The incentive effects of payment by results

Recently the English NHS has introduced an activity-based payment scheme for secondary care - the Payment by Results (PbR) policy. In this paper we discuss, from an economic perspective, the main intended and unintended incentives created by this policy. We also outline the role of different NHS institutions in monitoring and analysing the impact of PbR and consider the information and data requirements for such tasks.

Bacteriophage-mediated competition in Bordetella bacteria

Apparent competition between species is believed to be one of the principle driving forces that structure ecological communities, although the precise mecha nisms have yet to be characterized. Here we develop a model system that isolates phage-mediated interactions by neutralizing resource competition using two genetically identical Bordetella bronchiseptica strains that differ only in that one is the carrier of a phage and the other is susceptible to the phage. We observe and quantify the competitive advantage of the bacterial strain bearing the prophage in both invading and in resisting invasion by bacteria susceptible to the phage, and use our measurements to develop a mathematical model of phage-mediated competition. The model predicts, and experimental evidence confirms, that the competitive advantage conferred by the phage depends only on the relative phage pathology and is independent of other phage and host parameters. This work combines experimental and mathematical approaches to the study of phage-driven competition, and provides an experimentally tested framework for evaluation of the effects of pathogens/parasites on interspecific competition.Comment: 10pages, 8 figure

Establishing a Fair Playing Field for Payment by Results

The English government has encouraged private providers – known as Independent Sector Treatment Centres (ISTCs) – to treat publicly funded (NHS) patients. Providers are paid a fixed price per patient treated, adjusted to reflect geographical differences in input costs. But there may be other legitimate cost variations between providers. This report considers the regulatory and production-process constraints that could cause public and private providers costs to differ. Most of these exogenous cost differentials can be rectified by adjustments to the regulatory system or to the payment method. We find evidence that ISTCs are treating different types of patients than NHS hospitals. If these differences drive costs, payments for treatment might need to be differentiated by setting.

GeneFishing to reconstruct context specific portraits of biological processes.

Rapid advances in genomic technologies have led to a wealth of diverse data, from which novel discoveries can be gleaned through the application of robust statistical and computational methods. Here, we describe GeneFishing, a semisupervised computational approach to reconstruct context-specific portraits of biological processes by leveraging gene-gene coexpression information. GeneFishing incorporates multiple high-dimensional statistical ideas, including dimensionality reduction, clustering, subsampling, and results aggregation, to produce robust results. To illustrate the power of our method, we applied it using 21 genes involved in cholesterol metabolism as "bait" to "fish out" (or identify) genes not previously identified as being connected to cholesterol metabolism. Using simulation and real datasets, we found that the results obtained through GeneFishing were more interesting for our study than those provided by related gene prioritization methods. In particular, application of GeneFishing to the GTEx liver RNA sequencing (RNAseq) data not only reidentified many known cholesterol-related genes, but also pointed to glyoxalase I (GLO1) as a gene implicated in cholesterol metabolism. In a follow-up experiment, we found that GLO1 knockdown in human hepatoma cell lines increased levels of cellular cholesterol ester, validating a role for GLO1 in cholesterol metabolism. In addition, we performed pantissue analysis by applying GeneFishing on various tissues and identified many potential tissue-specific cholesterol metabolism-related genes. GeneFishing appears to be a powerful tool for identifying related components of complex biological systems and may be used across a wide range of applications

AMPA-15N - Synthesis and application as standard compound in traceable degradation studies of glyphosate

Stable isotope labeling of pollutants is a valuable tool to investigate their environmental transport and degradation. For the globally most frequently used herbicide glyphosate, such studies have, so far, been hampered by the absence of an analytical standard for its labeled metabolite AMPA-15N, which is formed during the degradation of all commercially available glyphosate isotopologues. Without such a standard, detection and quantitation of AMPA-15N, e.g. with LC-MS/MS, is not possible. Therefore, a synthetic pathway to AMPA-15N from benzamide-15N via the hemiaminal was developed. AMPA-15N was obtained in sufficient yield and purity to be used as a standard compound for LC-MS/MS analysis. Suitable MS-detection settings as well as a calibration using the internal standard (IS) approach were established for Fmoc-derivatized AMPA-15N. The use of different AMPA isotopologues as IS was complicated by the parallel formation of [M+H]+ and [M]+• AMPA-Fmoc precursor ions in ESI-positive mode, causing signal interferences between analyte and IS. We recommend the use of either AMPA-13C-15N, AMPA-13C-15N-D2 or a glyphosate isotopologue as IS, as they do not affect the linearity of the calibration curve. As a proof of concept, the developed analysis procedure for AMPA-15N was used to refine the results from a field lysimeter experiment investigating leaching and degradation of glyphosate-2-13C-15N. The newly enabled quantitation of AMPA-15N in soil extracts showed that similar amounts (0.05 - 0.22 mg·kg-1) of the parent herbicide glyphosate and its primary metabolite AMPA persisted in the topsoil over the study period of one year, while vertical transport through the soil column did not occur for either of the compounds. The herein developed analysis concepts will facilitate future design and execution of experiments on the environmental fate of the herbicide glyphosate

