Academic literature on the topic 'Progressive commissioning process'

Abstract The National Health Service (NHS) in England and Wales provides care for approximately 15000 children and adults with HbO. A national peer review of paediatric and adult HbO services against a set of quality standards was commenced in 2010 aiming to obtain a clear picture of service provision. These initial visits confirmed a lack of investment and marked inequalities of care highlighting the need for improved facilities, staffing and the establishment of networks of care. The results of the second national peer review programme (2015/6) are reported here with comparative analysis of performance against quality standards allowing an opportunity to establish whether the programme has led to improvements in the quality of, and access to, care. Methods Services were reviewed against a set of 51 quality standards established by a steering group of experienced UK clinicians from the UK Forum for Haemoglobin Disorders. They examined support for patients, staffing, training, facilities/equipment, service organisation, guidelines, governance/audit, clinical networks and commissioning. 32 centres were visited including all major city hospitals in England and smaller hospitals with significant HbO patient populations. Review visits were conducted by a team of doctors, nurses, patient representatives, psychologists and NHS managers and the process was overseen and supported by the West Midlands Quality Review Service. Following each review the centre received a standardised report of compliance highlighting areas of good practice and concerns. Results Overall the visits provide evidence of a progressive increase in compliance with the quality standard, more marked in paediatric services (fig 1 and 2). 14/16 (82%) of paediatric and 21/31 (68%) of adult centres showed an improvement in compliance. The percentage of change in compliance ranged from -12 to +39% in paediatric and -22 to +59% in adult centres. Other findings from the peer review visits showed:Themes from patient feedback were difficulties accessing adequate emergency care and support for Day Care units providing open access pain control.Out of hours transfusion was only available in 50% services, throughout the review process.Inequity of access to automated apheresis with several large centres not being able to provide this service.Inadequate dedicated medical and nursing time with a decrease in number of adult services with named lead nurse from 68% to 58% in successive reviews. A lack of specialist psychological support was almost universal and unchanged throughout the review period.In the 2015/16 review only 25% of services had completed audits specified in the standards, but increased numbers of services were developing a rolling programme of audit and participating in research.Assessment of pain control according to NICE Guidelines had been performed in most centres, however very few services were able to meet the 30 minute arrival to analgesia target.Transcranial Doppler services were of an inconsistent standard and no national quality assurance tool existed for this investigation.Increasing numbers of services (67% paediatrics, 75% adults) were participating in multidisciplinary meetings and this had improved from 47% in the previous review. Conclusion Peer review of NHS quality of care in England is mostly voluntary but generally valued. This is the first ever report of a nationwide iterative, quality standards-based HbO peer review programme. It was conducted with almost universal participation from individual services, highlighting the willingness of service providers to engage with this voluntary process. Thearguments to sustain such programmes include evidence of cost effectiveness but impact on outcomes is more difficult to demonstrate. This report demonstrates that higher rates of compliance with quality standards were observed following implementation of the peer review programme. In part this is likely to be driven by the peer review process and shows that this process can promote excellence in patient care. Figure 1 Figure 1. Figure 2 Figure 2. Disclosures Howard: Bluebird Bio: Consultancy, Honoraria; Novartis: Honoraria, Speakers Bureau.

Purpose Dual Diagnosis Anonymous (DDA) is a peer-led programme developed in the USA, which aims to address mental and addictive disorders in an integrated manner. This study is part of a mixed-methods evaluation of the first DDA pilot in the UK, and the purpose of this study is to explore the impact and mechanism of change of the programme through the perspective of DDA attendees, facilitators and the funding commissioners. Design/methodology/approach Six DDA members were interviewed three times over a period of 12 months, the facilitators were interviewed twice and the commissioner was interviewed once. The qualitative longitudinal data were analysed using a trajectory thematic analysis. Findings DDA attendance was perceived to have had a positive impact on five main areas: acceptance of self, of others and from others; social functioning; self-development; recovery progression; and feeling of hope. The possibility of addressing both mental health and addiction at the same time was a key factor in the recovery process. The facilitators observed that DDA had contributed to integrate members into employment and education, while the commissioner stressed the importance of joint commissioning and sustainability. Originality/value The longitudinal approach provided a unique insight into the recovery process of DDA members. Being able to address the mental health as well as the substance use problems was considered to be a fundamental strength of DDA in comparison to the single purpose peer-support fellowships.

Purpose – This paper aims to describe the working of one of the first Recovery Colleges (RCs) and explore the defining characteristics. Design/methodology/approach – This study explores the ways in which an educational approach contributes to the process of recovery as observed in the Nottingham Recovery College (NRC). A mixed-method research design was adopted, combining interviews, observation and visual methods as well as analysis of quantitative data. The process contributed to the continuing development of “fidelity criteria”, or defining principles and key features, of the college. Findings – The NRC demonstrates the possibilities of offering an alternative approach within mental health services; one which is educationally rather than therapeutically informed. The design and operation of the college is informed by educational principles in the creation and execution of the curriculum. This is critically developed through processes of co-production and co-facilitation by those with professional and lived experience, supported by policy development, rigorous documentation and the creation of a supportive, but challenging culture and environment. Students are offered very real opportunities for involvement, progression and leadership within and beyond the college. Research limitations/implications – Whilst building on work on education in self-management, the RCs move beyond the transmission of information to create new relationships between mental health professionals and students (rather than “service users”) – and through this, the relationship between students and their “condition” appears to be transformed. Early evidence suggests the NRC also provides a model of interaction that is distinct in educational terms. Practical implications – There is significant interest nationally and internationally in the development and operation of RCs in England. RCs present a possibility of transformation in the lives of people with long-term mental health conditions, with outcomes such as greater confidence and hope for the future in addition to widening social networks and providing opportunities for progression. They are also important in the implementation of Recovery through organisational change and the remodelling of commissioning arrangements. Originality/value – This is the first paper to be presented for publication specifically on the NRC. There is currently little published research on RCs. These are unique (and varying) organisations which are creating considerable interest nationally and internationally. An exploration of their defining characteristics will feed into subsequent larger-scale research.

