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Spillover effects of financial incentives for providers onto non-targeted patients: daycase surgery in English hospitals
- Philip Britteon, Søren Rud Kristensen, Yiu-Shing Lau, Ruth McDonald, Matt Sutton
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- Journal:
- Health Economics, Policy and Law / Volume 18 / Issue 3 / July 2023
- Published online by Cambridge University Press:
- 16 May 2023, pp. 289-304
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Background
Incentives for healthcare providers may also affect non-targeted patients. These spillover effects have important implications for the full impact and evaluation of incentive schemes. However, there are few studies on the extent of such spillovers in health care. We investigated whether incentives to perform surgical procedures as daycases affected whether other elective procedures in the same specialties were also treated as daycases.
Data8,505,754 patients treated for 92 non-targeted procedures in 127 hospital trusts in England between April and March 2016.
MethodsInterrupted time series analysis of the probability of being treated as a daycase for non-targeted patients treated in six specialties where targeted patients were also treated and three specialties where they were not.
ResultsThe daycase rate initially increased (1.04 percentage points, SE: 0.30) for patients undergoing a non-targeted procedure in incentivised specialties but then reduced over time. Conversely, the daycase rate gradually decreased over time for patients treated in a non-incentivised specialty.
DiscussionSpillovers from financial incentives have variable effects over different activities and over time. Policymakers and researchers should consider the possibility of spillovers in the design and evaluation of incentive schemes.
Predicting intention to hunt protected wildlife: a case study of Bewick's swan in the European Russian Arctic
- Julia L. Newth, Robbie A. McDonald, Kevin A. Wood, Eileen C. Rees, Igor Semenov, Anton Chistyakov, Galina Mikhaylova, Stuart Bearhop, Ruth L. Cromie, Anna Belousova, Petr Glazov, Ana Nuno
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Illegal killing of wildlife is a major conservation issue that, to be addressed effectively, requires insight into the drivers of human behaviour. Here we adapt an established socio-psychological model, the theory of planned behaviour, to explore reasons for hunting the Endangered Bewick's swan Cygnus columbianus bewickii in the European Russian Arctic, using responses from hunters to a questionnaire survey. Wider ecological, legal, recreational and economic motivations were also explored. Of 236 hunters who participated overall, 14% harboured intentions to hunt Bewick's swan. Behavioural intention was predicted by all components of the theory of planned behaviour, specifically: hunters' attitude towards the behaviour, perceived behavioural control (i.e. perceived capability of being able to perform the behaviour) and their subjective norms (perception of social expectations). The inclusion of attitude towards protective laws and descriptive norm (perception of whether other people perform the behaviour) increased the model's predictive power. Understanding attitudes towards protective laws can help guide the design of conservation measures that reduce non-compliance. We conclude that conservation interventions should target the socio-psychological conditions that influence hunters' attitudes, social norms and perceived behavioural control. These may include activities that build trust, encourage support for conservation, generate social pressure against poaching, use motivations to prompt change and strengthen peoples' confidence to act. This approach could be applied to inform the effective design, prioritization and targeting of interventions that improve compliance and reduce the illegal killing of wildlife.
The Problem of Success and Failure in Public-private Innovation Partnerships
- JONATHAN HAMMOND, SIMON BAILEY, OZ GORE, KATH CHECKLAND, SARAH DARLEY, RUTH MCDONALD, THOMAS BLAKEMAN
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- Journal:
- Journal of Social Policy / Volume 51 / Issue 4 / October 2022
- Published online by Cambridge University Press:
- 19 March 2021, pp. 771-791
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- October 2022
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Public-Private Innovation Partnerships (PPIPs) are increasingly used as a tool for addressing ‘wicked’ public sector challenges. ‘Innovation’ is, however, frequently treated as a ‘magic’ concept: used unreflexively, taken to be axiomatically ‘good’, and left undefined within policy programmes. Using McConnell’s framework of policy success and failure and a case study of a multi-level PPIP in the English health service (NHS Test Beds), this paper critically explores the implications of the mobilisation of innovation in PPIP policy and practice. We highlight how the interplay between levels (macro/micro and policy maker/recipient) can shape both emerging policies and their prospects for success or failure. The paper contributes to an understanding of PPIP success and failure by extending McConnell’s framework to explore inter-level effects between policy and innovation project, and demonstrating how the success of PPIP policy cannot be understood without recognising the particular political effects of ‘innovation’ on formulation and implementation.
