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Explores purchasing in relation to audit, guidelines and research. Notes that the purchasing function is still embryonic, as the NHS struggles to integrate the new reforms. Notes that the different threads need to be woven into a coherent pattern if the full potential of the NHS reforms is to be realized.

Limited resources must be invested wisely. Society′s humanitarian duty to care must be satisfied as well as the economic imperative to use resources rationally. This cannot properly be achieved by reduction of all considerations to a single number which represents a ratio of health gain to resource cost.

Considers the two issues of the range of health care services and balances within the range. Notes the necessity of conducting a national debate concerning the range and limits of service provision within the health service framework. Stresses the importance of making decisions of balance within the range at local level. Unless there is a rational framework for decision making at both levels, both patients and society itself will suffer from inconsistency, confusion and inequity.

This paper supports the desire of the UK Government to introduce to the National Health Service the concept of accountability for expenditure. General practice budgets will, for the first time, allow GPs, as purchasers of care, to define the needs of their patients and to arrange for those needs to be met, circumventing the arbitrary limits imposed on providers of care under the present arrangements. Should overspending of budgets occur, other doctors will review the decisions made. If the decisions are supported then it will be clear that the budget was insufficient rather than that the practitioner was profligate. The reverse might apply, but such peer review should not be unwelcome. Budgetary control will allow greater choice for the GP of the nature of 2° care provided for his patients. Trust between doctor and patient need not be undermined — indeed, patients may be more confident that they will not be exposed to inappropriate medical intervention. The responsibilities conferred by GP budgets should be accepted, the opportunities welcomed.

The purpose of this paper is to evaluate cow-calf producer incentive to adopt innovations in traits with important environmental and economic implications for the beef supply chain.

A whole farm multi-year farm optimization model that tracks changes in discounted net returns and methane emissions from the use of newer DNA-related technologies to breed for feed efficient cattle is developed. The analysis is situated within the context of whole beef cattle supply chain. This allows for the derivation of the entire value and environmental impact of the innovation, and the decomposition of value by different participants. The impact of different policies that can stimulate producer uptake and the diffusion of the innovation is also addressed.

The results of the study showed that whilst the use of the breeding technology yielded positive economic and environmental benefits to all producers in the supply chain, primary adopters were unlikely to adopt. This paper finds evidence of the misalignment in incentives within the supply chain with a significant proportion of the additional value going to producers who do not incur any additional cost from the adoption of the innovation. The study also highlighted the role of both public and market-based mechanisms in the innovation diffusion process.

This paper is unique as it is the first study that addresses producer incentive to adopt genomic selection for feed efficiency across the entire beef cattle supply chain, and incorporates both economic and environmental outcomes.

Licensed clubs in Australia offer a range of types of hospitality, gambling and entertainment. Increased competition is forcing them to reappraise features or attributes of their products in order to ensure that they are marketing the right mix of features to their patrons, both club members and visitors. Uses conjoint analysis in order to examine the utility obtained by patrons from alternative types of food and beverage service, gambling and entertainment at two major clubs. The study indicates value differences between clubs, and between patron groups, providing a basis for segmentation. The findings lead to indicators for club marketing strategy.

Revenge pornography is a growing risk among adolescents and young adults. Often stemming from sexting, some victims of revenge pornography report experiencing victim-blame similar to that accompanying the reporting of rape. The purpose of this paper is to explore the assumptions that underlie attributions of victim-blame, with a focus on perpetrator and victim responsibility, as well as gendered assumptions surrounding sexting.

A total of 222 UK university students (111 male, 111 females) read one of two versions of a hypothetical revenge pornography scenario, one involving a male victim of a female perpetrator, the other a female victim of a male perpetrator. They then responded to an open-ended question regarding responsibility.

Qualitative content analysis of these responses identified three inter-related themes: the victim’s behaviour, mitigating victim responsibility and minimising the behaviour.

The majority of participants in this study attributed at least some responsibility to the victims of revenge pornography depicted in the scenarios. Sex of the victim played a less important role than assumptions around sexting.

The study suggests that victim-blame is linked to the consent implied by sharing intimate images with a partner, but is also mitigated by the normative nature of this relationship practice. There was some evidence that the experience of male victims of revenge pornography is trivialised. These findings have implications for e-safety and victim support.

Audit activity is now widespread. There are a range of views about its prime purpose. Unless the audit programme has a clear purpose and direction, it will falter. As commissioning develops, there will be more explicit considerations of standards of care. Those standards will address both the processes of outcomes of care, focusing on effectiveness and appropriateness. They will best be generated by local agreement between purchasers, providers and clinicians, based on the knowledge available through research. Audit can provide a systematic appraisal of practice against such standards, while ensuring confidentiality for individual patients and clinicians. Property resourced, audit can play a valuable role directly linked to the commissioning process, which will ensure that the medical profession is fully engaged in the new dynamics of the NHS.

Clinical audit is the analysis of whether a predetermined standard of care is achieved over a given period of time. Evaluation of methods of care is an analysis of the benefits that might be expected to accrue from a particular method of treatment by statistical analysis of observations made on sample populations. The two activities have very different aims and approaches; they should not be confused.

This study aims to uncover the main predictors of financial distress in the Gulf Cooperation Council (GCC) countries using a wide range of global factors and asset classes.

This study uses novel approaches that take into account extreme events as well as the nonlinear behavior of time series over various time intervals (i.e. short, medium and long term) and during boom and bust episodes. This study primarily uses the conditional value at risk (CoVaR), the quantile multivariate causality test and the partial wavelet coherence method. The data collection period ranges from March 2014 to September 2022.

US T-bills and gold are the primary factors that can increase financial stability in the GCC region, according to VaRs and CoVaRs. More proof of the predictive value of the oil, gold and wheat markets, as well as geopolitical tensions, uncertainty over US policy and volatility in the oil and US equities markets, is provided by the multivariate causality test. When low extreme quantiles or cross extreme quantiles are taken into account, these results are substantial and sturdy. Lastly, after adjusting for the effect of crude oil prices, this study’s wavelet coherence results indicate diminished long-run connections between the GCC stock market and the chosen global determinants.

Despite the implications of the author’s research for decision makers, there are some limitations mainly related to the selection of Morgan Stanley Capital International (MSCI) GCC ex-Saudi Arabia. Considering the economic importance of the Kingdom of Saudi Arabia (KSA) in the region, the author believes that it would be better to include this country in the data to obtain more robust results. In addition, there is evidence in the literature of the existence of heterogeneous responses to global shocks; some markets are more vulnerable than others. This is another limitation of this study, as this study considers the GCC as a bloc rather than each country individually. These limitations could open up further research opportunities.

These findings are important for investors seeking to manage their portfolios under extreme market conditions. They are also important for government policies aimed at mitigating the impact of external shocks.