Research Governance Framework for Health and Social Care (PDF 351 KB)

This document sets out a framework for the governance of research conducted by or on behalf of the Health & Personal Social Services (HPSS)

Innovation and absorptive capacity: What is the role of technological frontier?

This paper explores how absorptive capacity affects the innovative performance and productivity dynamics of Spanish firms. A firm’s efficiency levels are measured using two variables: the labour productivity and the Total Factor Productivity (TFP). The theoretical framework is based on the seminal contributions of Cohen and Levinthal (1989, 1990) regarding absorptive capacity; and the applied framework is based on the four-stage structural model proposed by Crépon, Duguet and Mairesse (1998) for setting the determinants of R&D, the effects of R&D activities on innovation outputs, and the impacts of innovation on firm productivity. The present study uses a twostage structural model. In the first stage, a probit estimation is used to investigate how the sources of R&D, the absorptive capacity and a vector of the firm’s individual features influence the firm’s likelihood of developing innovations in products or processes. In the second phase, a quantile regression is used to analyze the effect of R&D sources, absorptive capacity and firm characteristics on productivity. This method shows the elasticity of each exogenous variable on productivity according to the firms’ levels of efficiency, and thus allows us to distinguish between firms that are close to the technological frontier and those that are further away from it. We used extensive firm-level panel data from 5,575 firms for the 2004-2009 period. The results show that the internal absorptive capacity has a strong impact on the productivity of firms, whereas the role of external absorptive capacity differs according to nature of the each industry and according the distance of firms from the technological frontier. Key words: R&D sources, innovation strategies, absorptive capacity, technological distance, quantile regression.

The Innovation and Imitation Dichotomy in Spanish firms: do absorptive capacity and the technological frontier matter?

This paper analyses whether a firm’s absorptive capacity and its distance from the technological frontier affect the choice between innovation and imitation in innovative Spanish firms. From an extensive survey of 5,575 firms during the 2004-2009 period, we found two significant results. With regard to the role of absorptive capacity, the empirical evidence shows that when innovative firms have difficulties in accessing external information and hire skilled workers, their innovative capacity is reduced. Meanwhile, with regard to distance from the technological frontier, the firms that reduce this gap manage to increase their innovative capacity at the expense of imitation. To summarise, when we studied firms’ absorptive capacity and their relative position to the technological frontier in tandem, we found that the two factors directly affected firms' ability to innovate or imitate. Key words: R&D sources, innovation and imitation strategies, absorptive capacity, technological frontier, ordered probit.

RQIA Governance Review of Northern Ireland Breast Screening Programme (PDF 700 KB)

RQIA Governance Review of the Northern Ireland Breast Screening Programme (March 2006)

Proliferation capacity and cytotoxic activity are mediated by functionally and phenotypically distinct virus-specific CD8 T cells defined by interleukin-7R{alpha} (CD127) and perforin expression.

Cytotoxicity and proliferation capacity are key functions of antiviral CD8 T cells. In the present study, we investigated a series of markers to define these functions in virus-specific CD8 T cells. We provide evidence that there is a lack of coexpression of perforin and CD127 in human CD8 T cells. CD127 expression on virus-specific CD8 T cells correlated positively with proliferation capacity and negatively with perforin expression and cytotoxicity. Influenza virus-, cytomegalovirus-, and Epstein-Barr virus/human immunodeficiency virus type 1-specific CD8 T cells were predominantly composed of CD127(+) perforin(-)/CD127(-) perforin(+), and CD127(-)/perforin(-) CD8 T cells, respectively. CD127(-)/perforin(-) and CD127(-)/perforin(+) cells expressed significantly more PD-1 and CD57, respectively. Consistently, intracellular cytokine (gamma interferon, tumor necrosis factor alpha, and interleukin-2 [IL-2]) responses combined to perforin detection confirmed that virus-specific CD8 T cells were mostly composed of either perforin(+)/IL-2(-) or perforin(-)/IL-2(+) cells. In addition, perforin expression and IL-2 secretion were negatively correlated in virus-specific CD8 T cells (P < 0.01). As previously shown for perforin, changes in antigen exposure modulated also CD127 expression. Based on the above results, proliferating (CD127(+)/IL-2-secreting) and cytotoxic (perforin(+)) CD8 T cells were contained within phenotypically distinct T-cell populations at different stages of activation or differentiation and showed different levels of exhaustion and senescence. Furthermore, the composition of proliferating and cytotoxic CD8 T cells for a given antiviral CD8 T-cell population appeared to be influenced by antigen exposure. These results advance our understanding of the relationship between cytotoxicity, proliferation capacity, the levels of senescence and exhaustion, and antigen exposure of antiviral memory CD8 T cells.

Long-term health-related quality of life and walking capacity of lung recipients with and without bronchiolitis obliterans syndrome.

