Contractual acrobatics: a configurational analysis of outcome specifications and payment in outcome-based contracts

Outcome-based contracting (OBC) seeks to improve public services by paying for service outcomes rather than service activities. This article explores the link between how outcomes are contractually specified and how much is paid for their achievement. Using fuzzy-set Qualitative Comparative Analysis, we test a framework for assessing the strength of outcome specifications in 34 UK-based social impact bonds, a particular form of OBC. Results show that contract features which define intended participant cohorts and include deadweight estimation approaches help constrain suppliers’ ability to appropriate value and thus reduce the likelihood that public managers pay for social outcomes of questionable value

A scoping study for potential community‐based carbon offsetting schemes in the Falkland Islands

A report to Falklands Conservation. In this report, we consider the potential for a future Falkland Island carbon offsetting scheme. Such a scheme would provide a mechanism by which businesses, organisations and individuals could invest in land‐management and restoration schemes that would deliver greenhouse gas reductions or removals, delivering financial support to farmers and others to adopt sustainable land‐management practices, undertake restoration and increase the extent of ecologically valuable habitats. Overall, we consider that a Falkland Island peatland carbon offsetting scheme would have the potential to deliver significant climate change mitigation, to support habitat conservation, and to generate new sources of income for farmers, other landowners and the Islands as a whole. Any scheme would need to be sustainable and developed in partnership with the camp community and wider Falkland society to ensure that it is appropriate for the culture, economics and environment of the Islands

Remembrance and Wellness Five Years After 9/11

It has been five years. For some people time has barely passed. Tuesday, September 11, 2001 feels like yesterday. To others these last five years seem an eternity. Many people have slipped back into their everyday lives. The horrific images, unimaginable sadness, security threats and unanswered questions have given way to a world that on the surface feels predictable and safe. But there are abrupt reminders that the world is not safe or predictable; everything familiar to us can change in an instant

Sequence- and structure-specific cytosine-5 mRNA methylation by NSUN6.

The highly abundant N6-methyladenosine (m6A) RNA modification affects most aspects of mRNA function, yet the precise function of the rarer 5-methylcytidine (m5C) remains largely unknown. Here, we map m5C in the human transcriptome using methylation-dependent individual-nucleotide resolution cross-linking and immunoprecipitation (miCLIP) combined with RNA bisulfite sequencing. We identify NSUN6 as a methyltransferase with strong substrate specificity towards mRNA. NSUN6 primarily targeted three prime untranslated regions (3'UTR) at the consensus sequence motif CTCCA, located in loops of hairpin structures. Knockout and rescue experiments revealed enhanced mRNA and translation levels when NSUN6-targeted mRNAs were methylated. Ribosome profiling further demonstrated that NSUN6-specific methylation correlated with translation termination. While NSUN6 was dispensable for mouse embryonic development, it was down-regulated in human tumours and high expression of NSUN6 indicated better patient outcome of certain cancer types. In summary, our study identifies NSUN6 as a methyltransferase targeting mRNA, potentially as part of a quality control mechanism involved in translation termination fidelity

Computer-aided recording of automatic endoscope washing and disinfection processes as an integral part of medical documentation for quality assurance purposes

<p>Abstract</p> <p>Background</p> <p>The reprocessing of medical endoscopes is carried out using automatic cleaning and disinfection machines. The documentation and archiving of records of properly conducted reprocessing procedures is the last and increasingly important part of the reprocessing cycle for flexible endoscopes.</p> <p>Methods</p> <p>This report describes a new computer program designed to monitor and document the automatic reprocessing of flexible endoscopes and accessories in fully automatic washer-disinfectors; it does not contain nor compensate the manual cleaning step. The program implements national standards for the monitoring of hygiene in flexible endoscopes and the guidelines for the reprocessing of medical products. No FDA approval has been obtained up to now. The advantages of this newly developed computer program are firstly that it simplifies the documentation procedures of medical endoscopes and that it could be used universally with any washer-disinfector and that it is independent of the various interfaces and software products provided by the individual suppliers of washer-disinfectors.</p> <p>Results</p> <p>The computer program presented here has been tested on a total of four washer-disinfectors in more than 6000 medical examinations within 9 months.</p> <p>Conclusions</p> <p>We present for the first time an electronic documentation system for automated washer-disinfectors for medical devices e.g. flexible endoscopes which can be used on any washer-disinfectors that documents the procedures involved in the automatic cleaning process and can be easily connected to most hospital documentation systems.</p

Impact of residual risk messaging to reduce false reassurance following test-negative results from asymptomatic coronavirus (SARS-CoV-2) testing: an online experimental study of a hypothetical test.