IntroductionStudies and research have shown that providing patient education through knowledge and counselling of the disease process and subsequent treatment empower patients and carers to improve patient’s health. Through understanding rationale for treatment, implications of non- compliance, non-adherence, disease progression and adverse effects of therapy, pharmacy staff are perfectly placed to empower patients and carers with evidence based knowledge and information to make their own educated decisions regarding therapy. The ‘Let’s Talk Medicines’ telephone service was set up in 2015 for exactly this purpose. It is a dedicated medicines information (MI) service aimed at patients, parents and carers, giving the opportunity to ask questions and obtain advice from specialist paediatric pharmacists about their child’s medicines once leaving the hospital. The services have vastly expanded over the last 2 and half years with the addition of an email address as an alternative means for contact. The helpline number and email address are heavily publicised to parents and carers through posters throughout the hospital, details published on all paediatric discharge summaries and printed information cards given to all outpatients during counselling.AimTo evaluate the service progression by analysing the sheer volume and types of queries over the last 3 years to identify how beneficial the novel service has proven to be.MethodsTo retrospectively analyse data from 3 monthly reports over the last 2.5 years of the service to identify number of calls, emails, types of queries received and users of the service.ResultsThe current service relies on all members of the pharmacy team answering calls on a dedicated patient line on an ad-hoc basis with several specialist pharmacists reviewing queries on a daily basis. Average call durations were between 5 to 8 minutes with more complex queries requiring in depth data search taking up to 30 minutes. All queries are logged on paper and then reviewed on a monthly basis as they are entered onto a database. Since the introduction of the service, the volume of calls received has increased by more than 50% with average of 35 per month in 2015 and 54 in 2017. Originally, the service was designed primarily for patients, parents and carers. Due to the increased recognition, the service has now been expanded to a variety of internal and external healthcare professionals, community practitioners and pharmacies, drug companies, commissioning staff, researchers and students. The types of queries range from supply issues, procurement of unlicensed medicines, to adverse effects, administration advice and complex pharmaceutical queries.ConclusionThe service has grown and developed with focus based around improving patient care, medication adherence and minimising medicines related risks. Through providing accurate, up-to-date and evidence based information its appeal has reached a wider audience including healthcare professionals. Combined with an increase in the number of calls and technological advances, a new email service has been rolled out in 2017, as an alternate means to contact the service. Direct comments from users of the service has shown positive feedback and trust.

Accurate monitoring of gas turbine performance is a means to an early detection of performance deviation from the design point and thus to an optimized operational control. In this process, the diagnosis of the combustion process is of high importance due to strict legal pollution limits as aging of the combustor during operation may lead to an observed progression of NOx emissions. The method presented here features a semi-empirical NOx formulation incorporating aging for the GT24/GT26 heavy duty gas turbines: Input parameters to the NOx-correlation are processed from actual measurement data in a simplified gas turbine model. Component deterioration is accounted for by linking changes in air flow distribution and control parameters to specific operational measurements of the gas turbine. The method was validated on three different gas turbines of the GE GT24/GT26 fleet for part- and baseload operation with a total of 374,058 long-term data points (5 min average), corresponding to a total of 8.5 years of observation, while only commissioning data were used for the formulation of the NOx correlation. When input parameters to the correlation are adapted for aging, the NOx prediction outperforms the benchmark prediction method without aging by 35.9, 53.7, and 26.2% in terms of root mean square error (RMSE) yielding a root-mean-squared error of 1.27, 1.84, and 3.01 ppm for the investigated gas turbines over a three-year monitoring period.

Abstract Background Community-based obesity prevention interventions are often commissioned despite the limited evidence base. HENRY (Health, Exercise, Nutrition for the Really Young) is a programme delivered to parents of preschool children across the UK. Early evidence suggests that it may be effective, but a robust evaluation has not been conducted. We initiated a systematic evaluation of HENRY by studying the feasibility of conducting a multi-centre definitive trial to evaluate its effectiveness and cost-effectiveness to prevent obesity. Objectives were to assess the feasibility of recruiting local authorities, centres and parents; test processes and time required to train and certify intervention staff; explore HENRY commissioning processes; identify potential sources (and associated impact) of contamination; and consider the feasibility of trial procedures. Methods We conducted a multi-centre, open labelled, two group, prospective, cluster randomised, controlled, feasibility study, with embedded process evaluation and pre-defined criteria for progression to definitive trial. We sought to recruit 120 parents from 12 children’s centres, across two UK local authority (government) areas. Within each local authority, we planned to randomise three centres to HENRY and three to ‘standard care’ control. Our plan was to collect data in family homes at baseline and 12 months, including parent and child height and weight, and parent-reported questionnaires on self-efficacy, feeding, eating habits, quality of life and resource use. Contamination, implementation and study acceptability were explored using parent interviews. Results We recruited two local authorities and 12 children’s centres within eight months. One hundred and seventeen parents were recruited (average 3.9 parents per programme) and follow-up data were collected from 85% of participants. Process data from 20 parents and 24 members of staff indicate that both would benefit from more detail about their involvement as participants, but that methods were acceptable. Contamination was likely, though the impact of this on behaviour was unclear. Conclusion Our findings indicate that a cluster RCT of HENRY to assess its effect on childhood obesity prevention is feasible. This study has allowed us to design a pragmatic definitive trial with minimal bias, taking account of lessons learnt from conducting evaluation research in public health settings. Trial registration ClinicalTrials.gov Identifier NCT03333733 registered 6th November 2017.

