Can processes make relationships work? The Triple Helix between structure and action

This contribution seeks to explore how complex adaptive theory can be applied at the conceptual level to unpack Triple Helix models. We use two cases to examine this issue – the Finnish Strategic Centres for Science, Technology & Innovation (SHOKs) and the Canadian Business-led Networks of Centres of Excellence (BL-NCE). Both types of centres are organisational structures that aspire to be business-led, with a considerable portion of their activities driven by (industrial) users’ interests and requirements. Reflecting on the centres’ activities along three dimensions – knowledge generation, consensus building and innovation – we contend that conceptualising the Triple Helix from a process perspective will improve the dialogue between stakeholders and shareholders

Executive summary

The MAP Commission feels strongly that it is time to restructure key support functions and to realign programs and services to eliminate duplication of effort, inefficiencies and poor service quality. The MAP Commission’s study and all previous studies confirm that state government is, in many senses, broken, and is in need of repair. The members of MAP believe this comprehensive report adds one more compelling reason to rethink and reinvent state government in the Palmetto State

Prophylactic dressing to minimize sacral pressure injuries in high-risk hospitalized patients: A pilot study

Aim: In this paper, we describe a trial protocol used to assess feasibility related to: study administration (recruitment, randomization, retention, compliance, eligibility criteria, suitability of protocol instructions and data collection questionnaires); resource and data management (suitability of site, time and budget allocation, management of personnel and data); intervention fidelity (treatment dose, violations); and effect size. Background: Pressure injury can lead to increases in hospital length of stay and cost. The sacrum is identified as one of the most common anatomical pressure injury sites for hospitalized patients. Silicone foam border dressings have been proposed as one strategy to reduce pressure injury incidence; however, rigorous testing of benefit in a general medical-surgical population is required. Design: Randomized controlled trial. Methods: Eighty patients will be recruited after assessment of high risk of pressure injury in a large tertiary hospital in south-east Queensland, Australia. Eligible, consenting participants will be randomly allocated to either a control group (routine care) or an intervention group (routine care and a sacral prophylactic dressing). The primary outcomes comprise feasibility criteria as identified above. The secondary measure is the presence and severity of sacral pressure injury via blind assessment of digital photographs. Research ethics approval was received in October 2013. Discussion: Prophylactic dressings applied to the sacrum may be an effective method for reducing pressure injury in high-risk general medical-surgical patients. However, more rigorous studies to confirm benefit are required. This pilot study will determine the feasibility and effect size to inform a larger randomized controlled trial

Towards New Triple Helix Organisations?:A Comparative Study of Competence Centres as Knowledge, Consensus and Innovation Spaces

This contribution explores new organisational forms facilitating Triple Helix relations. Analysts have pointed to the blurring of institutional boundaries and the emergence of hybrid organisations at the interface between university, industry and government. Starting out from the notion that Triple Helix organisations develop and maintain knowledge, consensus and innovation spaces, we explore four cases of competence centres that operate in this context. Comparing them, we identify Finnish SHOK centres as the most radical departure from more traditional forms of university–industry collaboration. These can be characterised as independent legal entities that are involved in integrating a large, possibly cluster-level or technology-focused network, defining the agenda for specific specialisation areas by engaging in all or most of the Triple Helix spaces. We argue they could be better positioned than existing intermediary organisations to deliver the Triple Helix concept.</p

The effect of provider- and workflow-focused strategies for guideline implementation on provider acceptance

<p>Abstract</p> <p>Background</p> <p>The effective implementation of clinical practice guidelines (CPGs) depends critically on the extent to which the strategies that are deployed for implementing the guidelines promote provider acceptance of CPGs. Such implementation strategies can be classified into two types based on whether they primarily target providers (<it>e.g.</it>, academic detailing, grand rounds presentations) or the work context (<it>e.g.</it>, computer reminders, modifications to forms). This study investigated the independent and joint effects of these two types of implementation strategies on provider acceptance of CPGs.</p> <p>Methods</p> <p>Surveys were mailed to a national sample of providers (primary care physicians, physician assistants, nurses, and nurse practitioners) and quality managers selected from Veterans Affairs Medical Centers (VAMCs). A total of 2,438 providers and 242 quality managers from 123 VAMCs participated. Survey items measured implementation strategies and provider acceptance (<it>e.g.</it>, guideline-related knowledge, attitudes, and adherence) for three sets of CPGs--chronic obstructive pulmonary disease, chronic heart failure, and major depressive disorder. The relationships between implementation strategy types and provider acceptance were tested using multi-level analytic models.</p> <p>Results</p> <p>For all three CPGs, provider acceptance increased with the number of implementation strategies of either type. Moreover, the number of workflow-focused strategies compensated (contributing more strongly to provider acceptance) when few provider-focused strategies were used.</p> <p>Conclusion</p> <p>Provider acceptance of CPGs depends on the type of implementation strategies used. Implementation effectiveness can be improved by using both workflow-focused as well as provider-focused strategies.</p

Evaluation of Health in Pregnancy grants in Scotland: a natural experiment using routine data

No abstract avialable

Modelling the demand for inbound medical tourism : The case of Malaysia

This paper empirically examines the macroeconomic determinants for medical tourism demand using time series econometrics methodology. We find that income, price, exchange rate, SARS outbreak, safety, medical quality, manpower, and medical facilities are significantly affecting the long-run demand behaviour of medical tourism in Malaysia. In order to attract medical tourists, policymakers in Malaysia should (a) reduce the medical prices, (b) reduce the crime rate and improve safety, and (c) continue the improvement of research, medical quality, manpower, and facilities to support the revolution of inbound medical tourism demand in Malaysia. This is to ensure the Malaysia's sustainable economic developmen