Jesus studies. Chapter two considers the first two of these specialties, namely research and interpretation. According to Bernier, one needs to distinguish between research proper and historical investigation. The former is a process that ultimately makes data available, while the latter interprets available data in order to construct history. Bernier argues that the conflation of these two fields gave rise to...

The Hierarchy of Antigen Delivery

The Hierarchy of Antigen Delivery

Functional Specialty of CD40 and Dendritic Cell Surface Lectins for Exogenous Antigen Presentation to CD8+ and CD4+ T Cells

Dendritic cells (DCs) are major antigen-presenting cells that can efficiently prime and cross-prime antigen-specific T cells. Delivering antigen to DCs via surface receptors is thus an appealing strategy to evoke cellular immunity. Nonetheless, which DC surface receptor to target to yield the optimal CD8+ and CD4+ T cell responses remains elusive. Herein, we report the superiority of CD40 over 9 different lectins and scavenger receptors at evoking antigen-specific CD8+ T cell responses. However, lectins (e.g., LOX-1 and Dectin-1) were more efficient than CD40 at eliciting CD4+ T cell responses. Common and distinct patterns of subcellular and intracellular localization of receptor-bound αCD40, αLOX-1 and αDectin-1 further support their functional specialization at enhancing antigen presentation to either CD8+ or CD4+ T cells. Lastly, we demonstrate that antigen targeting to CD40 can evoke potent antigen-specific CD8+ T cell responses in human CD40 transgenic mice. This study provides fundamental information for the rational design of vaccines against cancers and viral infections.

English

This qualitative phenomenological research study represents the personal and professional lived experiences of midlevel leaders’ effective management of virtual committees of practice (VCoP) in medical device companies in the Atlanta metro area. In-depth interviews were conducted with 15 leaders of VCoP from different medical device functional specialties. The study used a combination of the modified van Manen (1990) and van Kaam methods (Moustakas, 1994) to facilitate the analysis of the data gathered through in-depth interviews. This method served as the template for data collection and analysis. The research study revealed common themes after an analysis of data. Six emergent themes were identified: (a) empowerment, (b) communication, (c) trust, (d) encouragement/inspiration, (e) integrity, and (f) connecting with individuals. The research findings revealed a leadership model that relies on the development of genuine leaders/follower relationships to lead a VCoP effectively.

Opposing Roles of Dectin-1 Expressed on Human Plasmacytoid Dendritic Cells and Myeloid Dendritic Cells in Th2 Polarization.

Dendritic cells (DCs) can induce and control host immune responses. DC subset-dependent functional specialties and their ability to display functional plasticity, which is mainly driven by signals via pattern recognition receptors, identify DCs as immune orchestrators. A pattern recognition receptor, Dectin-1, is expressed on myeloid DCs and known to play important roles in Th17 induction and activation during fungal and certain bacterial infections. In this study, we first demonstrate that human plasmacytoid DCs express Dectin-1 in both mRNA and protein levels. More interestingly, Dectin-1-activated plasmacytoid DCs promote Th2-type T cell responses, whereas Dectin-1-activated myeloid DCs decrease Th2-type T cell responses. Such contrasting outcomes of Th2-type T cell responses by the two DC subsets are mainly due to their distinct abilities to control surface OX40L expression in response to β-glucan. This study provides new insights for the regulation of host immune responses by Dectin-1 expressed on DCs.

Dectin-1 expressed on pDCs and mDCs displays opposing roles in TH2 polarization (INC6P.321)

Abstract Dendritic cells (DCs) can induce and control host immune responses. DC subset-dependent functional specialties and their ability to display functional plasticity, which is mainly driven by signals via pattern-recognition receptors (PRRs), identify DCs as immune orchestrators. A PRR, Dectin-1 is expressed on myeloid DCs (mDCs) and is known to play an important role in TH17 responses. Here, we demonstrate that human plasmacytoid DCs (pDCs) express Dectin-1. Interestingly, Dectin-1-activated pDCs promote TH2 induction and activation, whereas Dectin-1-activated mDCs decrease both. This counter-regulation of TH2 by the two DC subsets is mainly due to their distinct abilities to control OX40L expression through different mechanisms. This study provides new insights for the regulation of host immune responses by DCs during microbial infections.

Innovation in small and medium-sized companies: Knowledge integration mechanisms and the role of top managers’ networks