Diaspora This article looks at diaspora through the transformations of an established public service broadcaster, the BBC World Service, by considering some of the findings of the AHRC-funded Tuning In: Contact Zones at the BBC World Service, which is part of the Diasporas, Migration and Identities program. Tuning In has six themes, each of which focuses upon the role of the BBC WS: The Politics of Translation, Diasporic Nationhood, Religious Transnationalism, Sport across Diasporas, Migrating Music and Drama for Development. The World Service, which was until 2011 funded by the Foreign Office, was set up to cater for the British diaspora and had the specific remit of transmitting ideas about Britishness to its audiences overseas. Tuning In demonstrates interrelationships between the global and the local in the diasporic contact zone of the BBC World Service, which has provided a mediated home for the worldwide British diaspora since its inception in 1932. The local and the global have merged, elided, and separated at different times and in different spaces in the changing story of the BBC (Briggs). The BBC WS is both local and global with activities that present Britishness both at home and abroad. The service has, however, come a long way since its early days as the Empire Service. Audiences for the World Service’s 31 foreign language services, radio, television, and Internet facilities include substantive non-British/English-speaking constituencies, rendering it a contact zone for the exploration of ideas and political opportunities on a truly transnational scale. This heterogeneous body of exilic, refugee intellectuals, writers, and artists now operates alongside an ongoing expression of Britishness in all its diverse reconfiguration. This includes the residual voice of empire and its patriarchal paternalism, the embrace of more recent expressions of neoliberalism as well as traditional values of impartiality and objectivism and, in the case of the arts, elements of bohemianism and creative innovation. The World Service might have begun as a communication system for the British ex-pat diaspora, but its role has changed along with the changing relationship between Britain and its colonial past. In the terrain of sport, for example, cricket, the “game of empire,” has shifted from Britain to the Indian subcontinent (Guha) with the rise of “Twenty 20” and the Indian Premier League (IPL); summed up in Ashis Nandy’s claim that “cricket is an Indian game accidentally discovered by the English” (Nandy viii). English county cricket dominated the airways of the World Service well into the latter half of the twentieth century, but the audiences of the service have demanded a response to social and cultural change and the service has responded. Sport can thus be seen to have offered a democratic space in which new diasporic relations can be forged as well as one in which colonial and patriarchal values are maintained. The BBC WS today is part of a network through which non-British diasporic peoples can reconnect with their home countries via the service, as well as an online forum for debate across the globe. In many regions of the world, it continues to be the single most trusted source of information at times of crisis and disaster because of its traditions of impartiality and objectivity, even though (as noted in the article on Al-Jazeera in this special issue) this view is hotly contested. The principles of objectivity and impartiality are central to the BBC WS, which may seem paradoxical since it is funded by the Commonwealth and Foreign office, and its origins lie in empire and colonial discourse. Archive material researched by our project demonstrates the specifically ideological role of what was first called the Empire Service. The language of empire was deployed in this early programming, and there is an explicit expression of an ideological purpose (Hill). For example, at the Imperial Conference in 1930, the service was supported in terms of its political powers of “strengthening ties” between parts of the empire. This view comes from a speech by John Reith, the BBC’s first Director General, which was broadcast when the service opened. In this speech, broadcasting is identified as having come to involve a “connecting and co-ordinating link between the scattered parts of the British Empire” (Reith). Local British values are transmitted across the globe. Through the service, empire and nation are reinstated through the routine broadcasting of cyclical events, the importance of which Scannell and Cardiff describe as follows: Nothing so well illustrates the noiseless manner in which the BBC became perhaps the central agent of national culture as its cyclical role; the cyclical production year in year out, of an orderly, regular progression of festivities, rituals and celebrations—major and minor, civic and sacred—that mark the unfolding of the broadcast year. (278; italics in the original) State occasions and big moments, including those directly concerned with governance and affairs of state, and those which focused upon sport and religion, were a big part in these “noiseless” cycles, and became key elements in the making of Britishness across the globe. The BBC is “noiseless” because the timetable is assumed and taken for granted as not only what is but what should be. However, the BBC WS has been and has had to be responsive to major shifts in global and local—and, indeed, glocal—power geometries that have led to spatial transformations, notably in the reconfiguration of the service in the era of postcolonialism. Some of these massive changes have involved the large-scale movement of people and a concomitant rethinking of diaspora as a concept. Empire, like nation, operates as an “imagined community,” too big to be grasped by individuals (Anderson), as well as a material actuality. The dynamics of identification are rarely linear and there are inconsistencies and disruptions: even when the voice is officially that of empire, the practice of the World Service is much more diverse, nuanced, and dialogical. The BBC WS challenges boundaries through the connectivities of communication and through different ways of belonging and, similarly, through a problematisation of concepts like attachment and detachment; this is most notable in the way in which programming has adapted to new diasporic audiences and in the reworkings of spatiality in the shift from empire to diversity via multiculturalism. There are tensions between diaspora and multiculturalism that are apparent in a discussion of broadcasting and communication networks. Diaspora has been distinguished by mobility and hybridity (Clifford, Hall, Bhaba, Gilroy) and it has been argued that the adjectival use of diasporic offers more opportunity for fluidity and transformation (Clifford). The concept of diaspora, as it has been used to explain the fluidity and mobility of diasporic identifications, can challenge more stabilised, “classic” understandings of diaspora (Chivallon). A hybrid version of diaspora might sit uneasily with a strong sense of belonging and with the idea