Translating evidence into practice: A shared priority in public health?

Translational and transdisciplinary research is needed to tackle complex public health problems. This article has three aims. Firstly, to determine how academics and non-academics (practitioners, policy makers and community workers) identified with the goals of the UKCRC Centre of Excellence for Public Health in Northern Ireland and how their attitudes varied in terms of knowledge brokerage and translation. Secondly, to map and analyse the network structure of the public health sector and the placement of the Centre within this. Thirdly, to aggregate responses from members of the network by work setting to construct the trans-sectoral network and devise the Root Mean Sum of Squares to determine the quality and potential value of connections across this network.The analysis was based on data collected from 98 individuals who attended the launch of the Centre in June 2008. Analysis of participant expectations and personal goals suggests that the academic members of the network were more likely to expect the work of the Centre to produce new knowledge than non-academics, but less likely to expect the Centre to generate health interventions and influence health policy. Academics were also less strongly oriented than non-academics to knowledge transfer as a personal goal, though more confident that research findings would be diffused beyond the immediate network. A central core of five nodes is crucial to the overall configuration of the regional public health network in Northern Ireland, with the Centre being well placed to exert influence within this. Though the overall network structure is fairly robust, the connections between some component parts of the network - such as academics and the third sector - are unidirectional.Identifying these differences and core network structure is key to translational and transdisciplinary research. Though exemplified in a regional study, these techniques are generalisable and applicable to many networks of interest: public health, interdisciplinary research or organisational involvement and stakeholder linkage.

"To be accepted as normal": Public understanding and misconceptions concerning survivors of brain injury.

PRIMARY OBJECTIVE: To determine the views held by the general public in Northern Ireland towards survivors of brain injury. RESEARCH DESIGN: Qualitative semi-structured interviews. METHODS AND PROCEDURES: Interviews were conducted with 16 members of the general public. Ten questions addressed issues such as the role of survivors of brain injury in society, the challenges they face and the characteristics ascribed to them. MAIN OUTCOMES AND RESULTS: When asked to describe someone with a brain injury participants typically used negative labels and identified the most common problems as relating to physical, cognitive, emotional and social functioning. There was a general failure to recognize that brain injury was a 'hidden' disability, with most participants expecting some outward manifestation. Relatively few previous studies have employed a qualitative approach to explore how the public perceives survivors of brain injury. CONCLUSION: Members of the public have an increasing awareness of the challenges faced by survivors of brain injury. However, in spite of this, perceptions of aggressiveness, dependency and unhappiness were still evident, suggesting potential problems in reintegrating survivors of brain injury with their communities.

Accruals accounting in the public sector: A road not always taken

The move from cash to accruals accounting by many governments is viewed as an aspect of an ongoing New Public Management agenda designed to achieve a more business-like and performance-focused public sector. Proponents argue that accruals accounting provides more appropriate information for decision makers and ultimately leads to a more efficient and effective public sector. The transition from cash to accruals accounting for UK central government departments was announced in the early 1990s and was embedded within approximately ten years. At that time there were clear indications that analogous changes, following a similar timeline, would occur in the Republic of Ireland (RoI). In reality, the changes were significantly less extensive. Utilising document analysis and interviews with key actors, this paper considers why a functioning accruals system was established in the UK whereas in the RoI the change to accruals accounting was a ‘road not taken’.

Establishing ex ante public construction supply chain guidelines in the public procurement of Schools' estate

Purpose – The purpose of this study is to explore the formative development of construction supply chain guidelines or proposals in a UK region’s schools’ estates procurement process to more effectively address a forthcoming increase in investment.

Design/methodology/approach – The research approach is interpretive. Using an action research approach, repeated semi-structured interviews and focus groups with a range of stakeholders are conducted.

Findings – The current construction supply chain in schools’ estate procurement has many difficulties, not least given the highly fragmented and disconnected nature of the projects. Synergies are being missed and there is little or no continuous improvement. Drawing on these findings, the research iteratively develops a range of proposals and guidelines to address this situation.

Research limitations/implications – This research adds weight to the current focus on pressing for change in the construction industry. It presents potentially valuable insights into the benefits of partnering arrangements and how these might usefully be incorporated into schools’ estate supply chain.

Practical implications – A set of guidelines is developed to guide the public procurement of schools’ estate in a UK region. These guidelines are set within the context of the Modernising and Rethinking Construction agenda.