IntroductionPrevious research has delivered strong theoretical and empirical evidence that successful product innovations result from the of organizations to share and create new and relevant knowledge (e.g. Nonaka & Takeuchi, 1995). In particular, it is argued that the organizational combinative ability (Kogut & Zander, 1992), that is flexible integration of the specialized knowledge of various organizational members (Grant, 1996), plays critical role for innovations. Contrary to the past, as expertise could be centralized in single person who knew [...] the product technology, production process, and means to market goods to others (Griffin & Hauser, 1996, p. 192), now an intensive cooperation and knowledge flow between different functional specialties (e.g. Maltz et al., 2001, p. 72) as well as hierarchical levels (e.g. Aalbers et al., 2011) becomes an important precondition for product innovation. Past research has revealed that particularly for highly innovative products, knowledge integration within organizations plays crucial role in increasing new product performance (Tsai et al., 2012). Previous studies also identified number of integration mechanisms by which crossborder exchange of knowledge within organizations can be fostered (e.g. Griffin & Hauser, 1996; Leenders & Wierenga, 2002). For instance, in comprehensive review of empirical work into the success factors of new product development (NPD), Ernst (2002) found that cross-functional project teams have both direct and an indirect positive effect on the success of new products (Ernst, 2002). More specifically, as argued by Griffin and Hauser (1996, p. 204), such cross-functional product development teams lead to higher marketplace success and shorter times to market by decreasing the barriers of functionally specialized thought worlds, languages and organizational responsibilities and providing forum in which information is utilized better, decisions are made more effectively, and conflicts are resolved. In similar vein, Valle and Avella (2003) found that firms which use cross-functional teams, are characterized by more effective NPD process (that is, lower development times and costs, and superior products) and higher percentage of new products that are successful in the market.In addition to cross-functional teams, large number of empirical studies identified the support of senior management as critical success factor of NPD (e.g. Brown & Eisenhardt, 1995; Cooper et al., 2004a). Senior managers provide the NPD team with the financial and political resources necessary to accelerate the progress of development projects (Brown & Eisenhardt, 1995). Moreover, senior managers help the NPD team to align their projects with the firm's overall strategic orientation. Thus, as Aalbers et al. (2011, p. 5) point out, vertical cross-hierarchy ties can provide the team with access to knowledge and information of different nature than that which the team accesses through its horizontal cross-unit ties. Accordingly, the participation of senior management in the gate meetings is seen as an important mechanism for knowledge integration within the new product development process (e.g. Cooper et al., 2004a).While numerous studies have addressed multiple aspects of integration and its impact on innovation performance, one important issue is still under-explored. In the samples of previous empirical studies big organizations were largely overrepresented (e.g. Griffin, 1997; Hauschildt & Salomo, 2011) and the contingencies of small and medium-sized enterprises (SMEs) have not been considered in comprehensive manner. This is critical point, since, as Welsh and White (1981) note, a small business is not little big business. Thus, management principles that have proven to be successful in large companies may prove the opposite in SMEs (Welsh & White, 1981). As SMEs constitute over 99 percent of all companies in the European Union, reinforcing national economies by their employment offers and revenues (Eurostat, 2009), focused analysis of knowledge integration in these companies is important from both the theoretical and the practical perspective. …

Informational diversity and entrepreneurial team performance: moderating effect of shared leadership

A research need exists regarding the relationship between entrepreneurial team informational diversity and team performance, including the conditions under which such diversity might benefit performance. This study explores the moderating effect of shared leadership on the relationship between informational diversity and entrepreneurial team performance. Four dimensions are used to measure informational diversity: functional specialty, educational specialty, educational level, and managerial skills. The results show that functional specialty diversity can improve entrepreneurial team performance. Managerial skill diversity can improve entrepreneurial team performance when leadership is shared among team members. These findings advance the understanding of entrepreneurial team performance and provide practical implications regarding team structure.

Entrepreneurial Team Diversity and Performance: An Investigation of What and How

In entrepreneurship research there is growing interest in the diversity of entrepreneurial teams because of their potential to shape new business growth. However, research on the relationship between different type of team diversity and entrepreneurial team performance remains inconsistent and inconclusive; especially empirical studies exploring the effect of personality diversity on entrepreneurial team performance are very rare. Using 144 teams in a university entrepreneurial park, this study investigated: (1) what type diversity affects entrepreneurial team performance; and (2) how does the effect occur. Three major findings emerged from this study. First, functional specialty diversity can improve entrepreneurial team performance. Skill diversity can improve entrepreneurial team performance only when leadership is shared among team members. Second, team members’ personalities matter; the effects of personality on entrepreneurial team diversity differ across the Big-5 personality traits. Third, shared leadership mediates the personality diversity - performance link. These findings advance research in entrepreneurship, groups and teams, and shared leadership, and provide practical implications for entrepreneurs regarding team composition as well.

CoPs and Robbers: Taking and Making Management in UK Healthcare

In the context of a rapidly fragmenting system of health care in the UK, management is becoming bound into a situation in which the administrative and performative demands of their work appear to increase in direct relation to the denigration that surrounds them, both inside and outside individual healthcare organisations. In this complex system, or industry, of healthcare, not only does management represent an important function in itself, but the links that are forged between different groups of managers from across a range groups, from clinical to functional specialties, become of fundamental importance. This paper uses the notion of communities of practice to analyse this coordination and communication between management groups and between knowledge domains. The analysis draws out differences in the percieved credibility of different knowledge domains: the enclosures of expertise built around them, and the bridges that operate between them. In their ability to control the flows of knowledge in and out of their own enclosures, both clinical and functional management groups can function as mutually independent professional groups. In contrast, general management is impeded in this function by its diffuse knowledge domains, its cultural denigration and its lack of professional credibility. Unable to either close ranks within organisations or branch out via external bodies, the resulting isolation of general management weds them ever more firmly to the political context of the NHS in which they function as a residual scapegoat category. Given the longterm inviability of such a category, this analysis prompts a questioning of the future appearance and function of general management in healthcare.