Public Procurement Law and Health care: From Theory to Practice. Research Paper in Law, 2/2010

From the Introduction. This contribution will focus on the core question if, how and to what extent the EU procurement rules and principles (may) affect the national health care systems. We start our analysis by summarizing the applicable EU public procurement legislation, principles and soft law and its exact scope in relation to health care. (section 2). Subsequently, we turn to the parties in a contract, subject to procurement rules in the field of health care, addressing both the definition of contracting authorities and relevant case law (section 3). This will then lead to an analysis of possible justifications for not holding a tender procedure in the field of health care (section 4). Finally, we illustrate the impact of EU public procurement rules on health care by analysing a Dutch case study, in which the question whether public hospitals in the Netherlands qualify as contracting authorities in terms of the Public Sector Directive stood central (section 5). Our conclusions will follow in section 6.

Promoting better use of the PSA test in general practice: Randomized controlled trial of educational strategies based on outreach visits and mailout

Background. Prostate-specific antigen (PSA) testing for prostate cancer is controversial. Demand for PSA testing is likely to rise in the UK, Australia and other western countries. Primary care needs to develop appropriate strategies to respond to this demand. Objectives. Our aim was to compare the effectiveness of educational outreach visits (EOVs) and mailout strategies targeting PSA testing in Australian primary care. Methods. A randomized controlled trial was conducted in general practices in southern Adelaide. The main outcome measures at baseline, 6 months and 12 months post-intervention were PSA testing rates and GP knowledge in key areas relating to prostate cancer and PSA testing. Results. The interventions were able to demonstrate a change in clinical practice. In the 6 months post-intervention, median PSA testing rate in the EOV group was significantly lower than in the postal group, which in turn was significantly lower than the control group (P < 0.001). Statistically significant differences were not, however, maintained in the 6-12 month post-intervention period. The EOV group, at 6 months follow-up, had a significantly greater proportion of 'correct' responses than the control group to questions about prostate cancer treatment effectiveness (P = 0.004) and endorsement of PSA screening by professional bodies (P = 0.041). Conclusions. Primary care has a central role in PSA testing for prostate cancer. Clinical practice in this area is receptive to evidence-based interventions.

Hegemony, Institutionalism and US Foreign Policy: theory and practice in comparative historical perspective

This paper explores the theoretical and policy implications of contemporary American hegemony. A key argument is that the development of US hegemony generally, and the distinctive turn in US foreign policy that has occurred in the wake of 11 September in particular, can best be understood by placing recent events in a comparative and historical framework. The immediate post-World War II order laid the foundations of a highly institutionalised multilateral system that provided key benefits for a number of countries while simultaneously constraining and enhancing US power. An historical reading of US hegemony suggests that its recent unilateralism is undermining the foundations of its power and influence.

Articulating discursive and materialist conceptions of practice in the logics approach to critical policy analysis

In this article it is argued that while Glynos and Howarth’s logics of critical explanation (LCE) offers an important and promising contribution to critical policy analysis, it, along with other approaches that focus on the meaning of social action, faces a growing challenge in the form of a so-called new materialist turn in social and political theory. The article argues that there is much to be gained for the logics approach in paying closer attention to the materiality of practices in terms not only of lending greater clarity to the conception and role of social practices in the logics approach but also in enabling it fully to deliver on its critical ambition. The article explores an alternative materialist approach to the study of social practices, which hails from the post-actor–networktheory tradition and which has ontological affinities with post-structuralism. The article begins with a brief analysis of the new materialist turn in its various guises. It then critically examines the logics approach, and, in particular its conception of practice. It then explores an alternative materialist and ethnographic reading of practice, focusing on medical and care practices. It concludes with an examination of the implications for a more materialist conception of practices for the LCE’s broad deconstructive, psychoanalytic and onto-political ambitions.

The role of meetings in the social practice of strategy

This article addresses the recent turn in strategy research to practice-based theorizing. Based on a data set of 51 meeting observations, the article examines how strategy meetings are involved in either stabilizing existing strategic orientations or proposing variations that cumulatively generate change in strategic orientations. Eleven significant structuring characteristics of strategy meetings are identified and examined with regard to their potential for stabilizing or destabilizing existing strategic orientations. Based on a taxonomy of meeting structures, we explain three typical evolutionary paths through which variations emerge, are maintained and developed, and are selected or de-selected. The findings make four main contributions. First, they contribute to the literature on strategy-as-practice by explaining how the practice of meetings is related to consequential strategic outcomes. Second, they contribute to the literature on organizational becoming by demonstrating the role of meetings in shaping stability and change. Third, they extend and elaborate the concept of meetings as strategic episodes. Fourth, they contribute to the literature on garbage can models of strategy-making.