Originality/value – The action research approach enabled the researchers to gain a unique insight into how public procurement and contractor personnel interact and to establish effective practical guidelines.

Public Accountability: a critical approach

'Public Accountability' has been variously described as, for example, Chameleon-like, as everexpanding and as an iconic concept. Public accountability (PA) is a contested but fundamental concept in the structure of contemporary public services. However, much of the existing literature on PA can be seen as reductionist or managerialist. The experiences of public service-users rarely feature and certainly not in the context as a potential agent for change. A second related strand concerns the introduction of New Public Management (NPM) models, and their impact on accountability in the public sector. A central line of argument is that to overcome the reductionist approaches researchers need to place their work in the broad context of these changes. To that end, this paper sets out a critical conceptualisation of 'public accountability', where it is seen as a dynamic social relationship through which civil society seeks to control and challenge the state. This critical PA conceptualisation is then applied to the context of Social Housing in England. The analysis highlights key changes in the structure of accountability relationships, but also stresses the opposition that the reforms have generated. Finally, the conclusion draws links to the debates in the anti-capitalist movement as providing a source of possible research projects.

Measuring the value to the public of pig welfare improvements: a contingent valuation approach

The welfare of farm animals is a policy area that has increased greatly in importance in recent years. When deciding whether a proposed policy should be implemented, it can be useful for policymakers to compare the costs of the proposed improvement with the perceived benefits. The costs are relatively straightforward to calculate but little is known about the benefits. The Contingent Valuation Method (CVM), a direct survey-based method, can be used to shed some light on this. This approach elicits the willingness-to-pay (WTP) for the provision of some public good or service. This paper reports the results of a contingent valuation study of the value of welfare improvements for growing pigs. Attitudes and opinions with regard to form animal welfare are explored and WTP elicited for various pig welfare improvements including increases in space allowance, environmental enrichment and research into improved pig housing design. The results reveal a positive WTP for these improvements. However, it is also noteworthy that a significant proportion of the general public is willing to pay nothing for these improvements. Overall, the study illustrates the usefulness of the CVM approach as a tool for policymakers in assessing the merits of possible policy initiatives affecting the welfare of animals.

The ‘Public Interest’ Agency of International Organizations? The case of the OECD Principles of Corporate Governance

This article seeks to outline and explore some of the conditions necessary for International Organizations (IOs) to perform in a public interest fashion through a case study of the Principles of corporate governance formulated by the OECD. Rather than the more commonly documented pathological and dysfunctional behavioural forms of IOs, the case of the Principles, both in their formulation by the OECD, and in their assessment by the World Bank through the ROSC process, represent an episode of IO agency protecting and promoting a wider public interest. In exercising their agency, IO staff, have made the Principles more agreeable to a wider range of interested parties, giving them a general interest orientation, in accordance with a proceduralist definition of public interest. This case should therefore encourage IPE scholars to consider carefully and systematically the sets of circumstances and conditions, which might be required for IO agency to take more socially useful forms. In the final section, three indicators are identified which might be evaluated in future research into the positive public interest agency of IOs across a range of cases.

Discharging not-for-profit accountability: UK charities and public discourse

Purpose: This paper aims to examine the accountability practices of large United Kingdom (UK) charities through public discourse.
Design/methodology/approach: Based on the ethical model of stakeholder theory, the paper develops a framework for classifying not-for-profit (NFP) accountability and analyzes the content of the annual reports and annual reviews of a sample of large UK charities using this framework.
Findings: The results suggest that contrary to the ethical model of stakeholder theory, the sample charities’ accountability practices are motivated by a desire to legitimize their activities and present their organizations’ activities in a positive light. These results contradict the raison d’eˆ tre of NFP organizations (NFPOs) and the values that they espouse. Research limitations/implications: Understanding the nature of accountability reporting in NFPOs has important implications for preparers and policy makers involved in furthering the NFP agenda. New research needs to examine shifts in accountability practices over time and assess the impact of the recent self-regulation developed to enhance sector accountability.
Originality/value: This paper contributes to the NFP accountability literature by: first, developing a framework of NFP accountability through public discourse using the ethical model of stakeholder theory; and second, advancing the understanding of the accountability practices of large UK charities.