that the broadcast media offer a multicultural space in which each voice can be heard and a wide range of cultures are present. Tuning In engaged with ways of rethinking the BBC’s relationship to diaspora in the twenty-first century in a number of ways: for example, in the intersection of discursive regimes of representation; in the status of public service broadcasting; vis-à-vis the consequences of diverse diasporic audiences; through the role of cultural intermediaries such as journalists and writers; and via global economic and political materialities (Gillespie, Webb and Baumann). Tuning In thus provided a multi-themed and methodologically diverse exploration of how the BBC WS is itself a series of spaces which are constitutive of the transformation of diasporic identifications. Exploring the part played by the BBC WS in changing and continuing social flows and networks involves, first, reconfiguring what is understood by transnationalism, diaspora, and postcolonial relationalities: in particular, attending to how these transform as well as sometimes reinstate colonial and patriarchal discourses and practices, thus bringing together different dimensions of the local and the global. Tuning In ranges across different fields, embracing cultural, social, and political areas of experience as represented in broadcasting coverage. These fields illustrate the educative role of the BBC and the World Service that is also linked to its particular version of impartiality; just as The Archers was set up to provide information and guidance through a narrative of everyday life to rural communities and farmers after the Second World War, so the Afghan version plays an “edutainment” role (Skuse) where entertainment also serves an educational, public service information role. Indeed, the use of soap opera genre such as The Archers as a vehicle for humanitarian and health information has been very successful over the past decade, with the “edutainment” genre becoming a feature of the World Service’s broadcasting in places such as Rwanda, Somalia, Nigeria, India, Nepal, Burma, Afghanistan, and Cambodia. In a genre that has been promoted by the World Service Trust, the charitable arm of the BBC WS uses drama formats to build transnational production relationships with media professionals and to strengthen creative capacities to undertake behaviour change through communication work. Such programming, which is in the tradition of the BBC WS, draws upon the service’s expertise and exhibits both an ideological commitment to progressive social intervention and a paternalist approach drawing upon colonialist legacies. Nowadays, however, the BBC WS can be considered a diasporic contact zone, providing sites of transnational intra-diasporic contact as well as cross-cultural encounters, spaces for cross-diasporic creativity and representation, and a forum for cross-cultural dialogue and potentially cosmopolitan translations (Pratt, Clifford). These activities are, however, still marked by historically forged asymmetric power relations, notably of colonialism, imperialism, and globalisation, as well as still being dominated by hegemonic masculinity in many parts of the service, which thus represent sites of contestation, conflict, and transgression. Conversely, diasporic identities are themselves co-shaped by media representations (Sreberny). The diasporic contact zone is a relational space in which diasporic identities are made and remade and contested. Tuning In employed a diverse range of methods to analyse the part played by the BBC WS in changing and continuing social and cultural flows, networks, and reconfigurations of transnationalisms and diaspora, as well as reinstating colonial, patriarchal practices. The research deconstructed some assumptions and conditions of class-based elitism, colonialism, and patriarchy through a range of strategies. Texts are, of course, central to this work, with the BBC Archives at Caversham (near Reading) representing the starting point for many researchers. The archive is a rich source of material for researchers which carries a vast range of data including fragile memos written on scraps of paper: a very local source of global communications. Other textual material occupies the less locatable cyberspace, for example in the case of Have Your Say exchanges on the Web. People also featured in the project, through the media, in cyberspace, and physical encounters, all of which demonstrate the diverse modes of connection that have been established. Researchers worked with the BBC WS in a variety of ways, not only through interviews and ethnographic approaches, such as participant observation and witness seminars, but also through exchanges between the service, its practitioners, and the researchers (for example, through broadcasts where the project provided the content and the ideas and researchers have been part of programs that have gone out on the BBC WS (Goldblatt, Webb), bringing together people who work for the BBC and Tuning In researchers). On this point, it should be remembered that Bush House is, itself, a diasporic space which, from its geographical location in the Strand in London, has brought together diasporic people from around the globe to establish international communication networks, and has thus become the focus and locus of some of our research. What we have understood by the term “diasporic space” in this context includes both the materialities of architecture and cyberspace which is the site of digital diasporas (Anderssen) and, indeed, the virtual exchanges featured on “Have Your Say,” the online feedback site (Tuning In). Living the Glocal The BBC WS offers a mode of communication and a series of networks that are spatially located both in the UK, through the material presence of Bush House, and abroad, through the diasporic communities constituting contemporary audiences. The service may have been set up to provide news and entertainment for the British diaspora abroad, but the transformation of the UK into a multi-ethnic society “at home,” alongside its commitment to, and the servicing of, no less than 32 countries abroad, demonstrates a new mission and a new balance of power. Different diasporic communities, such as multi-ethnic Londoners, and local and British Muslims in the north of England, demonstrate the dynamics and ambivalences of what is meant by “diaspora” today. For example, the BBC and the WS play an ambiguous role in the lives of UK Muslim communities with Pakistani connections, where consumers of the international news can feel that the BBC is complicit in the conflation of Muslims with terrorists. Engaging Diaspora Audiences demonstrated the diversity of audience reception in a climate of marginalisation, often bordering on moral panic, and showed how diasporic audiences often use Al-Jazeera or Pakistani and Urdu channels, which are seen to take up more sympathetic political positions. It seems, however, that more egalitarian conversations are becoming possible through the channels of the WS. The participation of local people in the BBC WS global project is seen, for example, as