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1 – 10 of over 18000This chapter will use A Propos de Nice, filmed by Jean Vigo and Boris Kaufman in February and March 1930, as a case study to illustrate how city films created segmented views of…
Abstract
This chapter will use A Propos de Nice, filmed by Jean Vigo and Boris Kaufman in February and March 1930, as a case study to illustrate how city films created segmented views of quotidian urban life in both form and content. In terms of form, short clips are juxtaposed in a rapid montage to form a segmented portrait of the city. In terms of content, the segments in Vigo's film, and the city film genre as a whole, are full of everyday events such as drinking coffee, washing clothes, sunbathing, and playing boules. The portrait of Nice that emerges within the film, then, is one of quotidian segmentation. This chapter will conduct a visual analysis of the film as it progresses, situating it within the history of Nice, cinematic conceptions of the city prior to its production, the city film genre, and the French avant-garde.
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Examines the interaction of patient organisations with the National Institute for Clinical Excellence (NICE) during the first two years of its existence. In particular, it…
Abstract
Examines the interaction of patient organisations with the National Institute for Clinical Excellence (NICE) during the first two years of its existence. In particular, it considers the intersection of two policy areas prominent in the Labour Government’s health reforms – patient participation and evidence‐based medicine. Data has been obtained from unstructured interviews with patient/carer representatives from NICE’s committees and patient/carer groups with an interest in NICE’s technology appraisals, supplemented by observation of NICE’s Board and Partners’ Council meetings, and analysis of documentary evidence. The paper focuses on “formal” and “informal” involvement of patient groups in NICE’s structures and appraisals process. Most interviewees felt that the patient voice had been strengthened in these areas, though there was concern about the relative weights of patient and scientific evidence. Thus NICE illustrates two paradoxes in Labour’s policy objectives – centralisation/participation and evidence‐based medicine/patient perspective – which may become problematic.
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This paper examines patient organisations’ participation in the technology appraisals process of the National Institute for Clinical Excellence (NICE). In particular, it considers…
Abstract
This paper examines patient organisations’ participation in the technology appraisals process of the National Institute for Clinical Excellence (NICE). In particular, it considers two policy areas prominent in recent UK government health reforms – patient participation and evidence‐based medicine (EBM). Data have largely been obtained from unstructured interviews with patient/carer groups involved in NICE’s technology appraisals, patient/carer representatives from NICE’s committees, and NICE personnel, supplemented by observation of NICE’s Board and Partners’ Council meetings, and analysis of documentary evidence. The paper focuses on the nature of “evidence” in NICE’s appraisals process, in particular patient groups’ concerns about the relative “weights” attached to patient and scientific evidence. NICE has taken some steps to allay such concerns, but more clarity is needed about how evidence from disparate sources is handled, if patient groups are to feel that their submissions of evidence have had more than marginal impact.
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John F.P. Bridges, Joshua P. Cohen, Peter G. Grist and Axel C. Mühlbacher
Purpose – Although the US has lagged behind international developments in health technology assessment (HTA), renewed interest in HTA in the US has been fueled by the…
Abstract
Purpose – Although the US has lagged behind international developments in health technology assessment (HTA), renewed interest in HTA in the US has been fueled by the appropriation of $1.1 billion comparative effectiveness research (CER) in 2009 and the debate over health care reform.
Approach – To inform CER practices in the US, we present case studies of HTA from England/Wales and Germany: contrasting methods; relevance to the US; and impact on innovation.
Findings – The National Institute of Health and Clinical Excellence (NICE) was established in 1999 to inform trusts within the National Health Service of England and Wales. It uses cost-effectiveness analysis to guide the allocation resource across preventative and curative interventions. In Germany, the Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG) was established in 2004 to inform reimbursement and pricing policies for the statutory sickness funds set by the Gemeinsamer Bundesausschuss (G-BA). IQWiG evaluates competing technologies within specific therapeutic areas, placing more weight on clinical evidence and the relative efficiency of competing therapies.
Practical implications – Although having deep political and cultural antecedents, differences between NICE and IQWiG can be explained by perspective: the former guiding resource allocation across an entire system (macro-evaluation), the latter focusing on efficiency within the bounds of a particular therapeutic area (micro-evaluation). Given the decentralized nature of the US health care system, and the relative powers of different medical specialties, the IQWiG model presents a more suitable case study to guided CER efforts in the US.
Clinical guidelines from National Institute of Clinical Excellence (NICE) have been developed by a rigorous process using the highest‐level evidence base. Their objectives are to…
Abstract
Clinical guidelines from National Institute of Clinical Excellence (NICE) have been developed by a rigorous process using the highest‐level evidence base. Their objectives are to reduce the variations in clinical care and end the postcode lottery of healthcare delivery. They are backed strongly by the government's agenda, are expected to be implemented and to be monitored, and this is to be monitored by CHAI. Up until now, clinical guidelines have had a secondary status to expert witness testimony in determining the standard of care in law in medical litigation. However, guidelines from NICE may have a more influential role in determining the standard of care in law by setting the standard of expected clinical practice. Trusts need to be sensitive to this as part of their risk management strategy. Trusts should facilitate the implementation of guidelines from NICE and audit their use through the framework of clinical governance. In the rare event that a trust should decide to positively diverge from such guidelines, it should do so only through a mechanism of due process that is required in public law for the accountability of the reasonableness of such a decision.
