Corporate governance in the NHS

Corporate Governance - which is concerned with the management and direction of organizations at the very highest level - has grown in importance in the private sector, from where the concept largely derives, as a result mainly of malpractice. As a consequence, interest in the topic has grown steadily, largely on the part of Governments, regulators and academics. Managerial reforms of the NHS introduced refashioned District Health Authorities (DHAs) which mimic the role and structure of the Company board. The research reported in this thesis is an assessment of corporate governance in post reform English DHAs. The research examines the characteristics of directors, the extent to which corporate governance can be empirically demonstrated, the extent to which it is consistent with the Working for Patients reforms, and, the consequences of such changes for the development of directors and of DHAs. The research also considers the relevance of the findings to other parts of the NHS and public sector. The work draws upon the conceptual framework established by Tricker (1984; also Hilmer & Tricker 1991) with detailed survey and case study findings concerned with issues of direction, executive management, supervision and accountability. The findings from this new research make an important contribution to the policy debate and to the literature(s) concerned

Small angle neutron scattering (SANS) studies of diffusion in bulk polystyrene near the glass transition temperature (Tg)

Ultraslow diffusion in bulk polymers has been measured by SANS. The experiment begins by measuring scattering from heterogeneous specimens containing domains of protonated‐and deuterated‐polymers at temperatures far below Tg. The samples are subsequently held [annealed] above Tg for a known time‐interval, then cooled below Tg where SANS is measured again. Scattering changes, from before to after annealing, are analysed to obtain diffusion coefficients. The recent Summerfield ‐ Ullman procedure is used to deconvolute portions of the scattering curve that decrease and increase with annealing time. Because of SANS sensitivity to small distances, the method yields D ≈ 10−18 to 10−15 cm2/s after annealing times of 1–24 h. Data analysis is complicated by “smearing effects” which produce apparent Q‐dependent diffusion coefficients. Representative experimental results on polystyrene at 108°–130°C are discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/112190/1/19880150127_ftp.pd

S-Duality at the Black Hole Threshold in Gravitational Collapse

We study gravitational collapse of the axion/dilaton field in classical low energy string theory, at the threshold for black hole formation. A new critical solution is derived that is spherically symmetric and continuously self-similar. The universal scaling and echoing behavior discovered by Choptuik in gravitational collapse appear in a somewhat different form. In particular, echoing takes the form of SL(2,R) rotations (cf. S-duality). The collapse leaves behind an outgoing pulse of axion/dilaton radiation, with nearly but not exactly flat spacetime within it.Comment: 8 pages of LaTeX, uses style "revtex"; 1 figure, available in archive, or at ftp://ftp.itp.ucsb.edu/figures/nsf-itp-95-15.ep

Chaotic Behavior in an Array of Coupled Josephson Weak Links

Using the resistively shunted junction model, an array of three resistively coupled, noncapacitive, Josephson weak links, driven only by dc bias currents, is studied for the existence of chaos. This system represents one of the set of three simplest Josephson systems that, in principle, can have chaotic dynamics. The results attest to the validity of the Ruelle-Takens-Newhouse scenario for the onset of chaos

Toward Better Understanding on How Group A <em>Streptococcus</em> Manipulates Human Fibrinolytic System

Group A Streptococcus pyogenes (GAS) is a human pathogen that commonly causes superficial infections such as pharyngitis, but can also lead to systemic and fatal diseases. GAS infection remains to be a major threat in regions with insufficient medical infrastructures, leading to half a million deaths annually worldwide. The pathogenesis of GAS is mediated by a number of virulence factors, which function to facilitate bacterial colonization, immune evasion, and deep tissue invasion. In this review, we will discuss the mechanism of molecular interaction between the host protein and virulence factors that target the fibrinolytic system, including streptokinase (SK), plasminogen-binding group A streptococcal M-like protein (PAM), and streptococcal inhibitor of complement (SIC). We will discuss our current understanding, through structural studies, on how these proteins manipulate the fibrinolytic system during infection

Ancient high-energy storm boulder deposits on Ko Samui, Thailand, and their significance for identifying coastal hazard risk

© 2016 Elsevier B.V. Coastal geomorphic processes associated with high-energy storm events are difficult to estimate over recent geological history, though their frequency and magnitude are important to assess in order to understand present-day coastal vulnerability. Studying ancient coastal boulder deposits can shed light on the previous physical conditions necessary for their deposition. In this study, we estimated the physical processes required to move reef-derived coral boulders on the east coast of Ko Samui, a rapidly developing tourist island off eastern peninsular Thailand. The position and dimensions of 97 coral boulders (weight: mean 2.9. t, max. 12.7. t; transport distance: max. 125. m) were measured at two sites and dated using uranium/thorium methods. Flow velocities of 2.3-8.6. m/s were required to transport the measured boulders, with individuals deposited up to 4.7. m above mean sea level. Age-dating suggests that events capable of the highest flow velocities occurred around AD 1600 and AD 1750. These were probably driven by tropical cyclones (typhoons). Boulder transport by events of similar magnitude has not been detected within the last 250. years. The non-occurrence of similar events in living memory has implications for hazard perceptions at this important tourist destination. However, there is also evidence of substantial Holocene sea-level changes in the Gulf of Thailand, as observed at nearby Ko Phaluai. This potentially offers a challenge for the interpretation of older boulders dating from the mid-Holocene, as sea level may have been more than 2. m higher than present. Thus, studies using coral boulders as a proxy for past storm-wave conditions must consider the broader sea-level history, and are probably best limited to the period post-2000. BP in the Gulf of Thailand

Choosing between Research Rigour or Support for Advocacy Movements, a False Dichotomy?

