The importance of environmental sustainability in public procurement of medical devices in health care sector

The aim of this thesis was to examine the role of environmental sustainability in the procurement of medical devices in health care sector. Current literature is mainly focused on other product groups and medical devices have been left without sufficient attention. Nevertheless, EU has recently developed green public procurement criteria for medical devices (EU GPP criteria for health care EEE) in order to support and offer guidelines for purchasers in hospitals. In this study, the criteria were used as a framework in order to examine the most significant environmental aspects for medical devices. The empirical research was executed in Finnish public hospitals with mixed method approach; quantitative data was collected by a survey and qualitative data was collected by interviews held for procurement specialists. The focus was on understanding the importance of environmental sustainability in the procurement of medical devices and which environmentally sustainable features would be the most significant. Of interest was also the medical device supplier view and how they could take environmental sustainability into consideration.

Investigating bias in recreational fishing surveys: Fishers listed in public telephone directories fish similarly to their unlisted counterparts

Several recent offsite recreational fishing surveys have used public landline telephone directories as a sampling frame. Sampling biases inherent in this method are recognised, but are assumed to be corrected through demographic data expansion. However, the rising prevalence of mobile-only households has potentially increased these biases by skewing raw samples towards households that maintain relatively high levels of coverage in telephone directories. For biases to be corrected through demographic expansion, both the fishing participation rate and fishing activity must be similar among listed and unlisted fishers within each demographic group. In this study, we tested for a difference in the fishing activity of listed and unlisted fishers within demographic groups by comparing their avidity (number of fishing trips per year), as well as the platform used (boat or shore) and species targeted on their most recent fishing trip. 3062 recreational fishers were interviewed at 34 tackle stores across 12 residential regions of Queensland, Australia. For each fisher, data collected included their fishing avidity, the platform used and species targeted on their most recent trip, their gender, age, residential region, and whether their household had a listed telephone number. Although the most avid fishers were younger and less likely to have a listed phone number, cumulative link models revealed that avidity was not affected by an interaction of phone listing status, age group and residential region (p > 0.05). Likewise, binomial generalized linear models revealed that there was no interaction between phone listing, age group and avidity acting on platform (p > 0.05), and platform was not affected by an interaction of phone listing status, age group, and residential region (p > 0.05). Ordination of target species using Bray-Curtis dissimilarity indices found a significant but irrelevant difference (i.e. small effect size) between listed and unlisted fishers (ANOSIM R < 0.05, p < 0.05). These results suggest that, at this time, the fishing activity of listed and unlisted fishers in Queensland is similar within demographic groups. Future research seeking to validate the assumptions of recreational fishing telephone surveys should investigate fishing participation rates of listed and unlisted fishers within demographic groups.

Methods matter: computational modelling in public health policy and planning

This work is aimed at understanding and unifying information on epidemiological modelling methods and how those methods relate to public policy addressing human health, specifically in the context of infectious disease prevention, pandemic planning, and health behaviour change. This thesis employs multiple qualitative and quantitative methods, and presents as a manuscript of several individual, data-driven projects that are combined in a narrative arc. The first chapter introduces the scope and complexity of this interdisciplinary undertaking, describing several topical intersections of importance. The second chapter begins the presentation of original data, and describes in detail two exercises in computational epidemiological modelling pertinent to pandemic influenza planning and policy, and progresses in the next chapter to present additional original data on how the confidence of the public in modelling methodology may have an effect on their planned health behaviour change as recommended in public health policy. The thesis narrative continues in the final data-driven chapter to describe how health policymakers use modelling methods and scientific evidence to inform and construct health policies for the prevention of infectious diseases, and concludes with a narrative chapter that evaluates the breadth of this data and recommends strategies for the optimal use of modelling methodologies when informing public health policy in applied public health scenarios.

