Commissioning for social value and voluntary sector organisations: tensions in implementation

This thesis contributes to our understanding of commissioning for social value in England by exploring commissioning as practised by local contracting authorities through the lens of front-line workers’ experiences in both local authorities and voluntary sector organisations. This study, which sees an emphasis on social value as an extension of the practice of commissioning for outcomes by local contracting authorities, sheds light on the tension between local authority attempts to improve public services on the one hand and the involvement of voluntary sector organisations (VSOs) in the provision of those services on the other. The Public Service (Social Value) Act 2012 (SVA) points towards a fundamental change that is taking place in the dominant discourse of public service provision. It places greater emphasis on the capacity of local communities, cementing the involvement of the local service providers in policies and services to improve the state's action within this discourse. The study uses a qualitative explorative case study methodology, informed by interviews and participatory observation methods, to explore individuals’ practice as situated within specific institutional contexts. Multiple sources of data were combined holistically from individual case studies. This thesis explores the complex lived realities of practice and yields significant insights into front-line workers’ experiences in local contracting authorities and voluntary sector engagement with the commissioning process grounded in providing social value. The thesis questions how front-line workers’ everyday practices regarding commissioning for social value are bound up with and contest institutional practices and how this work connects with issues of understanding the policy, co-creates a shared understanding of the policy, and monitors social value in commissioning contracts. The study has two empirical dimensions: first, the data gathered from the first phase of interviews, with participants holding a range of institutional roles engaged with the commissioning experience; second, the data gathered from three case studies focused on local contracting authorities from east England, in which participants occupied a range of front-line institutional roles. Data analysis demonstrates how established understandings of policy inform the everyday practices of front-line workers and shape practices within the commissioning system’s institutional contexts. The thesis proposes new ways of commissioning social value to deliver better outcomes for local people and communities. It throws light on some cases efforts to reach beyond routine commissioning practices and carve out an approach that involves ‘working collaboratively with local people and providers to maximise the value created’ in the commissioning process

The Impact of Economic Crisis on the Emerging Administrations from Southeastern Europe. Case Study: Romania

After 7 February 2007, the date on which in the United States was the beginning of the mega-global economic crisis, the financial world is vastly different and its reshaping is likely to persist for years or even decades. The consequences of the economic crisis extended beyond the economy itself. It affected the entire World, with a considerable impact on the EU Member States. The economies of the countries have been altered dramatically, and their patterns of governance have changed. One of these components of the models of governance is the public administration system. The paper can be included in the interdisciplinary field of administrative sciences, where the study of the economy plays an important role. The aim of the study is to analyze the impact of the crisis on the public administrations from Southeastern Europe, and the role of the anti-crisis measures taken at the level of the governance process of public administration. Therfore, the research attempts to provide an answer to a number of central research questions: 1. How the economic crises affected the emerging administrations from Southeastern Europe? 2. What were the anti-crisis measures taken at the level of public administration? The study is mainly qualitative based, and tries to identify in which consisted the impact of the economic crisis. It will be focused on the Southeastern European region, a region with some economic and democratic particularities due to the historical legacies of the totalitarian regimes it had. In particular, the paper focus on a case study- Romania public administration- a country from the Southeastern Europe. The paper develops on the premises that Romania public administration system was altered directly by the crises and the measures undertaken to reduce its impact. The research raises the awareness for academics and practitioners to the hardships that transition countries and emerging administrations from Southeastern Europe had to face in keeping the governmental system functionally. On these grounds, specialists can quickly realize how important it is to adapt administrative values and to rethink the reforms to rapidly changing environment

Fostering Sustainable Development and Entrepreneurship: The New Role of University

Sustainable development is a global objective to overcome the economic, environment and society crises worldwide. The research aims are twofold: (i) Explores the proactive and dynamic model of the university’s education system, focusing on the new role played by the School of Economics in the promotion of economic, social and environmental sustainability, and how this goes beyond, in stimulating bottom–up social entrepreneurship ideas through students engagement; (ii) Provides a descriptive analysis of innovative laboratories modules, by studying and mapping the best project proposals initiated by the student. Finally, it presents a case study analysis on waste management (UniRecycling) project, scaling up objectives, stakeholder mapping, activities and the expected results. The findings show the new role played by School of Economics, along with other partner institutions, in supporting the student’s engagement in practice-oriented workshops that enable the transfer of knowledge, skills, and self – development. The implications of the research to be developed show that a dynamic bottom-up model of learning and dissemination of sustainable and entrepreneurial should aim to sensitise students to be active and create project ideas for social and environmental entrepreneurship and build and strengthen the local territorial networks, to contribute to the creation of a system of services attentive to responsible and sustainable entrepreneurial development

The endovascular treatment of acute ischemic stroke - a perspective for Republic of Moldova

