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The United States devotes a larger share of its GDP to health care and spends more on health care per capita than any other country. The sheer size of the total spending on health care, at approximately $3.5 trillion in 2017, puts significant pressure on all payers and crowds out other forms of public and private spending.

In this brief commentary the authors suggest that, as part of the effort to deal with this pressure, the United States should look at borrowing a cost containment strategy from other countries: the use of hard caps on spending growth. The authors draw on our their experience of working with decision-makers over the last 20 years on the topic of priority setting to put forward some ideas on whether there is potential for application of trade-offs in the United States.

As hard caps force choices to be made, a necessary condition for successful implementation of this policy is the presence of an effective priority-setting framework to ensure that the right choices are made in operationalizing spending limitations. Work on this topic elsewhere can provide some insight into the use of a criteria-based framework for priority setting that purports transparency in decision-making to achieve value-based decisions.

Other countries still have much work to do, but there is a substantial track record of using formal priority-setting approaches that could potentially inform practice in the United States. We suggest that there are key segments of the US healthcare system where the adoption of formal priority-setting frameworks to guide trade-off decisions is feasible. Piloting such activity in these contexts is the next natural step in this line of inquiry.

This study aims to analyze the innovation overview of the Brazilian industrial sector using data published by innovation survey – PINTEC. The aim was to provide a macro and updated diagnosis of the innovation scenario in Brazil and build reflections for further studies.

The authors used information from the years 1998–2014 covered by PINTEC to analyze innovation indicators, namely, innovation types, problems and obstacles, novelty degree, established partnerships and interactions, as well as governmental incentives. This study is exploratory; thus, descriptive methods were used for data presentation through analyses and presented through figures and tables.

The results show that innovation of the Brazilian industrial sector is concentrated mainly in the acquisition of machinery and equipment, innovations that already exist in national or global markets, interactions for the innovation process with suppliers and governmental support for financing machinery and equipment acquisitions.

This study has relevance, as its results provide important subsidies for policy-makers to incorporate the needs and overcome challenges of innovation in Brazil.

The climate crisis presents a global threat. Research shows the necessity of joint communication efforts across different arenas—media, politics, business, academia and protest—to address this threat. However, communication about social change in response to the climate crisis comes with challenges. These challenges manifest, among others, in public accusations of inconsistency in terms of hypocrisy and incapability against self-declared change agents in different arenas. This increasingly turns public climate communication into a “blame game”.

Strategic communication scholarship has started to engage in this debate, thereby acknowledging climate communication as an arena-spanning, necessarily contested issue. Still, a systematic overview of specific inconsistency accusations in different public arenas is lacking. This conceptual article provides an overview based on a macro-focused public arena approach and decoupling scholarship.

Drawing on a systematic literature review of climate-related strategic communication scholarship and key debates from climate communication research in neighboring domains, the authors develop a framework mapping how inconsistency accusations of hypocrisy and incapacity, that is, policy–practice and means–ends decoupling, manifest in different climate communication arenas.

This framework creates awareness for the shared challenge of decoupling accusations across different climate communication arenas, underscoring the necessity of an arena-spanning strategic communication agenda. This agenda requires a communicative shift from downplaying to embracing decoupling accusations, from mutual blaming to approval of accountable ways of working through accusations and from confrontation to cooperation of agents across arenas.

The purpose of this paper is to show that lesson study by including elements from music and music education can sustainably expand and improve the dialogical space for teaching and learning in higher education, especially for primary and secondary teacher education students.

For the first time under the topic “Lesson Study: Music in Dialogue,” corresponding study programs were prepared at the University College of Teacher Education, Lower Austria. The data material from which answers to research questions can be generated are the “Didactic Design Pattern” and classical research lesson planning, observation and discussion instruments. Moreover, discussion protocols of the reflection meetings offered insights the participants gained through sharing their experience of a series of lesson study cycles including focussed collaboration between mentors, teachers, teacher education students and primary school pupils.