in the popular “Witness Seminars” that have both a current focus and one that is projected into the future, as in the case of the “2012 Generation” (that is, the young people who come of age in 2012, the year of the London Olympics). The Witness Seminars demonstrate the recuperation of past political and social events such as “Bangladesh in 1971” (Tuning In), “The Cold War seminar” (Tuning In) and “Diasporic Nationhood” (the cultural movements reiterated and recovered in the “Literary Lives” project (Gillespie, Baumann and Zinik). Indeed, the WS’s current focus on the “2012 Generation,” including an event in which 27 young people (each of whom speaks one of the WS languages) were invited to an open day at Bush House in 2009, vividly illustrates how things have changed. Whereas in 1948 (the last occasion when the Olympic Games were held in London), the world came to London, it is arguable that, in 2012, in contemporary multi-ethnic Britain, the world is already here (Webb). This enterprise has the advantage of giving voice to the present rather than filtering the present through the legacies of colonialism that remain a problem for the Witness Seminars more generally. The democratising possibilities of sport, as well as the restrictions of its globalising elements, are well represented by Tuning In (Woodward). Sport has, of course become more globalised, especially through the development of Internet and satellite technologies (Giulianotti) but it retains powerful local affiliations and identifications. At all levels and in diverse places, there are strong attachments to local and national teams that are constitutive of communities, including diasporic and multi-ethnic communities. Sport is both typical and distinctive of the BBC World Service; something that is part of a wider picture but also an area of experience with a life of its own. Our “Sport across Diasporas” project has thus explored some of the routes the World Service has travelled in its engagement with sport in order to provide some understanding of the legacy of empire and patriarchy, as well as engaging with the multiplicities of change in the reconstruction of Britishness. Here, it is important to recognise that what began as “BBC Sport” evolved into “World Service Sport.” Coverage of the world’s biggest sporting events was established through the 1930s to the 1960s in the development of the BBC WS. However, it is not only the global dimensions of sporting events that have been assumed; so too are national identifications. There is no question that the superiority of British/English sport is naturalised through its dominance of the BBC WS airways, but the possibilities of reinterpretation and re-accommodation have also been made possible. There has, indeed, been a changing place of sport in the BBC WS, which can only be understood with reference to wider changes in the relationship between broadcasting and sport, and demonstrates the powerful synchronies between social, political, technological, economic, and cultural factors, notably those that make up the media–sport–commerce nexus that drives so much of the trajectory of contemporary sport. Diasporic audiences shape the schedule as much as what is broadcast. There is no single voice of the BBC in sport. The BBC archive demonstrates a variety of narratives through the development and transformation of the World Service’s sports broadcasting. There are, however, silences: notably those involving women. Sport is still a patriarchal field. However, the imperial genealogies of sport are inextricably entwined with the social, political, and cultural changes taking place in the wider world. There is no detectable linear narrative but rather a series of tensions and contradictions that are reflected and reconfigured in the texts in which deliberations are made. In sport broadcasting, the relationship of the BBC WS with its listeners is, in many instances, genuinely dialogic: for example, through “Have Your Say” websites and internet forums, and some of the actors in these dialogic exchanges are the broadcasters themselves. The history of the BBC and the World Service is one which manifests a degree of autonomy and some spontaneity on the part of journalists and broadcasters. For example, in the case of the BBC WS African sports program, Fast Track (2009), many of the broadcasters interviewed report being able to cover material not technically within their brief; news journalists are able to engage with sporting events and sports journalists have covered social and political news (Woodward). Sometimes this is a matter of taking the initiative or simply of being in the right place at the right time, although this affords an agency to journalists which is increasingly unlikely in the twenty-first century. The Politics of Translation: Words and Music The World Service has played a key role as a cultural broker in the political arena through what could be construed as “educational broadcasting” via the wider terrain of the arts: for example, literature, drama, poetry, and music. Over the years, Bush House has been a home-from-home for poets: internationalists, translators from classical and modern languages, and bohemians; a constituency that, for all its cosmopolitanism, was predominantly white and male in the early days. For example, in the 1930s and 1940s, Louis MacNeice was commissioning editor and surrounded by a friendship network of salaried poets, such as W. H. Auden, Dylan Thomas, C. Day Lewis, and Stephen Spender, who wrote and performed their work for the WS. The foreign language departments of the BBC WS, meanwhile, hired émigrés and exiles from their countries’ educated elites to do similar work. The biannual, book-format journal Modern Poetry in Translation (MPT), which was founded in 1965 by Daniel Weissbort and Ted Hughes, included a dedication in Weissbort’s final issue (MPT 22, 2003) to “Poets at Bush House.” This volume amounts to a celebration of the BBC WS and its creative culture, which extended beyond the confines of broadcasting spaces. The reminiscences in “Poets at Bush House” suggest an institutional culture of informal connections and a fluidity of local exchanges that is resonant of the fluidity of the flows and networks of diaspora (Cheesman). Music, too, has distinctive characteristics that mark out this terrain on the broadcast schedule and in the culture of the BBC WS. Music is differentiated from language-centred genres, making it a particularly powerful medium of cross-cultural exchange. Music is portable and yet is marked by a cultural rootedness that may impede translation and interpretation. Music also carries ambiguities as a marker of status across borders, and it combines aesthetic intensity and diffuseness. The Migrating Music project demonstrated BBC WS mediation of music and identity flows (Toynbee). In the production and scheduling notes, issues of migration and diaspora are often addressed directly in the programming of music, while the movement of peoples is a leitmotif in all programs in which music is played and discussed. Music genres are mobile, diasporic, and can