Focus group method and methodology:current practice and recent debate

This paper considers the contemporary use of focus groups as a method of data collection within qualitative research settings. The authors draw upon their own experiences of using focus groups in educational and 'community' user-group environments in order to provide an overview of recent issues and debates surrounding the deployment of focus group methods and to pick out specific areas of contention in relation to both their epistemological and practical implications. Accordingly, the paper reflects on some of the realities of 'doing' focus groups whilst, at the same time, highlighting common problems and dilemmas which beginning researchers might encounter in their application. In turn, the paper raises a number of related issues around which there appears to have been a lack of academic discussion to date.

Servitization: academic research and business practice

En los últimos años, la servitización de la manufactura ha llegado a ser un tópico de interés tanto a nivel académico como empresarial. Así, las empresas están contemplando que la servitización es una forma de mejorar su posición competitiva y estar más cerca de sus clientes. Diferentes estudios empíricos han intentado explicar por qué y cómo se servitiza. Facilitan información clave para entender mejor el proceso de servitización. La conexión entre la academia y la práctica empresarial es decisiva en los fundamentos de este tópico de investigación. La fundamentación del mismo, permitirá continuar con su desarrollo y a la puesta en práctica en las empresas. Así, este número especial pretende contribuir en el avance de la teoría y práctica de la servitización. In recent years, the servitization of manufacturing has become a topic of interest to both academics and practitioners. Indeed, companies are realising that servitization is a way to enhance their competitive advantage and get closer to their customers. Several empirical studies have attempted to explain why and how to servitize. They provide important insights to better understand the processes of servitization. The connection between academia and business practices is decisive in the foundation of this research topic. This foundation will allow continuing with its development, contributing in turn to improve the implementation in companies. Hence, this special issue aims to contribute to the theoretical and practical aspects of servitization.

Implementing restorative justice practice in schools: what pedagogy reveals

In the ongoing pursuit for creating safe, nurturing and relational school cultures, educators continue to turn to restorative justice (rj) principles and practice. Predominantly, schools begin to engage with rj in an effort to address harm done, causing its discourse to be situated in literature tied to classroom management and behaviour. However, in this location, the effectiveness of rj can be limited because the power relationships underlying the original punitive, managerial structures maintain their grip. Drawing on a qualitative study that examines the experiences of educators committed to implementing rj principles, this article explores how placing rj in the context of engaged, productive pedagogies better nurtures the hoped for relational and peaceful school culture.

Engaging future engineers:pedagogy, policy & practice

Despite being frequently misrepresented as outdated or old fashioned (IMechE, 2009, p1), engineering is increasingly called upon to deal with some of societies biggest challenges including those associated with climate, infrastructure and security. In order to meet such challenges there needs to be a supply of engineering talent able to turn its collective mind to what is required. Yet at a time when demands for engineers able to provide innovative solutions to contemporary problems is possibly at its highest, the profession is plagued by shortages and an inability to attract young people (DIUS, 2008; RAE 2008; NSF, 2009). Although the current situation appears critical, potential future shortages of engineers means that unless action is taken urgently, matters will get worse during the next 20 to 30 years. For higher education, the challenge is how to change young peoples perceptions of engineering in such a manner that it is seen as a worthwhile and rewarding career. This paper considers this challenge, looking in detail at why young people fail to view engineering positively. A theoretical framework outlining the various real-life barriers and drivers is proposed. A critical analysis of current policy and practice suggests that in order to promote engineering as a profession that young people want to enter, both pedagogic and policy grounded solutions need to be found. By bringing together pedagogy and policy within an engineering framework the paper adds to current debates in engineering education whilst providing a distinctive look at what seems to be a recurring problem. © 2009 Authors.

Using protocols in ICU practice. Engaging the staff.

Aims/Purpose: Protocols are evidenced-based structured guides for directing care to achieve improvements. But translating that evidence into practice is a major challenge. It is not acceptable to simply introduce the protocol and expect it to be adopted and lead to change in practice. Implementation requires effective leadership and management. This presentation describes a strategy for implementation that should promote successful adoption and lead to practice change.
Presentation description: There are many social and behavioural change models to assist and guide practice change. Choosing a model to guide implementation is important for providing a framework for action. The change process requires careful thought, from the protocol itself to the policies and politics within the ICU. In this presentation, I discuss a useful pragmatic guide called the 6SQUID (6 Steps in QUality Intervention Development). This was initially designed for public health interventions, but the model has wider applicability and has similarities with other change process models. Steps requiring consideration include examining the purpose and the need for change; the staff that will be affected and the impact on their workload; and the evidence base supporting the protocol. Subsequent steps in the process that the ICU manager should consider are the change mechanism (widespread multi-disciplinary consultation; adapting the protocol to the local ICU); and identifying how to deliver the change mechanism (educational workshops and preparing staff for the changes are imperative). Recognising the barriers to implementation and change and addressing these locally is also important. Once the protocol has been implemented, there is generally a learning curve before it becomes embedded in practice. Audit and feedback on adherence are useful strategies to monitor and sustain the changes.
Conclusion: Managing change successfully will promote a positive experience for staff. In turn, this will encourage a culture of enthusiasm for translating evidence into practice.

