Back to the future in NHS reform

PURPOSE - In the mid 1990s the NHS ‘did’ competition, in the mid 2000s the NHS is ‘doing’ choice. This paper aims to cut through the rhetoric, highlight the differences and parallels between then and now and identify if these differences will have a different or the same impact on local services. DESIGN/METHODOLOGY/APPROACH – Following a review of literature from the 1990s, a qualitative research study is used to examine the impact of competition and markets in the 1990s. The discussion examines the implications of this study for current system reform. FINDINGS - Patient choice recreates many of the features of the internal market, but despite concerns at the time, the internal market did not have a significant impact on services. It is likely that patient choice will similarly have a limited impact. RESEARCH LIMITATIONS/IMPLICATIONS - The research is a case study confined to Day Surgery in one part of the North of England. ORIGINALITY/VALUE - The paper reminds academics and practitioners what happened last time the NHS attempted to introduce a market-based system

Human Errors in Data Breaches: An Exploratory Configurational Analysis

Information Systems (IS) are critical for employee productivity and organizational success. Data breaches are on the rise—with thousands of data breaches accounting for billions of records breached and annual global cybersecurity costs projected to reach $10.5 trillion by 2025. A data breach is the unauthorized disclosure of sensitive information—and can be achieved intentionally or unintentionally. Significant causes of data breaches are hacking and human error; in some estimates, human error accounted for about a quarter of all data breaches in 2018. Furthermore, the significance of human error on data breaches is largely underrepresented, as hackers often capitalize on organizational users’ human errors resulting in the compromise of systems or information. The research problem that this study addressed is that organizational data breaches caused by human error are both costly and have the most significant impact on Personally Identifiable Information (PII) breaches. Human error types can be classified in three categories—Skill-Based Error (SBE), Rule-Based Mistakes (RBM), and Knowledge-Based Mistakes (KBM)—tied to the associated levels of human performance. The various circumstantial and contextual factors that influence human performance to cause or contribute to human error are called Performance Influencing Factors (PIF). These PIFs have been examined in the safety literature and most notably in Human Reliability Analysis (HRA) applications. The list of PIFs is context specific and had yet to be comprehensively established in the cybersecurity literature—a significant research gap. The main goal of this research study was to employ configurational analysis—specifically, Fuzzy-Set Qualitative Analysis (fsQCA)—to empirically assess the conjunctural causal relationship of internal (individual) and external (organizational and contextual) Cybersecurity Performance Influencing Factors (CS-PIFs) leading to Cybersecurity Human Error (CS-HE) (SBE, RBM, and KBM) that resulted in the largest data breaches across multiple organization types from 2007 to 2019 in the United States (US). Feedback was solicited from 31 Cybersecurity Subject Matter Experts (SME), and they identified 1st order CS-PIFs and validated the following 2nd order CS-PIFs: organizational cybersecurity; cybersecurity policies and procedures; cybersecurity education, training, and awareness; ergonomics; cybersecurity knowledge, skills, and abilities; and employee cybersecurity fitness for duty. Utilizing data collected from 102 data breach cases, this research found that multiple combinations, or causal recipes, of CS-PIFs led to certain CS-HEs, that resulted in data breaches. Specifically, seven of the 36 fsQCA models had solution consistencies that exceeded the minimum threshold of 0.80, thereby providing argument for the contextual nature of CS-PIFs, CS-HE, and data breaches. Two additional findings were also discovered—five sufficient configurations were present in two models, and the absence of strong cybersecurity knowledge, skills, and abilities is a necessary condition for all cybersecurity human error outcomes in the observed cases

Burnout in the Workplace: A Review of the Data and Policy Responses in the EU

This report looks at the extent of burnout experienced by workers in the EU, based on national research. As a starting point, the report sets out to consider whether burnout is viewed as a medical or occupational disease. It then examines the work determinants associated with burnout and looks at the effects of burnout, including psychosocial and physical work factors, work intensity and work organisation. It also reviews national strategies and policies regarding this issue, the involvement of the social partners in the current debate, as well as preventive actions currently in place

Truck accident litigation

Meeting proceedings of a seminar by the same name, held March 4, 2020

The OMERACT-OARSI Core Domain Set for Measurement in Clinical Trials of Hip and/or Knee Osteoarthritis