be constitutive of Paul Gilroy’s “Black Atlantic” (Gilroy), which foregrounds the itinerary of West African music to the Caribbean via the Middle Passage, cross-fertilising with European traditions in the Americas to produce blues and other hybrid forms, and the journey of these forms to Europe. The Migrating Music project focused upon the role of the BBC WS as narrator of the Black Atlantic story and of South Asian cross-over music, from bhangra to filmi, which can be situated among the South Asian diaspora in east and south Africa as well as the Caribbean where they now interact with reggae, calypso, Rapso, and Popso. The transversal flows of music and lyrics encompasses the lived experience of the different diasporas that are accommodated in the BBC WS schedules: for example, they keep alive the connection between the Irish “at home” and in the diaspora through programs featuring traditional music, further demonstrating the interconnections between local and global attachments as well as points of disconnection and contradiction. Textual analysis—including discourse analysis of presenters’ speech, program trailers and dialogue and the BBC’s own construction of “world music”—has revealed that the BBC WS itself performs a constitutive role in keeping alive these traditions. Music, too, has a range of emotional affects which are manifest in the semiotic analyses that have been conducted of recordings and performances. Further, the creative personnel who are involved in music programming, including musicians, play their own role in this ongoing process of musical migration. Once again, the networks of people involved as practitioners become central to the processes and systems through which diasporic audiences are re-produced and engaged. Conclusion The BBC WS can claim to be a global and local cultural intermediary not only because the service was set up to engage with the British diaspora in an international context but because the service, today, is demonstrably a voice that is continually negotiating multi-ethnic audiences both in the UK and across the world. At best, the World Service is a dynamic facilitator of conversations within and across diasporas: ideas are relocated, translated, and travel in different directions. The “local” of a British broadcasting service, established to promote British values across the globe, has been transformed, both through its engagements with an increasingly diverse set of diasporic audiences and through the transformations in how diasporas themselves self-define and operate. On the BBC WS, demographic, social, and cultural changes mean that the global is now to be found in the local of the UK and any simplistic separation of local and global is no longer tenable. The educative role once adopted by the BBC, and then the World Service, nevertheless still persists in other contexts (“from Ambridge to Afghanistan”), and clearly the WS still treads a dangerous path between the paternalism and patriarchy of its colonial past and its responsiveness to change. In spite of competition from television, satellite, and Internet technologies which challenge the BBC’s former hegemony, the BBC World Service continues to be a dynamic space for (re)creating and (re)instating diasporic audiences: audiences, texts, and broadcasters intersect with social, economic, political, and cultural forces. The monologic “voice of empire” has been countered and translated into the language of diversity and while, at times, the relationship between continuity and change may be seen to exist in awkward tension, it is clear that the Corporation is adapting to the needs of its twenty-first century audience. ReferencesAnderson, Benedict. Imagined Communities, Reflections of the Origin and Spread of Nationalism. London: Verso, 1983. Anderssen, Matilda. “Digital Diasporas.” 2010. 30 Nov. 2010 ‹http://www8.open.ac.uk/researchprojects/diasporas/cross-research/digital-diasporas›. Bhabha, Homi. The Location of Culture. London: Routledge, 1994. Briggs, Asa. A History of Broadcasting in the United Kingdom, Volume II: The Golden Age of Wireless. Oxford: Oxford UP, 1995. Cheesman, Tom. “Poetries On and Off Air.” 2010. 30 Nov. 2010 ‹http://www8.open.ac.uk/researchprojects/diasporas/cross-research/bush-house-cultures›. Chivallon, Christine. “Beyond Gilroy’s Black Atlantic: The Experience of the African Diaspora.” Diaspora 11.3 (2002): 359–82. Clifford, James. Routes: Travel and Translation in the Late Twentieth Century. Cambridge: Cambridge UP, 1997. Fast Track. BBC, 2009. 30 Nov. 2010 ‹http://www.bbc.co.uk/worldservice/sport/2009/03/000000_fast_track.shtml›. Gillespie, Marie, Alban Webb, and Gerd Baumann (eds.). “The BBC World Service 1932–2007: Broadcasting Britishness Abroad.” Special Issue. The Historical Journal of Film, Radio and Television 28.4 (Oct. 2008). Gillespie, Marie, Gerd Baumann, and Zinovy Zinik. “Poets at Bush House.” 2010. 30 Nov. 2010 ‹http://www8.open.ac.uk/researchprojects/diasporas/about›. Gilroy, Paul. Black Atlantic. MA: Harvard UP, 1993. Giulianotti, Richard. Sport: A Critical Sociology. Cambridge: Polity, 2005. Goldblatt, David. “The Cricket Revolution.” 2009. 30 Nov. 2010 ‹http://www.bbc.co.uk/programmes/p0036ww9›. Guha, Ramachandra. A Corner of a Foreign Field: The Indian History of an English Game. London: Picador, 2002. Hall, Stuart. “Cultural Identity and Diaspora.” Identity: Community, Culture, Difference. Ed. Jonathan Rutherford. London: Lawrence and Wishart, 1990, 223–37. Hill, Andrew. “The BBC Empire Service: The Voice, the Discourse of the Master and Ventriloquism.” South Asian Diaspora 2.1 (2010): 25–38. Hollis, Robert, Norma Rinsler, and Daniel Weissbort. “Poets at Bush House: The BBC World Service.” Modern Poetry in Translation 22 (2003). Nandy, Ashis. The Tao of Cricket: On Games of Destiny and the Destiny of Games. New Delhi: Oxford UP, 1989. Pratt, Mary Louise. Imperial Eyes: Travel Writing and Transculturation. London: Routledge, 1992. Reith, John. “Opening of the Empire Service.” In “Empire Service Policy 1932-1933”, E4/6: 19 Dec. 1932. 30 Nov. 2010 ‹http://www.open.ac.uk/socialsciences/diasporas/research.htm›. Scannell, Paddy, and David Cardiff. A Social History of British Broadcasting, 1922-1938. Oxford: Basil Blackwell, 1991. Skuse, Andrew. “Drama for Development.” 2010. 30 Nov. 2010 ‹http://www8.open.ac.uk/researchprojects/diasporas/core-research/drama-for-development›. Sreberny, Annabelle. “The BBC World Service and the Greater Middle East: Comparisons, Contrasts, Conflicts.” Guest ed. Annabelle Sreberny, Marie Gillespie, Gerd Baumann. Middle East Journal of Culture and Communication 3.2 (2010). Toynbee, Jason. “Migrating Music.” 2010. 30 Nov. 2010 ‹http://www8.open.ac.uk/researchprojects/diasporas/core-research/migrating-music›. Tuning In. 30 Nov. 2010 ‹http://www.open.ac.uk/socialsciences/diasporas/index.htm›. Webb, Alban. “Cold War Diplomacy.” 2010. 30 Nov. 2010 ‹http://www8.open.ac.uk/researchprojects/diasporas/projects/cold-war-politics-and-bbc-world-service›. Woodward, Kath. Embodied Sporting Practices. Regulating and Regulatory Bodies. Basingstoke, Palgrave Macmillan, 2009.

