Search results

The purpose of this paper is to propose a methodological approach to increase the clearance rate of cold cases in The Netherlands and to contribute to the development of intelligence-driven criminal investigations in general police practice and within cold case investigations in particular.

This proposal is based on practical investigative experience and academic knowledge.

Reconstructing scenarios helps convert cold case information into intelligence, which is beneficial to law enforcement agencies in terms of time, resources and prioritising cold cases. Intelligence contributes to the formulation of more effective queries and to a more efficient adaptation of new and existing investigation methods, leading to a higher cold case clearance rate. Moreover, scenario reconstruction creates a link between intelligence and investigation, i.e. between science and practice, which adds to the further development of intelligence-driven investigations.

When carrying out scenario reconstructions, practical implications are expected, as intelligence products are currently not or barely used in practice and science is not yet embedded in the investigational practice.

To move from scenario reconstruction to intelligence-driven criminal investigation, the gap between science and the investigational practice needs to be bridged by persons familiar with both. This study hopes to provide the necessary and relevant impetus to this dialogue.

This article compares and contrasts the main quality standards in the highly regulated pharmaceutical industry with specific focus on Good Clinical Practice (GCP), the standard for designing, conducting, recording and reporting clinical trials involving human participants.

Comparison is made to ISO quality standards, which can be applied to all industries and types of organisation. The study is then narrowed to that of contract research organisations (CROs) involved in the conduct of clinical trials.

The paper concludes that the ISO 9000 series of quality standards can act as a company‐wide framework for quality management within such organisations by helping to direct quality efforts on a long‐term basis without any loss of compliance.

This study is valuable because comparative analysis in this domain is uncommon.

Connected Health is an emerging and rapidly developing field never before witnessed across the healthcare sector. It has the potential to transform healthcare service systems by increasing its safety, quality and overall efficiency. However, as healthcare technologies or medical devices continuously rely more on software development, one of the core challenges is examining how Connected Health is regulated – often impacting Connected Health innovation. The purpose of this paper is to present an understanding of how Connected Health is regulated. Many of these regulatory developments fall under “medical devices”, giving rise to Software-as-a-Medical Device (SaaMD).

Through an extensive literature review, this paper demystifies Connected Health regulation. It presents the outcome of expert discussions which explore the key regulatory developments in the context of Connected Health to provide a practical guide to understanding how regulation can potentially shape healthcare innovation.

Several key issues are identified, and the authors present a comprehensive overview of regulatory developments relating to Connected Health with a view to support the continued growth of IT-enabled healthcare service models. The authors also identify the key challenges in Connected Health and identify areas for future research.

A key outcome of this research is a clearer understanding of the opportunities and challenges that regulation and standards present to Connected Health. Furthermore, this research is of critical importance in a first attempt towards recognising the impact of regulation and standards compliance in Connected Health.

Chapter X of The Social System is often cited as the “charter” for the specialty field of medical sociology. A notable feature of its analysis is the argument that the physician is an agent of social control in relation to the patient. This argument grounds the application to medical practice of Parsons’ general conception that social control is an aspect of all social relationships. Parsons started by addressing the situation of a patient who assumes the sick role and then becomes the patient of a physician. The sick role involves a suspension of at least some of the performance expectations associated with a person's everyday social life, such as expectations of working productively at one's job, attending the meeting of a civic association, or caring for one's family members. But in assuming the sick role, an individual encounters new expectations that he or she should try to get well. For minor illnesses this may involve only resting, drinking fluids, and avoiding stress. For more serious illnesses, given our culture's valuation of scientific medicine, it typically involves placing oneself in the care of a physician. It then becomes the physician's duty to offer treatment and guidance to restore one's health and enable one to return to meet expectations of everyday roles. Thus the physician becomes an agent of social control.

The US Senate hearings on pricing in the market for drugs in 1959, and lasting ten months, was part of a series of wider senatorial hearings into a range of American industries including the markets for milk, bread, automobiles, and steel, undertaken by the Senate Subcommittee on Antitrust and Monopoly, chaired by Senator Estes Kefauver of Tennessee between 1957 and 1963. The study examines how a body that had the initial investigational remit to examine the subject of ‘administered prices’ in the drug industry, became instead largely a systematic critique of the marketing activities and techniques practiced by pharmaceutical firms of the day.

