The consumerism of ‘voice’ in Norwegian health policy and its dynamics in the transformation of health services

The policy of voice consumerism in Norwegian health policy has enabled patients to be involved in discussions about professional practice. Principles of openness have been successfully introduced in services bound by professional autonomy and discretion. This article demonstrates the influence that Norwegian patients and their representatives have been able to have on service provision in brain injury rehabilitation and mental healthcare.     

Particulate matter air pollution control programs in Japan — an analysis of health risks in the absence of future remediation

The objective of this case study was to assess potential health risks and productivity loss in the absence of future additional environmental control of particulate matter (PM) in Japan. Assuming a 10% decline in PM, the estimates of the numbers of possible cases of premature mortality and morbidity that could be prevented in the year 2010 were (1) 8700 long term deaths, (2) 12,000 cases of chronic bronchitis, (3) 24,000 cases of cardiovascular disease, (4) 10,000 cases of pneumonia, (5) 18,000 asthma attacks, and (6) 12,000 cases of acute bronchitis during a one year period. The best estimate of medical costs plus lost productivity in adults and children was $56 billion USD. When compared to a separately derived estimate of $31 billion USD in avoided pollution control costs, the health risk to no‐control benefit ratio of 1.8 suggests that additional future pollution control policies would successfully prevent a large expense to the society in medical care and lost productivity while imposing a lesser cost to the private sector in control equipment, to government in oversight expenses and to society in opportunity costs.     

A meta‐level analysis of major trends in environmental health risk governance

Internationally but also within countries, large differences exist regarding how environmental health risks (EHRs) are governed. Despite these differences, at a meta‐level some general trends can be discerned that may point to a convergence of EHR governance regimes. One, EHR governance regimes are increasingly taking into account cost‐benefit considerations, sectoral goals outside the health risk domain, public concerns and stakeholder interests in early stages of decision‐making. Two, EHR objectives are increasingly integrated in other, sectoral policies such as land use planning. Three, an increased differentiation of EHR standards is observed (partly as a consequence of the former characteristic). Still little systematic empirical research has been conducted on the dynamics in EHR governance regimes and their causes, on what EHR governance regimes have produced in terms of (perceived) risk reduction and on how these results can be explained. This paper proposes a systematic framework for analysing, explaining and evaluating shifts in EHR governance regimes. The framework in turn is applied to examine and understand the shift towards more integrated and differentiated EHR governance regimes.     

Perceptions of farmers on health risks and risk reduction measures in wastewater‐irrigated urban vegetable farming in Ghana

This paper draws upon the social science literature to evaluate whether materialist/post‐materialist, environmental, and scientific/technological worldviews predict levels of support for biotechnology applications. The novelty of this research is two‐fold: 1) it incorporates the post‐materialist hypothesis in risk perception models, and 2) it evaluates the effects of the these three worldviews simultaneously. Data from a regional southwest telephone survey in the United States conducted in Spring 2004 were used to investigate whether these three worldviews were related to support of various animal and plant biotechnology applications. The results illustrated that post‐materialist values were not significantly related to support for animal or plant biotechnology applications. However, environmental and science and technology measures were related to support. One of the new ecological paradigm items, “humans have the right to modify nature,” was consistently related to support for animal and plant biotechnology applications, and anti‐anthropocentric values were related to support for two plant applications. General attitudes toward science and technology were related to support for both animal and plant biotechnology applications. The results provide evidence that perceptions of these applications are multi‐dimensional and that respondents conceptualize animal and plant biotechnology applications differently.     

Extensions and intensions of management control—The inclusion of health

Interest in management control of intangibles has grown remarkably during the last decades and now includes managing employee health. Research in this field is so far in the early stages: few empirical studies have been undertaken and fewer studies take into consideration the implications of such systems. In this paper we wish to contribute to the field with a qualitative study of instances of management control of health in ten Swedish organizations.Many good intentions lie behind the idea of making health and ill-health a subject for management control and the expected results are very positive—lower sick-leave rates, reduction of costs and human suffering. Such intentions stand for an intension, i.e. the ideas, properties or state of affairs that are connoted by a word or symbol, in this case what can be connoted by the concept of management control of health, its conceptual position. An intension, however, is not given insofar as a word or concept may be associated to more than one. Thus we set out to interpret management control of health in terms of two conceptual positions, modernism and postmodernism, in order to bring forth two very different intensions of management control of health: one where the practice is seen as an investment with a purpose to visualize ill-health and increase efficiency by putting in place measures to increase employee health; the other where the practice is seen as a means to make the individual accountable in order to be able to intensify control and colonize leisure.     

