Between adaptability and the urge to control: making long-term water policies in the Netherlands

Triggered by recent flood catastrophes and increasing concerns about climate change, scientists as well as policy makers increasingly call for making long-term water policies to enable a transformation towards flood resilience. A key question is how to make these long-term policies adaptive so that they are able to deal with uncertainties and changing circumstances. The paper proposes three conditions for making long-term water policies adaptive, which are then used to evaluate a new Dutch water policy approach called ‘Adaptive Delta Management’. Analysing this national policy approach and its translation to the Rotterdam region reveals that Dutch policymakers are torn between adaptability and the urge to control. Reflecting on this dilemma, the paper suggests a stronger focus on monitoring and learning to strengthen the adaptability of long-term water policies. Moreover, increasing the adaptive capacity of society also requires a stronger engagement with local stakeholders including citizens and businesses.

Diversity and Inclusion As the Key to Innovating Talent Management in Law Firms?

In this chapter we argue that there is a need to reconceptualise what we mean by talent in the legal profession beyond a view that the most valuable people are those who have the highest fee-earning potential or the best CV packed with excellent grades and exceptional experiences and extra curricula achievements. And further we need a more sophisticated understanding of how organisational decision-making may be structured to provide developmental opportunities to allow talent to be nurtured and to flourish on individual and team levels. In turn, we suggest that planning, management and accountability cycles within legal entities need to be strengthened so as to ensure creativity and success in a context in which it is possible to deliver on the promise of fair access and promotion. Consequently, this chapter explores the diversity problem within the legal profession(s), further it interrogates what is “talent”, and how and why we should seek to manage and develop it. It then evaluates how talent diversity has been managed in the legal professional context, examined through what we have categorised as three waves of diversity strategies. We interrogate why diversity initiatives have not been more successful given the efforts placed on them by professional bodies and firms themselves. We posit that by using diversity as a case study in talent management legal entities may develop a more effective approach to talent management generally within law firms that will be of benefit to all lawyers and support professionals rather than just those who are from traditionally low participation groups.

The Affordable Care Act and the Transformation of US Health Care

The neoliberal period was accompanied by a momentous transformation within the US health care system.  As the result of a number of political and historical dynamics, the healthcare law signed by President Barack Obama in 2010 ‑the Affordable Care Act (ACA)‑ drew less on universal models from abroad than it did on earlier conservative healthcare reform proposals. This was in part the result of the influence of powerful corporate healthcare interests. While the ACA expands healthcare coverage, it does so incompletely and unevenly, with persistent uninsurance and disparities in access based on insurance status. Additionally, the law accommodates an overall shift towards a consumerist model of care characterized by high cost sharing at time of use. Finally, the law encourages the further consolidation of the healthcare sector, for instance into units named “Accountable Care Organizations” that closely resemble the health maintenance organizations favored by managed care advocates. The overall effect has been to maintain a fragmented system that is neither equitable nor efficient. A single payer universal system would, in contrast, help transform healthcare into a social right.

Expanding Agri-Food Production and Employment in the Presence of Climate Policy Constraints: Quantifying the Trade-Off in Ireland

This chapter explores the trade-off between competing objectives of employment creation and climate policy commitments in Irish agriculture. A social accounting matrix (SAM) multiplier model is linked with a partial equilibrium agricultural sector model to simulate the impact of a number of GHG emission reduction scenarios, assuming these are achieved through a constraint on beef production. Limiting the size of the beef sector helps to reduce GHG emissions with a very limited impact on the value of agricultural income at the farm level. However, the SAM multiplier analysis shows that there would be significant employment losses in the wider economy. From a policy perspective, a pragmatic approach to GHG emissions reductions in the agriculture sector, which balances opportunities for economic growth in the sector with opportunities to reduce associated GHG emissions, may be required.

Sustainability, creativity and innovation in project management – Model development for assessing organizational performance through projects

Today a number of studies are published on how organizational strategy is developed and how organizations contribute to local and regional development through the realization of these strategies. There are also many articles dealing with the success of a project by identifying the criteria and the factors that influence them. This article introduces the project-oriented strategic planning process that reveals how projects contribute to local and regional development and demonstrates the relationship between this approach and the regional competitiveness model as well as the KRAFT concept. There is a lot of research that focuses on sustainability in business. These studies argue that sustainability is very important to the success of a business in the future. The Project Excellence Model that analyses project success does not contain the sustainability criteria; the GPM P5 standard consists of sustainability components related either to the organizational level. To fill this gap a Project Sustainability Excellence Model (PSEM) was developed. The model was tested by interviews with managers of Hungarian for-profit and non-profit organizations. This paper introduces the PSEM and highlights the most important elements of the empirical analysis.