Usability and Security in Medication. Administration Applications

The traditional process of filling the medicine trays and dispensing the medicines to the patients in the hospitals is manually done by reading the printed paper medicinechart. This process can be very strenuous and error-prone, given the number of sub-tasksinvolved in the entire workflow and the dynamic nature of the work environment.Therefore, efforts are being made to digitalise the medication dispensation process byintroducing a mobile application called Smart Dosing application. The introduction ofthe Smart Dosing application into hospital workflow raises security concerns and callsfor security requirement analysis. This thesis is written as a part of the smart medication management project at EmbeddedSystems Laboratory, A˚bo Akademi University. The project aims at digitising the medicine dispensation process by integrating information from various health systems, and making them available through the Smart Dosing application. This application is intended to be used on a tablet computer which will be incorporated on the medicine tray. The smart medication management system include the medicine tray, the tablet device, and the medicine cups with the cup holders. Introducing the Smart Dosing application should not interfere with the existing process carried out by the nurses, and it should result in minimum modifications to the tray design and the workflow. The re-designing of the tray would include integrating the device running the application into the tray in a manner that the users find it convenient and make less errors while using it. The main objective of this thesis is to enhance the security of the hospital medicine dispensation process by ensuring the security of the Smart Dosing application at various levels. The methods used for writing this thesis was to analyse how the tray design, and the application user interface design can help prevent errors and what secure technology choices have to be made before starting the development of the next prototype of the Smart Dosing application. The thesis first understands the context of the use of the application, the end-users and their needs, and the errors made in everyday medication dispensation workflow by continuous discussions with the nursing researchers. The thesis then gains insight to the vulnerabilities, threats and risks of using mobile application in hospital medication dispensation process. The resulting list of security requirements was made by analysing the previously built prototype of the Smart Dosing application, continuous interactive discussions with the nursing researchers, and an exhaustive state-of-the-art study on security risks of using mobile applications in hospital context. The thesis also uses Octave Allegro method to make the readers understand the likelihood and impact of threats, and what steps should be taken to prevent or fix them. The security requirements obtained, as a result, are a starting point for the developers of the next iteration of the prototype for the Smart Dosing application.

Regional Workshop for designers monitors responsible for training programs for staff in public and school libraries

In Bogota, from 22 to 26 September 1980 a Seminar Workshop on Education and Training of Personnel in the organization and management of school libraries, sponsored by UNESCO, CERLAL, SECAB and the National Ministry of Colombia. The meeting reiterated that one of the weaknesses of library services is the lack of qualified personnel. As an immediate action is decided to set up a working group composed of experts from those agencies that have had experiences in the field of personnel training, such as Colombia, Venezuela and Costa Rica.

Representativeness, legitimacy and power in public involvement in health-care management

Public participation in health-service management is an increasingly prominent policy internationally. Frequently, though, academic studies have found it marginalized by health professionals who, keen to retain control over decision-making, undermine the legitimacy of involved members of the public, in particular by questioning their representativeness. This paper examines this negotiation of representative legitimacy between staff and involved users by drawing on a qualitative study of service-user involvement in pilot cancer-genetics services recently introduced in England, using interviews, participant observation and documentary analysis. In contrast to the findings of much of the literature, health professionals identified some degree of representative legitimacy in the contributions made by users. However, the ways in which staff and users constructed representativeness diverged significantly. Where staff valued the identities of users as biomedical and lay subjects, users themselves described the legitimacy of their contribution in more expansive terms of knowledge and citizenship. My analysis seeks to show how disputes over representativeness relate not just to a struggle for power according to contrasting group interests, but also to a substantive divergence in understanding of the nature of representativeness in the context of state-orchestrated efforts to increase public participation. This divergence might suggest problems with the enactment of such aspirations in practice; alternatively, however, contestation of representative legitimacy might be understood as reflecting ambiguities in policy-level objectives for participation, which secure implementation by accommodating the divergent constructions of those charged with putting initiatives into practice.

Public and user participation in public service delivery: tensions in policy and practice

Social-scientific analysis of public-participation initiatives has proliferated in recent years. This review article discusses some key aspects of recent work. Firstly, it analyses some of the justifications put forward for public participation, drawing attention to differences and overlaps between rationales premised on democratic representation/representativeness and those based on more technocratic ideas about the knowledge that the public can offer. Secondly, it considers certain tensions in policy discourses on participation, focusing in particular on policy relating to the National Health Service and other British public services. Thirdly, it examines the challenges of putting a coherent vision for public participation into practice, noting the impediments that derive from the often-competing ideas about the remit of participation held by different groups of stakeholders. Finally, it analyses the gap between policy and practice, and the consequences of this for the prospects for the enactment of active citizenship through participation initiatives.

Hospital Staff Perceptions of Health Promotion Activities in Public Hospitals

The aim of this study was to determine the level of staff support for health promotion activities in Queensland public hospitals.

Barriers to health promotion activities in public hospitals

Despite the central role hospitals have in the health care system, relatively few health promotion activities are conducted in Australian public hospitals. This study investigated the types of obstacles that were perceived to inhibit health promotion activities in hospitals. A questionnaire for self-completion was sent to medical superintendents in all public hospitals in Queensland and 112 questionnaires were returned (92.6 per cent response rate). The results indicated that lack of finance, lack of interest by relevant others, and needs (for appropriate programs, training and patient receptivity) were the barriers reported by superintendents. The barriers of 'interest' and 'needs' were related to a lack of written policies in some areas, but not directly to levels of other health promotion activities being conducted in the hospitals. Success in facilitating health promotion programs in hospitals will need to include a change in the environment, in particular the views of medical superintendents. The combination of attitude change and the availability of a motivated person (such as a health promotion officer) to lead the activities may be needed in order to produce an increase in the level of health promotion in public hospitals. Article in Australian and New Zealand Journal of Public Health 20(5):500-4 · November 1996