Developing Professional Practice in L&D

The first theme of the book is ‘Directions’. This theme concerns the present and potential future expectations that L&D professionals may face in their practice. Chapter 1 is about ‘Developing professional practice in L&D’. In the first section, I discuss what is ‘professionalism’ and what it means for L&D professionals in terms of their development. In this chapter, I argue that expectations of L&D from senior management are growing. L&D professionals need to be able demonstrate ability to influence decision making by developing new competencies that enable them to provide senior management with new insight, which in turn increases L&D’s strategic credibility. In examining the diverse activities and tasks that L&D professionals currently, and may be expected to undertake in the future, four roles emerge; capacity and capability builders, boundary spanners, consultants and change agents. Capacity building primarily concerns creating space, time, and cultivating the right environment for the workforce to develop, which can be a challenge given how fire-fighting appears to be prevalent in many organizations today. Capability building involves enhancing knowledge, developing skills and competencies of the workforces, whilst boundary spanning involves networking and growing partnerships within and outside the organization. ‘Being a consultant’ is briefly touched upon as it is further discussed in Chapter 5, whilst the role of a change agent involves instigating and managing change. This chapter concludes with a discussion of twelve important knowledge, skill and capability areas that L&D professionals must develop to advance their practice.

Principles and Practice of Fire Modelling: A Collection of Lecture Notes for a Short Course

Once the preserve of university academics and research laboratories with high-powered and expensive computers, the power of sophisticated mathematical fire models has now arrived on the desk top of the fire safety engineer. It is a revolution made possible by parallel advances in PC technology and fire modelling software. But while the tools have proliferated, there has not been a corresponding transfer of knowledge and understanding of the discipline from expert to general user. It is a serious shortfall of which the lack of suitable engineering courses dealing with the subject is symptomatic, if not the cause. The computational vehicles to run the models and an understanding of fire dynamics are not enough to exploit these sophisticated tools. Too often, they become 'black boxes' producing magic answers in exciting three-dimensional colour graphics and client-satisfying 'virtual reality' imagery. As well as a fundamental understanding of the physics and chemistry of fire, the fire safety engineer must have at least a rudimentary understanding of the theoretical basis supporting fire models to appreciate their limitations and capabilities. The five day short course, "Principles and Practice of Fire Modelling" run by the University of Greenwich attempt to bridge the divide between the expert and the general user, providing them with the expertise they need to understand the results of mathematical fire modelling. The course and associated text book, "Mathematical Modelling of Fire Phenomena" are aimed at students and professionals with a wide and varied background, they offer a friendly guide through the unfamiliar terrain of mathematical modelling. These concepts and techniques are introduced and demonstrated in seminars. Those attending also gain experience in using the methods during "hands-on" tutorial and workshop sessions. On completion of this short course, those participating should: - be familiar with the concept of zone and field modelling; - be familiar with zone and field model assumptions; - have an understanding of the capabilities and limitations of modelling software packages for zone and field modelling; - be able to select and use the most appropriate mathematical software and demonstrate their use in compartment fire applications; and - be able to interpret model predictions. The result is that the fire safety engineer is empowered to realise the full value of mathematical models to help in the prediction of fire development, and to determine the consequences of fire under a variety of conditions. This in turn enables him or her to design and implement safety measures which can potentially control, or at the very least reduce the impact of fire.

Music teacher biography and its impact on teaching practice

This paper describes research carried out as part of a wider doctoral study on ‘the biography of music teachers, their understanding of musicality and the implications for secondary music education’. Music teachers will come from a range of diverse backgrounds, though research data would suggest that most seem to have been educated as ‘classical’ music performers which will have an affect on what they perceive to be central competencies in the development of young musicians. In turn, this will determine, to some extent, what is taught and learned in the secondary music classroom. This study explores the impact of the biography of secondary music teachers as they seek to develop the musicianship of their pupils and present the activities in which the young people will be expected to participate. A mixed methods approach has been taken, including surveys, observation and interviews. Surveys amongst a sample of experienced and trainee teachers have produced a range of quantitative data on respondents’ experience of and values related to music education; whilst qualitative data in the form of lesson observation notes and transcription of semi-structured interviews have been the result of working with a small sub-set of participants. The outcomes of study have suggested a clear link between biography and classroom practice but that there are also other potential tensions which arise, such as in the subject knowledge development of practitioners as they move from musician to teacher. Implications for a variety of stakeholders in secondary music education include a consideration of the development of subject knowledge together with potential review of national and local education policy, the nature of undergraduate music study and the ‘shape’ of initial teacher training in England.