Can patients drive the future of health care?

As the traditional system of health care in the United States gives way to a regime run increasingly by the private sector, a powerful force is emerging: the patient. According to Harvard Business School professor Regina Herzlinger, health care is much like other service industries. Providers that hope to survive must cater to increasingly demanding and well-educated consumers. In a review of Herzlinger's book Market-Driven Health Care: Who Wins, Who Loses in the Transformation of America's Largest Service Industry, Alexandra Wyke, managing editor at the Economist Intelligence Unit, argues that the path to consumerism in medicine will be longer and bumpier than Herzlinger suggests. Consumers of medicine don't simply want health care to be more convenient; they want cures for all ills. How can providers gratify this appetite for ever better medicine? Furthermore, patients are not always capable of making sound decisions about their medical care. And health care professionals, who emphasize the complex nature of decision making in medicine, are doing their best to keep patients from holding the health care steering wheel. Herzlinger has written a bullish book on the virtues of market-driven health care, but, Wyke contends, she has overlooked the far-reaching effects that emerging technology could have in shaping medicine--especially in reducing the need for specialists. She also has given short shrift to the young managed-care industry, which has succeeded in controlling costs and is now under competitive pressure to meet patients' needs better.     

Examining inequities in children’s environmental health: results of a survey on the risk perceptions and protective actions of new mothers

Young children are more highly exposed and vulnerable to environmental health hazards than adults due to a variety of physiological and behavioural factors. Despite the significant responsibility mothers typically bear in managing their children’s health, little is known about how they perceive and negotiate these risks in their day-to-day lives. To better understand mothers’ environmental health risk perceptions and associated protective actions across socio-economic and geographic contexts, a telephone survey was conducted among new mothers (n = 606) recruited through two Public Health Units in Ontario, Canada. Analyses revealed that approximately half of the respondents were moderately or highly concerned about environmental health risks, ranging in nature from household products to outdoor air contaminants. Factors affecting the likelihood of experiencing concern included lower income and lower levels of perceived control. With regard to protective actions, 43% reported taking three or more actions to reduce environmental health risks to their children, with the likelihood of taking action being negatively affected by factors including low income and first language other than English or French, and positively affected by being a first-time parent (primiparous). This study contributes to our understanding of environmental health risk perceptions and associated protective behaviours among new mothers, and has implications for the development of more context-focused risk management and communication strategies.     

To fear or not to fear? Applying the social amplification of risk framework on two environmental health risks in Singapore

Abstract

Smoke haze and dengue fever seasons were nationwide environmental health risk events that plagued Singapore between April and June 2013. Although relatively harmless compared to dengue fever, people in Singapore were visibly more disturbed by smoke haze. They engaged in preventive behaviors such as frantic purchasing of protective masks or staying indoors most of the time. Such reactions hint at the possibility of the social amplification of risk, a term coined to explain irrationally high public concerns over relatively minor risk issues, due to the visible nature of the risk event or people’s reactions to it. The current study aims to confirm the social amplification of risk for the haze event, as well as to test for the underlying reasons behind this phenomenon. Among the antecedents explored were the influence of information channels (traditional media and social media) on risk perception, negative affect, information seeking, and information sharing on the enactment of preventive behaviors. Data were collected from a sample of 343 college students through an online questionnaire. Results supported the presence of social amplification of risk for the haze event, and social media exposure was found to overshadow the influence of traditional media exposure on risk perception, negative affect, information seeking, information sharing, and preventive behaviors.     

New development: A game of responsibility? The regulation of health and social care professionals

The UK's law commissions in a recent joint report have recommended that individual regulatory bodies for medical and other healthcare professions receive more decision-making power and that procedural regulation (for example fitness to practice proceedings) be standardized. Patient wellbeing and professional standing of practitioners are likely to be deeply affected. The legislative process needs to be scrutinized closely to ascertain that government and regulatory bodies do not use the reform to shirk accountability and engage in a blame game.     