Les bâtiments à faible consommation d'énergie connaissent, ces dernières années, un grand intérêt étant donné le rôle important qu'ils jouent dans la diminution des émissions de gaz à effet de serre d'une part, et la flambée des prix des combustibles, d'autre part. Néanmoins, dans de nombreux cas la réalisation de ce type de bâtiments n'atteint pas les performances escomptées. Ce problème est dû en grande partie à : 1) la perte d'informations tout au long du cycle de vie du bâtiment, 2) la non évaluation régulière des décisions prises par les acteurs intervenants. Le commissionnement en tant que processus de contrôle qualité joue un rôle important dans le bon déroulement du processus de réalisation de bâtiments à faible consommation d'énergie. Cette recherche vise à développer une méthodologie dont l'objectif est d'assister les personnes responsables de cette mission dans la définition de plans de commissionnement adaptés à leurs projets. Nous avons réalisé en premier, un état de l'art de la réalisation des bâtiments à faible consommation d'énergie, que nous avons par la suite confronté à la réalité à travers une enquête auprès des acteurs du bâtiment et d'étude de cas réels. Cette étape nous a permis de formuler une hypothèse concernant la nécessité d'un commissionnement "évolutif" -adapté aux particularités de chaque projet - et de décrire une méthodologie globale d'assistance à la conception des bâtiments à faible consommation d'énergie, qui intègre une aide à la décision, une gestion de l'information et un commissionnement "évolutif" qui vient vérifier le bon déroulement des deux premiers. Pour mettre en application cette méthodologie, une boîte à outils a été développée. Elle est constituée de : 1) un outil dit "statique" qui permet de définir un premier plan de commissionnent générique qui répond aux caractéristiques d'un projet, à partir d'une base de données exhaustives de tâches de commissionnement, 2) un outil dit "dynamique" basé sur les probabilités, qui permet de mettre à jour le plan de commissionnement initial (générique), en l'adaptant au projet en cours. Cette mise à jour permet de prendre en compte les particularités et imprévus rencontrés lors de la réalisation d'un projet, rendant ainsi le plan de commissionnement plus précis. Une expérimentation, dans un cas réel, du premier outil et des applications du second ont été faites pour montrer leurs possibilités et leurs limites. Les résultats font apparaître deux points importants : 1) l'intérêt d'avoir un plan de commissionnement structuré et évolutif pour vérifier la qualité de la réalisation des bâtiments à faible consommation d'énergie et assurer ainsi l'atteinte des performances souhaitées, 2) l'intérêt d'utiliser un outil probabiliste tel que les réseaux Bayésiens pour anticiper les dérives et prendre en charge les imprévus rencontrés lors de ce processus vivant. Cette méthodologie représente une base pour le développement d'outils d'assistance à la définition de plans de commissionnement "évolutifs" pour le neuf et l'existant, et tous les secteurs du bâtiment

Metrological verification consists of proving by calibration measurements that specified requirements are met. The result of an audit is a compliance decision followed by re-commissioning or non-compliance followed by an adjustment, repair, decommissioning, or device reform. At the regional blood transfusion center of Oujda, from 2010 to 2018 the number of metrological qualification has increased from 88 to 152 acts with compliance going from 92% to 97%, thus the number of visit for preventive and curative maintenance of the share of external companies has also increased since 2010 to 2018 from 10 annual visits to 43 annual visits, which indicates a strong progressive metrological activity and an important place of the metrological process in the continuity of guaranteeing a safety of the result obtained from the operations carried out for the practitioners and for donor and recipient patients of the blood product. An action plan was implemented to correct the anomalies identified such as the acquisition of new metrology equipment, to predict the change of climatic chambers and non-adapted devices, the acquisition of more sophisticated machines and the establishment of a continuous recording system of the cold chain.

