Outsourcing transitions and the employment relationship implications

Drawing on three longitudinal case studies involving the outsourcing of public leisure services, this paper explores the work transitions of staff as they transfer from one organisation to another using a three-phase analytical framework. The obtained findings confirm the idea that outsourcing can be a difficult transition to go through, with losses occurring in relation to terms and conditions of employment. However, they also show how such changes can occur alongside the development of seemingly positive employment relationships with the new employer that challenge the view that the employment effects of public service outsourcing are invariably perceived in a negative light by employees. In doing so, the study’s findings are seen to point towards the value of exploring outsourcing related work transitions longitudinally and through the lens of the adopted analytical framework. They are also seen to have implications for how such transitions are theorised and managed, including how we might understand the nature of the employment relationship and the role of line managers

Outsourcing transitions and the employment relationship implications

Drawing on three longitudinal case studies involving the outsourcing of public leisure services, this paper explores the work transitions of staff as they transfer from one organisation to another using a three-phase analytical framework. The obtained findings confirm the idea that outsourcing can be a difficult transition to go through, with losses occurring in relation to terms and conditions of employment. However, they also show how such changes can occur alongside the development of seemingly positive employment relationships with the new employer that challenge the view that the employment effects of public service outsourcing are invariably perceived in a negative light by employees. In doing so, the study’s findings are seen to point towards the value of exploring outsourcing related work transitions longitudinally and through the lens of the adopted analytical framework. They are also seen to have implications for how such transitions are theorised and managed, including how we might understand the nature of the employment relationship and the role of line managers

She Wouldn\u27t Do : What I Asked Her To

https://digitalcommons.library.umaine.edu/mmb-vp/4768/thumbnail.jp

Controlling Methicillin-Resistant Staphylococcus Aureus (MRSA) in a Hospital and the Role of Hydrogen Peroxide Decontamination: An Interrupted Time Series Analysis

Objectives The impact of surface disinfection versus detergent cleaning on healthcare associated infection rates remains unresolved. We aimed to evaluate the efficacy of hydrogen peroxide (HP) decontamination against methicillin-resistant Staphylococcus aureus (MRSA). Design Single centred retrospective before and after study design. Setting Launceston General Hospital, Tasmania, Australia. Participants Patients with MRSA infection or colonisation. Interventions Rooms occupied by patients with MRSA infection or colonisation were cleaned following discharge with either detergent or HP. Main outcome measures MRSA room contamination following cleaning; new MRSA acquisition in patients. ResultsOver 3600 discharge cleans were completed, with more than 32 600 environmental swabs processed. MRSA was isolated from 24.7% rooms following detergent cleaning and from 18.8% of rooms after HP (p Conclusions Use of HP disinfection led to a decrease in residual MRSA contamination in patient rooms compared with detergent. It may also have encouraged the reduction in patient MRSA acquisition despite several confounders including staff feedback on terminal cleaning, additional MRSA screening and quicker laboratory methods. Infection control is best served by concurrent interventions targeting both the patient and healthcare environment

Energy-led domestic retrofit: impact of the intervention sequence

Interviews conducted with householders reveal that energy efficiency is often a lesser motivation than other factors for undertaking home improvement work. Homeowners' approach to refurbishment is typically staged over several years, not as a whole house retrofit. As the operational performance of an individual emission-reducing technology typically depends on what other measures are already in place, the retrofit intervention sequence can potentially affect the overall performance of the dwelling. The impact of the intervention sequence on a semi-detached 1930s house is investigated with dynamic thermal modelling, using five sequences based on different homeowner personas developed from qualitative interviews. The results show that, whilst a whole house retrofit would reduce cumulative CO2 emissions over 25 years by 54%, the sequences actually implemented by the individual households result in significantly smaller reductions of between 42% and 24%. This variation in operational performance due to the intervention sequence means that there is a variable return on the investment for a particular technology and, significantly, that different sequences will yield different cumulative emission reductions. This has significant consequences for policies providing financial incentives for energy-led retrofit, particularly to include the intervention sequence and timing

The Prognostic Value of a Single, Randomly Timed Circulating Tumor DNA Measurement in Patients with Metastatic Melanoma