Objective: To update the 1997 OMERACT-OARSI (Outcome Measures in Rheumatology-Osteoarthritis Research Society International) core domain set for clinical trials in hip and/or knee osteoarthritis (OA). Methods: An initial review of the COMET database of core outcome sets (COS) was undertaken to identify all domains reported in previous COS including individuals with hip and/or knee OA. These were presented during 5 patient and health professionals/researcher meetings in 3 continents (Europe, Australasia, North America). A 3-round international Delphi survey was then undertaken among patients, healthcare professionals, researchers, and industry representatives to gain consensus on key domains to be included in a core domain set for hip and/or knee OA. Findings were presented and discussed in small groups at OMERACT 2018, where consensus was obtained in the final plenary. Results: Four previous COS were identified. Using these, and the patient and health professionals/researcher meetings, 50 potential domains formed the Delphi survey. There were 426 individuals from 25 different countries who contributed to the Delphi exercise. OMERACT 2018 delegates (n = 129) voted on candidate domains. Six domains gained agreement as mandatory to be measured and reported in all hip and/or knee OA clinical trials: pain, physical function, quality of life, and patient’s global assessment of the target joint, in addition to the mandated core domain of adverse events including mortality. Joint structure was agreed as mandatory in specific circumstances, i.e., depending on the intervention. Conclusion: The updated core domain set for hip and/or knee OA has been agreed upon. Work will commence to determine which outcome measurement instrument should be recommended to cover each core domain

An exploration of the social factors that may have contributed in the UK to perceptions of work-relevant upper limb disorders in keyboard users

The outputs that form the basis of this PhD submission include a web site that summarises a unique collection of over 200 Court Judgments in personal injury claims for work-related upper limb disorders heard in the UK, together with a number of more conventional publications. Individually, these outputs all address upper limb disorders associated with work although they each had slightly different objectives and the audiences for which they were produced significantly influenced the type of publication in which they appeared. Together, they help illustrate when, how and, to some extent, why upper limb disorders associated with keyboard use became the issue it did in the UK in the late 1980s and 1990s. While many might now regard keyboard or computer use as an innocuous task, in the late 1980s and 1990s upper limb disorders associated with keyboard use, particularly computer use, became the subject of litigation, legislation, industrial disputes and widespread publicity. The outputs on which this submission is based, together, suggest that following the importation of the concept of repetitive strain injuries (RSI) from Australia in the later 1980s, the activities of trades unions and journalists in the UK promoted work-relevant upper limb symptoms and disorders associated with keyboard use as work-induced injuries. Subsequently, a small number of successful, union-backed, personal injury claims, which involved contentious medical evidence and perhaps an element of iatrogenesis, were widely promoted as proof that computer use causes injury. Around the same time, the government chose to implement flawed Regulations relating to the design and use of computer workstations, which failed to distinguish between that which might give rise to discomfort, fatigue and frustration and that which might give rise to injury. The existence of these Regulations, which among other things require regular, individual risk assessments of computer users, unlike any other type of work, could be interpreted as further 'proof' that computer use causes injury. The approach to the prevention and management of musculoskeletal disorders advocated in current HSE guidance, including the risk assessment strategy, remain capable of generating distorted perceptions of the risks arising from keyboard and computer use

Predicting Bearing Fault in the Drone Freight Industry: Legal Liability in Australia

Many people are now aware of drones or remotely piloted aircraft (RPAs), and several others have predicted the significant impacts that drones will bring across society. Today, there is an expectation that drones will play a pivotal role in industries such as surveillance, security, surveying, construction, and freight transport. However, in all these cases, whenever a drone is flying over a populated area, it poses a danger to people or things on the ground. Perhaps the sector where the greatest risk of injury to the everyday person exists is the drone delivery industry. The drone freight industry is proliferating fast, with many companies like Skycart and Amazon investing in this sector. These companies plan to transport groceries, medical supplies, food, and par- cels, among many other things. If fleets of delivery drones are deployed around suburbs, the descent to lower altitudes and the general logistics of an airborne delivery presents a novel risk of harm. A drone failure resulting in a crash could lead to property damage, destruction of natural environments, and injury or death to persons, especially in areas of high population density. One promising way to prevent such harm is to use structural condition monitoring technology to preempt any deterioration of the airworthiness of a drone. In the absence of any existing precedent or authority on this, this Article investigates the legal implications of using such technology to guide future regulations and areas of research