Evaluating the current integrated pest management recommendations in Canada for carrot weevil (Coleoptera: Curculionidae) and carrot rust fly (Diptera: Psilidae)
- Zachariah Telfer, Jason Lemay, Mary Ruth McDonald, Cynthia Scott-Dupree
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- Journal:
- The Canadian Entomologist / Volume 151 / Issue 3 / June 2019
- Published online by Cambridge University Press:
- 15 April 2019, pp. 391-405
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The primary insect pests in Canadian carrot production are carrot rust fly (Psila rosae (Fabricius); Diptera: Psilidae) and carrot weevil (Listronotus oregonensis (LeConte); Coleoptera: Curculionidae). An integrated pest management programme for these pests exists in Québec and Ontario, where most Canadian carrot (Daucus carota subsp. sativus (Hoffmann) Schübler and Martens; Apiaceae) production occurs. As current carrot insect integrated pest management recommendations are decades old, laboratory and field trials were performed to evaluate the carrot insect integrated pest management recommendations. Carrot weevil populations were evaluated in the laboratory for resistance to the primary product used for control, phosmet. Ontario carrot weevils exhibited negligible mortality when exposed to phosmet compared with > 80% mortality in a susceptible strain. Using data from a carrot integrated pest management programme, weather data was correlated with monitoring and damage data of both pests from historical records. Increased carrot weevil captures were weakly related to increased damage. Carrot weevil damage was reduced by following integrated pest management recommendations in one of three trials. No strong relationship between weather and carrot rust fly captures was identified, suggesting the degree day model for carrot rust fly activity needs revision. In field trials, carrot rust fly damage was negligible despite integrated pest management recommendations for insecticide applications. Future research should include improving carrot weevil monitoring and control and increasing the carrot rust fly action threshold to optimise insecticide applications.
A comprehensive regional clinical and educational ECPR protocol decreases time to ECMO in patients with refractory out-of-hospital cardiac arrest
- Brian Grunau, Sarah Carrier, Jamil Bashir, William Dick, Luke Harris, Robert Boone, Dan Kalla, Frank Scheuermeyer, Brian Twaites, Ron Straight, James Abel, Ken McDonald, Ruth MacRedmond, David Agulnik, Joe Finkler, Jeanne MacLeod, Jim Christenson, Anson Cheung
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- Journal:
- Canadian Journal of Emergency Medicine / Volume 19 / Issue 6 / November 2017
- Published online by Cambridge University Press:
- 16 August 2017, pp. 424-433
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- November 2017
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Objective
Extracorporeal membrane oxygenation within CPR (ECPR) may improve survival for refractory out-of-hospital cardiac arrest (OHCA). We developed a prehospital, emergency department (ED), and hospital-based clinical and educational protocol to improve the key variable of time-to-ECPR (TTE).
MethodsIn a single urban health region we involved key prehospital, clinical, and administrative stakeholders over a 2-year period, to develop a regional ECPR program with destination to a single urban tertiary care hospital. We developed clear and reproducible inclusion criteria and processes, including measures of program efficiency. We conducted seminars and teaching modules to paramedics and hospital-based clinicians including monthly simulator sessions, and performed detailed reviews of each treated case in the form of report cards. In this before-and-after study we compared patients with ECPR attempted prior to, and after, protocol implementation. The primary outcome was TTE, defined as the time of initial professional CPR to establishment of extracorporeal circulation. We compared the median TTE for patients in the two groups using the Wilcoxon signed rank test.
ResultsFour patients were identified prior to the protocol and managed in an ad hoc basis; for nine patients the protocol was utilized. Overall favourable neurological outcomes among ECPR-treated patients were 27%. The median TTE was 136 minutes (IQR 98 - 196) in the pre-protocol group, and 60 minutes (IQR 49 - 81) minutes in the protocol group (p=0.0165).
ConclusionAn organized clinical and educational protocol to initiate ECPR for patients with OHCA is feasible and significantly reduces the key benchmark of time-to-ECPR flows.