BACKGROUND: Outcome after lung transplantation (LTx) is affected by the onset of bronchiolitis obliterans syndrome (BOS) and lung function decline. Reduced health-related quality of life (HRQL) and physical mobility have been shown in patients developing BOS, but the impact on the capacity to walk is unknown. We aimed to compare the long-term HRQL and 6-minute walk test (6MWT) between lung recipients affected or not by BOS Grade > or =2. METHODS: Fifty-eight patients were prospectively followed for 5.6 +/- 2.9 years after LTx. Assessments included the St George's Respiratory Questionnaire (SGRQ) and the 6MWT, which were performed yearly. Moreover, clinical complications were recorded to estimate the proportion of the follow-up time lived without clinical intercurrences after transplant. Analyses were performed using adjusted linear regression and repeated-measures analysis of variance. RESULTS: BOS was a significant predictor of lower SGRQ scores (p < 0.01) and reduced time free of clinical complications (p = 0.001), but not of 6MWT distance (p = 0.12). At 7 years post-transplant, results were: 69.0 +/- 21.8% vs 86.9 +/- 5.6%, p < 0.05 (SGRQ); 58.5 +/- 21.6% vs 88.7 +/- 11.4%, p < 0.01 (proportion of time lived without clinical complications); and 82.2 +/- 10.9% vs 91.9 +/- 14.2%, p = 0.27 (percent of predicted 6MWT), respectively, for patients with BOS and without BOS. CONCLUSIONS: Despite significantly less time lived without clinical complications and progressive decline of self-reported health status, the capacity to walk of patients affected by BOS remained relatively stable over time. These findings may indicate that the development of moderate to severe BOS does not prevent lung recipients from walking independently and pursuing an autonomous life.

Acute Hospital Bed Capacity - A National Review

The Programme for Prosperity and Fairness outlined the commitment of the Government to a review of hospital bed capacity in both acute and non-acute settings, to be carried out by the Department of Health and Children in conjunction with the Department of Finance and in consultation with the Social Partners. The focus of this report is on bed capacity in publicly-funded acute hospitals in Ireland. The capacity needs of the sub-acute sector have been assessed separately in the context of the Health Strategy, Quality and Fairness: A Health System for You. Download document here

Replacement therapy for iron deficiency improves exercise capacity and quality of life in patients with cyanotic congenital heart disease and/or the Eisenmenger syndrome

La teràpia suplementària de ferro millora la capacitat d’exercici i la qualitat de vida en malalts amb una cardiopatia congènita cianòtica i/ o síndrome d’Eisenmenger El dèficit de ferro és una troballa comú en la cardiopatia congènita cianòtica, i pot ser la causa d’una reducció en la capacitat d’exercici. Actualment, està indicada la reposició dels dipòsits de ferro en aquest grup de malalts, éssent les evidències científiques escasses. En el present treball investiguem la seguretat i eficàcia del tractament amb ferro en malalts amb una cardiopatia congènita cianòtica. Per tal motiu, vint-i-cinc malalts amb una cardiopatia congenita cianòtica i dèficit de ferro van ser inclosos de forma prospectiva entre Agost del 2008 i Gener del 2009. El tractament utilitzat fou fumarat ferròs oral, fins a una dosi màxima de 200 mg tres vegades al dia. En l’anàlisi basal i als tres mesos de seguiment es va utilitzar el test de qualitat de vida “CAMPHOR”, el test de la marxa dels 6 minuts i la prova d’esforç amb consum d’oxigen. L’edat mitja fou 39.9+/-10.9 anys, 80% dones. Catorze malalts tenien la síndrome d’Eisenmenger, sis una malaltia cianòtica complexa i cinc circulació de Fontan. Cap d’ells va haver d'interrompre el tractament degut a efectes adversos. Després de tres mesos de tractament, l’hemoglobina (19.0+/-2.9g/dL a 20.4+/-2.7g/dL, p&0.001), ferritina (13.3+/-4.7mug/L a 54.1+/-24.2mug/L, p&0.001) i saturació de transferrina (17.8+/-9.6% a 34.8+/-23.4%, p&0.001) van augmentar significativament. També hi va haver una millora significativa en la puntuació del test de qualitat de vida (20.7+/-10.9 a 16.2+/-10.4, p=0.001) i el test de la marxa (371.7+/-84.7m a 402.8.0+/-74.9m, p=0.001). No es van evidenciar canvis significatius en els valors de consum d’oxigen (40.7+/-9.2% a 43.8+/-12.4%, p=0.15). En definitiva, la teràpia suplementària amb ferro en els malats amb una cardiopatia congènita cianòtica i dèficit de ferro és segura i millora la qualitat de vida i la capacitat funcional. En aquest grup de malalts, per tant, és aconsellable identificar el dèficit de ferro i restaurar-ne els seus dipòsits.

