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The purpose of this study was to examine the concept of value in healthcare through a practical appraisal of the applicability of a conceptual framework, which is aimed at supporting the measurement and realisation of financial benefits from process improvement (PI) activities in a hospital setting.

A single case study of a hospital system in Melbourne, Victoria, Australia, was used to assess the applicability of the framework. The study sought to verify the framework's intention, that PI methods could be used to address known wastes that contribute to the cost of providing healthcare. The case study examines the current approach taken by the hospital to measure and realise financial benefits from PI activities and compares these to the components of the Strategy to Balance Cost and Quality in Health Care framework to assess its applicability in practice.

The case study revealed that the steps described in the framework were fundamentally in place albeit with some variation. Importantly, the case study identified an additional step that could be added into the framework to support hospitals to better define their portfolio of initiatives to deliver value. The case study also clarified three types of contributory elements that should be in place for the application of the framework to be successful.

The Framework to Achieve Value in Healthcare is offered to hospitals as a model by which they can look to reduce expenditure through the removal of non-value adding activities. The modification to the conceptual framework has arisen from a single case study and would benefit from further testing by other hospitals in other policy settings (i.e. other countries).

This is the first paper to examine and enhance an existing framework to assist hospitals balance cost and quality through PI.

This paper reports on a study into the market for electronic publishing in the Welsh language which was undertaken for the Welsh Books Council. The scope of the potential market is estimated including both home computer users, educational institutes and libraries. The current Welsh multimedia industry is described and topics are considered that might be possible for electronic publication. Financial details are given of the amount of sponsorship needed.

Using data from a survey of social services departments, this paper looks at how local authorities are addressing the needs of people with learning disabilities for protection from crime and abuse within the context of adult protection developments. Previous research indicated that victimisation of this group was less likely to be treated seriously by key agencies. Here, the situation is reassessed.

Numerous problems have arisen in the application of freezing methods to the various types of food products. One problem is concerned with the determination of the direct effects of low temperatures upon the food itself and another problem is to determine the effects of low temperatures upon other factors which may in turn affect the quality of the food. We are especially interested in knowing the exact effects of freezing and other low temperatures upon the micro‐organisms associated with foods. Bacteria constitute the most significant group of micro‐organisms affecting the sanitation and keeping qualities of foods. Those bringing about the decomposition of food products, while they are many and vary greatly, depending upon the nature of the food, are chiefly organisms from the air, water and soil. The types of bacteria found in foods vary greatly in their action on the food and also in reaction or response to varying temperature conditions. The action of micro‐organisms on foods of high carbohydrate content results in fermentations, while the action of the micro‐organisms on foods of high protein content will result, chiefly, in putrefactive changes. The former type of change usually occurs at a more rapid rate, when conditions are favourable, but the latter change usually results in a more undesirable condition of the food. While certain types of bacteria grow best at temperatures well above human body temperatures and others even as low as the freezing point of water, a large majority of those found in foods and the ones normally responsible for the detrimental changes in foods, are active only between 50° and 100° F. It is this latter group which is most implicated in food spoilage and it is significant that this group will be most effectively suppressed by low temperatures. Bacteria are much less affected by low than by high temperatures. Cold alone does not kill most types of bacteria, but slows down their activities to such an extent that they multiply very slowly, if at all. Many bacteria will die off, however, when held at a temperature below that which permits growth and reproduction. Bacteria, generally speaking, will be more easily killed when frozen in pure water than when frozen in foods containing albuminous matter and fats. There are a few bacteria of the cold‐loving type, which may actually multiply and cause slow decomposition at temperatures of 0° C. or less, if substances in solution are present to depress the crystallising point of water. Cold not only retards the growth of bacteria by the direct physiological effect of slowing down the rate of metabolism, but also depresses bacterial activity through its effect on their water and food supplies. Bacteria cannot grow and multiply in a completely frozen or crystallised medium, since they are by nature aquatic and are unable to carry on their normal activities except in a liquid medium. There is no evidence that bacteria maintain a body temperature which would make water available from a completely frozen medium. Bacteria may only utilise food when it is in soluble form, and thus capable of diffusion through their semipermeable cell membranes. When the temperature is sufficiently low to cause the crystallisation of most of the water, the remaining constituents become relatively more concentrated and this will further suppress the activity of the bacterial cells by affecting their osmotic pressures. These effects are very similar to those of partial desiccation or drying. In the course of experimentation some very striking examples of bacterial resistance to low temperatures have been reported. Lactobacillus and aerobacter have been reported to survive in peas stored at −10° C. for two years; whilst bacteria of the genus Pseudomonas were reported to increase in numbers when stored at −4° C. In general it may be said that practically all pathogenic bacteria likely to be found in foods will die off rather rapidly at low temperatures. However, this should not be interpreted to mean that infected foods can be made safe by low temperatures alone. Among the disease producing bacteria transmitted through foods, those of special significance include the organisms and toxins of botulism, typhoid fever, the several organisms of food poisoning called ptomaine poisoning, belonging to the Salmonella group (Salmonella enteritidis, etc.), and various organisms causing infections of the general nature of dysenteries or summer complaints of infants and adults. Frozen foods present no greater threat of botulism than foods preserved by other methods, yet it has been shown that Clostridium botulinum spores may survive freezing at −16° C. for as long as 14 months. The vegetables when thawed become toxic in from three to six days. Experiments have shown that Clostridium botulinum in foods preserved by “quick freezing” and subsequent storage at temperatures below 10° C., show no toxin production for at least 30 days. The lower the temperature of storage the greater the protection against botulism. All foods in which Clostridium botulinum might be present, and which have not been thoroughly heated, should be refrigerated at or near the freezing point. All foods which may harbour the botulism organisms or toxins should be selected with special care, before they are frozen, and care should be taken to see that they are kept frozen until used by the customer. Frozen vegetables should be used immediately after thawing. Thawing and refreezing is always objectionable since such a practice leads to loss of quality, and since bacterial growth and activity may occur during the period of thawing. While the typhoid organisms (Eberthella typhosa) shows considerable variation in resistance to low temperatures, it has been shown that about 99 per cent. will be killed immediately by freezing. Temperatures below freezing apparently have little more effect than the freezing point temperature. Small numbers of the Salmonella and similar organisms of the food poisoning groups may survive in frozen foods for periods of several weeks. It has been shown, however, that no significant growth of activity of these organisms will occur if the foods are refrigerated at 5° C. (41° F.) or less. Moulds and yeasts are of relatively little importance in frozen foods, both from the standpoint of sanitation and food spoilage. While low temperatures will materially retard the rate of enzymatic changes within food products, there is evidence that such changes continue to take place in frozen foods, even considerably below the freezing point. These changes probably account, in part, for the fact that frozen foods once thawed, will decompose more rapidly than foods which have not been frozen.

