Integrating process and factor understanding of environmental innovation by water utilities

Innovations in technology and organisations are central to enabling the water sector to adapt to major environmental changes such as climate change, land degradation or drinking water pollution. While there are literatures on innovation as a process and on the factors that influence it, there is little research that integrates these. Development of such an integrated understanding of innovation is central to understanding how policy makers and organisations can stimulate and direct environmental innovation. In the research reported here a framework is developed that enables such an integrated analysis of innovation process and factors. From research interviews and the literature twenty factors were identified that affect the five stages of the environmental innovation process in English and Welsh water utilities. The environmental innovations investigated are measures taken by water utilities to reduce or prevent pollution in drinking water catchments rather than technical measures to treat water. These Source Control Interventions are similar to other environmental innovations, such as ecosystem and species conservation, in that they emphasise the mix of technology, management and engagement with multiple actors. Results show that in water utilities direct performance regulation and regulation that raises awareness of a ‘performance’ gap as a ‘problem’ can stimulate innovation, but only under particular organisational, natural physical and regulatory conditions. The integrated framework also suggests that while flexible or framework legislation (e.g. Water Framework Directive) does not stimulate innovation in itself, it has shaped the option spaces and characteristics of innovations selected towards source control instead of technical end-of-pipe solutions

Oral versus intravenous antibiotics for bone and joint infection

BACKGROUND The management of complex orthopedic infections usually includes a prolonged course of intravenous antibiotic agents. We investigated whether oral antibiotic therapy is noninferior to intravenous antibiotic therapy for this indication. METHODS We enrolled adults who were being treated for bone or joint infection at 26 U.K. centers. Within 7 days after surgery (or, if the infection was being managed without surgery, within 7 days after the start of antibiotic treatment), participants were randomly assigned to receive either intravenous or oral antibiotics to complete the first 6 weeks of therapy. Follow-on oral antibiotics were permitted in both groups. The primary end point was definitive treatment failure within 1 year after randomization. In the analysis of the risk of the primary end point, the noninferiority margin was 7.5 percentage points. RESULTS Among the 1054 participants (527 in each group), end-point data were available for 1015 (96.3%). Treatment failure occurred in 74 of 506 participants (14.6%) in the intravenous group and 67 of 509 participants (13.2%) in the oral group. Missing end-point data (39 participants, 3.7%) were imputed. The intention-to-treat analysis showed a difference in the risk of definitive treatment failure (oral group vs. intravenous group) of −1.4 percentage points (90% confidence interval [CI], −4.9 to 2.2; 95% CI, −5.6 to 2.9), indicating noninferiority. Complete-case, per-protocol, and sensitivity analyses supported this result. The between-group difference in the incidence of serious adverse events was not significant (146 of 527 participants [27.7%] in the intravenous group and 138 of 527 [26.2%] in the oral group; P=0.58). Catheter complications, analyzed as a secondary end point, were more common in the intravenous group (9.4% vs. 1.0%). CONCLUSIONS Oral antibiotic therapy was noninferior to intravenous antibiotic therapy when used during the first 6 weeks for complex orthopedic infection, as assessed by treatment failure at 1 year. (Funded by the National Institute for Health Research; OVIVA Current Controlled Trials number, ISRCTN91566927. opens in new tab.

Interactive models of industrial technology transfer : a process approach

School of Managemen

Technology, knowledge translation and policy : conceptual frameworks and case-studies

The aim of this thesis is to develop, present and then demonstrate conceptual structures that link together an apparently heterogeneous range of research activity about technology in situations which are the subject of decision-making and policy formulation. Technology is considered to be knowledge as applied in organisations, communities, policy contexts and so on. It thus takes in not only the physical processes and output of the engineering sciences but also the new forms of organisation which use that output, their impacts on, and interactions with, people at large and with the so-called natural systems in which those people are embedded and with which they also interact. Methodologically many of the research publications which this thesis incorporates approach technology related issues and problems from the bottom up, from the most microscopic level of the individual human actor, the smallest feasible level of natural and engineered systems. It is an attempt to redress the top down perspectives which dominate technology and science policy formulation and decision making. This approach often requires research interaction at the level of the individual person or at the lowest level of physical and biological activity relevant to the issue at hand and the appropriate techniques for such interaction are debated and demonstrated. The principles of "translation" or "mapping" which are capable of being applied to a range of interactions between different domains (physically engineered, diverse individuals and knowledge) are developed. The thesis then shows how the representation of responses of people to products and services has evolved and begins to focus on organisations as suppliers of those products and processes. Technology is articulated as knowledge in the context of technology transfer into organisations and the thesis shows how those ideas evolved into the concept of knowledge dynamics in organisations. The problems of interactions which involve bio- physical systems as well as engineered systems and people and the issues of sustainability and policy relevant research are introduced. The nature of integrative interdisciplinary research about these issues is presented as a form of knowledge dynamics. The thesis shows how the concepts above can be used to distinguish between policy and decision relevant issues, and how they help to provide a conceptual framework within which the similarities and differences between knowledge policy in organisations and science research policy can be compared. Thus it is a series of interdisciplinary explorations into complex decision and policy relevant situations in which technology, in the form of knowledge and as the study of interaction between the designed physical world, people, organisations and natural systems, is a constant theme