Review of governance and accountability mechanisms in the General Medical Services schemes

Click here to download PDF

Governance von Universitätsbibliotheken : Optimierungsmöglichkeiten aus institutioneller Sicht

Ausgangspunkt der Arbeit bildet die Beobachtung, dass Universitäts­biblio­theken unterschiedliche Aufgaben zu Händen verschiedener Akteure erfüllen - so nehmen Universitätsbibliotheken in der Schweiz häufig Aufgaben einer Kantonsbibliothek wahr. Universitätsbibliotheken zeichnen sich durch unterschiedliche Rechts- und Organisationsformen aus, unterhalten Beziehungen zu Dritten und sind deshalb verschiedenen Instanzen zur Rechenschaft verpflichtet. Sie sind, schliesslich, in Zusammenschlüsse unterschiedlicher Natur eingebunden. Vor diesem Hintergrund wirft die vorliegende Arbeit die Frage nach der Steuerung des Unternehmens Universitätsbibliothek auf. Anhand ausgewählter Fallbeispiele wird aufgezeigt, wie sich unterschiedliche Governance-Modelle gestalten. Dabei wird insbesondere auf die Rechts- und Organisationsform, auf institutionelle Strukturen, auf Steuerungsinstrumente (Auftrag und finanzielle Rahmenbedingungen), auf institutionelle Beziehungen sowie auf die Autonomie der Bibliothek eingegangen. Darauf auf­bau­end werden Vor- und Nachteile der Modelle hinsichtlich der Erfüllung des Doppelauftrags (Universitäts- und Kantonsbibliothek) diskutiert. Es zeigt sich, dass Universitäts- und Kantonsauftrag komplementäre Funktionen darstellen, wobei allerdings vereinzelt Schwierigkeiten auftreten können. Die Rechts- und Organisationsform sowie, insbesondere, die Trägerschaft bilden ein zentrales Element im Hinblick auf die Auftragserfüllung. Gleichzeitig sind auch weitere Elemente zentral, beispielsweise Instrumente, welche nicht nur die Aufgaben, sondern die Zuständigkeiten der beteiligten Akteure festhalten. Parmi les nombreuses fonctions remplies par les bibliothèques universitaires en Suisse, celle de bibliothèque cantonale est la plus fréquente. Les formes juridiques et/ou d'organisation des bibliothèques universitaires suisses sont multiples ; les bibliothèques entretiennent des liens avec des tiers et elles sont, par conséquent, tenues de rendre des comptes à diverses instances. Comme toutes les bibliothèques, elles s'intègrent, finalement, à des réseaux de nature différente. Dans ce contexte, le présent travail soulève la question de la gouvernance de la bibliothèque universitaire. Il décrit, à partir d'exemples choisis, différents modèles de gouvernance en s'intéressant surtout à la forme juridique et/ou d'organisation, aux structures institutionnelles, aux instruments de gouvernance concernant la mission et les conditions cadres financières de la bibliothèque, aux relations institutionnelles et à l'autonomie de la bibliothèque. L'analyse permet ainsi une réflexion sur les avantages et les inconvénients des différents modèles de gouvernance au vu de la double mission universitaire et cantonale des bibliothèques. Le présent travail montre que les fonctions universitaires et cantonales sont à priori complémentaires et ne donnent lieu qu'à des difficultés mineures. La forme juridique et/ou d'organisation ainsi que l'autorité de tutelle constituent des éléments déterminants pour l'accomplissement de la (double) mission de la bibliothèque. Parallèlement, d'autres éléments jouent également un rôle important - par exemple, les instruments permettant non seulement de régler les tâches de la bibliothèque, mais aussi de déterminer les compétences de tous les acteurs intéressés.

Framework for Corporate and Financial Governance for Regulatory Bodies under the aegis of the Department of Health and Children

The document should be read as supplementary to existing requirements as set out both in statute â?" particularly legislation specific to your organisation, the Health Acts 1947-2004, Ombudsman Act, 1980, Data Protection Acts 1988 & 2003, Freedom of Information Acts 1997-2003, Ethics in Public Office Acts 1995 & 2001, Ombudsman for Children Act, 2002 and the Comptroller and Auditor General (Amendment) Act, 1993 – and in Government approved guidelines, including the Code of Practice for the Governance of State Bodies (2001), Public Financial Procedures, The Role and Responsibilities of Accounting Officers (2003) and Risk Management Guidance for Government Departments and Offices (2004). Read the report (PDF, 1.4mb)  

Framework for Corporate and Financial Governance for Agencies funded by the Department of Health and Children

Corporate governance is the system by which organisations direct and control their functions and relate to their stakeholders in order to manage their business, achieve their mission and objectives and meet the necessary standards of accountability, integrity and propriety. It is a key element in improving efficiency and accountability as well as enhancing openness and transparency. A significant element of the Governmentâ?Ts programme for health service reform is the strengthening of governance and accountability arrangements across the health system. Read the Report (PDF, 1mb)