Does environmental investment pay off?—portfolio analyses of the E in ESG during political conflicts and public health crises

This paper examines the contribution of environmental investment on firm value during the Russia-Ukraine War and Global Public Health Crisis. Using media-based environmental scores, we investigate the performance of the emission-reduction-based and green-innovation-based portfolios. The results indicate that while engaging in environmental activities decreases firm value during the noncrisis time, it creates value when companies face market-wide crises. Our findings suggest that environmental investment serves as a risk-hedging vehicle for political and health crises. In addition, compared to corporate ESG disclosures, firm-level media-based environmental scores mitigate the endogeneity between a company's ESG disclosure policies and its firm characteristics.     

On patients’ interests and accountability: reflecting on some dilemmas in social audit in primary health care

The NHS in the UK continues to undergo rapid reforms incorporating New Public Financial Management techniques with limited attention only given to the theoretical underpinning and practical limitations of participatory health choice and evaluation. The study adopts a reflexive approach to realizing the aim of implementing empowering social audit—a paradigm founded in a polyvocal citizenship perspective (PCP). The paper explores the ethical dilemmas in implementing social audit in Primary Health Care. The research follows on from consultation with patients to reflect on concerns of accountability, patients’ interests and values. Democratic participation and informed choice are inextricably bounded by the existing economic, informational and power relationships. These potentially constricting factors are discussed using the illustrative case of generic prescribing. Patients preference for voice participation and their affirmation for “accountability" (albeit under-defined at present) should encourage engagement with a community development approach for new social accounting and social audit.     

Disinvestment in health— the challenges facing general practitioner (GP) commissioners

The economic downturn is placing increasing pressure on the financing of health care. For many health care providers, this means difficult decisions need to be made over what will and will not be funded. The NHS has not typically been good at decommissioning and disinvesting in services. The recent proposed changes to the commissioning function will mean that clinicians will have a leading role in population-based priority-setting. This could well enhance the quest for legitimacy in relation to difficult resource allocation decisions. However, it is unlikely that GPs alone will be able to meet the challenges ahead, and reasonable disinvestment decisions will require GPs to engage with a number of stakeholders including government, interest groups and the wider civic society.     

e Application of USB Interface in Da

示的电路中,通过使I/O引脚在高电平、低电平和高阻态三种状态间切换,就将电源分别设在上限、下限和额定输出电压三个值。为便于图解说明,此例中的电阻阻值是经计算得出的,而非标准阻值。若反馈电压V FB为0.8V,则只需求解出R FM1的阻值(必须在现有设计的R F1上并联一个电阻R FM1     

Without the denominator where is the quality improvement paradigm in the nation's health care reform?

This paper will argue that there is room for improvement in the quality of health care delivered in the United States. A quality improvement paradigm requires an assessment, inventory and prioritization of areas for improvement. It further nurtures the imperative of process improvement for the achievement of a targeted outcome. The dual obligations of reduction in outcome variability, and resource management, provide an exciting milieu for the integration of clinical practice, the numerator, with population based medicine, the denominator.     

Trust and affect: how do they impact risk information seeking in a health context?

This study examines college students’ intention to seek information about the H1N1 flu vaccine. We specifically focused on the relationship between trust and affect and whether they work together to influence risk information seeking. Results indicated that positive affect moderated the relationship between trust and information seeking, but negative affect did not. While both positive affect and negative affect influenced risk information seeking, when combined with trust, only positive affect remained as a significant predictor. These results suggest that by understanding the role that trust and affect play, medical professionals and disease control agencies can tailor their communication efforts to increase an individual’s intention to seek information about preventive measures. Specifically, maintaining the public’s trust and positive feelings toward these entities is key to successful communication about prevention measures such as vaccination.     

