We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Chapter 8 examines regulatory rules, beginning with an examination of written rules. It underlines the inescapability of interpretive uncertainty and considers ways in which that uncertainty can be addressed, including varying the precision of rules, how they are specified, the publication of interpretive ‘guidance’ (sometimes called ‘soft law’) and the delegation of detailed standard-setting to ‘technical experts’.
Pregnancy weight gain standards are charts describing percentiles of weight gain among participants with no risk factors that could adversely affect weight gain. This detailed information is burdensome to collect. We investigated the extent to which exclusion of various pre-pregnancy, pregnancy and postpartum factors impacted the values of pregnancy weight gain percentiles. We examined pregnancy weight gain (kg) among 3178 participants of the US nuMoM2b-Heart Health Study (HHS). We identified five groups of potential exclusion criteria for pregnancy weight gain standards: socio-economic characteristics (group 1), maternal morbidities (group 2), lifestyle/behaviour factors (group 3), adverse neonatal outcomes (group 4) and longer-term adverse outcomes (group 5). We established the impact of different exclusion criteria by comparing the median, 25th and 75th percentiles of weight gain in the full cohort with the values after applying each of the five exclusion criteria groups. Differences > 0·75 kg were considered meaningful. Excluding participants with group 1, 2, 3 or 4 exclusion criteria had no impact on the 25th, median or 75th percentiles of pregnancy weight gain. Percentiles were only meaningfully different after excluding participants in group 5 (longer-term adverse outcomes), which shifted the upper end of the weight gain distribution to lower values (e.g. 75th percentile decreased from 19·6 kg to 17·8 kg). This shift was due to exclusion of participants with excess postpartum weight retention > 5 kg or > 10 kg. Except for excess postpartum weight retention, most potential exclusion criteria for pregnancy weight gain standards did not meaningfully impact chart percentiles.
Fish and other seafood are a major component of New Zealanders’ diet; the 2018/2019 and 2019/2020 New Zealand Health Survey found that nearly three quarters of New Zealanders eat seafood at least once a week(1). Environmental and ethical factors influence New Zealand consumers’ purchase of seafood and consumers prefer to get their information about seafood at the point of purchase(2). However, environmental claims are not regulated under the Australia New Zealand Food Standards Code, unlike health and nutrition claims. Some seafood products are certified by programmes (e.g. Best Aquaculture Practice (BAP)), ensuring the seafood was sourced according to specific criteria related to environmental management, but other products carry self-declared environmental claims that have not been independently verified. This study aimed to describe labelling practices, including environmental claims, on fish and seafood packaged products sold in major New Zealand supermarkets and available in the 2022 Nutritrack database. Nutritrack is an annual survey conducted by trained fieldworkers who take photographs of all packaged food and beverage products displaying a nutrition information panel (NIP) from 4 major supermarkets in New Zealand. Information from the photographs, including the NIP and the ingredients list is entered into the Nutritrack database. For this study, data (including fish species, harvest location, processing country, fishing method, environmental certifications and self-declared environmental claims) were extracted from the archived photographs of all sides of the packaged fish and seafood products in the 2022 Nutritrack database. Self-declared environmental claims were assessed against the ISO 14021 standard for “Environmental labels and declarations — Self-declared environmental claims (Type II environmental labelling)” on specific criteria that were relevant for seafood products, including if the self-declared claim mentioned the word “sustainable” (as this term is difficult to substantiate and should be avoided); was vague and non-specific; or overstated the benefits (to imply multiple benefits from a single environmental change). There were 369 fish and seafood products included in this study. Eighty-eight products (23.8%) displayed a certification; the Marine Stewardship Council’s certification (MSC) for wild fish was the most common and was featured by 72 products (19.5%). One hundred and fifty-two products (41.2%) displayed at least one self-declared claim. Thirty-three distinct self-declared environmental claims were identified, 16 (48.5%) of which breached the ISO 14021 standard for environmental declarations because they used the term “sustainable” and 26 (78.8%) of which breached the ISO 14021 standard because they were vague. This analysis suggests that stricter regulation is needed for self-declared environmental claims on fish and other seafood products available for purchase in New Zealand, to prevent greenwashing and to provide consumers transparent, accurate and substantiated information.
