Exchanging knowledge on participation by EU health consumers and patients in research, quality and policy

Sponsored by ZonMw (The Netherlands Organisation for Health Research and Development) The Hague 11–12 April 2013

Innovation and policy networks:the social shaping of BSE-related technologies and the inadequate assessmant of related risks

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Evidence-based nanoscopic and molecular framework for excipient functionality in compressed orally disintegrating tablets

The work investigates the adhesive/cohesive molecular and physical interactions together with nanoscopic features of commonly used orally disintegrating tablet (ODT) excipients microcrystalline cellulose (MCC) and D-mannitol. This helps to elucidate the underlying physico-chemical and mechanical mechanisms responsible for powder densification and optimum product functionality. Atomic force microscopy (AFM) contact mode analysis was performed to measure nano-adhesion forces and surface energies between excipient-drug particles (6-10 different particles per each pair). Moreover, surface topography images (100 nm2-10 μm2) and roughness data were acquired from AFM tapping mode. AFM data were related to ODT macro/microscopic properties obtained from SEM, FTIR, XRD, thermal analysis using DSC and TGA, disintegration testing, Heckel and tabletability profiles. The study results showed a good association between the adhesive molecular and physical forces of paired particles and the resultant densification mechanisms responsible for mechanical strength of tablets. MCC micro roughness was 3 times that of D-mannitol which explains the high hardness of MCC ODTs due to mechanical interlocking. Hydrogen bonding between MCC particles could not be established from both AFM and FTIR solid state investigation. On the contrary, D-mannitol produced fragile ODTs due to fragmentation of surface crystallites during compression attained from its weak crystal structure. Furthermore, AFM analysis has shown the presence of extensive micro fibril structures inhabiting nano pores which further supports the use of MCC as a disintegrant. Overall, excipients (and model drugs) showed mechanistic behaviour on the nano/micro scale that could be related to the functionality of materials on the macro scale. © 2014 Al-khattawi et al.

The legacy of climategate:revitalizing or undermining climate science and policy?

The release of emails from a server at the University of East Anglia's Climate Research Unit (CRU) in November 2009 and the following climategate controversy have become a topic for interpretation in the social sciences. This article picks out some of the most visible social science comments on the affair for discussion. These comments are compared to an account of what can be seen as problematic practices by climate scientists. There is general agreement in these comments that climate science needs more openness and transparency. But when evaluating climategate a variety of responses is seen, ranging from the apologetic to the highly critical, even condemning the practices in question. It is argued that reluctance to critically examine the climategate affair, including suspect practices of scientists, has to do with the nature of the debate which is highly politicized. A call is made for more reflection on this case which should not be closed off because of political expediency. © 2012 John Wiley & Sons, Ltd.

Plant closures and taskforce responses:an analysis of the impact of and policy response to MG Rover in Birmingham

This paper explores the socio-economic impacts and associated policy responses to the collapse of MG Rover at Longbridge in Birmingham. Critically, it attempts to move beyond a ‘standard’ taskforce narrative that emphasizes the role of the regional response. While recognizing that significant policy ‘successes’ were indeed evident at the regional level in anticipating and responding to the crisis, a wider perspective is required that situates this taskforce response in (1) a fuller understanding of labour market precariousness (that in turn mitigates some of its policy ‘successes’), and (2) more local perspectives that highlight the local impacts of closure, the role of the neighbourhood level officials and the third sector in mediating these. Taking this broader perspective suggests that longer-term, workers face a precarious situation and the need for policies to create and sustain ‘good quality’ jobs remains paramount. Adding in more local perspectives, a key lesson from the Longbridge experience for dealing with closures more generally is that the public policy responses must be: multidimensional in that they transcend narrow sector-based concerns and addresses broader spatial impacts; inclusive in that they build on a broad coalition of economic and social stakeholders; and long-term in that they acknowledge that adaptation takes many years. If anything, the Birmingham Longbridge experience demonstrates the difficulty of achieving such responses in the context of crisis where action is imperative and deliberation a luxury.