Strategies to Prevent Clostridium difficile Infections in Acute Care Hospitals: 2014 Update
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- Erik R. Dubberke, Philip Carling, Ruth Carrico, Curtis J. Donskey, Vivian G. Loo, L. Clifford McDonald, Lisa L. Maragakis, Thomas J. Sandora, David J. Weber, Deborah S. Yokoe, Dale N. Gerding
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 35 / Issue S2 / September 2014
- Published online by Cambridge University Press:
- 10 May 2016, pp. S48-S65
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- September 2014
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Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections (HAIs). The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their Clostridium difficile infection (CDI) prevention efforts. This document updates “Strategies to Prevent Clostridium difficile Infections in Acute Care Hospitals,” published in 2008. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The list of endorsing and supporting organizations is presented in the introduction to the 2014 updates.
Strategies to Prevent Clostridium difficile Infections in Acute Care Hospitals: 2014 Update
- Erik R. Dubberke, Philip Carling, Ruth Carrico, Curtis J. Donskey, Vivian G. Loo, L. Clifford McDonald, Lisa L. Maragakis, Thomas J. Sandora, David J. Weber, Deborah S. Yokoe, Dale N. Gerding
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 35 / Issue 6 / 01 June 2014
- Published online by Cambridge University Press:
- 10 May 2016, pp. 628-645
- Print publication:
- 01 June 2014
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- By Christopher Ames, Cathy W. Barks, Ronald Berman, Anthony J. Berret, Robert Beuka, William Blazek, Elisabeth Bouzonviller, Jackson R. Bryer, Deborah Clarke, Gretchen Comba, Kirk Curnutt, Linda De Roche, Suzanne Del Gizzo, Kathleen Drowne, Richard Fine, Edward Gillin, Michael K. Glenday, Richard Godden, Steven Goldleaf, Peter L. Hays, Pearl James, Joel Kabot, Heidi M. Kunz, Jarom Lyle McDonald, Philip McGowan, Bonnie Shannon McMullen, Bryant Mangum, Lauren Rule Maxwell, James H. Meredith, Linda Patterson Miller, James Nagel, Michael Nowlin, Ruth Prigozy, Laura Rattray, Walter Raubicheck, Deborah Davis Schlacks, Gail D. Sinclair, Robert Sklar, Linda Wagner-Martin, James L. W. West, Doni M. Wilson
- Edited by Bryant Mangum, Virginia Commonwealth University
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- F. Scott Fitzgerald in Context
- Published online:
- 05 February 2013
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- 18 March 2013, pp xi-xx
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Insecticide use and crop selection in regions with high GM adoption rates
- Scott W. Fausti, Tia Michelle McDonald, Jonathan G. Lundgren, Jing Li, Ariel Ruth Keating, Mike Catangui
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- Renewable Agriculture and Food Systems / Volume 27 / Issue 4 / December 2012
- Published online by Cambridge University Press:
- 19 December 2011, pp. 295-304
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South Dakota has been a leading adopter of genetically modified organism (GM) crops since their introduction in 1996. In 2009, South Dakota shared the top adoption rate with Iowa for the percentage of acres planted with Bt corn. However; South Dakota has also recently experienced a significant increase in the proportion of acres treated with insecticide. The empirical evidence presented suggests that corn, hay and sunflower production in South Dakota have experienced an intensification of insecticide use in 2007 relative to past US Census of Agriculture reporting years. This study links the proportion of acres planted for a specific crop to the proportion of total acres treated with insecticide at the county level. This approach provides insight on how changing cropping patterns in South Dakota have influenced insecticide use. Empirical results indicate that the upper-bound estimate for insecticide usage on non-Bt corn acreage increased from 38% in 2002 to all non-Bt corn acres planted in 2007. The implication of this result is that in 2007 South Dakota producers were likely treating a percentage of their Bt corn acres with insecticide. Changing cropping patterns in South Dakota are also compared to that in other states in the US Corn Belt region. It appears that the South Dakota experience is not unique and is part of a broader trend.