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Karen Gough, Samantha Churchward, Eluned Dorkins, Jason Fee, Susan Oxborrow, John Parker and Helen Smith
The NICE Guidelines for Schizophrenia are designed to give guidance on the best practice in treatment and management of schizophrenia. These guidelines have 13 standards which…
Abstract
The NICE Guidelines for Schizophrenia are designed to give guidance on the best practice in treatment and management of schizophrenia. These guidelines have 13 standards which services can use for the purpose of audit. As schizophrenia is our service's most common diagnosis, an audit against the guidelines was undertaken. The results indicated that we met three of the standards. Recommendations have been implemented to improve practice on standards that were not met, and this has led to some creative practice development. Despite the labour‐intensive nature of the audit, the results gave a clear indication of areas where there was a need for improvement and will act as a good baseline for re‐audit.
Valerie Beattie and Brian Hockley
To date over 20 guidelines or technology appraisals have been issued. At first, it seemed implicit that these guidelines would be subject to the audit process and that NICE would…
Abstract
To date over 20 guidelines or technology appraisals have been issued. At first, it seemed implicit that these guidelines would be subject to the audit process and that NICE would provide guidance and practical support for undertaking this activity. NICE have now issued a template for the audit of NICE guidelines based on a multi‐level approach. While audit of NICE guidance is an essential element of the whole clinical governance agenda, the burden of work that this could introduce to Trusts may be unsustainable. Suggests possible alternatives to auditing NICE guidance and proposes the use of a minimum dataset and full exploitation of electronic means of data harvesting.
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S. Christofle, C. Papetti and M. Ferry
To know the role of online social media (OSM) on the experience and communication of a gay film festival (ZeFestival) in a tourist destination: Nice, France
Abstract
Purpose
To know the role of online social media (OSM) on the experience and communication of a gay film festival (ZeFestival) in a tourist destination: Nice, France
Methodology/approach
Literature review accompanied with a qualitative study and netnographic analysis.
Findings
Informs on the use of OSMs by both organizers and festival goers, with a much poorer involvement of stakeholders than was envisaged. Proposes avenues for finding the causes of this lack of communication and sharing of the online experience.
Research limitations/implications
An exploratory study of a single gay film festival. The research work should be extended to other gay cultural events in Nice and France as a whole.
Practical implications
Recommendations for online experience sharing and communication before, during, and after the event.
Originality/value
This theme has been hardly broached on an international scale and never in a French context.
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The purpose of the paper is to provide healthcare organisations with an example of how the implementation of new interventional procedures and NICE guidance can be improved by…
Abstract
Purpose
The purpose of the paper is to provide healthcare organisations with an example of how the implementation of new interventional procedures and NICE guidance can be improved by adopting a synergistic approach.
Design/methodology/approach
The paper shows that following the introduction of the Interventional Procedure Programme (NICE) and the issue of Department of Health advice in 2003, it was considered that the hospital's process for implementing new interventional procedures should be revised and would be more effectively managed by integrating with the well established process for implementing NICE guidance. The strategy for implementing NICE guidance and the new interventional procedure ratification process at the Luton and Dunstable Hospital NHS Trust are outlined and describe individual and corporate roles and responsibilities that promote local ownership.
Findings
The paper provides information on how the Trust incorporated the national perspective into a local model, which ensures a well‐coordinated multidisciplinary approach to introducing innovative clinical practice safely.
Practical implications
This paper demonstrates a useful tool that may be adapted by other healthcare organisations and clinical governance professionals responsible for implementing new interventional procedures into local practice. The role of the Interventional Procedure Governance Committee in supporting the application, review, ratification and monitoring processes is explained.
Originality/value
The paper identifies a practical approach, ensuring that practice follows recommendations within guidance already published by NICE or are reported to the Interventional Procedure Programme if the procedure is not already included within the work programme.
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This paper seeks to describe the public health guidance development activity of the new National Institute for Health and Clinical Excellence (NICE).
Abstract
Purpose
This paper seeks to describe the public health guidance development activity of the new National Institute for Health and Clinical Excellence (NICE).
Design/methodology/approach
The paper outlines the origins of the public health guidance development work, the types of guidance in public health which NICE will produce, the methodological approach which will be used, the advisory body structure, the health economics which will inform judgements about cost‐effectiveness, the audiences for the guidance and the approach to health inequalities which will be taken.
Findings
The future recommendations which NICE will make in public health are signalled.
Originality/value
The paper provides a summary of the key processes which will be used in the production of public health guidance.
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