Perceptions of European medical staff on the facilitators and barriers to physical closeness between parents and infants in neonatal units

AIM: Studies have provided insights into factors that may facilitate or inhibit parent-infant closeness in neonatal units, but none have specifically focused on the perspectives of senior neonatal staff. The aim of this study was to explore perceptions and experiences of consultant neonatologists and senior nurses in five European countries with regard to these issues. METHODS: Six small group discussions and three one-to-one interviews were conducted with 16 consultant neonatologists and senior nurses representing nine neonatal units from Estonia, Finland, Norway, Spain and Sweden. The interviews explored facilitators and barriers to parent-infant closeness and implications for policy and practice and thematic analysis was undertaken. RESULTS: Participants highlighted how a humanising care agenda that enabled parent-infant closeness was an aspiration, but pointed out that neonatal units were at different stages in achieving this. The facilitators and barriers to physical closeness included socio-economic factors, cultural norms, the designs of neonatal units, resource issues, leadership, staff attitudes and practices and relationships between staff and parents. CONCLUSION: Various factors affected parent-infant closeness in neonatal units in European countries. There needs to be the political motivation, appropriate policy planning, legislation and resource allocation to increase measures that support closeness agendas in neonatal units. This article is protected by copyright. All rights reserved.

Strategic Management of Resources for International Business Operations in Small Consulting Firms - People, Processes and Tools in Managing International operations

Research on strategic management of resources for small consulting firms which are international or planning to operate internationally is scarce or not existing at all. It is however important to start generating the theories that will support managers in their decision making and planning. This thesis investigates how do small management consulting firms manage their internal and external resources while operating in international markets. Throughout the study, aspects related to internal and external resources management as well as management strategies in these firms have been examined in relations to firm’s internationalisation activities. A qualitative analysis was carried out whereby four small consulting firms in Export Management Consulting, Integration Services Consulting-, Software Development Consulting- and Business Solutions Consulting companies were interviewed. In order to generate the holistic understanding of the study, the thesis writer selected Value Enhanced Collaborative Working (VECW) model as an analysis framework. The model focuses on people, processes and tools as key elements that small consulting firms consider when thinking about managing their international operations. The findings of the thesis reveal that, internal and external resources in the interviewed consulting firms are viewed similarly, but managed differently depending on the nature and size of the firm. Firm’s management strategies concentrate on the adequate utilisation of the employees' motivation and experiences, effective stakeholders' management, various administrative evaluation processes and tools, the ability to realise useful networks, constant improvement through employee trainings, employees and customers’ feedbacks as well as enhanced freedom in order to support employees’ creativity. Further research to examine functional administrative tools and tools that small consulting firms could use to assess their resource capabilities when planning to become international would benefit the smaller businesses in terms of resources management and certainty in planning.

Fishing effort and fish yield over a 15 year period on Lake Victoria, Uganda: management implications

The National Fisheries Resources Research Institute (NaFIRRI), the Directorate of Fisheries Resources (DiFR), the Local Government fisheries staff and those from the Beach Management Units (BMUs) of the riparian districts to Lake Victoria regularly and jointly conduct Frame and Catch Assessment Surveys. The information obtained is used to guide fisheries management and development. We reveal the trends in the commercial fish catch landings and fishing effort on the Uganda side of Lake Victoria, over a 15 year period (2000-2015) and provide the underlying factors to the observed changes. The contribution of the high value large size species (Nile perch and Tilapia) to the commercial catch of Lake Victoria has significantly reduced while that of the low value small size species, Mukene has increased over a ten year (2005-2015)period. The information is intended to update and sensitize the key stakeholders on the status of the Lake Victoria fisheries. In addition, the information provided is expected to guide policy formulation and management planning by the fisheries managers at all levels including the BMUs and Landing Site Management Committees (LSMCs), the Local government fisheries staff and the Directorate of Fisheries Resources. The information is anticipated to create awareness among the lakeside fisher communities to reverse the current trend in fish declines.

