The authors analyze competing forces affecting the diffusion of telemedicine practices across organizations, potential learning effects from telemedicine practice, and their implications for the development of telemedicine-based networks. They also speculate on the learning, diffusion, and institutional effects that telemedical collaboration may trigger; five sets of propositions are advanced to explain these effects.

Building inductively on twenty-four in depth interviews, the authors argue that boundaryless organizations will alter both career theories and actual career mobility patterns. The paper illustrates how both organizational and population level learning can affect individual job transitions within and cross organizations. The three evolutionary learning steps of variation. selection and retention all remain important, but the impact of variation processes may increase. Boundaryless organizations will thus generate career patterns reflecting an underlying logic of organizational learning rather than producing simple atomistic exchange between unfettered actors.

Although pregnant women rely on medical interventions to treat and prevent a wide variety of health conditions, they are frequently excluded or underrepresented in clinical research. The resulting dearth of pregnancy-specific evidence to guide clinical decisionmaking routinely exposes pregnant women, and their future offspring, to risk of uncertain harms for uncertain benefits. The two legal factors regularly cited as obstacles to such research are the federal regulatory scheme and fear of liability. This article reveals a far more nuanced and complex view of the legal context. First, legal professionals may—at any time from product conception to marketing—influence decisions about research with pregnant women. Second, factors not previously articulated in the literature may prompt legal professionals to slow or halt such research. They include: financial interests, regulatory ambiguity, obstacles to risk management, and site-specific laws unrelated to research. Any efforts to promote the ethical inclusion of pregnant women in research must acknowledge the role of legal decisionmakers and address their professional concerns.

This paper examines the limitations and biases of world university rankings and asks what drivers explain their ongoing proliferation and popularity. It is argued that rankings are having a corrosive effect on higher education systems, institutions and staff by encouraging policy reforms at the governmental level and a reallocation of resources at the institutional level that may improve standings in the rankings but do not necessarily enhance quality research and teaching. Global rankings are linked to the rise of an international market in higher education, particularly with respect to international students. The author argues that what is at stake in the debate over university rankings is fundamentally whether higher education is to be thought of as having intrinsic value, or whether it is defined narrowly in instrumentalist and consumerist terms. KEY WORDS: University rankings • Quality assurance • Assessment of higher education • Learning outcomes • Performance indicators Resale or republication not permitted without written consent of the publisher Contribution to the Theme Section 'Global university rankings uncovered' FREE REE ACCESS CCESS