Contributors
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. Hackett, Getatchew Haile, Douglas John Hall, Nicholas Hammond, Daphne Hampson, Jehu J. Hanciles, Barry Hankins, Jennifer Haraguchi, Stanley S. Harakas, Anthony John Harding, Conrad L. Harkins, J. William Harmless, Marjory Harper, Amir Harrak, Joel F. Harrington, Mark W. Harris, Susan Ashbrook Harvey, Van A. Harvey, R. Chris Hassel, Jione Havea, Daniel Hawk, Diana L. Hayes, Leslie Hayes, Priscilla Hayner, S. Mark Heim, Simo Heininen, Richard P. Heitzenrater, Eila Helander, David Hempton, Scott H. Hendrix, Jan-Olav Henriksen, Gina Hens-Piazza, Carter Heyward, Nicholas J. Higham, David Hilliard, Norman A. Hjelm, Peter C. Hodgson, Arthur Holder, M. Jan Holton, Dwight N. Hopkins, Ronnie Po-chia Hsia, Po-Ho Huang, James Hudnut-Beumler, Jennifer S. Hughes, Leonard M. Hummel, Mary E. Hunt, Laennec Hurbon, Mark Hutchinson, Susan E. Hylen, Mary Beth Ingham, H. Larry Ingle, Dale T. Irvin, Jon Isaak, Paul John Isaak, Ada María Isasi-Díaz, Hans Raun Iversen, Margaret C. Jacob, Arthur James, Maria Jansdotter-Samuelsson, David Jasper, Werner G. Jeanrond, Renée Jeffery, David Lyle Jeffrey, Theodore W. Jennings, David H. Jensen, Robin Margaret Jensen, David Jobling, Dale A. Johnson, Elizabeth A. Johnson, Maxwell E. Johnson, Sarah Johnson, Mark D. Johnston, F. Stanley Jones, James William Jones, John R. Jones, Alissa Jones Nelson, Inge Jonsson, Jan Joosten, Elizabeth Judd, Mulambya Peggy Kabonde, Robert Kaggwa, Sylvester Kahakwa, Isaac Kalimi, Ogbu U. Kalu, Eunice Kamaara, Wayne C. Kannaday, Musimbi Kanyoro, Veli-Matti Kärkkäinen, Frank Kaufmann, Léon Nguapitshi Kayongo, Richard Kearney, Alice A. Keefe, Ralph Keen, Catherine Keller, Anthony J. Kelly, Karen Kennelly, Kathi Lynn Kern, Fergus Kerr, Edward Kessler, George Kilcourse, Heup Young Kim, Kim Sung-Hae, Kim Yong-Bock, Kim Yung Suk, Richard King, Thomas M. King, Robert M. Kingdon, Ross Kinsler, Hans G. Kippenberg, Cheryl A. Kirk-Duggan, Clifton Kirkpatrick, Leonid Kishkovsky, Nadieszda Kizenko, Jeffrey Klaiber, Hans-Josef Klauck, Sidney Knight, Samuel Kobia, Robert Kolb, Karla Ann Koll, Heikki Kotila, Donald Kraybill, Philip D. W. Krey, Yves Krumenacker, Jeffrey Kah-Jin Kuan, Simanga R. Kumalo, Peter Kuzmic, Simon Shui-Man Kwan, Kwok Pui-lan, André LaCocque, Stephen E. Lahey, John Tsz Pang Lai, Emiel Lamberts, Armando Lampe, Craig Lampe, Beverly J. Lanzetta, Eve LaPlante, Lizette Larson-Miller, Ariel Bybee Laughton, Leonard Lawlor, Bentley Layton, Robin A. Leaver, Karen Lebacqz, Archie Chi Chung Lee, Marilyn J. Legge, Hervé LeGrand, D. L. LeMahieu, Raymond Lemieux, Bill J. Leonard, Ellen M. Leonard, Outi Leppä, Jean Lesaulnier, Nantawan Boonprasat Lewis, Henrietta Leyser, Alexei Lidov, Bernard Lightman, Paul Chang-Ha Lim, Carter Lindberg, Mark R. Lindsay, James R. Linville, James C. Livingston, Ann Loades, David Loades, Jean-Claude Loba-Mkole, Lo Lung Kwong, Wati Longchar, Eleazar López, David W. Lotz, Andrew Louth, Robin W. Lovin, William Luis, Frank D. Macchia, Diarmaid N. J. MacCulloch, Kirk R. MacGregor, Marjory A. MacLean, Donald MacLeod, Tomas S. Maddela, Inge Mager, Laurenti Magesa, David G. Maillu, Fortunato Mallimaci, Philip Mamalakis, Kä Mana, Ukachukwu Chris Manus, Herbert Robinson Marbury, Reuel Norman Marigza, Jacqueline Mariña, Antti Marjanen, Luiz C. L. Marques, Madipoane Masenya (ngwan'a Mphahlele), Caleb J. D. Maskell, Steve Mason, Thomas Massaro, Fernando Matamoros Ponce, András Máté-Tóth, Odair Pedroso Mateus, Dinis Matsolo, Fumitaka Matsuoka, John D'Arcy May, Yelena Mazour-Matusevich, Theodore Mbazumutima, John S. McClure, Christian McConnell, Lee Martin McDonald, Gary B. McGee, Thomas McGowan, Alister E. McGrath, Richard J. McGregor, John A. McGuckin, Maud Burnett McInerney, Elsie Anne McKee, Mary B. McKinley, James F. McMillan, Ernan McMullin, Kathleen E. McVey, M. Douglas Meeks, Monica Jyotsna Melanchthon, Ilie Melniciuc-Puica, Everett Mendoza, Raymond A. Mentzer, William W. Menzies, Ina Merdjanova, Franziska Metzger, Constant J. Mews, Marvin Meyer, Carol Meyers, Vasile Mihoc, Gunner Bjerg Mikkelsen, Maria Inêz de Castro Millen, Clyde Lee Miller, Bonnie J. Miller-McLemore, Alexander Mirkovic, Paul Misner, Nozomu Miyahira, R. W. L. Moberly, Gerald Moede, Aloo Osotsi Mojola, Sunanda Mongia, Rebeca Montemayor, James Moore, Roger E. Moore, Craig E. Morrison O.Carm, Jeffry H. Morrison, Keith Morrison, Wilson J. Moses, Tefetso Henry Mothibe, Mokgethi Motlhabi, Fulata Moyo, Henry Mugabe, Jesse Ndwiga Kanyua Mugambi, Peggy Mulambya-Kabonde, Robert Bruce Mullin, Pamela Mullins Reaves, Saskia Murk Jansen, Heleen L. Murre-Van den Berg, Augustine Musopole, Isaac M. T. Mwase, Philomena Mwaura, Cecilia Nahnfeldt, Anne Nasimiyu Wasike, Carmiña Navia Velasco, Thulani Ndlazi, Alexander Negrov, James B. Nelson, David G. Newcombe, Carol Newsom, Helen J. Nicholson, George W. E. Nickelsburg, Tatyana Nikolskaya, Damayanthi M. A. Niles, Bertil Nilsson, Nyambura Njoroge, Fidelis Nkomazana, Mary Beth Norton, Christian Nottmeier, Sonene Nyawo, Anthère Nzabatsinda, Edward T. Oakes, Gerald O'Collins, Daniel O'Connell, David W. Odell-Scott, Mercy Amba Oduyoye, Kathleen O'Grady, Oyeronke Olajubu, Thomas O'Loughlin, Dennis T. Olson, J. Steven O'Malley, Cephas N. Omenyo, Muriel Orevillo-Montenegro, César Augusto Ornellas Ramos, Agbonkhianmeghe E. Orobator, Kenan B. Osborne, Carolyn Osiek, Javier Otaola Montagne, Douglas F. Ottati, Anna May Say Pa, Irina Paert, Jerry G. Pankhurst, Aristotle Papanikolaou, Samuele F. Pardini, Stefano Parenti, Peter Paris, Sung Bae Park, Cristián G. Parker, Raquel Pastor, Joseph Pathrapankal, Daniel Patte, W. Brown Patterson, Clive Pearson, Keith F. Pecklers, Nancy Cardoso Pereira, David Horace Perkins, Pheme Perkins, Edward N. Peters, Rebecca Todd Peters, Bishop Yeznik Petrossian, Raymond Pfister, Peter C. Phan, Isabel Apawo Phiri, William S. F. Pickering, Derrick G. Pitard, William Elvis Plata, Zlatko Plese, John Plummer, James Newton Poling, Ronald Popivchak, Andrew Porter, Ute Possekel, James M. Powell, Enos Das Pradhan, Devadasan Premnath, Jaime Adrían Prieto Valladares, Anne Primavesi, Randall Prior, María Alicia Puente Lutteroth, Eduardo Guzmão Quadros, Albert Rabil, Laurent William Ramambason, Apolonio M. Ranche, Vololona Randriamanantena Andriamitandrina, Lawrence R. Rast, Paul L. Redditt, Adele Reinhartz, Rolf Rendtorff, Pål Repstad, James N. Rhodes, John K. Riches, Joerg Rieger, Sharon H. Ringe, Sandra Rios, Tyler Roberts, David M. Robinson, James M. Robinson, Joanne Maguire Robinson, Richard A. H. Robinson, Roy R. Robson, Jack B. Rogers, Maria Roginska, Sidney Rooy, Rev. Garnett Roper, Maria José Fontelas Rosado-Nunes, Andrew C. Ross, Stefan