3 resultados para Gatekeeper, Neutrality, Objectivity
Resumo:
The Private Finance Initiative (PFI) has become one of the UK’s most contentious public policies. Despite New Labour’s advocacy of PFI as a means of achieving better value for money, criticisms of PFI have centred on key issues such as a lack of cost effectiveness, exaggerated pricing of risk transfers, excessive private sector profits, inflexibility and cumbersome administrative arrangements. Nevertheless, PFI has persisted as a key
infrastructure procurement method in the UK and has been supported as such by successive governments, as well as influencing policy in the Republic of Ireland and other European Nations. This paper explores this paradoxical outcome in relation to the role played in the UK by the National Audit Office (NAO). Under pressure to justify its support for PFI, the Blair government sought support for its policies by encouraging the NAO to investigate issues relating to PFI as well as specific PFI projects. It would have been expected that in fulfilling its role as independent auditor, the NAO would have examined whether PFI projects could have been delivered more efficiently, effectively or economically through other means. Yet, in line with earlier research, we find evidence that the NAO failed to comprehensively assess
key issues such as the value for money of PFI projects, and in so doing effectively acted as a legitimator of PFI policy. Using concepts relating to legitimacy theory and the idea of framing, our paper looks into 67 NAO private finance reports published between 1997 and 2011, with the goal of identifying the preferences, values and ideology underpinning the
NAO’s view on PFI during this period. Our analysis suggests that the NAO sought to legitimise existing PFI practices via a selective framing of problems and questions. Utilising a longitudinal approach, our analysis further suggests that this patterns of selective framing persisted over an extended time period during which fundamental parameters of the policy (such as contract length, to name one of the most important issues) were rarely addressed.
Overall the NAO’ supportive stance toward PFI seems to have relied on 1) a focused on positive aspects of PFI, such as on time delivery or lessons learned, and 2) positive comments on aspects of PFI that were criticised elsewhere, such as the lack of flexibility of underlying contractual arrangements. Our paper highlights the possibility that, rather than providing for a critical assessment of existing policies, national auditing bodies can
contribute to the creation of legitimatory environments. In terms of accounting research we would suggests that the objectivity and independence of accounting watchdogs should not be taken for granted, and that instead a critical investigation of the biases which can characterise these bodies can contribute to a deeper understanding of the nature of lobbying networks in the modern state.
Resumo:
Background
There is a growing body of evidence suggesting patients with life-limiting illness use medicines inappropriately and unnecessarily. In this context, the perspective of patients, their carers and the healthcare professionals responsible for prescribing and monitoring their medication is important for developing deprescribing strategies. The aim of this study was to explore the lived experience of patients, carers and healthcare professionals in the context of medication use in life-limiting illness.
MethodsIn-depth interviews, using a phenomenological approach: methods of transcendental phenomenology were used for the patient and carer interviews, while hermeneutic phenomenology was used for the healthcare professional interviews.
ResultsThe study highlighted that medication formed a significant part of a patient’s day-to-day routine; this was also apparent for their carers who took on an active role-as a gatekeeper of care-in managing medication. Patients described the experience of a point in which, in their disease journey, they placed less importance on taking certain medications; healthcare professionals also recognize this and refer it as a ‘transition’. This point appeared to occur when the patient became accepting of their illness and associated life expectancy. There was also willingness by patients, carers and healthcare professionals to review and alter the medication used by patients in the context of life-limiting illness.
ConclusionsThere is a need to develop deprescribing strategies for patients with life-limiting illness. Such strategies should seek to establish patient expectations, consider the timing of the discussion about ceasing treatment and encourage the involvement of other stakeholders in the decision-making progress.
Resumo:
We have fabricated a new van-der-Waals heterostructure composed by BN/graphene/C60. We performed transport measurements on the preliminary BN/graphene device finding a sharp Dirac point at the neutrality point. After the deposition of a C60 thin film by thermal evaporation, we have observed a significant n-doping of the heterostructure. This suggests an unusual electron transfer from C60 into the BN/graphene structure. This BN/graphene/C60 heterostructure can be of interest in photovoltaic applications. It can be used to build devices like p-n junctions, where C60 can be easily deposited in defined regions of a graphene junction by the use of a shadow mask. Our results are contrasted with theoretical calculations.