Energy-based damage and fracture framework for viscoelastic asphalt concrete

A framework based on the continuum damage mechanics and thermodynamics of irreversible processes using internal state variables is used to characterize the distributed damage in viscoelastic asphalt materials in the form of micro-crack initiation and accumulation. At low temperatures and high deformation rates, micro-cracking is considered as the source of nonlinearity and thus the cause of deviation from linear viscoelastic response. Using a non-associated damage evolution law, the proposed model shows the ability to describe the temperature-dependent processes of micro-crack initiation, evolution and macro-crack formation with good comparison to the material response in the Superpave indirect tensile (IDT) strength test.

Plant closures, precariousness and policy responses:revisiting MG Rover 10 years on

With automotive plants being closed in Australia and western Europe, this article reflects on the employment status of ex-MG Rover (MGR) workers following the closure of the Longbridge plant in 2005. In particular, it draws on Standing's typology of labour market insecurity and uses a mixed-methods approach including an analysis of a longitudinal survey of some 200 ex-MGR workers, and in-depth interviews with ex-workers and policy-makers. While the policy response to the closure saw significant successes in terms of the great majority of workers successfully adjusting into re-employment, and with positive findings in terms of re-training and education, the paper finds significant challenges in terms of security of employment, income, job quality and representation at work years after closure. In particular, the paper posits that the general lack of attention to employment security at the macrolevel effectively undermined elements of a positive policy response over the longer run. This in turn suggests longer-term policy measures are required to address aspects of precariousness at work.

Combined quality function deployment and logical framework analysis to improve quality of emergency care in Malta

Purpose – The purpose of this paper is to develop an integrated patient-focused analytical framework to improve quality of care in accident and emergency (A&E) unit of a Maltese hospital. Design/methodology/approach – The study adopts a case study approach. First, a thorough literature review has been undertaken to study the various methods of healthcare quality management. Second, a healthcare quality management framework is developed using combined quality function deployment (QFD) and logical framework approach (LFA). Third, the proposed framework is applied to a Maltese hospital to demonstrate its effectiveness. The proposed framework has six steps, commencing with identifying patients’ requirements and concluding with implementing improvement projects. All the steps have been undertaken with the involvement of the concerned stakeholders in the A&E unit of the hospital. Findings – The major and related problems being faced by the hospital under study were overcrowding at A&E and shortage of beds, respectively. The combined framework ensures better A&E services and patient flow. QFD identifies and analyses the issues and challenges of A&E and LFA helps develop project plans for healthcare quality improvement. The important outcomes of implementing the proposed quality improvement programme are fewer hospital admissions, faster patient flow, expert triage and shorter waiting times at the A&E unit. Increased emergency consultant cover and faster first significant medical encounter were required to start addressing the problems effectively. Overall, the combined QFD and LFA method is effective to address quality of care in A&E unit. Practical/implications – The proposed framework can be easily integrated within any healthcare unit, as well as within entire healthcare systems, due to its flexible and user-friendly approach. It could be part of Six Sigma and other quality initiatives. Originality/value – Although QFD has been extensively deployed in healthcare setup to improve quality of care, very little has been researched on combining QFD and LFA in order to identify issues, prioritise them, derive improvement measures and implement improvement projects. Additionally, there is no research on QFD application in A&E. This paper bridges these gaps. Moreover, very little has been written on the Maltese health care system. Therefore, this study contributes demonstration of quality of emergency care in Malta.

Resisting the final word:challenging stale media and policy representations of students’ performative technological encounters in university education

This article explores powerful, constraining representations of encounters between digital technologies and the bodies of students and teachers, using corpus-based Critical Discourse Analysis (CDA). It discusses examples from a corpus of UK Higher Education (HE) policy documents, and considers how confronting such documents may strengthen arguments from educators against narrow representations of an automatically enhanced learning. Examples reveal that a promise of enhanced ‘student experience’ through information and communication technologies internalizes the ideological constructs of technology and policy makers, to reinforce a primary logic of exchange value. The identified dominant discursive patterns are closely linked to the Californian ideology. By exposing these texts, they provide a form of ‘linguistic resistance’ for educators to disrupt powerful processes that serve the interests of a neoliberal social imaginary. To mine this current crisis of education, the authors introduce productive links between a Networked Learning approach and a posthumanist perspective. The Networked Learning approach emphasises conscious choices between political alternatives, which in turn could help us reconsider ways we write about digital technologies in policy. Then, based on the works of Haraway, Hayles, and Wark, a posthumanist perspective places human digital learning encounters at the juncture of non-humans and politics. Connections between the Networked Learning approach and the posthumanist perspective are necessary in order to replace a discourse of (mis)representations with a more performative view towards the digital human body, which then becomes situated at the centre of teaching and learning. In practice, however, establishing these connections is much more complex than resorting to the typically straightforward common sense discourse encountered in the Critical Discourse Analysis, and this may yet limit practical applications of this research in policy making.