The Diffusion of Risks in Public Private Partnership Contracts

Purpose The UK government argues that the benefits of public private partnership (PPP) in delivering public infrastructure stem from: transferring risks to the private sector within a structure in which financiers put their own capital at risk; and, the performance based payment mechanism, reinforced by the due diligence requirements imposed by the lenders financing the projects (HM Treasury, 2010). Prior studies of risk in PPPs have investigated ‘what’ risks are allocated and to ‘whom’, that is to the public or the private sector. The purpose of this study is to examine ‘how’ and ‘why’ PPP risks are diffused by their financiers. Design/methodology/approach This study focuses on the financial structure of PPPs and on their financiers. Empirical evidence comes from interviews conducted with equity and debt financiers. Findings The findings show that the financial structure of the deals generates risk aversion in both debt and equity financiers and that the need to attract affordable finance leads to risk diffusion through a network of companies using various means that include contractual mitigation through insurance, performance support guarantees, interest rate swaps and inflation hedges. Because of the complexity this process generates, both procurers and suppliers need expensive expert advice. The risk aversion and diffusion and the consequent need for advice add cost to the projects impacting on the government’s economic argument for risk transfer. Limitations and implications The empirical work covers the private finance initiative (PFI) type of PPP arrangements and therefore the risk diffusion mechanisms may not be generalisable to other forms of PPP, especially those that do not involve the use of high leverage or private finance. Moreover, the scope of this research is limited to exploring the diffusion of risk in the private sector. Further research is needed on how risk is diffused in other settings and on the value for money implication of risk diffusion in PPP contracts. Originality/value The expectation inherent in PPP is that the private sector will better manage those risks allocated to it and because private capital is at risk, financiers will perform due diligence with the ultimate outcome that only viable projects will proceed. This paper presents empirical evidence that raises questions about these expectations. Key words: public private partnership, risk management, diffusion, private finance initiative, financiers

Individual and Public-Program Adaptation: Coping with Heat Waves in Five Cities in Canada

Heat Alert and Response Systems (HARS) are currently undergoing testing and implementation in Canada. These programs seek to reduce the adverse health effects of heat waves on human health by issuing weather forecasts and warnings, informing individuals about possible protections from excessive heat, and providing such protections to vulnerable subpopulations and individuals at risk. For these programs to be designed effectively, it is important to know how individuals perceive the heat, what their experience with heat-related illness is, how they protect themselves from excessive heat, and how they acquire information about such protections. In September 2010, we conducted a survey of households in 5 cities in Canada to study these issues. At the time of the survey, these cities had not implemented heat outreach and response systems. The study results indicate that individuals' recollections of recent heat wave events were generally accurate. About 21% of the sample reported feeling unwell during the most recent heat spell, but these illnesses were generally minor. Only in 25 cases out of 243, these illnesses were confirmed or diagnosed by a health care professional. The rate at which our respondents reported heat-related illnesses was higher among those with cardiovascular and respiratory illnesses, was higher among younger respondents and bore no relationship with the availability of air conditioning at home. Most of the respondents indicated that they would not dismiss themselves as

The role of operations management in public sector policy and practice alignment: a local government analysis

In responding to the demand for change and improvement, local government has applied a plethora of operations management-based methods, tools and techniques. This article explores how these methods, specifically in the form of performance management models, are used to improve alignment between central government policy and local government practice, an area which has thus far been neglected in the literature. Using multiple case studies from Environmental Waste Management Services, this research reports that models derived in the private sector are often directly ‘implanted’ into the public sector. This has challenged the efficacy of all performance management models. However, those organisations which used models most effectively did so by embedding (contextualisation) and extending (reconceptualisation) them beyond their original scope. Moreover, success with these models created a cumulative effect whereby other operations management approaches were probed, adapted and used.

Catalysing open innovation through publicly funded R&D: A Comparison of University and Company-based research centres

Public funding of university and company-based R&D centres of excellence is widespread both in core and more peripheral regions. What is less well-known is whether these R&D centres can catalyse multi-directional, multi-actor and iterative innovation. Based on data from a real-time monitoring study, this article explores the development of 18 R&D centres’ external connections. University-based R&D centres establish more new connections than company-based centres and are more likely to be interacting with small or micro-firms. However, there is a general bias towards links with larger firms; micro, small and medium-sized enterprises also are less likely to be involved in collaborative R&D with research centres than other types of relationships. The results suggest the potential for R&D centres to act as a catalyst for open innovation but emphasise the need to ensure that the focus of the R&D being conducted is relevant to the needs of smaller firms.