Rossbach, François Rossier, John D. Roth, John K. Roth, Phillip Rothwell, Richard E. Rubenstein, Rosemary Radford Ruether, Markku Ruotsila, John E. Rybolt, Risto Saarinen, John Saillant, Juan Sanchez, Wagner Lopes Sanchez, Hugo N. Santos, Gerhard Sauter, Gloria L. Schaab, Sandra M. Schneiders, Quentin J. Schultze, Fernando F. Segovia, Turid Karlsen Seim, Carsten Selch Jensen, Alan P. F. Sell, Frank C. Senn, Kent Davis Sensenig, Damían Setton, Bal Krishna Sharma, Carolyn J. Sharp, Thomas Sheehan, N. Gerald Shenk, Christian Sheppard, Charles Sherlock, Tabona Shoko, Walter B. Shurden, Marguerite Shuster, B. Mark Sietsema, Batara Sihombing, Neil Silberman, Clodomiro Siller, Samuel Silva-Gotay, Heikki Silvet, John K. Simmons, Hagith Sivan, James C. Skedros, Abraham Smith, Ashley A. Smith, Ted A. Smith, Daud Soesilo, Pia Søltoft, Choan-Seng (C. S.) Song, Kathryn Spink, Bryan Spinks, Eric O. Springsted, Nicolas Standaert, Brian Stanley, Glen H. Stassen, Karel Steenbrink, Stephen J. Stein, Andrea Sterk, Gregory E. Sterling, Columba Stewart, Jacques Stewart, Robert B. Stewart, Cynthia Stokes Brown, Ken Stone, Anne Stott, Elizabeth Stuart, Monya Stubbs, Marjorie Hewitt Suchocki, David Kwang-sun Suh, Scott W. Sunquist, Keith Suter, Douglas Sweeney, Charles H. Talbert, Shawqi N. Talia, Elsa Tamez, Joseph B. Tamney, Jonathan Y. Tan, Yak-Hwee Tan, Kathryn Tanner, Feiya Tao, Elizabeth S. Tapia, Aquiline Tarimo, Claire Taylor, Mark Lewis Taylor, Bishop Abba Samuel Wolde Tekestebirhan, Eugene TeSelle, M. Thomas Thangaraj, David R. Thomas, Andrew Thornley, Scott Thumma, Marcelo Timotheo da Costa, George E. “Tink” Tinker, Ola Tjørhom, Karen Jo Torjesen, Iain R. Torrance, Fernando Torres-Londoño, Archbishop Demetrios [Trakatellis], Marit Trelstad, Christine Trevett, Phyllis Trible, Johannes Tromp, Paul Turner, Robert G. Tuttle, Archbishop Desmond Tutu, Peter Tyler, Anders Tyrberg, Justin Ukpong, Javier Ulloa, Camillus Umoh, Kristi Upson-Saia, Martina Urban, Monica Uribe, Elochukwu Eugene Uzukwu, Richard Vaggione, Gabriel Vahanian, Paul Valliere, T. J. Van Bavel, Steven Vanderputten, Peter Van der Veer, Huub Van de Sandt, Louis Van Tongeren, Luke A. Veronis, Noel Villalba, Ramón Vinke, Tim Vivian, David Voas, Elena Volkova, Katharina von Kellenbach, Elina Vuola, Timothy Wadkins, Elaine M. Wainwright, Randi Jones Walker, Dewey D. Wallace, Jerry Walls, Michael J. Walsh, Philip Walters, Janet Walton, Jonathan L. Walton, Wang Xiaochao, Patricia A. Ward, David Harrington Watt, Herold D. Weiss, Laurence L. Welborn, Sharon D. Welch, Timothy Wengert, Traci C. West, Merold Westphal, David Wetherell, Barbara Wheeler, Carolinne White, Jean-Paul Wiest, Frans Wijsen, Terry L. Wilder, Felix Wilfred, Rebecca Wilkin, Daniel H. Williams, D. Newell Williams, Michael A. Williams, Vincent L. Wimbush, Gabriele Winkler, Anders Winroth, Lauri Emílio Wirth, James A. Wiseman, Ebba Witt-Brattström, Teofil Wojciechowski, John Wolffe, Kenman L. Wong, Wong Wai Ching, Linda Woodhead, Wendy M. Wright, Rose Wu, Keith E. Yandell, Gale A. Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- Book:
- The Cambridge Dictionary of Christianity
- Published online:
- 05 August 2012
- Print publication:
- 20 September 2010, pp xi-xliv
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two - Creating a patient-led NHS: empowering ‘consumers’or shrinking the state?