Innovation calling-components of the innovative organisation : a call centre perspective

This paper presents a literature review that was carried out to understand and group the organisational characteristics that affect the front-line employees innovative ability to encourage incremental process innovation. The findings of the literature review identified six key organisational areas and subsequent components that were important to stimulating innovative ability. To understand how the organisational components could be related to a particular context they were discussed in relation to a mass production form of call centre that are focused on cost reduction and operational efficiency. It was found that by analysing the context in relation to the organisational components of an innovative organisation that it could be concluded that mass production call centres do not have the characteristics that are apparent of an innovative organisation, which leads to the identification of a wider research area that links types of call centre with their organisational characteristics and their innovative ability. The paper also identifies that the matter of front-line employees role in the organisational innovative ability of call centres is a research area that requires further empirical investigation in order that innovation can be used to support call centres move up the value chain

Barriers to Family Suspicious Activity Reporting (SAR) of Mobilization Behaviors and Pre-Operational Planning: Report to the U.S. Department of Homeland Security

As part of a NCITE funded project, the “Building Family Resilience as a Form of Terrorism Prevention focuses on how to support bystanders\u27 response to potential radicalization of someone they know and care about. While this project addresses the relationship among family members, the study has broader application to other types of bystanders such as K-12 educators, school counselors, and athletic coaches; all of whom are well positioned to prevent and intervene with youth radicalization. The project is focused on how relatives interpret potential “warning signs” and what, if any, action they pursue to address perceived radicalization. As part of this study, we assess whether relatives contact any governmental or non-governmental authorities to help address the issue

Understanding how organisational characteristics of UK contact centres impact their scope for innovation

Advances in information and communications technology (ICT) has allowed the location of contact centres to be disjointed from the country they are providing service to, resulting in the UK having to compete with other countries as a location for contact centres, but the UK industry cannot match the low labour cost of many offshore locations. This means that the UK contact centres have to now compete on other factors rather than cost. There are many ways in which organisations can compete but one of the key ways for developed economies to compete is through increased innovation. Therefore the aim of the research is to examine how UK contact centres approach innovation. The research is carried out through a structured methodology of a systematic literature review and comparative case studies. The main findings of the research are that UK contact centres approach innovation in two main ways, either structured or ad-hoc and that they are involved in a range of different types of innovation, with the aim innovation type being process innovation

Factors influencing an organisation's ability to manage innovation : a structured literature review and conceptual model

Management literature prescribes innovation as a stimulus for sustained competitive advantage in companies; however, the nature of the development in this field has resulted in the literature being broad and fragmented. This paper focuses on the body of literature concerned with the factors which influence innovation management in organisations. The aim of this research is to present a holistic view of the factors that affect innovation management. Using a systematic literature review approach, using over 100 papers, this research identifies nine key factors that impact on an organisation’s ability to manage innovation. These nine factors have been identified as management style and leadership, resources, organisational structure, corporate strategy, technology, knowledge management, employees and innovation process. This paper then discusses the inductively derived model that presents the important relationships identified between the factors to present a holistic view of innovation management. From this, we open up the debate on innovation management as a systemic approach rather than being focused on the singular factors. We can therefore conclude that a number of dominant relationships exist between the factors with the innovation process being the only endogenous factor within the model

Enablers and barriers to innovation activities in call centres

Call centres have an operating model that aim to reduce costs - this has led to both customers and employees having issues with the current model. This has led to the view that contact centres are not entities in which innovation would occur. This paper identifies the barriers and enablers to innovation activities within call centres and discusses the implications of these to the wider service context