The study draws on the Senate Subcommittee hearings for prescription drugs.

Three objectionable marketing practices were identified by the Antitrust Subcommittee: the use of sales representatives and high-pressure sales techniques; industry promotional practices, expenditure and deceptiveness; and the role of drug branding to hold consumers captive to major brands.

Rather than being an investigation that was perceived by some as out of tune with the major events of the day (most notably civil rights), it will be demonstrated that, far from being an anachronism, the hearings were an important precursor to the consumer rights movement, which peaked in the 1960s and 1970s, and a link will be established between antitrust issues and contemporary consumer politics.

The paper demonstrates the historical value of studying regulatory body appraisals of marketing practices.

The Industrial Training Research Unit is Britain's only research centrse of any size looking into problems of occupational training and is grant‐aided by the DE. ITRU has tended to concentrate its activities on training for manual work, on which it speaks with unique authority. Much of its work is concerned with the retraining of adults, so much so that at one time it was called The Industrial Retraining Unit. Its modus operandi is such as to appeal to practising trainers. Its work is based firmly on research but its aim is to solve practical problems of training encountered inside companies and it is this blend of practical experience with the investigational approach which makes its work so interesting. Any book by these two authors on the subject of training would command respect and attention, but one on the problems of retraining adults represents a milestone. This is the field in which they have specialised for a long time, in which they have an accumulation of hitherto unpublished information. The book describes many actual investigations and training exercises; the authors analyse the exercises, draw their conclusions and, to some extent, deduce certain basic principles. This anecdotal approach makes for easy reading; the deducing of conclusions makes for information which can be applied by the reader. The topics which the authors talk about are those which practising trainers will see as the real issues. All this results in a most exciting and usable book, unique in its field. With the permission of the authors and the publisher we now follow with edited extracts from the chapter which summarises the main conclusions arrived at in the earlier chapters. This is not the complete chapter — only about half of it. We have slightly changed the style of presentation. At this moment there are no agreed principles of adult retraining. We have underscored parts of the text to highlight statements which might reasonably be taken as fundamental principles in this aspect of training. This is our idea, not the idea of the authors whose claims are more modest.

The quality of asthma care may be affected if asthma management is overlooked, thus needing frequent clinical audits to identify areas for improvement. The purpose of this paper is to evaluate the quality of the process (e.g. documentation of asthma-specific information), the structure (e.g. availability of resources) and the outcome (e.g. proportion of patients prescribed with asthma medications) at a university-based primary care clinic. The associated clinical factors for non-documentation of asthma control at the last visit were also examined.

This retrospective study involved auditing medical records and the pharmacy data system of 433 adult patients with asthma to evaluate 18 quality indicators. The standard target for the indicators of process and structure was 80 percent and the standard target for the indicators of outcome was 100 percent.

All the indicators failed to reach the standard targets. Documentation of asthma-specific information and availability of resources were deficient. The non-documentation of asthma control was significantly associated with presence of acute complaint(s) unrelated to asthma, presence of other issues and number of the documented parameters for asthma control. Although the prescription rates of inhaled reliever and preventer were substandard, they were reasonably high compared to the targets.

In this study, evaluation of the quality of care was limited by absence of asthma register, use of paper-based medical records and restricted practice capacity. Besides, the asthma-specific assessments and management were only audited at one particular time. Furthermore, the findings of this study could not be generalised to other settings that used other methods of record keeping such as patient-held cards and electronic medical records. Future studies should sample asthma patients from a register, evaluate more reliable quality indicators (e.g. over-prescription of short-acting β-2 agonist and underuse of inhaled corticosteroid) and assess asthma management over a duration of time.

This study provides quality information on all aspects of asthma care (process, structure and outcome) which can be a basis for clinical improvement. It is hoped that the study could assist the stakeholders to plan strategies for improvement of the asthma care. A more strategic and reliable system of documentation is needed, such as the use of a simple template or structured form, which should not jeopardise the provision of personalised and comprehensive care. With complete documentation, thorough investigational audits can be continuously performed to determine the quality of asthma care.

