Leadership of healthcare commissioning networks in England: a mixed-methods study on clinical commissioning groups.

To explore the relational challenges for general practitioner (GP) leaders setting up new network-centric commissioning organisations in the recent health policy reform in England, we use innovation network theory to identify key network leadership practices that facilitate healthcare innovation.

Policy as a struggle for meaning: disentangling knowledge translation across international health contexts

Over the last decade, research in medical science has focused on knowledge translation and diffusion of best practices to enable improved health outcomes. However, there has been less attention given to the role of policy in influencing the translation of best practice across different national contexts. This paper argues that the underlying set of public discourses of healthcare policy significantly influences its development with implications for the dissemination of best practices. Our research uses Critical Discourse Analysis to examine the policy discourses surrounding the treatment of stroke across Canada and the U.K. It focuses in specific on how concepts of knowledge translation, user empowerment, and service innovation construct different accounts of the health service in the two countries. These findings provide an important yet overlooked starting point for understanding the role of policy development in knowledge transfer and the translation of science into health practice. © 2011 Operational Research Society. All rights reserved.

Global civil aviation black carbon emissions.

Aircraft black carbon (BC) emissions contribute to climate forcing, but few estimates of BC emitted by aircraft at cruise exist. For the majority of aircraft engines the only BC-related measurement available is smoke number (SN)-a filter based optical method designed to measure near-ground plume visibility, not mass. While the first order approximation (FOA3) technique has been developed to estimate BC mass emissions normalized by fuel burn [EI(BC)] from SN, it is shown that it underestimates EI(BC) by >90% in 35% of directly measured cases (R(2) = -0.10). As there are no plans to measure BC emissions from all existing certified engines-which will be in service for several decades-it is necessary to estimate EI(BC) for existing aircraft on the ground and at cruise. An alternative method, called FOX, that is independent of the SN is developed to estimate BC emissions. Estimates of EI(BC) at ground level are significantly improved (R(2) = 0.68), whereas estimates at cruise are within 30% of measurements. Implementing this approach for global civil aviation estimated aircraft BC emissions are revised upward by a factor of ~3. Direct radiative forcing (RF) due to aviation BC emissions is estimated to be ~9.5 mW/m(2), equivalent to ~1/3 of the current RF due to aviation CO2 emissions.

Updated correlation between aircraft smoke number and black carbon concentration

Aircraft emissions of black carbon (BC) contribute to anthropogenic climate forcing and degrade air quality. The smoke number (SN) is the current regulatory measure of aircraft particulate matter emissions and quantifies exhaust plume visibility. Several correlations between SN and the exhaust mass concentration of BC (CBC) have been developed, based on measurements relevant to older aircraft engines. These form the basis of the current standard method used to estimate aircraft BC emissions (First Order Approximation version 3 [FOA3]) for the purposes of environmental impact analyses. In this study, BC with a geometric mean diameter (GMD) of 20, 30, and 60 nm and filter diameters of 19 and 35 mm are used to investigate the effect of particle size and sampling variability on SN measurements. For BC with 20 and 30 nm GMD, corresponding to BC emitted by modern aircraft engines, a smaller SN results from a given CBC than is the case for BC with 60 nm GMD, which is more typical of older engines. An updated correlation between CBC and SNthat accounts for typical size of BC emitted by modern aircraft is proposed. An uncertainty of ±25% accounts for variation in GMD in the range 20-30 nm and for the range of filter diameters. The SN-CBC correlation currently used in FOA3 underestimates by a factor of 2.5-3 for SN <15, implying that current estimates of aircraft BC emissions derived from SN are underestimated by the same factor. Copyright © American Association for Aerosol Research.

A trichordal temporal approach to digital coordination: the sociomaterial mangling of the CERN grid

This paper develops a sociomaterial perspective on digital coordination. It extends Pickering’s mangle of practice by using a trichordal approach to temporal emergence. We provide new understanding as to how the nonhuman and human agencies involved in coordination are embedded in the past, present, and future. We draw on an in-depth field study conducted between 2006 and 2010 of the development, introduction, and use of a computing grid infrastructure by the CERN particle physics community. Three coordination tensions are identified at different temporal dimensions, namelyobtaining adequate transparency in the present, modeling a future infrastructure, and the historical disciplining of social and material inertias. We propose and develop the concept of digital coordination, and contribute a trichordal temporal approach to understanding the development and use of digital infrastructure as being orientated to the past and future while emerging in the present.

Air quality and climate impacts of alternative bus technologies in Greater London.

The environmental impact of diesel-fueled buses can potentially be reduced by the adoption of alternative propulsion technologies such as lean-burn compressed natural gas (LB-CNG) or hybrid electric buses (HEB), and emissions control strategies such as a continuously regenerating trap (CRT), exhaust gas recirculation (EGR), or selective catalytic reduction with trap (SCRT). This study assessed the environmental costs and benefits of these bus technologies in Greater London relative to the existing fleet and characterized emissions changes due to alternative technologies. We found a >30% increase in CO2 equivalent (CO2e) emissions for CNG buses, a <5% change for exhaust treatment scenarios, and a 13% (90% confidence interval 3.8-20.9%) reduction for HEB relative to baseline CO2e emissions. A multiscale regional chemistry-transport model quantified the impact of alternative bus technologies on air quality, which was then related to premature mortality risk. We found the largest decrease in population exposure (about 83%) to particulate matter (PM2.5) occurred with LB-CNG buses. Monetized environmental and investment costs relative to the baseline gave estimated net present cost of LB-CNG or HEB conversion to be $187 million ($73 million to $301 million) or $36 million ($-25 million to $102 million), respectively, while EGR or SCRT estimated net present costs were $19 million ($7 million to $32 million) or $15 million ($8 million to $23 million), respectively.

Dialogical strategies for orchestrating strategic innovation networks: the case of the Internet of Things

Strategic innovation has been shown to provide significant value for organisations whilst at the same time challenging traditional ways of thinking and working. There is less known, however, as to how organisations collaborate in innovation networks to achieve strategic innovation. In this paper we explore how innovation networks are orchestrated in developing a strategic innovation initiative around the Internet of Things. We show how a hub actor brings together a diverse group of actors to initially create and subsequently orchestrate the strategic innovation network through the employ of three dialogical strategies, namely persuasive projection, reflective development, and definitional control. Further, we illuminate how different types of legitimacy are established through these various dialogical strategies in orchestrating strategic innovation networks.