Risk definition and the struggle for legitimation: a case study of Bt cotton in Andhra Pradesh, India

This article explores the struggle for legitimation associated with the attempt to define the risk of Bt cotton, a genetically modified crop, in Andhra Pradesh, India. Beck asserts that, given the uncertainty associated with risk society, efforts to define risk are creating the need for a new political culture. This article argues that this political culture emerges from attempts to legitimate power within risk definition. This is examined using critical discourse analysis on interview excerpts with key figures in the Bt cotton debate. Legitimation is explored using the categories of legitimation developed by Van Leeuwen. These are (a) authorisation; (b) moral evaluation; (c) rationalisation; and (d) mythopoesis. The analysis highlights that the political culture which emerges in response to risk society is in a state of constant flux and contingent upon the ongoing struggle for legitimation with regard to the definition of risk.

Diagnosis of Student’s Attitudes towards Mathematics in the First Year of Three Graduate Programs in Business Administration

The objective of this research was to determine the student’s attitudes towards Mathematics at the beginning of their graduate studies in Business Administration. The study used an exploratory, non-experimental, cross-sectional design. The instrument used was a questionnaire based on willingness, confidence, utility, motivation and anxiety with Likert questions. The study concluded that students have a negative attitude towards Mathematics; it is considered as a useful but difficult discipline and, for that reason, students show anxiety and lack of confidence when applying mathematical procedures.

From Deep North to international governance exemplar : Fitzgerald's impact on the international anti-corruption movement

In pre-Fitzgerald Queensland, the existence of corruption was widely known but its extent and modes of operation were not fully evident. The Fitzgerald Report identified the need for reform of the structure, procedures and efficiency in public administration in Queensland. What was most striking in the Queensland reform process was that a new model for combatting corruption had been developed. Rather than rely upon a single law and a single institution, existing institutions were strengthened and new institutions were introduced to create a set of mutually supporting and mutually checking institutions, agencies and laws that jointly sought to improve governmental standards and combat corruption. Some of the reforms were either unique to Queensland or very rare. One of the strengths of this approach was that it avoided creating a single over-arching institution to fight corruption. There are many powerful opponents of reform. Influential institutions and individuals resist any interference with their privileges. In order to cause a mass exodus from an entrenched corruption system, a seminal event or defining process is needed to alter expectations and incentives that are sufficient to encourage significant numbers of individuals to desert the corruption system and assist the integrity system in exposing and destroying it. The Fitzgerald Inquiry was such an event. This article also briefly addresses methods for destroying national corruption systems where they emerge and exist.

From deep North to global governance exemplar : Fitzgerald's impact on the International Anti-corruption Movement

In pre-Fitzgerald Queensland, the existence of corruption was widely known but its extent and modes of operation were not fully evident. The Fitzgerald Report identified the need for reform of the structure, procedures and efficiency in public administration in Queensland. What was most striking in the Queensland reform process was that a new model for combating corruption had been developed. Rather than rely upon a single law and a single institution, existing institutions were strengthened and new institutions were instituted to create a set of mutually supporting and mutually checking institutions, agencies and laws that jointly sought to improve governmental standards and combat corruption. Some of the reforms were either unique to Queensland or very rare. One of the strengths of this approach was that it avoided creating a single overarching institution to fight corruption. There are many powerful opponents of reform. Influential institutions and individuals resist any interference with their privileges. In order to cause a mass exodus from an entrenched corruption system, a seminal event or defining process is needed to alter expectations and incentives that are sufficient to encourage significant numbers of individuals to desert the corruption system and assist the integrity system in exposing and destroying it. The Fitzgerald Inquiry was such an event. The article also briefly addresses methods for destroying national corruption system where they emerge and exist.

Las reformas económicas y la modernización del Estado

Resumen: El presente artículo trata conjuntamente acerca de los contenidos y la estrategia para la Modernización del Estado que se desprende de las recientes experiencias en cuanto a la aplicación de las Reformas Económicas de los años 80s y 90s, como así también de los últimos desarrollos de nuevas áreas de investigación como la Economía Institucional y la Teoría del Capital Social. Desde este punto de vista para diseñar una Estrategia de Modernización del Estado es esencial una visión estratégica de las actividades que el Estado debe realizar, delegar o incentivar. Asimismo las orientaciones fundamentales pasan por la existencia de consensos sobre políticas de largo plazo, la independencia del funcionamiento, un correcto diseño de reglas en lugar de conductas discrecionales, un balance entre subsidiariedad y participación, el logro de la excelencia de la función pública y de la lucha contra la corrupción.