Means different things to different people, making it difficult to enforce
Chronic non-communicable diseases (NCDs) cause the majority of premature deaths, disability, and healthcare expenditures in the U.S. Six largely modifiable risk behaviors and factors (tobacco use, poor nutrition, physical inactivity, alcohol abuse, drug abuse, and poor mental health) account for more than 50% of premature mortality and considerably more morbidity and disability. The IOM proposed that population burden of disease and preventability should be major determinants of the amount of research funding provided by the U.S. NIH. Data on NIH prevention funding between fiscal years 2010 and 2012 for human behavioral interventions that target the modifiable risk factors of NCDs were analyzed during 2013-2014. The NIH prevention portfolio comprises approximately 37% human behavioral studies and 63% basic biomedical, genetic, and animal studies. Approximately 65% of studies were secondary prevention versus 23% for primary prevention, and 71% of studies intervened at the individual and family levels. Diet and exercise were the most-studied risk factors (41%), and few studies conducted economic analyses (12%). NIH spends an estimated $2.2-$2.6 billion annually (7%-9% of the total of $30 billion) on human behavioral interventions to prevent NCDs. Although NIH prevention funding broadly aligns with the current burden of disease, overall funding remains low compared to funding for treatment, which suggests funding misalignment with the preventability of chronic diseases.
Purpose-The purpose of this paper is to present a case study of the Heathrow Terminal 5 project and to illustrate a customised application of the Balanced Scorecard in a major infrastructure project with multiple stakeholders. Design/methodology/approach-The research methodology applied in this work was based on the case study methodology. The focus was on ''how'' questions and exploratory analysis of primary and secondary data supported in-depth interviews with members from both the project team and suppliers. Findings-The application of the concept of the Balanced Scorecard by Kaplan and Norton in project management is less frequent in comparison with operations management. The study has established a proven application of the Balanced Scorecard in managing quality in a major infrastructure project. Practical implications-For practitioners of major projects the paper gives implications for implementing the theoretical and customising requirements of the Balanced Scorecard involving key stakeholders. Originality/value-The paper illustrates that metrics can be customised for major projects within the framework of the Kaplan and Norton Balanced Scorecard and that suppliers should be empowered to own the monitoring and improvement process using their performance data.
We consider the influence that John Forrester’s work has had on thinking in, with, and from cases in multiple disciplines. Forrester’s essay ‘If p, Then What? Thinking in Cases’ was published in History of the Human Sciences in 1996 and transformed understandings of what a case was, and how case-based thinking worked in numerous human sciences (including, centrally, psychoanalysis). Forrester’s collection of essays Thinking in Cases was published posthumously, after his untimely death in 2015, and is the inspiration for the special issue we introduce. This comprises new research from authors working in and across the history of science and medicine, gender and sexuality studies, philosophy of science, semiotics, film studies, literary studies and comparative literature, psychoanalytic studies, medical humanities, and sociology. This research addresses what it means to reason in cases in particular temporal, spatial, or genre-focused contexts; introduces new figures (e.g. Eugène Azam, C. S. Peirce, Michael Balint) into lineages of case-based reasoning; emphasizes the unfinished and unfinishable character of some case reading and autobiographical accounts; and shows the frequency with which certain kinds of reasoning attempted with cases fail (often in instructive ways). The special issue opens up new directions for thinking and working with cases and case-based reasoning in the humanities and human sciences.
‘Deliberate self-harm’, ‘self-mutilation’ and ‘self-injury’ are just some of the terms used to describe one of the most prominent issues in British mental health policy in recent years. This article demonstrates that contemporary literature on ‘self-harm’ produces this phenomenon (to varying extents) around two key characteristics. First, this behaviour is predominantly performed by those identified as female. Second, this behaviour primarily involves cutting the skin. These constitutive characteristics are traced back to a corpus of literature produced in the 1960s and 1970s in North American psychiatric inpatient institutions; analysis shows how pre-1960 works were substantially different. Finally, these gendered and behavioural assertions are shown to be the result of historically specific processes of exclusion and emphasis.
Summary. Concepts used by historians are as historical as the diagnoses or categories that are studied. The example of Munchausen syndrome (deceptive presentation of illness in order to adopt the 'sick role') is used to explore this. Like most psychiatric diagnoses, Munchausen syndrome is not thought applicable across time by social historians of medicine. It is historically specific, drawing upon twentieth-century anthropology and sociology to explain motivation through desire for the 'sick role'. Ian Hacking's concepts of 'making up people' and 'looping effects' are regularly utilised outside of the context in which they are formed. However, this context is precisely the same anthropological and sociological insight used to explain Munchausen syndrome. It remains correct to resist the projection of Munchausen syndrome into the past. However, it seems inconsistent to use Hacking's concepts to describe identity formation before the twentieth century as they are given meaning by an identical context.
The increasing provision of psychiatric expertise in general hospitals makes possible new interpretations of self-injury - as psychosocial communication, or affect self-regulation - and creates the phenomenon of 'self-harm' as we understand it today.
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