Processes of auditability in sustainability assurance – the case of materiality construction

This study examines how financial audit-styled concepts such as materiality are transferred to non-financial audit arenas. Drawing on a case study of assurors working within a Big 4 professional services firm, we uncover a number of interrelated features of the materiality determination and assessment process within sustainability assurance (assurance on sustainability reports). We illustrate how assuror flexibility, underpinned by assuror intuition, is central to uncovering assurance technologies deemed capable of addressing the materiality of ambiguous sustainability data. Assurors with no financial audit background retrospectively rationalise their intuition using the assumed authority of structured financial audit methodologies. This facilitates the tentative translation of financial audit knowledge to the sustainability assurance domain. Collaborative, holistic decision-making processes inform the assurors’ continual construction of materiality and are characterised by alliances of (accountant and non-accountant) ‘expert’ assurors merging formal and tacit knowledge. These alliances seek social cohesion within sustainability assurance teams in order to establish a social consensus among assurors around the materiality determination and assessment process. Our analysis develops and extends Power’s theorisation of how new areas are made auditable and advances our understanding of the more practical aspects of non-financial assurance services offered by Big 4 professional services firms.     

Is the social representation of nanotechnology anchored in that of GMOs?

The use of nanotechnology (devices/materials composed of parts less than 10 nanometres) in the development of new products is rapidly expanding. Industrialists and decision-makers consider nanotechnology to be the next industrial revolution, but fear they risk the same resistance to nanotechnology that their counterparts experienced with genetically modified organisms (GMOs). Although risk perception studies have shown that perceived risk of GMOs is quite high compared to that related to nanotechnology, no study to date has explored a potential direct social representation link between the two. The present study aims to fill that gap by comparing the social representations of nanotechnology and GMOs among a population of non-experts. This study was conducted with 282 students in human and social sciences and natural sciences. Using a free association task with the inductive words ‘nanotechnology’ and ‘GMO (genetically modified organism)’, we identified the existing social representations of the two based on a structural approach. While the representation of GMOs is objectified in the field of agriculture, objectification for nanotechnology seems to still be lacking, although its possible objectification likely lies in computing and robotics. Our calculation of the rate of similarity of associative words with nanotechnology and GMOs indicated no present, direct link between their social representations. We discuss the possible evolution of the social representation of nanotechnology over time.     

Students’ conceptions of learning in the context of an accounting degree

Students' conceptions of learning (CoL) play an important role in the learning process leading to the development of generic skills. This paper investigates whether CoL of accounting students can be developed by incorporating high-level cognitive skills progressively within the accounting curriculum. First, the study explored, using phenomenography, the variation in accounting students' CoL. The findings highlighted some nuances in accountings students' CoL and that lower-order CoL were prevalent among accounting students. However, more (less) third-year students than second-year students adopted higher- (lower-) order CoL. Upon examining the learning objectives, teaching methods and assessment of all units comprising the accounting major of the host university, evidence was found that CoL are progressively developed and shaped, albeit in a limited way, based on the levels of cognitive domain emphasised within the curriculum. The findings highlight the need for accounting educators to take a whole of the programme approach to developing higher-order CoL.     

Potential Business Opportunities in Construction of New Towns

A Summarized Introduction to the 6 Key Towns in Beijing:The construction of new towns in Beijing means a cut-in point to the accelerated urbanization of rural areas in the suburbs of the City, and is a stimulus to the modernization of the rural areas and the urbanization of the capital city. In order to speed up the construction of towns in the suburbs,     

The measurement of harmonization in the form and content of the auditor’s report in the European Union

This study attempts to determine the degree of harmonization in the form and content of the auditor’s report in the European Union. To accomplish this goal, audit reports from 1995 annual reports of the largest industrial companies in Austria, Belgium, Denmark, Finland, France, Germany, Ireland, Italy, Netherlands, Portugal, Spain, Sweden and the United Kingdom are analyzed. The analysis uses the basic elements of the auditor’s report listed in the International Standard on Auditing, “The Auditor’s Report on Financial Statements” as the control. Comparability is tested using the chi-square statistic which tests for equality of the proportions of the various elements in the auditor’s report across the Member States. The results reveal that harmonization exists in three of the five elements in the auditor report relating to form (appropriate title, the dating of the report and the listing of the location of the auditor’s office). Harmonization does not exist for the remaining two elements related to form, nor does it exist for any of elements related to content.