Characteristics and management of Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemase in a tertiary hospital.

Background: The emergence of Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemases is rare. We report an occurrence of Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemases in a Chinese tertiary care hospital from November 2010 to December 2012. Methods: The clinical characteristics of 30 patients were described. The genetic relationship of isolates was determined by pulsed-field gel electrophoresis (PFGE). Carbapenemases were detected by modified Hodge test (MHT) and polymerase chain reactions (PCRs). Amplicons were sequenced and blasted to determine the genotype. Results: Most infected patients were from intensive care unit and had complex and serious underlying illnesses requiring mechanical ventilation. PFGE revealed that Klebsiella pneumoniae showed two major PFGE types. Two Klebsiella oxytoca had an indistinguishable PFGE pattern, while four Enterobacter cloacae were different strains. The sequencing studies showed Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemase in the 23 infected patients. The majority of patients had infections with the carbapenemase-producing Enterobacteriaceae (CPE) strain, most were successfully treated with a range of antibiotics and discharged. Conclusion: It is important to maintain a high index of suspicion to screen for carbapenemase-producing Enterobacteriaceae strains. Rapid identification of these strains and implementation of stringent procedures are the key to prevent major outbreaks in a hospital setting. Keywords:

Professional development programs in health promotion : tools and processes to favor new practices

Developing innovative interventions that are in sync with a health promotion paradigm often represents a challenge for professionals working in local public health organizations. Thus, it is critical to have both professional development programs that favor new practices and tools to examine these practices. In this case study, we analyze the health promotion approach used in a pilot intervention addressing children’s vulnerability that was developed and carried out by participants enrolled in a public health professional development program. More specifically, we use a modified version of Guichard and Ridde’s (Une grille d’analyse des actions pour lutter contre les inégalités sociales de santé. In Potvin, L., Moquet, M.-J. and Jones, C. M. (eds), Réduire les Inégalités Sociales en Santé. INPES, Saint-Denis Cedex, pp. 297– 312, 2010) analytical grid to assess deductively the program participants’ use of health promotion practices in the analysis and planning, implementation, evaluation, sustainability and empowerment phases of the pilot intervention. We also seek evidence of practices involving (empowerment, participation, equity, holism, an ecological approach, intersectorality and sustainability) in the intervention. The results are mixed: our findings reveal evidence of the application of several dimensions of health promotion (equity, holism, an ecological approach, intersectorality and sustainability), but also a lack of integration of two key dimensions; that is, empowerment and participation, during various phases of the pilot intervention. These results show that the professional development program is associated with the adoption of a pilot intervention integrating multiple but not all dimensions of health promotion. We make recommendations to facilitate a more complete integration. This research also shows that the Guichard and Ridde grid proves to be a thorough instrument to document the practices of participants.

Errors in preparation and medication management in nursing professionals

The preparation and administration of medications is one of the most common and relevant functions of nurses, demanding great responsibility. Incorrect administration of medication, currently constitutes a serious problem in health services, and is considered one of the main adverse effects suffered by hospitalized patients. Objectives: Identify the major errors in the preparation and administration of medication by nurses in hospitals and know what factors lead to the error occurred in the preparation and administration of medication. Methods: A systematic review of the literature. Deined as inclusion criteria: original scientiic papers, complete, published in the period 2011 to May 2016, the SciELO and LILACS databases, performed in a hospital environment, addressing errors in preparation and administration of medication by nurses and in Portuguese language. After application of the inclusion criteria obtained a sample of 7 articles. Results: The main errors identiied in the pr eparation and administration of medication were wrong dose 71.4%, wrong time 71.4%, 57.2% dilution inadequate, incorrect selection of the patient 42.8% and 42.8% via inadequate. The factors that were most commonly reported by the nursing staff, as the cause of the error was the lack of human appeal 57.2%, inappropriate locations for the preparation of medication 57.2%, the presence of noise and low brightness in preparation location 57, 2%, professionals untrained 42.8%, fatigue and stress 42.8% and inattention 42.8%. Conclusions: The literature shows a high error rate in the preparation and administration of medication for various reasons, making it important that preventive measures of this occurrence are implemented.