Simple Summary In this study, we investigated the associations of circulating tumor DNA (ctDNA), measured at a random time point during the patient’s treatment, with tumor progression and routine blood markers (protein S100, lactate dehydrogenase (LDH), and C-reactive protein (CRP)) in a cohort of patients with metastatic melanoma. Detectable ctDNA was associated with the presence of extracerebral disease, tumor progression, and poorer overall survival (OS). Elevated S100 and CRP was correlated with detectable ctDNA, whereas LDH was not. Our results further support the use of ctDNA in the clinical management of patients with metastatic melanoma. Abstract Melanoma currently lacks validated blood-based biomarkers for monitoring and predicting treatment efficacy. Circulating tumor DNA (ctDNA), originating from tumor cells and detectable in plasma, has emerged as a possible biomarker in patients with metastatic melanoma. In this retrospective, single-center study, we collected 129 plasma samples from 79 patients with stage IIIB–IV melanoma as determined by the American Joint Committee on Cancer (AJCC, 8th edition). For the determination of ctDNA levels, we used eight different assays of droplet digital polymerase chain reaction (ddPCR) to detect the most common hotspot mutations in the BRAF and NRAS genes. The aim of the study was to investigate the association of the detectability of ctDNA at a non-prespecified time point in a patient’s treatment with tumor progression, and to correlate ctDNA with commonly used biomarkers (protein S100, LDH, and CRP). Patients with detectable ctDNA progressed more frequently in PET-CT within 12 months than those without detectable ctDNA. Detectability of ctDNA was associated with shorter OS in univariate and multivariate analyses. ctDNA was detectable in a statistically significantly larger proportion of patients with distant metastases (79%) than in patients with no distant metastases or only intracranial metastases (32%). Elevated protein S100 and CRP correlated better with detectable ctDNA than LDH. This study supports the potential of ctDNA as a prognostic biomarker in patients with metastatic melanoma. However, additional prospective longitudinal studies with quantitative assessments of ctDNA are necessary to investigate the limitations and strengths of ctDNA as a biomarker. Keywords: ctDNA; melanoma; tumor progression; PET-CT; S100; biomarke

Charge-Fluctuation-Induced Non-analytic Bending Rigidity

In this Letter, we consider a neutral system of mobile positive and negative charges confined on the surface of curved films. This may be an appropriate model for: i) a highly charged membrane whose counterions are confined to a sheath near its surface; ii) a membrane composed of an equimolar mixture of anionic and cationic surfactants in aqueous solution. We find that the charge fluctuations contribute a non-analytic term to the bending rigidity that varies logarithmically with the radius of curvature. This may lead to spontaneous vesicle formation, which is indeed observed in similar systems.Comment: Revtex, 9 pages, no figures, submitted to PR

Introducing a Clinical Practice Guideline Using Early CT in the Diagnosis of Scaphoid and Other Fractures

Objective: We developed and implemented clinical practice guideline (CPG) using computerized tomography (CT) as the initial imaging method in the emergency department management of scaphoid fractures. We hypothesized that this CPG would decrease unnecessary immobilization and lead to earlier return to work.Methods: This observational study evaluated implementation of our CPG, which incorporated early wrist CT in patients with “clinical scaphoid fracture”: a mechanism of injury consistent with scaphoid fracture, anatomical snuff box tenderness, and normal initial plain x-rays. Outcome measures were the final diagnosis as determined by orthopaedic review of the clinical and imaging data. Patient outcomes included time to return to work and patient satisfaction as determined by telephone interview at ten days.Results: Eighty patients completed the study protocol in a regional emergency department.In this patient population CT detected 28 fractures in 25 patients, including six scaphoid fractures, five triquetral fractures, four radius fractures, and 13 other related fractures. Fifty-three patients had normal CT. Eight of these patients had significant ongoing pain at follow up and had an MRI, with only two bone bruises identified. The patients with normal CTs avoided prolonged immobilization (mean time in plaster 2.7 days) and had no or minimal time off work (mean 1.6 days). Patient satisfaction was an average 4.2/5.Conclusion: This CPG resulted in rapid and accurate management of patients with suspected occult scaphoid injury, minimized unnecessary immobilization and was acceptable to patients.[WestJEM. 2009;10(4):227-232.