Within the lesson study groups, the space for cooperation and dialogue widened considerably and the interest in the work and expertise of each other increased. Based on the principles of a “community of practice,” this study shows the positive effects of professional collaboration on primary and secondary teacher education students and a lasting impact on their pupils’ learning. Thereby, the dialogical principle was found to play a central and important role. In connection with music- and art-related processes, previous limitations in teaching and learning with music can be exceeded for pupils, teacher education students and teachers.

This study, therefore, provides new insights into questions of organization and implementation, as well as scientific and didactic support in professional learning communities.

So far, there has been little practitioner research through lesson study in the field of music education. In particular, lesson study enhancing the cooperation between music education and other subject areas through dialogical-integrative work has brought about knowledge and insights of great importance for the further development of an appropriate didactic approach in dialogic music education.

The purpose of this paper is to examine the association between consumers’ emotions towards emerging e-banking technology, perceived risk and subsequent intention to adopt emerging e-banking technology.

An online questionnaire was used to collect data, which were analysed in a quantitative study. The final sample of 224 educated young consumers, familiar with emerging e-banking technology, allowed testing of the research hypotheses by applying confirmatory factor analysis and structural equation modelling (SEM).

The empirical results indicate that deterrence emotions and hedonic motivation are associated with consumers’ perceived risk and, subsequently, their intention to adopt emerging e-banking technology. Additionally, analysing the moderating role of hedonic motivation in the association between consumers’ deterrence emotions towards emerging e-banking technology and their perceived risk highlights the significant association of deterrence emotions with perceived risk, regardless of the presence of hedonic motivation.

This study demonstrates the association between consumers’ emotions, perceived risk and subsequent intention to adopt emerging e-banking technology whilst underscoring the importance of distinguishing between different types of emotions and their corresponding appraisals.

Innovation is today considered a competitive differential for improving the performance of companies, and technology parks are seen as environments with favorable conditions for such innovation. The purpose of this study is to develop a framework for analyzing favorable conditions for innovation in technology parks, the innovations produced and organizational performance.

To this end, the authors conducted bibliographic research and in-depth interviews with managers of companies based at the Tecnopuc Science and Technology Park, and managers of the park itself, to establish practical support for previous theoretical findings.

As a result, a framework was developed to link the favorable conditions for innovation, and organizational performance.

The analysis model proposed here synthesizes the contributions made by several scholars on the theme, allowing for a more detailed and integrated interpretation of the phenomenon, namely, the ways through which the effective development of innovation takes place in companies residing in technology parks and the contribution of innovation to the specific performance of companies.

The use of the proposed framework can help direct park managers’ action towards those relationships or activities that prove to be ineffective in achieving desired goals.

The use of the proposed model in empirical surveys will allow for better understanding of the phenomenon involving the features of technology parks and their effects on innovation and the performance of companies installed there, considering that such parks allow them to access resources with lower transaction costs.

This study aims to take a dual-process perspective and argues that peer influence on increasing impulse buying may also operate automatically. If-then plans, which can automate action control, may, thus, help regulate peer influence. This research extends existing literature explicating the deliberate influence of social norms.

Study 1 (N = 120) obtained causal evidence that forming an implementation intention (i.e. an if-then plan designed to automate action control) reduces peer impact on impulse buying in a laboratory experiment with young adults (students) selecting food items. Study 2 (N = 686) obtained correlational evidence for the role of norms, automaticity and implementation intentions in impulse buying using a large sample of high-school adolescents working on a vignette about clothes-shopping.

If-then plans reduced impulse purchases in the laboratory (Study 1). Both reported deliberation on peer norms and the reported automaticity of shopping with peers predicted impulse buying but an implementation intention to be thriftily reduced these links (Study 2).

This research highlights the role of automatic social processes in problematic consumer behaviour. Promising field studies and neuropsychological experiments are discussed.

Young consumers can gain control over automatic peer influence by using if-then plans, thereby reducing impulse buying.

