Reference costs and the pursuit of efficiency in the 'new' NHS

Both the White Paper, The New NHS, and the later consultation document, A National Framework for Assessing Performance, stress the need to develop new instruments to tackle inefficiency in the NHS. Among these instruments it has been proposed to benchmark Trusts, and by association Health Authorities, using Healthcare Resource Group (HRG) costs. The NHS Executive has published plans for a system of ‘Reference Costs’ that will itemise the cost of every treatment in every Trust. These reference costs will be derived from costing HRGs and are to be used for many purposes: benchmarking cost improvement, measuring relative efficiency, identifying best practice, funding transfers and costing health improvement programmes. This paper examines the construction of reference costs, considers incentives to use the information appropriately and asks whether a single accounting construct, the costed HRG, can be expected to contribute successfully to its many intended functions of regulation and management.performance measures; costing

Deployment of quality assurance procedures for digital library programmes

Many digital library programmes have a development philosophy based on use of open standards. In practice, however, projects may not have procedures in place to ensure that project deliverables make use of appropriate open standards. In addition there will be occasions when open standards are not sufficiently mature for deployment in a service environment or use of open standards will require expertise or resources which are not readily available

Religion, globalization and modernity:from macro-processes to micro-dynamics

Three aspects of the globalization – religion relationship are explored by this article. These three aspects are: growing religious diversity (as a macro-structural phenomenon); increasing organizational differentiation (as a mid-range institutional dynamic); and enhanced subjectivized religiosity (as a micro-social process). Discussion of these aspects is theoretically informed by the concept of ‘globalizing modernity’ which regards the networks and flows of globalization as implicated in the worldwide diffusion of processes and dynamics which are typically ‘modern’ in their character and impact. In addition to other examples drawn from various parts of the world, this article engages the Santo Daime religion as a working case-study which both grounds and exemplifies the issues addressed

Elucidating the molecular genetics of host and nonhost resistance in barley to stripe rust

Plants have a remarkable ability to resist the majority of pathogenic microbes they encounter. As such, they are described as nonhosts. Nonhost resistance is often conceptualised as a qualitative separation from host resistance. Classification into these two states is generally facile, as they fail to fully describe the range of states that exist in the transition from host to nonhost. This poses a problem when studying pathosystems that cannot be classified into either of these categories due to their intermediate status relative to the two extremes. Therefore, the terms intermediate host and intermediate nonhost have been proposed to describe pathosystems in the evolutionary transition between host and nonhost status. At present, a significant amount of research exists into the molecular genetics of host and nonhost pathosystems but very little is known about intermediate systems. The work in this Ph. D. thesis focuses on the interaction of barley with Puccinia striiformis f. sp. tritici, the causal agent of wheat stripe rust, as an intermediate host pathosystem. The first research chapter describes the development of two microscopic phenotypic assays used to quantify P. striformis f. sp. tritici in barley leaves challenged with the pathogen. These assays are then used to screen a large panel of barley accessions to define the intermediate host status of barley relative to a host pathosystem. Subsequently, these assays play a key role in determining that the genetic architecture of resistance in barley is underpinned by three major effect resistance loci: Rpst1, Rpst2, and Rpst3. Using a combination of classical map-based genetics and contemporary genomics information I identify a candidate NLR gene underlying Rpst2 resistance on chromosome 7HL. Furthermore, I show that distinct genes condition host and nonhost resistance in barley by mapping the host resistance gene, rps2 to chromosome 2HL