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Clinical practice guidelines are increasingly being recognised as integral to the clinical effectiveness agenda. According to the recent Scottish White Paper, Scotland “leads the way in clinical effectiveness”. The Scottish Intercollegiate Guidelines Network (SIGN), established in 1993, has produced over 20 clinical practice guidelines, and plans to produce at least as many more, while reviewing existing guidelines at a minimum of every two years. This represents a substantial investment of NHS resources. This paper investigates whether this investment is being recouped in Scottish NHS acute trusts via the implementation of SIGN guidelines, and whether their implementation is being audited properly. It is argued that without clinical audit, guideline implementation is unlikely to succeed. This has important ramifications for the implementation of clinical governance.

The British National Health Service (NHS) has experienced various phases of reform and reorganisation during the last 15 years. During this time it has been suggested that the role of the patient is analogous to that of the consumer. Meanwhile there has been increasing application of the techniques of health economics. This paper examines the rationale for these developments, placing them in wide historial context, and arguing that far from being a passive consumer of pre‐packed healthcare, patients ought to be considered as partners in a continuing process of inquiry, in accordance with John Dewey’s philosophy of instrumentalism. As a result it is argued that the present commodification of healthcare in the UK should be halted, in order to preserve and build on the achievements of the NHS.

Resurgent interest in the life and work of the Italian Cambridge economist Piero Sraffa is leading to New Directions in Sraffa Scholarship. This chapter introduces readers to some of these developments. First and perhaps foremost is the fact that as of September 2016 Sraffa’s archival material has been uploaded onto the website of the Wren Library, Trinity College, Cambridge University, as digital colour images; this chapter introduces readers to the history of these events. This history provides sharp relief on the extant debates over the role of the archival material in leading to the final publication of Production of Commodities by Means of Commodities, and readers are provided a brief sketch of these matters. The varied nature of Sraffa scholarship is demonstrated by the different aspects of Sraffa’s intellectual legacy which are developed and discussed in the various entries of our Symposium. The conclusion is reached that we are on the cusp of an exciting phase change of tremendous potential in Sraffa scholarship.

The rise of the regulatory state during the Gilded Age was closely associated with the development of institutionalist ideas in American academia. In their analysis of the emergent regulatory environment, institutionalists like John Commons operated with a fundamentally marginalist theory of value and distribution. This engagement is a central explanation for the ultimate ascendancy of neoclassical economics, and the limitations of the regulatory environment that emerged in the Progressive Era. The eventual rise of the Chicago School and its deregulatory ambitions did constitute a rupture, but one achieved without rejecting preceding conceptions of competition and value. The substantial compatibility of the view of markets underlying both the regulatory and deregulatory periods is stressed, casting doubt about the transformative potential of the resurgent regulatory impulse in the New Gilded Age.

There is considerable literature indicating the importance of social connectedness and its relationship to wellbeing. For problem substance users, a similar literature emphasises the importance of the transition from a social network supportive of use to one that fosters recovery. Within this framework, the therapeutic community (TC) is seen as a critical location for adopting a transitional identity (i.e. from a “drug user” to a “member of the TC”), as part of the emergence of a “recovery identity” following treatment. The purpose of this paper is to outline a model for conceptualising and measuring identity based on the theories of social identity and recovery capital, and pilots this model within a TC setting.

A social identity mapping was used with TC residents to test their identification with “using” and “TC” groups, and their relationship to recovery capital.

The network mapping method was acceptable to TC residents, and provided valuable insights into the social networks and social identity of TC residents.

This paper explores issues around mapping social identity and its potential in the TC and other residential settings.

The paper integrates a number of conceptual models to create a new framework for understanding transitions in social networks during treatment and reports on a novel measurement method underpinning this.

As the engineering design process becomes increasingly complex, multidisciplinary teams need to work together, integrating diverse expertise across a range of disciplinary models. Where changes arise, these design teams often find it difficult to handle these design changes due to the complexity and interdependencies inherent in engineering systems. This paper aims to develop an innovative approach to clarifying system interdependencies and predicting the design change propagation at the asset level in complex engineering systems based on the digital-twin-driven design structure matrix (DSM).

The paper first defines the digital-twin-driven DSM in terms of elements and interdependencies, where the authors have defined three types of interdependency, namely, geospatial, physical and logical, at the asset level. The digital twin model was then used to generate the large-scale DSMs of complex engineering systems. The cluster analysis was further conducted based on the improved Idicula–Gutierrez–Thebeau algorithm (IGTA-Plus) to decompose such DSMs into modules for the convenience and efficiency of predicting design change propagation. Finally, a design change propagation prediction method based on the digital-twin-driven DSM has been developed by integrating the change prediction method (CPM), a load-capacity model and fuzzy linguistics. A section of an infrastructure mega-project in London was selected as a case study to illustrate and validate the developed approach.

The digital-twin-driven DSM has been formally defined by the spatial algebra and Industry Foundation Classes (IFC) schema. Based on the definitions, an innovative approach has been further developed to (1) automatically generate a digital-twin-driven DSM through the use of IFC files, (2) to decompose these large-scale DSMs into modules through the use of IGTA-Plus and (3) predict the design change propagation by integrating a digital-twin-driven DSM, CPM, a load-capacity model and fuzzy linguistics. From the case study, the results showed that the developed approach can help designers to predict and manage design changes quantitatively and conveniently.

This research contributes to a new perspective of the DSM and digital twin for design change management and can be beneficial to assist designers in making reasonable decisions when changing the designs of complex engineering systems.

The paper seeks to analyze the discourse of meaning and interpretation in the social sciences. It aims to provide a historical overview of the hermeneutics and the need for scientific as well as general understanding, and to emphasize the importance of the interpretive approach in management history.

The paper provides an in‐depth literature review of interpretation.

Interpretative approach is a basic building block of all science and management praxis.

Literature is limited to social science.

The paper highlights the importance of interpretation in management dialogue and praxis, vis‐à‐vis a sole reliance on rationalistic methods.

The originality of the paper lies in the scope of its literature review and the broad understanding it provides for management praxis.