This research helps understand new precursors of impulse buying in understudied European samples of young consumers.

The main objective of this study is to investigate what are the critical success factors that exist for continuous improvement (CI) methodology deployment in the Irish medical technology (MedTech) industry. The research will, in particular, seek to establish if the highly regulated nature of the global MedTech industry is an additional critical failure factor (CFF) for the deployment of CI methodology. The study involves the analysis of the benefits, challenges, CFFs and tools most utilised for the application to the deployment of CI methodologies in the Irish medical device (MD) industry.

A quantitative survey was utilised in this study. The main participants were made up of senior quality professionals working in operational excellence, quality consultants, quality directors, quality engineers, quality managers and quality supervisors working in both manufacturing and service sectors from Irish MD companies. A total of 94 participants from the Irish MedTech industry responded to the survey.

The main finding of this study is that 42% of participants perceived that a highly regulated environment was a CFF to CI, whilst 79% of respondents utilised Lean Six Sigma in their organisations, and productivity and financial factors were found to be the highest reasons for CI deployment amongst the Irish MedTech industry. The top CFFs highlighted for CI in regulated industries were fear of extra validation activity, compliance versus quality culture and a regulatory culture of being “safe”. Another relevant finding presented in this paper is that just over 48% of participants felt that CI tools are very strongly integrated into the industries quality management systems (QMSs) such as the corrective and preventative action system, non-conformance and audit systems.

All data collected in the survey came from professionals working for Irish indigenous and multinational MedTech companies. It is important to highlight that n = 94 is a low sample size, which is enough for a preliminary survey but reinforcing the limitation in terms of generalisation of the results. A further study on a wider European and global scale as well as a comparison with the highly regulated pharma industry would be informative.

The authors understand that this is the very first research focussed on the CFFs for CI in the MedTech/MD manufacturing industry with a specific focus on the highly regulated nature of the industry as a potential CFF. The results of this study represent an important first step towards a full understanding of the applicability and use of CI in the medical-device-manufacturing industries on a global scale.

The conventional project delivery (CPD) approach has been reported in the literature as the most widely used project delivery method in the construction industry globally compared to other delivery methods. However, researchers and practitioners have argued that the approach, specifically during the production of design documentation under the CPD, lacks certain capabilities that ensure quality and enhance project delivery. Therefore, this study aims to use the Ghanaian construction industry to identify the capabilities required of the CPD in practice, particularly during the production of design documentation.

The study design follows a pragmatist philosophy and uses mixed methods based on a deductive approach. Data collection involved a questionnaire survey, followed by semi-structured interviews. Quantitative data analysis used descriptive and inferential statistics, whereas qualitative data analysis used content analysis with the assistance of IBM SPSS and QSR Nvivo 12 Pro.

Findings indicate that there should be incentives for producing good design documentation quality; mandatory coordination of design documentation; improving collaboration among designers; and allowing contractors to make input during the design stage.

The results indicate the need for the identified capabilities to be introduced in the CPD approach to improve design documentation quality.

This study offers a significant insight into the specific capabilities that are required of the CPD approach in practice particularly, in the production of design documentation

Gender competence as part of engineering education can better prepare men and women to work on sustainable solutions that benefit entire societies. This chapter describes the framework and lessons learned of a community of practice (CoP) for gender equality facilitated by the Mediterranean Engineering Schools Network. Faculty and students from Mediterranean European, North African and Middle Eastern countries came together in this CoP, which was supported by the TARGET project, to develop a practical plan using a reflexive approach. The transfer of knowledge between generations is achieved by using participatory learning processes, facilitating mindful awareness, widening experiences, deepening understandings and building a gender-sensitive mindset. Students embarked on the journey to become change agents. The process led to the consolidation of gender equality knowledge, competence building and the development of change agents for gender equality. This CoP can inspire other institutions to undertake a participatory path towards gender equality – at local, regional, or global level.