Exploring value creation from an ecosystem perspective: A critical examination of social procurement policy

From qualitative research undertaken in Scotland, the authors analyse procurement policy reforms. Utilizing a public service ecosystem framework, barriers to value creation were found, including overly bureaucratic practices, centrally devised rules, and conflicting organizational aims. The authors develop insights into ways policy design and implementation creates (or does not create) value across the many levels of an ecosystem where procurement policy reforms have impact, demonstrating the benefits of using a service ecosystem framework for understanding nuanced impacts and perceptions of policy implementation

Exploring value creation from an ecosystem perspective: A critical examination of social procurement policy

From qualitative research undertaken in Scotland, the authors analyse procurement policy reforms. Utilizing a public service ecosystem framework, barriers to value creation were found, including overly bureaucratic practices, centrally devised rules, and conflicting organizational aims. The authors develop insights into ways policy design and implementation creates (or does not create) value across the many levels of an ecosystem where procurement policy reforms have impact, demonstrating the benefits of using a service ecosystem framework for understanding nuanced impacts and perceptions of policy implementation

Multi-ancestry genome-wide association study of 21,000 cases and 95,000 controls identifies new risk loci for atopic dermatitis

Genetic association studies have identified 21 loci associated with atopic dermatitis risk predominantly in populations of European ancestry. To identify further susceptibility loci for this common, complex skin disease, we performed a meta-analysis of >15 million genetic variants in 21,399 cases and 95,464 controls from populations of European, African, Japanese and Latino ancestry, followed by replication in 32,059 cases and 228,628 controls from 18 studies. We identified ten new risk loci, bringing the total number of known atopic dermatitis risk loci to 31 (with new secondary signals at four of these loci). Notably, the new loci include candidate genes with roles in the regulation of innate host defenses and T cell function, underscoring the important contribution of (auto)immune mechanisms to atopic dermatitis pathogenesis

Exploring value creation from an ecosystem perspective: A critical examination of social procurement policy

IMPACT: Public procurement policy reforms, and specifically social procurement practices designed to support the social economy and create social value, are growing in popularity. However, there is still limited knowledge around the extent to which rhetorical aims of procurement reforms are perceived to be realized through the implementation of social procurement policies. This research provides important insights for social procurement advocates and, in particular, for policy-makers and public managers working at all levels of government. The authors highlight how reforms in Scotland have seemingly benefited the social economy by tangibly directing significant spend toward social economy organizations and changing societal and individual beliefs about their social and economic value. At the same time, there are still barriers to value creation at organizational and individual levels. These findings are important for those attempting to strengthen their social procurement policies and encourage collaboration in a way that advantages actors working across the public service ecosystem.</p

Exploring value creation from an ecosystem perspective : a critical examination of social procurement policy

From qualitative research undertaken in Scotland, we analyse procurement policy reforms. Utilising a public service ecosystem framework, we find barriers to value creation include overly bureaucratic practices, centrally devised rules, and conflicting organizational aims. We develop insights into ways policy design and implementation creates (/ does not create) value across the many levels of an ecosystem where procurement policy reforms have impact, demonstrating the benefits of using a service ecosystem framework for understanding nuanced impacts and perceptions of policy implementation

Do stroke clinical practice guideline recommendations for the intervention of thickened liquids for aspiration support evidence based decision making? A systemetic review and narrative synthesis

Background Aspiration is a common sequela post stroke as a result of oropharyngeal dysphagia. It is primarily managed by recommending thickened liquids whereby a thickening agent is added to liquids to increase viscosity and slow bolus speed. However, the evidence supporting this intervention is not strong and clinicians may rely on tools such as clinical practice guidelines to support clinical decision-making. The purpose of this systematic review and narrative synthesis was to evaluate the evidentiary bases of recommendations made by clinical guidelines regarding the thickened liquids intervention. Methods A systematic review was conducted on stroke clinical guidelines retrieved via searches conducted across a range of databases including Academic Search Complete, CINAHL, MEDLINE and the Cochrane Library as well as through association websites. Guidelines were eligible for inclusion if they focused on adult stroke populations, made recommendations relating to the intervention of thickened liquids and were published after January 2010 and before December 2018. Four independent reviewers rated the methodological quality of the guidelines using the AGREE-II instrument. Intervention recommendations were extracted and analysed using the Criteria for Levels of Evidence Reported from the Canadian Stroke Best Practice Recommendations and a framework examining the evidence used by guidelines to support intervention recommendations. Results Thirteen clinical guidelines were included in the review. The methodological quality of included guidelines was variable but generally good-excellent overall. Thirty recommendations regarding the intervention were extracted. Of these, 16 recommendations were classed as a recommendation to use the treatment and all guidelines made this recommendation. Much of the evidence used to scaffold recommendations did not directly support the intervention and the evidence used was inconsistent across recommendations. Conclusions Despite the limited evidence base for the thickened liquid intervention, there was consensus evident among stroke guidelines in recommending it. This is despite limited empirical support. Further, much of the evidence used to support recommendations was not appropriate, suggesting less than satisfactory evidence-based practices in formulating recommendations. In this case, clinical guidelines may not be reliable decision-support tools for facilitating clinical decision-making

Multi-ethnic genome-wide association study of 21,000 cases and 95,000 controls identifies new risk loci for atopic dermatitis

Genetic association studies have identified 21 loci associated with atopic dermatitis risk predominantly in populations of European ancestry. To identify further susceptibility loci for this common complex skin disease, we performed a meta-analysis of >15 million genetic variants in 21,399 cases and 95,464 controls from populations of European, African, Japanese and Latino ancestry, followed by replication in 32,059 cases and 228,628 controls from 18 studies. We identified 10 novel risk loci, bringing the total number of known atopic dermatitis risk loci to 31 (with novel secondary signals at 4 of these). Notably, the new loci include candidate genes with roles in regulation of innate host defenses and T-cell function, underscoring the important contribution of (auto-)immune mechanisms to atopic dermatitis pathogenesis