Exploring the determinants of CAP reform: A Delphi survey of key decision-makers

A panel of key decision-makers, closely involved in the 1992, 1999 and 2003 CAP reforms, participated in a Delphi survey designed to ascertain what had prompted the European Commission to launch these reform initiatives and what factors were relevant in determining the reform packages subsequently decided by the Council.

Understanding construction competitiveness: the initial results of a Delphi survey in Finland, Sweden and the UK

The competitiveness of the construction industry is an important issue for many countries as the industry makes up a substantial part of their GDP – about 8% in the UK. A number of competitiveness studies have been undertaken at company, industry and national levels. However, there has been little focus on sustainable competitiveness and the many factors that are involved. This paper addresses that need by investigating what construction industry experts consider to be the most important factors of construction industry competitiveness. It does so by conducting a Delphi survey among industry experts in Finland, Sweden and the UK. A list of 158 factors was compiled from competitiveness reports by institutions such as World Economic Forum and International Institute of Management Development, as well as from explorative workshops in the countries involved in the study. For each of the countries, experts with different perspectives of the industry, including, consultants, contractors and clients, were asked to select their 30 most influential factors. They then ranked their chosen factors in order of importance for the competitiveness of their construction industry. The findings after the first round of the Delphi process underline the complexity of the term competitiveness and the wide range of factors that are considered important contributors to competitiveness. The results also indicate that what are considered to be the most important factors of competitiveness is likely to differ from one country to another.

Thessaly and Macedon at Delphi

The Daochos Monument at Delphi has received some scholarly attention from an art-historical and archaeological perspective; this article, however, examines it rather as a reflection of contemporary Thessalian history and discourse, an aspect which has been almost entirely neglected. Through its visual imagery and its inscriptions, the monument adopts and adapts long-standing Thessalian themes of governance and identity, and achieves a delicate balance with Macedonian concerns to forge a symbolic rapprochement between powers and cultures in the Greek north. Its dedicator, Daochos, emerges as far more than just the puppet of Philip II of Macedon. This hostile and largely Demosthenic characterisation, which remains influential even in modern historiography, is far from adequate in allowing for an understanding of the relationship between Thessalian and Macedonian motivations at this time, or of the importance of Delphi as the pan-Hellenic setting of their interaction. Looking closely at the Daochos Monument instead allows for a rare glimpse into the Thessalian perspective in all its complexity.

Content validation for level of use of feature rich systems: a Delphi study of electronic medical records systems

Introduction. Feature usage is a pre-requisite to realising the benefits of investments in feature rich systems. We propose that conceptualising the dependent variable 'system use' as 'level of use' and specifying it as a formative construct has greater value for measuring the post-adoption use of feature rich systems. We then validate the content of the construct as a first step in developing a research instrument to measure it. The context of our study is the post-adoption use of electronic medical records (EMR) by primary care physicians. Method. Initially, a literature review of the empirical context defines the scope based on prior studies. Having identified core features from the literature, they are further refined with the help of experts in a consensus seeking process that follows the Delphi technique. Results.The methodology was successfully applied to EMRs, which were selected as an example of feature rich systems. A review of EMR usage and regulatory standards provided the feature input for the first round of the Delphi process. A panel of experts then reached consensus after four rounds, identifying ten task-based features that would be indicators of level of use. Conclusions. To study why some users deploy more advanced features than others, theories of post-adoption require a rich formative dependent variable that measures level of use. We have demonstrated that a context sensitive literature review followed by refinement through a consensus seeking process is a suitable methodology to validate the content of this dependent variable. This is the first step of instrument development prior to statistical confirmation with a larger sample.

Assessment of the impact of government animal welfare policy on farm animal welfare in the UK

The paper presents the method and findings of a Delphi expert survey to assess the impact of UK government farm animal welfare policy, form assurance schemes and major food retailer specifications on the welfare of animals on forms. Two case-study livestock production systems are considered, dairy and cage egg production. The method identifies how well the various standards perform in terms of their effects on a number of key farm animal welfare variables, and provides estimates of the impact of the three types of standard on the welfare of animals on forms, taking account of producer compliance. The study highlights that there remains considerable scope for government policy, together with form assurance schemes, to improve the welfare of form animals by introducing standards that address key factors affecting animal welfare and by increasing compliance of livestock producers. There is a need for more comprehensive, regular and random surveys of on-farm welfare to monitor compliance with welfare standards (legislation and welfare codes) and the welfare of farm animals over time, and a need to collect farm data on the costs of compliance with standards.