Edited by
Roland Dix, Gloucestershire Health and Care NHS Foundation Trust, Gloucester,Stephen Dye, Norfolk and Suffolk Foundation Trust, Ipswich,Stephen M. Pereira, Keats House, London
Psychiatric intensive care units (PICUs) treat patients with an acute episode of a major mental illness who present with additional risk of harm to themselves or others that cannot be managed on an acute psychiatric ward. This chapter outlines standards of care that are expected upon such units, what they are and how the standards were developed with clinical rationale. It also gives examples of other guidelines and standards that impact practice within a PICU setting. It also describes the process of quality improvement in such units and how this relates to continual positive progress within a PICU setting. It alludes to how the principles of psychiatric intensive care can be incorporated within other settings and the need for clear definition of subspecialities within psychiatry.
Social workers make decisions every day involving the protection of children and/or adults who are at risk of, or are experiencing, abuse and neglect, exercising power and authority derived from law. Social workers must act within the law: “doing things right.” Accountable, legally literate practice additionally includes standards from administrative law when statutory duties are used. However, decision-making frequently also raises ethical dilemmas, including whether, when, and how to intervene in people’s lives. Practice must, therefore, be ethically literate: “doing right things.” Human rights, equality, and social justice issues will also feature in social work decision-making: “right thinking.” This chapter presents a framework for social worker decision-making that is legally and ethically, but also emotionally, relationally, organizationally and knowledge, literate. It proposes that this framework is transferable across the different jurisdictions within which social workers practice, and that it helps social workers to make good as well as lawful decisions.
Edited by
Rachel Thomasson, Manchester Centre for Clinical Neurosciences,Elspeth Guthrie, Leeds Institute of Health Sciences,Allan House, Leeds Institute of Health Sciences
This chapter addresses the question of what constitutes a good liaison psychiatry service. It briefly considers two national initiatives that have addressed the quality of mental healthcare in general hospitals – the Care Quality Commission (CQC) acute hospital inspection programme and two National Confidential Enquiry into Patient Outcome and Death (NCEPOD) reports. However, the chapter primarily focusses on the setting and measurement of standards for liaison psychiatry services by the UK Psychiatric Liaison Accreditation Network (PLAN).
To examine the impact of a Patient and Public Involvement exercise on the development of British Congenital Cardiac Association Fetal Cardiology Standards 2021.
Design:
Open-ended, semi-structured interviews were undertaken to inform the design of a study to improve the quality of parents’ experiences during antenatal and perinatal care of their child with CHD. This Patient and Public Involvement exercise was used to inform the final version of the drafted ‘Standards’.
Setting:
One-on-one interviews with parents who responded to a request on the closed Facebook page of the user group “Little Hearts Matter”: “Would you be interested in helping us to design a study about parents’ experience on learning that their child had CHD”?
Patients:
Parents of children with single ventricle CHD.
Results:
Twenty-one parents (18 mothers, 3 fathers) participated. Parents responses were reported to have variably reinforced, augmented, and added specificity in the later stages of drafting to six of the seven subsections of Section C Information and Support for Parents including: “At the time of the Scan”; “Counselling following the identification of an abnormality”; “Written information/resources”; “Parent support”; “Communication with other teams and ongoing care”; and “Bereavement support”.
Conclusions:
This Patient and Public Involvement exercise successfully informed the development of Standards after the initial drafting. It contributed to the establishment of face validity of the ‘Standards’, especially when consistent with what is reported in the literature. Further research is needed to explore approaches to involving and standardising Patient and Public Involvement in the development of clinical standards.
One of the world’s greatest experiments in open innovation is mobile wireless. Technology enterprises have invested billions of R&D dollars to develop 2G, 3G, 4G, now 5G, and hopefully 6G soon. Technology developers make investments and look to the patent system and associated regulators to reward them for risky investments, should their patented technologies become included in the standards. In recent years there has been an uptick in the number of technology implementers. But because patents are not self-enforcing, unlicensed use occurs, which is corrosive of the open innovation system that allows non-vertically integrated firms to compete at the device level. This chapter reviews antitrust theories that some implementers have used to avoid paying royalties to patent owners. This is examined in the context of the FRAND licensing regime established by ETSI, a standards development organization. “Hold up” and “hold out” theories are examined. Hold up theories lack empirical support and are misused by some implementers—particularly those in China—who would prefer to free ride on the R&D investments of others. Restoring and revitalizing technology markets for mobile wireless likely requires limits to be placed on the availability of FRAND licenses with respect to recalcitrant technology implementers. Otherwise, the innovation ecosystem will be harmed, and open innovation (that is, licensing) business models will collapse.