Using the case study of the Hunger and Nutrition Commitment Index (HANCI), this article seeks to answer key questions relating to the conceptualisation and operationalisation of engaged excellence, exploring the tensions between research and policy advocacy. While the concept of ‘engaged excellence’ recognises that excellence can be constituted by high‑quality research as well as by research that supports efforts to influence policy, it could be more specific in taking position on discussions that situate these to be mutually incompatible. Evidence from multiple contexts has shown that research is much more likely to influence policy if researchers engage with civil society. Research for international development, which explicitly aims to reduce inequalities, accelerate sustainability, and build more inclusive societies, can gain from active engagement with policy advocates. It is a false dichotomy to separate out research from research for advocacy, and there is much to be gained from such a collaboration

The Importance of Small Fire Refugia in the Central Sierra Nevada, California, USA

Fire refugia – the unburned areas within fire perimeters – are important to the survival of many taxa through fire events and the revegetation of post-fire landscapes. Previous work has shown that species use and benefit from small-scale fire refugia (1 m2 to 1000 m2), but our understanding of where and how fire refugia form is largely limited to the scale of remotely sensed data (i.e., 900 m2 Landsat pixels). To examine the causes and consequences of small fire refugia, we field-mapped all unburned patches ≥1 m2 within a contiguous 25.6 ha forest plot that burned at generally low-to-moderate severity in the 2013 Yosemite Rim Fire, California, USA. Within the Yosemite Forest Dynamics Plot (YFDP), there were 685 unburned patches ≥1 m2, covering a total unburned area of 12,597 m2 (4.9%). Small refugia occurred in all fire severity classifications. Random forest models showed that the proportion of unburned area of 100 m2 grid cells corresponded to pre-fire density and basal area of trees, distance to the nearest stream, and immediate fire mortality, but the relationships were complex and model accuracy was variable. From a pre-fire population of 34,061 total trees ≥1 cm diameter at breast height (1.37 m; DBH) within the plot (1,330 trees ha-1), trees of all five of the most common species and those DBH \u3c30 cm had higher immediate survival rates if their boles were wholly or partially within an unburned patch (P ≤0.001). Trees 1 cm ≤ DBH \u3c10 that survived were located closer to the center of the unburned patch than the edge (mean 1.1 m versus 0.6 m; ANOVA; P ≤0.001). Four-year survival rates for trees 1 cm ≤ DBH \u3c10 cm were 58.8% within small refugia and 2.7% in burned areas (P ≤0.001). Species richness and the Shannon Diversity Index (SDI) were associated with unburned quadrats in NMDS ordinations 3 years post-fire. Burn heterogeneity in mixed-conifer forests likely exists at all scales and small refugia contribute to diversity of forest species and structures. Thus, managers may wish to consider scales from 1-m2 to the landscape when designing fuel reduction prescriptions. The partial predictability of refugia location suggests that further work may lead to predictive models of refugial presence that have considerable potential to preserve ecological function or human habitation in fire-frequent forests

Exploring the mutual influence among the social innovation factors amid the COVID-19 pandemic

From the triple bottom line, the social aspect has received relatively limited attention during the Corona Virus Disease (COVID-19) pandemic, particularly in the emerging economies. Social innovation factors help improve the sustainability performance of the companies. This study develops a social innovation decision framework and analyses the interrelationships among social innovation factors considering the COVID-19 situation. For this purpose, the Decision-Making Trial and Evaluation Laboratory (DEMATEL) is extended by integrating the Z numbers and rough fuzzy set theory into its computational procedure. Z-numbers address the uncertainty of the decision and experts’ confidence in the evaluation and rough numbers are used for aggregating the experts’ opinions. On this basis, the mutual influence of social innovation factors and the influence weights of these factors are investigated. The results suggest that a quick response to market demand for sustainable products is the most influential factor in attaining social sustainability innovation during the pandemic. This article is concluded by providing insights for industrial experts and decision-makers to understand the underpinnings of social sustainability innovation during unforeseen situations

Eating with a smaller spoon decreases bite size, eating rate and ad libitum food intake in healthy young males

There is a paucity of data examining the effect of cutlery size on the microstructure of within-meal eating behaviour or food intake. Therefore, the present studies examined how manipulation of spoon size influenced these eating behaviour measures in lean young men. In study one, subjects ate a semi-solid porridge breakfast ad libitum, until satiation. In study two, subjects ate a standardised amount of porridge, with mean bite size and mean eating rate covertly measured by observation through a one-way mirror. Both studies involved subjects completing a familiarisation visit and two experimental visits, where they ate with a teaspoon (SMALL) or dessert spoon (LARGE), in randomised order. Subjective appetite measures (hunger, fullness, desire to eat and satisfaction) were made before and after meals. In study one, subjects ate 8 % less food when they ate with the SMALL spoon (SMALL 532 (SD 189) g; LARGE 575 (SD 227) g; P=0·006). In study two, mean bite size (SMALL 10·5 (SD 1·3) g; LARGE 13·7 (SD 2·6) g; P<0·001) and eating rate (SMALL 92 (SD 25) g/min; LARGE 108 (SD 29) g/min; P<0·001) were reduced in the SMALL condition. There were no condition or interaction effects for subjective appetite measures. These results suggest that eating with a small spoon decreases ad libitum food intake, possibly via a cascade of effects on within-meal eating microstructure. A small spoon might be a practical strategy for decreasing bite size and eating rate, likely increasing oral processing, and subsequently decreasing food intake, at least in lean young men