The Planning Act of 28 June 2006 prescribed that a reversible repository in a deep geological formation be chosen as the reference solution for the long-term management of high-level and intermediate-level long-lived radioactive waste. It also entrusted the responsibility of further studies and investigations on the siting and design of the new repository upon the French Radioactive Waste Management Agency (Agence nationale pour la gestion des de´chets radioactifs – Andra), in order for the review of the creation-licence application to start in 2015 and, subject to its approval, the commissioning of the new repository in 2025. In late 2009, Andra submitted to the French government proposals concerning the implementation and the design of Cige´o (Centre industriel de stockage ge´ologique). A significant step of the project was completed with the delineation of an interest zone for the construction of the repositor’s underground facilities in 2010. This year, Andra has launched a new dialogue phase with local actors in order to clarify the implementation scenarios on the surface. The selected site will be validated after the public debate that is now scheduled for the first half of 2013. This debate will be organized by the National Public Debate Committee (Commission nationale du de´bat public). In parallel, the State is leading the preparation of an territorial development scheme, which will be presented during the public debate. The 2009 milestone also constitutes a new step in the progressive design process of the repository. After the 1998, 2001 and 2005 iterations, which focused mainly on the long-term safety of the repository, the Dossier 2009 highlighted its operational safety, with due account of the non-typical characteristics of an underground nuclear facility. It incorporates the first results of the repository-optimisation studies, which started in 2006 and will continue in the future. The reversibility options for the repository constitute proposals in terms of added flexibility in repository management and in package-recovery levels. They orient the design of the repository in order to promote those reversibility components. They contribute to the dialogue with stakeholders in the preparation of the public debate and of the future act on the reversibility conditions of the repository. The development of the repository shall be achieved over a long period, around the century. Hence, the designer will acquire additional knowledge at every new development of the project, notably during Phase 1, which he may reuse during the following phase, in order, for instance, to optimise the project. This process is part of the approach proposed by Andra in 2009 pursuant to the reversibility principle.

Accurate monitoring of gas turbine performance is a means to an early detection of performance deviation from the design point and thus to an optimized operational control. In this process, the diagnosis of the combustion process is of high importance due to strict legal pollution limits as aging of the combustor during operation may lead to an observed progression of NOx emissions. The method presented here features a semi-empirical NOx formulation incorporating aging for the GT24/GT26 heavy duty gas turbines: Input parameters to the NOx-correlation are processed from actual measurement data in a simplified gas turbine model. Component deterioration is accounted for by linking changes in air flow distribution and control parameters to specific operational measurements of the gas turbine. The method was validated on three different gas turbines of the GE GT24/GT26 fleet for part- and baseload operation with a total of 374,058 long-term data points (5 min average), corresponding to a total of 8.5 years of observation, while only commissioning data was used for the formulation of the NOx correlation. When input parameters to the correlation are adapted for aging, the NOx prediction outperforms the benchmark prediction method without aging by 36.7, 54.0 and 26.7 % in terms of RMSE yielding a root-mean-squared error of 1.26, 1.81 and 2.99 ppm for the investigated gas turbines over a three year monitoring period.

The prevention of fatigue damages in components is a major responsibility during the entire operation of every nuclear power plant. Hence, fatigue is a central concern of AREVA’s R&D activities in the view of changing boundary conditions: modification of the code based approaches, life-time extension, new plants with scheduled operating periods of 60 years (e.g. EPR, BWR1000) and improvement of disposability. Simultaneously, an integrated approach to the fatigue issue is the way to an optimization of costs and plant operation as well as a minimization of non-destructive testing requirements. The AREVA fatigue concept provides for a multiple step process against fatigue before and during the entire operation of nuclear power plants. Indeed, fatigue analyses are undertaken at the design stage and for Plant LIfe Management & Plant License EXtension (PLIM-PLEX) activities. The quality of all fatigue analyses crucially depends on the determination of the real operational loads including the high loads of the initial start-up in the commissioning phase. It has to be pointed out that mainly thermal transient loading is fatigue relevant for nuclear power plant components. AREVA utilizes a measuring system called FAMOS (Fatigue Monitoring System) recording the real transient loading continuously on site. The direct processing of the measured temperatures is used for a first fast fatigue estimation after every operational cycle. This procedure is highly automated and allows for a rough estimation of the recent partial usage factor as well as the qualitative comparability of the data (loads, fatigue damage increment). In the framework of the decennial Periodic Safety Inspection (PSI) a detailed fatigue check conforming to the code rules (e.g. [1, 2, 3]) is carried out in order to determine the current state of the plant. This fatigue check is based on the real loads (specification of thermal transient loads based on measurements) and finite element analyses in connection with the local strain approach to design against fatigue. The finite element analyses always include transient thermal determination of the temperature field and subsequent determination of (local) stresses and strains. The latter analyses might be simplified elastic plastic or fully elastic plastic. Another Code requirement is the additional check against progressive plastic deformation (ratcheting) which is demanded by the design code (e.g. [1, 2, 3]). In the case of the elastic plastic approach much care has to be taken with respect to the application of an appropriate material law. Advanced nonlinear kinematic material laws are favored at AREVA at the present time in order to carry out realistic ratcheting simulations. One alternative to this approach is the application of the so called direct method based on the shake down theorems [25]. As a conclusion, one essential benefit of the integrated AREVA fatigue concept can easily be identified: Locations of potential fatigue failure are reliably identified and all efforts can be concentrated on these fatigue critical components. Thus, expensive costs for inspection can be essentially reduced. Of course, one requirement is the application of a temperature measurement system in the power plant. The concept itself is supported and its further development is ensured by numerous R&D activities, derived methods and tools as well as the further development of design codes. For example, it is planned to integrate direct measurements of fatigue damage, more sophisticated analysis concepts for fatigue damage (application of short crack fracture mechanics to fatigue crack growth), to combine fatigue damage monitoring and models for 3D crack growth simulation and to develop an alternative approach of high cycle fatigue initiation based on damage models in the integrated AREVA concept.