Times are changing as our global ecosystem for commercializing innovation helps bring new technologies to market, networks grow, and interconnections and transactions become more complex around standards, all to enable vast opportunities to improve the human condition, to further competition, and to improve broad access. The policies that governments use to structure their legal systems for intellectual property, especially patents, as well as for competition—or antitrust—continue to have myriad powerful impacts and raise intense debates over challenging questions. This chapter explores a representative set of debates about policy approaches to patents, to elucidate particular ideas to bear in mind about how adopting a private law, property rights-based approach to patents enables them to better operate as tools for facilitating the commercialization of new technologies in ways that best promote the goals of increasing access while fostering competition and security for a diverse and inclusive society.
Effective health-care makes a large and increasing contribution to preventing disease and prolonging life by reducing the population burden of disease. However, only the right kind of health-care delivered in the right way, at the right time, to the right person can improve health. Health-care interventions that are powerful enough to improve population health are also powerful enough to cause harm if incorrectly used. How can public health specialists know whether their interventions are having the desired effect? Clinicians can monitor the impact of their treatments on an individual patient basis, but how do we examine the impact of a new service? This chapter looks at what we mean by quality of health-care and considers some frameworks for its evaluation.
To explain countries’ varying participation in the Belt and Road Initiative, this chapter begins with a discussion of recipient country characteristics that impact the demand for Chinese spending, including the political regime, clientelism, and the public-private orientation of the corporate sector. It then discusses the supply-side factors that influence Chinese foreign spending, including the Chinese Communist Party (CCP), state-owned entities (e.g., SOEs), and private firms. Finally, it evaluates the compatibility of these demand and supply characteristics. The key prediction is that electoral autocracies will display the strongest compatibility with Chinese foreign construction spending. This is amplified when the leaders of these regimes have a weak or insecure hold on power. Electoral autocracies are also predicted to be the most avid adopters of Chinese standards stemming from their eagerness for Chinese infrastructure spending.
The moral foundations of crisis response seem simple: responders save lives, reduce human suffering, and pursue a lofty societal goal. Yet, crises often produce morally complicated situations as well. Crisis organizations have adopted norms, which help responders to work in complex moral contexts, but these norms cause moral distress when responders do not fully agree with them. Responders can choose to deviate from the norms and follow their inner moral convictions instead. This will not remove the moral complexities of their work though. Rather, it means that crisis professionals have to resolve moral dilemmas on their own and bear the full weight of moral responsibility. The moral dilemma for responders concerns this tension between following organizational norms and their own convictions. In response, crisis organizations could pursue an ethical culture by promoting organizational deliberation on moral questions in crisis operations. Creating an ethical culture allows for an open, flexible attitude by enabling active dialogue and collective reflection on moral dilemmas in crises. It facilitates a confrontation with the inevitable moral discomforts of crisis response.
The SUERC Radiocarbon Laboratory reports approximately 3000 unknown samples per year with an additional 1200 samples processed for quality assurance purposes. In addition to the primary OxII standard (SRM-4990C) required for AMS batch normalization, secondary “known-age” standards have been used over many years to evaluate individual batch quality. These have included wood (as prepared alpha-cellulose), barley mash, humic acid, a background mammoth bone, known-age bones, and a whisky sample. In this paper, we present some of the results gathered over routine laboratory operation (for more than 10 years) and examine the results illustrating how they are being used to monitor and quality assure performance. Since many of these samples have also been used in the Glasgow intercomparisons, we will also reflect on the results, as well as the actual and potential uses of such samples.
The next generation of high-power lasers enables repetition of experiments at orders of magnitude higher frequency than what was possible using the prior generation. Facilities requiring human intervention between laser repetitions need to adapt in order to keep pace with the new laser technology. A distributed networked control system can enable laboratory-wide automation and feedback control loops. These higher-repetition-rate experiments will create enormous quantities of data. A consistent approach to managing data can increase data accessibility, reduce repetitive data-software development and mitigate poorly organized metadata. An opportunity arises to share knowledge of improvements to control and data infrastructure currently being undertaken. We compare platforms and approaches to state-of-the-art control systems and data management at high-power laser facilities, and we illustrate these topics with case studies from our community.
In the late twentieth century, the European Union (EU) emerged as a global leader in setting environmental protections, including vehicle emissions standards. But member state consensus around environmental rules did not come easily, and the regional norms eventually set by the EU and its predecessor, the European Economic Community, had complex origins. This article argues that common emissions standards were ultimately achieved through a public-private process during the program to create the Single European Market in the 1980s and 1990s. For regional policymakers, standards were key to achieving an internal car market and strengthening the auto industry's global competitiveness; for many European carmakers and their transnational business associations, common norms could facilitate economies of scale and level the playing field. The “liberal environmentalism” born out of this convergence of interests produced common standards that fell pragmatically between the greenest member states and those most invested in protecting their national champion firms.