OBJECTIVES: Individuals who receive a negative lateral flow coronavirus test result may misunderstand it as meaning 'no risk of infectiousness', giving false reassurance. This experiment tested the impact of adding information to negative test result messages about residual risk and the need to continue protective behaviours. DESIGN: 4 (residual risk) × 2 (post-test result behaviours) between-subjects design. SETTING: Online. PARTICIPANTS: 1200 adults from a representative UK sample recruited via Prolific (12-15 March 2021). INTERVENTIONS: Participants were randomly allocated to one of eight messages. Residual risk messages were: (1) 'Your coronavirus test result is negative' (control); (2) message 1 plus 'It's likely you were not infectious when the test was done' (current NHS Test & Trace (T&T); (3) message 2 plus 'But there is still a chance you may be infectious' (elaborated NHS T&T); and (4) message 3 plus infographic depicting residual risk (elaborated NHS T&T+infographic). Each message contained either no additional information or information about the need to continue following guidelines and protective behaviours. OUTCOME MEASURES: (1) Proportion understanding residual risk of infectiousness and (2) likelihood of engaging in protective behaviours (scales 1-7). RESULTS: The control message decreased understanding relative to the current NHS T&T message: 54% versus 71% (Adjusted Odds Ratio (AOR)=0.56 95% CI 0.34 to 0.95, p=0.030). Understanding increased with the elaborated NHS T&T (89%; AOR=3.25 95% CI 1.64 to 6.42, p=0.001) and elaborated NHS T&T+infographic (91%; AOR=5.16 95% CI 2.47 to 10.82, p<0.001) compared with current NHS T&T message. Likelihood of engaging in protective behaviours was unaffected by information (AOR=1.11 95% CI 0.69 to 1.80, χ2(1)=0.18, p=0.669), being high (M=6.4, SD=0.9) across the sample. CONCLUSIONS: A considerable proportion of participants misunderstood the residual risk following a negative test result. The addition of a single sentence ('But there is still a chance you may be infectious') to current NHS T&T wording increased understanding of residual risk. TRIAL REGISTRATION NUMBER: OSF: https://osf.io/byfz3/

Impact of residual risk messaging to reduce false reassurance following test-negative results from asymptomatic coronavirus (SARS-CoV-2) testing: an online experimental study of a hypothetical test.

OBJECTIVES: Individuals who receive a negative lateral flow coronavirus test result may misunderstand it as meaning 'no risk of infectiousness', giving false reassurance. This experiment tested the impact of adding information to negative test result messages about residual risk and the need to continue protective behaviours. DESIGN: 4 (residual risk) × 2 (post-test result behaviours) between-subjects design. SETTING: Online. PARTICIPANTS: 1200 adults from a representative UK sample recruited via Prolific (12-15 March 2021). INTERVENTIONS: Participants were randomly allocated to one of eight messages. Residual risk messages were: (1) 'Your coronavirus test result is negative' (control); (2) message 1 plus 'It's likely you were not infectious when the test was done' (current NHS Test & Trace (T&T); (3) message 2 plus 'But there is still a chance you may be infectious' (elaborated NHS T&T); and (4) message 3 plus infographic depicting residual risk (elaborated NHS T&T+infographic). Each message contained either no additional information or information about the need to continue following guidelines and protective behaviours. OUTCOME MEASURES: (1) Proportion understanding residual risk of infectiousness and (2) likelihood of engaging in protective behaviours (scales 1-7). RESULTS: The control message decreased understanding relative to the current NHS T&T message: 54% versus 71% (Adjusted Odds Ratio (AOR)=0.56 95% CI 0.34 to 0.95, p=0.030). Understanding increased with the elaborated NHS T&T (89%; AOR=3.25 95% CI 1.64 to 6.42, p=0.001) and elaborated NHS T&T+infographic (91%; AOR=5.16 95% CI 2.47 to 10.82, p<0.001) compared with current NHS T&T message. Likelihood of engaging in protective behaviours was unaffected by information (AOR=1.11 95% CI 0.69 to 1.80, χ2(1)=0.18, p=0.669), being high (M=6.4, SD=0.9) across the sample. CONCLUSIONS: A considerable proportion of participants misunderstood the residual risk following a negative test result. The addition of a single sentence ('But there is still a chance you may be infectious') to current NHS T&T wording increased understanding of residual risk. TRIAL REGISTRATION NUMBER: OSF: https://osf.io/byfz3/