- Edited by Linda Bauld, Karen Clarke, Tony Maltby
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- Book:
- Social Policy Review 18
- Published by:
- Bristol University Press
- Published online:
- 15 January 2022
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- 28 June 2006, pp 33-48
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Summary
Introduction
Health policy in England in recent years has been described as embodying elements of both modernisation and marketisation. These processes are intended to achieve a transformation from an ‘old’ monolithic service into a ‘new’ National Health Service (NHS), fit for the 21st century, and are to be pursued in part by curbing the monopoly powers of health care providers and ‘harnessing the powers of healthcare users as individuals wishing to access good quality healthcare’ (Allsop and Baggott, 2004, p 29). Following the Labour Party's re-election in May 2005, while it commenced a third term in office with a much-reduced majority, this did nothing to dampen its commitment to increase patient choice and promote diversity in the provision of care. The Labour government's role has also been described as moving away from management and towards regulation, setting standards and targets, but allowing local discretion as to how these are achieved (Klein, 2005). Whether this move to ‘enforced self-regulation’ (Hood et al, 2000; Dent, 2005) is perceived as allowing for greater discretion by those working in the NHS is a moot point, as is the extent to which central government is willing to withdraw from hands-on management. However, on the basis of policies announced in 2005, it seems clear that the government is serious in its intention to reform both the way in which care is commissioned and the way it is provided.
In March 2005, prior to the General Election, Nigel Edwards, Director of Policy for the NHS Confederation, addressed a meeting on the subject of ‘Payment By Results’ (PBR), a tariff-based system for paying hospitals for care provided. The Confederation is the membership body that represents the vast majority of NHS organisations and the audience largely comprised NHS employees (see www.nhsconfed.org). Edwards’ suggestion that New Labour politicians think they have ‘fixed what's wrong with hospitals’ and are now turning their attention to primary care was greeted with laughter by attendees. This perhaps reflects scepticism towards the potential for PBR to ‘fix’ the problems of secondary care within the NHS, but the shift in focus, towards ‘fixing’ problems outside of hospitals, is certainly borne out by policy developments in 2005.
Le Langage De Giraudoux
- Ruth Elizabeth McDonald
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- Journal:
- PMLA / Publications of the Modern Language Association of America / Volume 63 / Issue 3 / September 1948
- Published online by Cambridge University Press:
- 02 December 2020, pp. 1029-1050
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- September 1948
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J'aime beaucoup les premières phrases de chapitre qui vous donnent par leur tenue une pleine satisfaction de vous-même, vous délivrant en une seconde de toute appréhension d'unanimisme, de passéisme, de populisme, et habillent les personnages pour les vraies tragédies du cœur,—la première phrase de ce chapitre, par exemple. La voici, ample et réelle: Nancy Rolla, adorablement coiffée par Rose Desca, ses jambes croisées mettant en valeur de minuscules souliers en serpent de Perugia, un rouge Antoine spécial et des yeux violets composant sur son visage mat une alliance de couleurs qu'aucun pavillon national jamais ne réalisera, dans le fond de sa Bugatti, et tout en contemplant un magnifique ciel signé lui aussi, attendait Maléna que le chauffeur était monté prévenir, et se demandait pourquoi sa jeune amie l'avait convoquée si tôt—-des aiguilles de diamant marquaient dix heures à sa montre de rubis,—dans ce matin de printemps débutant dont les premiers effluves caressaient, sur une gorge ravissante, les revers et les fronces du manteau de marocain noir livré la veille par Chanel … Au moins l'on sait, avec une pareille phrase, où l'on est, dans quelle époque, quelle humeur, et la littérature atteint une vérité encore supérieure aux vérités que lui procurent les écoles ci-dessus nommées : celle du chromo.