In this chpater, we review the standards and guidelines for adaptive trial designs and master protocols. Methodological rigour and transparent reporting are required in all clinical trials. Adaptive trial designs and master protocols are no exception. The standard reporting guidelines and risk-of-bias assessments for conventional trials can be applied to adaptive trial designs and master protocols. Adaptive trial designs have pre-planned adaptations and analysis plans that are specified in a formal way that outline how the data will be used to guide the design. Planning of adaptive clinical trials, basket trials, umbrella trials, and platform trials will require early engagement with the stakeholders and methodologists to think through potential hurdles and challenges of the statistical design and its implementation.
This chapter examines the array of technologies that is transforming the global TV system. The first part is devoted to communications satellites, which fulfil multiple distribution functions for all kinds of rights holders, and the second turns to internet distribution. It covers the origins of video streaming before explaining how it works and why it is dethroning broadcasting and downloading as the most popular way of accessing content. The chapter examines the role of video coding formats, content delivery networks (CDNs), and cloud computing in video distribution. It concludes by highlighting the role of standards and standard-setting organisations, arguing that their international evolution mirrors that of the TV industry and emphasising the crucial role they play in digital value chains over which no one in particular has an oversight.
No matter how good a smart device may be, it remains useless outside the context of a digital ecosystem. Internet of Things (IoT) environments are possible as long as services and products can interconnect smoothly and exchange data in real time. Therefore, interoperability ranks high in global policy agendas, with the promise of bringing an end to network effects slanted in favour of ecosystem orchestrators. However, recent regulatory initiatives introducing interoperability obligations risk falling short of their intent or even risk generating unintended consequences in the absence of a coherent approach to standardisation. Against this backdrop, focusing on the UK Open Banking experience, this article makes a proposal for workable interoperability in IoT ecosystems aimed at ensuring market contestability without undermining incentives to innovate.
In the social debate about animal welfare we can identify three different views about how animals should be raised and how their welfare should be judged: (1) the view that animals should be raised under conditions that promote good biological functioning in the sense of health, growth and reproduction, (2) the view that animals should be raised in ways that minimise suffering and promote contentment, and (3) the view that animals should be allowed to lead relatively natural lives. When attempting to assess animal welfare, different scientists select different criteria, reflecting one or more of these value-dependent views. Even when ostensibly covering all three views, scientists may differ in what they treat as inherently important versus only instrumentally important, and their selection of variables may be further influenced by a desire to use measures that are scientifically respected and can be scored objectively. Value assumptions may also enter animal welfare assessment at the farm and group level (1) when empirical data provide insufficient guidance on important issues, (2) when we need to weigh conflicting interests of different animals, and (3) when we need to weigh conflicting evidence from different variables. Although value assumptions cannot be eliminated from animal welfare assessment, they can be made more explicit as the first step in creating animal welfare assessment tools. Different value assumptions could lead to different welfare assessment tools, each claiming validity within a given set of assumptions.
Animal welfare is of increasing significance for European consumers and citizens. Previously, agricultural production focused mainly on supply, price and competition but consumers now expect their food to be produced and processed with greater respect for the welfare of the animals. Food quality is therefore determined by the welfare status of the animals from which it was produced as well as the nature and safety of the end product. Thus, practical welfare improvement strategies and reliable on-farm monitoring systems for assessing the animals’ welfare status and evaluating potential risks are urgently required to accommodate societal concerns and market demands. It is also of paramount importance to define the kind of information that consumers want about the final products and to develop effective strategies for communicating welfare standards to the public. Generating an intensified dialogue with all factions of society on welfare issues as well as appropriate labelling of animal products and farming systems that offer guarantees about welfare issues and production conditions will, in turn, promote transparency and the societal sustainability of European agriculture. Welfare is multidimensional. It cannot be measured directly but only inferred from external parameters. Therefore, the integration of the most appropriate specialist expertise in Europe is essential to develop, refine, standardise and intercalibrate welfare monitoring systems and to identify and validate remedial measures. We must establish a European standard for welfare assessment systems in order to facilitate intra-European trade and marketing. Only then can we harmonise labelling that is informative and relevant to all European consumers.