The MG Rover closure and policy response: an evaluation of the Task Force model in the UK

In recent years there have been a number of high-profile plant closures in the UK. In several cases, the policy response has included setting up a task force to deal with the impacts of the closure. It can be hypothesised that task force involving multi-level working across territorial boundaries and tiers of government is crucial to devising a policy response tailored to people's needs and to ensuring success in dealing with the immediate impacts of a closure. This suggests that leadership, and vision, partnership working and community engagement, and delivery of high quality services are important. This paper looks at the case of the MG Rover closure in 2005, to examine the extent to which the policy response to the closure at the national, regional and local levels dealt effectively with the immediate impacts of the closure, and the lessons that can be learned from the experience. Such lessons are of particular relevance given the closure of the LDV van plant in Birmingham in 2009 and more broadly – such as in the case of the downsizing of the Opel operation in Europe following its takeover by Magna.

A conceptual framework of accounting policy choice under SSAP 20

Purpose - To provide a framework of accounting policy choice associated with the timing of adoption of the UK Statement of Standard Accounting Practice (SSAP) No. 20, "Foreign Currency Translation". The conceptual framework describes the accounting policy choices that firms face in a setting that is influenced by: their financial characteristics; the flexible foreign exchange rates; and the stock market response to accounting decisions. Design/methodology/approach - Following the positive accounting theory context, this paper puts into a framework the motives and choices of UK firms with regard to the adoption or deferment of the adoption of SSAP 20. The paper utilises the theoretical and empirical findings of previous studies to form and substantiate the conceptual framework. Given the UK foreign exchange setting, the framework identifies the initial stage: lack of regulation and flexibility in financial reporting; the intermediate stage: accounting policy choice; and the final stage: accounting choice and policy review. Findings - There are situations where accounting regulation contrasts with the needs and business objectives of firms and vice-versa. Thus, firms may delay the adoption up to the point where the increase in political costs can just be tolerated. Overall, the study infers that firms might have chosen to defer the adoption of SSAP 20 until they reach a certain corporate goal, or the adverse impact (if any) of the accounting change on firms' financial numbers is minimal. Thus, the determination of the timing of the adoption is a matter which is subject to the objectives of the managers in association with the market and economic conditions. The paper suggests that the flexibility in financial reporting, which may enhance the scope for income-smoothing, can be mitigated by the appropriate standardisation of accounting practice. Research limitations/implications - First, the study encompassed a period when firms and investors were less sophisticated users of financial information. Second, it is difficult to ascertain the decisions that firms would have taken, had the pound appreciated over the period of adoption and had the firms incurred translation losses rather than translation gains. Originality/value - This paper is useful to accounting standards setters, professional accountants, academics and investors. The study can give the accounting standard-setting bodies useful information when they prepare a change in the accounting regulation or set an appropriate date for the implementation of an accounting standard. The paper provides significant insight about the behaviour of firms and the associated impacts of financial markets and regulation on the decision-making process of firms. The framework aims to assist the market and other authorities to reduce information asymmetry and to reinforce the efficiency of the market. © Emerald Group Publishing Limited.

Political parties and public policy in the German Länder:when parties matter

When Parties Matter looks at the extent to which political parties can make a difference to public policy, focusing on the regional level in Germany. Politicians of the left and the right sometimes have radically different views, but inevitably the combined forces of legal and financial constraints, bureaucracy, public expectations and the 'weight of history' restrict their ability to translate political disagreement into policy change. Giving a detailed examination of education policy, childcare and family policy, and labour market policy in three German regions between 1999 and 2006, this book provides insights into what politicians can and cannot achieve, in particular at the level below the nation-state.