This study could provide useful findings to guide healthcare providers in developing a more strategic model of asthma care that can ensure asthma patients to receive a personalised, comprehensive, holistic and continuous care. Through this approach, their physical and psychosocial well-being can be optimised.

Even though our healthcare has advanced, the quality of asthma care is still suboptimal which requires further improvement. However, it could be considered assuring due to high outcome levels of asthma care despite having limited resources and practice capacity.

The purpose of this paper is to establish historic regulatory conditions and priority national characteristics eliciting outstanding best practices in clinical trial regulatory systems, towards global health objectives through targeted economic development.

Exploratory review of clinical trial processes of three industrialized nations with similar democratic processes – Japan, the UK and the USA – in order to determine the efficacy of international clinical trials.

Outstanding best practices in national vaccine clinical trials can guide the international economic development, manufacturing and distribution policy strategies necessary to form the basis of a cross‐cultural global delivery system.

This study's contribution to academic literature is threefold: first, it reviews established fundamental clinical trial processes for Japan, the UK and the USA; second, it distinguishes similarities and differences to determine best practices; and third, it suggests changes in regulatory vaccine clinical trials towards achieving global health objectives.

Describes a study to measure the quality of service provided by food‐poisoning surveillance agencies in England and Wales in terms of the requirements of a representative consumer ‐ the egg producing industry ‐ adopting “egg associated” outbreak investigation reports as the reference output. Defines and makes use of four primary performance indicators: accessibility of information; completeness of evidence supplied in food‐poisoning outbreak investigation reports as to the sources of infection in “egg‐associated” outbreaks; timeliness of information published; and utility of information and advice aimed at preventing or controlling food poisoning. Finds that quality expectations in each parameter measured are not met. Examines reasons why surveillance agencies have not delivered the quality demanded. Makes use of detailed case studies to illustrate inadequacies of current practice. Attributes failure to deliver “accessibility” to a lack of recognition on the status or nature of “consumers”, combined with a self‐maintenance motivation of the part of the surveillance agencies. Finds that failures to deliver “completeness” and “utility” may result from the same defects which give rise to the lack of “accessibility” in that, failing to recognize the consumers of a public service for what they are, the agencies feel no need to provide them with the data they require. The research indicates that self‐maintenance by scientific epidemiologists may introduce biases which when combined with a politically inspired need to transfer responsibility for food‐poisoning outbreaks, skew the conduct of investigations and their conclusions. Contends that this is compounded by serious and multiple inadequacies in the conduct of investigations, arising at least in part from the lack of training and relative inexperience of investigators, the whole conditioned by interdisciplinary rivalry between the professional groups staffing the different agencies. Finds that in addition failures to exploit or develop epidemiological technologies has affected the ability of investigators to resolve the uncertainties identified. Makes recommendations directed at improving the performance of the surveillance agencies which, if adopted will substantially enhance food poisoning control efforts.

Purpose – This chapter explores the pharmaceutical industry's strategic utilization of empowerment discourse in two realms: direct-to-consumer advertising (DTCA) and clinical drug development.

Methodology – It draws upon two research projects that examine the role of the pharmaceutical industry in the political economy of healthcare in the United States: Ronald's policy analysis and participant observation of DTCA policy hearings and Fisher's participant observation and interviewing of the clinical trials industry.

Findings – Empowerment rhetoric is mobilized by the pharmaceutical industry to create specific expectations about patient-consumer behavior, particularly the responsibilities associated with the consumption of drugs.

Research implications – The social and economic implications of DTCA and drug trials must be understood within their broader historical and contemporary contexts of health advocacy, consumerism, and medical neoliberalism.

Practical implications – The chapter offers alternative constructions of healthcare subjects and pharmaceutical practices that can mitigate the power of the pharmaceutical industry and bring about better pharmaceutical governance.

Originality/value of chapter – By analyzing findings from two empirical projects, this chapter is able to shed light on trends in the pharmaceutical industry's discourse about empowerment and consumption from the clinical testing to marketing of new drugs.