Department of Neurosurgery, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova, The 6th International Medical Congress for Students and Young Doctors, May 12-14, 2016Introduction: The endovascular approach as an elective method of treatment for acute ischemic stroke, gained rapidly its popularity, practical application and legal consent after major international trials. Purpose and objectives: this study represents a review of international clinical trials outcomes containing the up to date and comprehensive recommendations regarding the acute ischemic stroke endovascular treatment. Methods and materials: Cases of 5 international trials were reviewed in order to accomplish a view, contending the best approach for the patients that fitted: therapeutic window (from 6h to 12h); proximal arterial thrombosis confirmed by angiographic CT; a National Institutes of Health Stroke Scale (NIHSS) evaluation (from 8 up to 29), age 18-80 and the most important reference – used technique: mechanical maneuvers (thrombectomy, thrombaspiration, mechanical rupture, entrapment or the temporary endovascular bypass) versus both thrombolysis (thrombolytic agents with adjunctive therapy) and mechanical actions. Results: Best outcome were registered for the patients that have been treated both with thrombolysis and using the mechanical approach as well: high scores for Barthel index and great rating for an early reperfusion, CT confirmed. Conclusion: Involving the data of an increased rate for the acute ischemic stroke, raising by years, in the Republic of Moldova, as well as the abominable long term effect on the patient’s life quality, an endovascular intervention is requested.Considering the speed of development of endovascular neurosurgery, rational premises could be made equally in our republic with the foundation of endovascular specialists, exploiting the full capacity of CT and availability of the essential drugs. Consequently, the education of the population is needed to determine the early symptoms of an ongoing stroke, so on they could fit the therapeutic window for the endovascular engagement, starting with basic thrombolysis, in order to diminish the potential irreversible impact on the patient’s health

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Relatório de estágio em farmácia comunitária

Relatório de estágio realizado no âmbito do Mestrado Integrado em Ciências Farmacêuticas, apresentado à Faculdade de Farmácia da Universidade de Coimbr

Public Administration Reforms in Transition Countries: Albania and Romania Between the Webberian Model and the New Public Management

<p>A general trend is easily observable in the literature on public administration reforms in postcommunist countries and it consists in analyses of the degree of adoption and success of the New Public Management (NPM) model. Relevant implementation gaps for some levels as well as areas of reform, which cannot be ascribed to the NPM in these countries, are highlighted. The combination of these two features – also common, and not by accident, to other Continental European countries – may well be read as the adoption of a modernization framework different from the NPM, which some authors have come to recognize as the New Weberianism. Nonetheless, both models are not sufficiently developed and analyzed to provide a framework for evaluating country experiences. Therefore, the paper will firstly perform a systematic review of the literature on the context and cultural dependency of public management reforms, the debate on the NPM and the New Weberianism, with the aim of defining an analytical theoretical framework suitable for the analysis and comparison of country experiences; secondly, undertake an in-depth evaluation of public management reform trends in two countries – Albania and Romania – and contrast these with OECD countries’ experience. Public administrations of some European countries, including Albania and Romania, are not NPM “laggards” but have instead chosen to adopt a different modernization model: i.e. the New Weberianism. Implications for future research and policy-makers are drawn.</p

Public Administration reforms in Albania and Romania: between the Weberian Model and the New Public Management

A general trend is easily observable in the literature on public administration reforms in post-communist countries and it consists in analyses of the degree of adoption and success of the New Public Management (NPM) model. A relevant implementation gap for some areas of reform which cannot be ascribed to the NPM are highlighted. The combination of these two features - also common, and not by accident, to other European countries - may well be read as the adoption of a modernisation framework different from the NPM, which some authors have come to recognize as a Neo Weberian model. Still, both models are not sufficiently developed and analytical to provide a framework for evaluating country experiences. Therefore, the paper will: 1) perform a systematic review of the literature on the context and cultural dependency of public management reforms, the debate on the NPM and the New Weberianism, with the aim of defining an analytical theoretical framework suitable for the analysis and comparison of country experiences; 2) undertake an in-depth evaluation of public management reform trends in two countries - Albania and Romania - and contrasts these with OECD countries' experience, with the aim of highlighting the approach adopted and how administrative history and traditions influence the reform results. The case studies are analysed with a specific focus on the scope, contents and sequence of reforms as well as on the role of international institutions. Public administrations of some European countries, including Albania and Romania, are not NPM "laggards" but have instead chosen to adopt a different modernisation model: i.e. the New Weberianism. Implications for future research and policy-makers are drawn.Public Administration Reform,Albania,Romania,Weberian Model,New Public Management

RESINES EPOXYDES MESOMORPHES

PARIS-MINES ParisTech (751062310) / SudocSudocFranceF

Predictors of retransplantation in liver transplant

Surgery Department II, Faculty of Medicine N1, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova, The 6th International Medical Congress for Students and Young Doctors, May 12-14, 2016Introduction: A small subgroup of patients undergoing liver transplantation (LT) require retransplantation (RT), which is correlated with significantly higher morbidity, lower survival rates and increased medical costs. The purpose of the study is to determine the predictive factors of RT, following LT, clinical and laboratory findings were studied during the period from 2013 till 2016, effectuated by a medical team from Republican Clinical Hospital. Materials and Methods: Liver transplant evidence was sourced from the National Transplantation Agency database starting with February 1st, 2013, to March 20th, 2016. Covariates selected from the database for inclusion in the analysis admitted: recipient’s age, cold and warm ischemia time, donor’s type (cadaveric versus living), body mass index (BMI), model for end-stage liver disease (MELD) score at transplant, albumin level at transplant, gender of the recipient and transplant year. Recipient hepatitis C virus (HCV) and hepatocellular carcinoma (HCC) status were determined by using United Network for Organ Sharing (UNOS)/Organ Procurement and Transplantation Network (OPTN) primary diagnosis coding. Generalized linear modeling was used to determine the odds ratios (ORs) for the risk of RT in liver transplant recipients. According to National Transplantation Agency of Republic of Moldova since 2013 were registered 212 potential brain death donors, but families of 99 (46,69 %) of them have refused donation.Conclusion: Our analysis identified several host and graft-related predictors of RT in liver transplant recipients. Efforts must be directed to reduce the significant number of RT in the era of donor shortage and ever increasing demand for LT. Both, the community and physicians should therefore approach organ transplant positively and objectively and treat ethical, social and religious issues as negotiable perspectives and not barriers to organ transplant