The question has been recently raised as to how far the operation of the Sale of Food and Drugs Acts of 1875, 1879, and 1899, and the Margarine Act, 1887, is affected by the Act 29 Charles II., cap. 7, “for the better observation of the Lord's Day, commonly called Sunday.” At first sight it would seem a palpable absurdity to suppose that a man could escape the penalties of one offence because he has committed another breach of the law at the same time, and in this respect law and common‐sense are, broadly speaking, in agreement; yet there are one or two cases in which at least some show of argument can be brought forward in favour of the opposite contention.

Application of the numerical method to the art of Medicine was regarded not as a “trivial ingenuity” but “an important stage in its development”; thus proclaimed Professor Bradford Hill, accepted as the father of medical statistics, a study still largely unintelligible to the mass of medical practitioners. The need for Statistics is the elucidation of the effects of multiple causes; this represents the essence of the statistical method and is most commendable. Conclusions reached empirically under statistical scrutiny have mistakes and fallacies exposed. Numerical methods of analysis, the mathematical approach, reveals data relating to factors in an investigation, which might be missed in empirical observation, and by means of a figure states their significance in the whole. A simplified example is the numerical analysis of food poisoning, which alone determines the commonest causative organisms, the commonest food vehicles and the organisms which affect different foods, as well as changes in the pattern, e.g., the rising incidence of S. agona and the increase of turkey (and the occasions on which it is served, such as Christmas parties), as a food poisoning vehicle. The information data enables preventive measures to be taken. The ever‐widening fields of Medicine literally teem with such situations, where complexities are unravelled and the true significance of the many factors are established. Almost every sphere of human activity can be similarly measured. Apart from errors of sampling, problems seem fewer and controversy less with technical methods of analysis then on the presentation and interpretation of figures, or as Bradford Hill states “on the application of common sense and on elementary rules of logic”.

In most businesses effective leadership is still considered to be tough, competitive, rational, impersonal, strategic, etc.— in short, the traditional male model. Recently, however, sociologists and business writers have begun to challenge this model. Recognition increases that we need leaders who are participatory and supportive. Furthermore, increased world competition, new technologies, shifting markets, and other economic pressures are forcing corporations to change the way they do business. Even the old rules of management and leadership do not always hold true anymore. Fortunately, this period of change happens to coincide with the entry of more and more women into managerial positions, which works to their advantage. And it does because it puts them on the same footing as their male peers, who must learn the new rules, too.

The first series of colours experimented upon was the high‐grade Kohnstamm colours, which have been physiologically tested and prepared especially for use in colouring food products. The results recorded below are not the results of a single determination, but the experiments were repeated until we were satisfied, working with the chemicals we used, and by the methods employed, that the results were uniform and reliable. The results with the Kohnstamm dyes are as follows : —

Peter Drucker reflects upon his two novels with indulgence, describing the first as “my seventieth birthday…present” (Drucker, 1987, p. 12). Upon reading these novels, aspiring novelists might well agree. For, whilst Drucker is proud to describe himself as “a professional writer” (Drucker, 1987, p. 9), and has been remarkably successful as a non-fiction writer, it does not seem unfair to speculate that were it not for his illustrious name, he might never have secured a publisher for these novels. There is very little in the way of a plot, the characters are unmemorable and the dialogue is boring. One might thus well ask why bother to review a novel of so little literary merit written nearly twenty years ago? Such a question is easily answered. Drucker wrote his 1984 novel The Temptation to do Good for a specific purpose. And that purpose is intimately connected with ethical issues in organizations.

The possibility of introducing flexible working practices is investigated, focusing on the position of area catering supervisor in Sutcliffe Catering Ltd. The investigation was carried out in the light of demographic changes currently facing British industry. It is concluded that the position of Area Catering Supervisor can be made flexible by either introducing flexible working practices within the job description or by introducing flexible arrangements that do not change the structure of the job, but enable tasks to be conducted more easily. It is recommended that these changes are introduced in two stages comprising short‐term and long‐term initiatives.