The Acute Care Undergraduate TEaching (ACUTE) initiative: consensus development of core competencies in acute care for undergraduates in the United Kingdom

Background: The care of the acutely ill patient in hospital is often sub-optimal. Poor recognition of critical illness combined with a lack of knowledge, failure to appreciate the clinical urgency of a situation, a lack of supervision, failure to seek advice and poor communication have been identified as contributory factors. At present the training of medical students in these important skills is fragmented. The aim of this study was to use consensus techniques to identify the core competencies in the care of acutely ill or arrested adult patients that medical students should possess at the point of graduation. Design: Healthcare professionals were invited to contribute suggestions for competencies to a website as part of a modified Delphi survey. The competency proposals were grouped into themes and rated by a nominal group comprised of physicians, nurses and students from the UK. The nominal group rated the importance of each competency using a 5-point Likert scale. Results: A total of 359 healthcare professionals contributed 2,629 competency suggestions during the Delphi survey. These were reduced to 88 representative themes covering: airway and oxygenation; breathing and ventilation; circulation; confusion and coma; drugs, therapeutics and protocols; clinical examination; monitoring and investigations; team-working, organisation and communication; patient and societal needs; trauma; equipment; pre-hospital care; infection and inflammation. The nominal group identified 71 essential and 16 optional competencies which students should possess at the point of graduation. Conclusions: We propose these competencies form a core set for undergraduate training in resuscitation and acute care.

Developing consensus on hospital prescribing indicators of potential harms amenable to decision support

Aim: To develop a list of prescribing indicators specific for the hospital setting that would facilitate the prospective collection of high severity and/or high frequency prescribing errors, which are also amenable to electronic clinical decision support (CDS). Method: A three-stage consensus technique (electronic Delphi) was carried out with 20 expert pharmacists and physicians across England. Participants were asked to score prescribing errors using a 5-point Likert scale for their likelihood of occurrence and the severity of the most likely outcome. These were combined to produce risk scores, from which median scores were calculated for each indicator across the participants in the study. The degree of consensus between the participants was defined as the proportion that gave a risk score in the same category as the median. Indicators were included if a consensus of 80% or more was achieved. Results: A total of 80 prescribing errors were identified by consensus as being high or extreme risk. The most common drug classes named within the indicators were antibiotics (n=13), antidepressants (n=8), nonsteroidal anti-inflammatory drugs (n=6), and opioid analgesics (n=6).The most frequent error type identified as high or extreme risk were those classified as clinical contraindications (n=29/80). Conclusion: 80 high risk prescribing errors in the hospital setting have been identified by an expert panel. These indicators can serve as the basis for a standardised, validated tool for the collection of data in both paperbased and electronic prescribing processes, as well as to assess the impact of electronic decision support implementation or development.

Travail des enfants et droit à l’éducation au Burkina Faso: L’exemple de la carrière de Pissy

Cet article décrit et analyse le travail des enfants dans une carrière de granit d’un quartier de la ville de Ouagadougou, interroge le rapport entre l’école et le travail du point de vue des acteurs du site pour apprécier l’argument de la scolarisation comme solution alternative au travail des enfants. Les données proviennent d’une enquête réalisée dans le cadre de notre recherche doctorale au Burkina Faso, de février à avril 2009, dont la carrière de Pissy a été un des terrains d’enquête1. Les enquêtés sont constitués de parents et de leurs enfants âgés de moins de 16 ans ayant des trajectoires différentes : non scolarisés,scolarisés, déscolarisés et à la fois écoliers et travailleurs. Les personnes ont été choisies aléatoirement selon leur accord et disponibilité, en variant leur emplacement. L’approche choisie privilégie le point de vue des différents acteurs du site,l’analyse de leurs discours et l’observation de leurs pratiques de travail. La prise en compte du point de vue des enfants s’appuie sur la perspective théorique développée par James & Prout (1997), où les enfants sont des acteurs compétents dans la sphère du travail et de la vie sociale. L’article présente d’abord le processus d’institutionnalisation de l’école et la situation du travail des enfants au Burkina Faso, puis décrit les logiques autour du travail des enfants dans la carrière en montrant que celui-ci n’est pas seulement lié à la nécessité économique. Enfin, il confronte les alternatives au travaildes enfants invoquées par les enfants et leurs parents aux solutions d’éducation proposées par l’état et la société civile. This article is about a particular case of children in working situation: children crushing the granite in the quarry of Pissy. Their working conditions are considered as dangerous by national and international legal texts. This article aims to grasp the experience of children who work in this frame in order to test the hypothesis according to which schooling would be an effective tool of struggle against child labour. The fieldwork reveals that child labour in the quarry is not only guided by economic aspects. The wish of the parents (and of some children and teenagers) to find another job for working children reopen the debate on “the right to work” for children.